Brave Girl Eating Read Free

starvation. I think: That could have been my daughter. It wasn’t. It’s not. If I have anything to say about it, it won’t be.
    This is our family’s story. Kitty was diagnosed with anorexia in June 2005. In August of that year we began family-based treatment (FBT), also known as the Maudsley approach, to help her recover. That was the start of the hardest year of all of our lives. That year, I learned just how brave my daughter is. Five or six times a day, she sat at the table and faced down panic and guilt, terror and delusions and physical pain, and kept going. And she emerged on the other side. After months of being lost, she came back to us and to herself, and the world took on color and sound and meaning once more.
    Between 3 and 6 percent of all teens deal with an eating disorder, whether it’s anorexia, bulimia, binge eating disorder, or the all-too-common ED-NOS, or eating disorder not specified. Many more struggle with other devastating illnesses, both mental and physical: Schizophrenia. Bipolar disorder. Depression and anxiety. Autism. Cystic fibrosis. Cerebral palsy. Autoimmune disorders.
    We have a long history, in this country and elsewhere in the Western world, of implicating families in their children’s illnesses.As I write, the Academy for Eating Disorders has released a position paper—two years in the making—that acknowledges, among other things, that “family factors” may play some role in both causing and sustaining an eating disorder. But it goes on to say, “Current knowledge refutes the idea that [families] are either the exclusive or even the primary mechanisms that underlie risk. Thus, the AED stands firmly against any etiologic model of eating disorders in which family influences are seen as the primary cause of anorexia nervosa or bulimia nervosa, and condemns generalizing statements that imply families are to blame for their child’s illness.”
    The AED’s paper takes a step in the right direction—one that’s already been taken when it comes to illnesses like schizophrenia and autism, where the biological underpinnings and mechanisms of the diseases are more widely accepted. We’ll get there for eating disorders, too; it’s just going to take awhile.
    One of the hopeful signs is the slow rise of family-based treatment, which aligns parents with the teenager rather than separating them, as has been the norm. This sea change is not specific to eating disorders, but it’s particularly encouraging in that context because of the hundred-plus-year history of blaming parents for anorexia and bulimia. As I write, the Children’s Hospital in Westmead, Australia, has just opened two family units, so parents and siblings can stay at the hospital with a child undergoing treatment for anorexia. “It’s very scary for an eight-or nine-year-old to be away from home and in hospital for weeks and weeks,” says the director, Dr. Sloane Madden. “Treating the whole family as inpatients creates a much more friendly and private environment and is much more similar to what it will be like at home when they are discharged.”
    I believe we’re in the midst of a cultural shift in how we see families across the board. Parents do have an enormous influenceon their children, both good and bad. The experiences of childhood and adolescence can profoundly shape a person’s life. But we’re also more and more aware of the other forces that contribute, from genetics to biology to the influence of peers and the media. And we know, now, that even imperfect families—and aren’t we all imperfect?—can effectively support a child through one of the most hellish experiences of his or her life.
    So this book is for the families whose children struggle not just with eating disorders but with depression, anxiety, schizophrenia, autism, bipolar disorder, and so many other illnesses that change the nature of a