Two years ago my daughter was in the ICU with complications from anorexia nervosa. She was transferred to the inpatient eating disorders program for several weeks. Since then we’ve used a 3 meal/3 snack routine at home.
So now, two years later, my 13-year old is at sleep-away camp out of town. I sent her with a lot of snacks and talked with 2 counselors about her condition - and her needs for a fridge close-by, supervised eating at a certain level, and someone she could check-in with if she was having a hard time. She was in a strong place with her weight and consistent in her eating for the last 4 months, so I felt she would be successful with these things in place, but I am getting reports of that she is skipping meals and throwing food out.
Do you have recommendations for summer camp in general and/or guidelines in assessing readiness for going away to camp/eating away from home?
Scott Bullock, MSW, LISW-S responds:
This is a tough question and there are many different thoughts running through my mind on how to answer. First, let’s focus on the meal plan established while she was an inpatient. Hopefully, this meal plan was not so regimented that it allowed your daughter’s eating disorder to feel safe and untouchable, even with weight gain. Remember, the patient and the eating disorder need to be challenged and monitored by competent people (i.e., parents). Secondly, we need to remember, as parents and professionals, that there is a lag time between body recovery and the recovery of the mind. Before she left for camp, questions I would be asking myself are: Is she fully weight restored? Have her cognitions cleared, and is she clearly more rational about her eating disordered behaviors? Does she still respond negatively to peer and societal comments and beliefs?
It is also important to reflect on your thoughts and beliefs about eating disorders before your child was affected. Even the best trained and well intended summer programs will have biases and beliefs that reflect mainstream thinking. As you remember, it took some time in Phase I to retrain your own thinking, learning not to blame yourself or your daughter for the illness. There was also the learning curve of knowing how manipulative the eating disorder could be and differentiating between whether it was the eating disorder speaking or whether it was your daughter. This was difficult enough for you to figure out as a parent, much less trying to educate an entire camp.
I think these decisions should always be discussed in Family Sessions, where the therapist can be a non-biased, emotion-free participant in the discussion. However, in the end it comes down to you as parents to make the decision on whether you feel your child is ready.
Scott Bullock, MSW, LISW-S
Mr. Bullock is a therapist at the Lindner Center of Hope. He has more than with 17 years of experience in the treatment of adolescents and adults and is undergoing certification in family-based treatment. Read more about Mr. Bullock here.