Information and care for parents is the basis for helping adolescents suffering from anorexia | Family | Moms and dads

July 2023, eleven thirty in the morning, mental health center of the Hospital del Tajo in the south of Madrid. The waiting room is full of patients. Adults and teenagers communicate there. It was the turn of Carmen (16 years old), diagnosed with anorexia, and her parents. They come to the appointment, talk with a child psychiatrist and after 10 minutes the parents leave, leaving their daughter in the care of a specialist. From that point on, what the patient and doctor say in the consultation stays there because the doctor has made his parents aware of the confidentiality clause if there is no relevant information for them.

The focus is mostly on the patient, but what about the family? “Parents and siblings stay away, so you try to seek support and information in other ways. In terms of patient care, public health alone is not enough since consultations are held once a month. In addition, you will have to find a supportive psychologist in the private sector to see the patient weekly,” explains Martina (not her real name), a doctor by profession at a Barcelona hospital and mother of David (not her real name). 12 years old, diagnosed with anorexia for three months. “Community counseling is infrequent and time-limited, so there is no room for families who feel completely helpless, alone and very afraid of making a mistake,” says Barbara Alcaide Garcia, an expert psychologist in eating disorders (ED). ) Family and Survivor Services of the Association Against Anorexia and Bulimia (ACAB). “However,” he continues, “family is the main support because awareness and preparation will make recovery easier.”

This lack of information and time was also felt by Flors Moreno Aguilar, a resident of the municipality of Tremp (Lleida) and mother of Lluna Iglesias Moreno, a 21-year-old girl who has suffered from anorexia since she was 12.” The problem with consultations is that there is no room for family, so if you want to intervene or have doubts about your daughter’s disease and how to deal with it, you are taking time away from your daughter or the patient who comes from behind . ” this mother laments.

The ANAR Foundation, an organization that helps children and teenagers at risk of eating disorders, warns that disorders such as anorexia and bulimia continue to rise in teenagers. Anorexia is characterized by significant restriction of food intake, an intense fear of gaining weight, and a distorted body image that is not always easy to detect. “Lluna’s cousin warned us that when she stayed to eat at school, she would throw away the food. This is precisely what alarmed us. Yes, I noticed that he became sadder and locked himself in the room alone, but it seemed to me that this was typical for adolescence,” admits Moreno. “We acted quickly, although by the time it explodes you are already late because it has been brewing for a long time,” he adds.

Martina’s experience as a doctor allowed her to quickly discover what was happening to her son and also to act quickly: “I noticed that he was sad and depressed and that he was eating less, but I thought he was not feeling well because he was suffering too. bullying At school. After a few months he started losing weight and told me he looked fat. Moreover, I saw him hiding the scales under the rug… Since I work in a hospital, he was visited by a psychiatrist the following week.”

Family as an engine of change

Empowering families to be the driving force behind changing the approach to this disorder is a priority of a new treatment model recently launched at the Sant Joan de Déu hospital in Barcelona. This treatment allows the whole family to participate in very serious cases and is based on successful experiences in Sweden and Australia. “This is a new unit whose task is to treat very complex eating disorders, that is, these are patients who, despite more than a year of treatment in full or partial hospitalization, relapse again after discharge as a “relapser.” “explains Eduardo Serrano Troncoso, child and adolescent psychologist and coordinator of the eating disorders unit of this hospital.

This new model focuses on the whole family, not just the patient. “This is systemic family therapy in which we look at the relationships and dysfunctions that are occurring in the home due to the presence of the person with the eating disorder and intervene on a global scale to gain a shared vision,” Serrano says. The expert explains that this treatment is aimed at empowering families so that they have the skills to cope with the symptoms of the disease at home.

The results of this program, which lasts about four months and runs for just over six months, are promising: “Although we still don’t have enough of a sample to be statistically significant, preliminary data shows that families feel safer after discharge. because they have the tools to cope with emotional discomfort and difficulties during the appointment,” Serrano explains.

How should the family act?

Each family has a different approach to solving this problem. Prestigious British psychiatrist Janet Treasure, in his book Eating Disorders: A Practical Guide to Caring for a Loved One. offers an animal metaphor to recognize a family’s emotional response style and promote a more adaptive style. “For example, an ostrich is the type of caregiver that buries its head in the sand and sees nothing, while a rhinoceros takes everything in front of it and tends to be in control. On the other hand, the dolphin swims accompanied and is a figure corresponding to a family that knows how to accompany well,” explains Alkaid.

According to this psychologist, parents and siblings should sympathize with the affected person, their child who is suffering greatly, and play a supportive role: “For example, regarding food, they should not insist that they eat and eat, but they should talk he: “We know that this is very difficult for you, we are offering you what the nutritionist or nurse told us, we want you to leave here, we know that you are very ill.” In short, as he summarizes, acting not as therapists, but as parents. Alkaid’s other recommendation is that at home we don’t talk about food, weight and body image: “There are behaviors that we normalize, such as saying, ‘You look really good,’ but the patient translates that as ‘he says.’ “I look good, I’m sure I’ve gained weight.”

Moreno, who has lived with her daughter Lluna’s anorexia for nine years, recommends that parents try to talk to the specialist who is treating their child so that, if possible, he can treat them too: “And then they should look for information in specific associations in the TCA and training on this subject. Hence, it is important to acknowledge that you have a condition and have clear instructions on how to guide you through this process.”

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