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As the mother of a daughter who died of anorexia nervosa, I would like to write about a program that I feel, considering my experience, holds new hope for the victims of anorexia and bulimia. The therapy is family-based and called the Maudsley Method or Approach.
The Maudsley Method was created by child psychiatrists and psychologists in London, and it is now practiced from one end of the United States to the other: Columbia University, Mt. Sinai School of Medicine, Duke University, The University of Chicago, Stanford University, and the University of California at San Diego, according to the Maudsley Parents website, maudsleyparents.org .
But what exactly is The Maudsley Method? Dr. Cris Haltom, a licensed psychologist and a Cornell University Ph. D., explains that “The Maudsley Approach is applied to adolescents 18 and under who are living with their families. It is designed to intervene aggressively in the first stages of illness and is a short-term model, as short as twenty sessions or six months in duration. It is conventional wisdom that recovery is best achieved when eating disorders are treated in the earliest stages, in order to prevent long term, chronic illness.” There is a huge difference in the Maudsley Method compared to other forms of therapy.
The difference is that unlike so many eating disorder therapies, the Maudsley Method does not demonize parents, but after instruction by a trained eating disorder professional, actually puts the parents in charge of re-feeding their own child.
My daughter was eighteen and in college when she became anorexic so ineligible for the Maudsley Method. Yet every time she came home from college for the summer we re-fed her. The semester we took her out of college because of anorexia we re-fed her. When she moved to another state for work and needed help, I lived with her and re-fed her. She went to a psychologist as well, but the family was not included. I realize this is anecdotal information, but considering my experience, I also believe the Maudsley Method’s position is right: families can re-feed their own children especially when trained and included in therapy.
This parental instruction and re-feeding or in the case of bulimia, eliminating the binging and purging behaviors are part of the first stage of treatment. There are definite ground rules for this stage: parents may not use force or punishment to get their adolescent to eat in a healthy way. But instead, they must draw on their deep knowledge of their own child for what they intuitively know will work.
But make no mistake; this will be an intense experience since a parent must be with the anorexic adolescent for breakfast, lunch, dinner and two snacks to make sure she eats. And the parent of a bulimic adolescent must endure hours of standing guard to prevent binging and purging.
What the Maudsley Method calls “functional” rewards are used. For example a parent might say, “I’m afraid something will happen to you if you go out to the movies in this weak condition,” rather than the parent saying, “You didn’t eat your dinner so you can’t go to the movies.” This keeps the focus on the disease not on child. The first stage also includes family meetings with the therapist to check re-feeding progress and to receive advice and encouragement.
In part 2, we’ll be discussing stage two and three of the Maudsley Method and research results.
http://www.maudsleyparents.org/whatismaudsley.html
http://www.edsurvivalguide.com/eatingdisorder-maudsley.htm
http://news-service.stanford.edu/news/2005/august10/med-lock-081005.html
Add a Comment10 Comments
Hi Anne,
Thank you for taking the time to write such a beautiful, insightful comment. I’ll admit it is hard to write about the new treatments that might have helped my daughter and especially success stories. But like a mother who donates her child’s organs so that someone else can benefit, I’m donating my daughter’s experiences in the hope that others may learn form them and possibly turn away from this horrible disease. That’s why I started writing about her a year ago, but as you say it was under another name then.
After the seventeen years of my daughter’s suffering and death, I’ve come to the point where privacy seems underrated. Initially, I wanted to people to know who she really was as a person: a witty, intelligent young woman who accomplished so much in spite of this debilitating disease. So if she could not extricate herself from this disease with her intelligence and all the help her family tried to give her, this is absolutely a disease that girls and women should stay far, far, away from.
I have been trying to post this response for two days. Guess it's the cold.
Sincerely,
Mary Sornberger
January 4, 2010 - 5:55pmThis Comment
Hi Anne,
Thank you for taking the time to write such a beautiful, insight comment. I’ll admit it is hard to write about the new treatments that might have helped my daughter and especially success stories. But like a mother who donates her child’s organs so that someone else can benefit, I’m donating my daughter’s experiences in the hope that others may learn form them, and possibly, turn away from this horrible disease. That’s why I started writing about her a year ago, but as you say, then it was under another name.
After the seventeen years of my daughter’s suffering and death, I’ve come to the point where privacy seems underrated. Initially, I wanted to people to know who she really was as a person: a witty, intelligent young woman who accomplished so much in spite of this debilitating disease. So if she could not extricate herself from this disease with her intelligence and all the help her family tried to give her, this is absolutely a disease that girls and women should stay far, far, away from.
Sincerely,
Mary
January 3, 2010 - 10:22amThis Comment
Anne,
I guessed they fooled me.
Mary
January 3, 2010 - 9:51amThis Comment
Hi Anne,
Thank you for taking the time to write such a beautiful, insight comment. I’ll admit it is hard to write about the new treatments that might have helped my daughter and especially the success stories. But like a mother who donates her child’s organs so that someone else can benefit, I’m donating my daughter’s experiences in the hope that others may learn form them, and possibly, turn away from this horrible disease. That’s why I started writing about her a year ago, but as you say, then it was under another name.
After the seventeen years of my daughter’s suffering and death, I’ve come to the point where privacy seems underrated. Initially, I wanted people to know who she really was as a person: a witty, intelligent young woman who accomplished so much in spite of this debilitating disease. So if she could not extricate herself from this disease with her intelligence and all the help her family tried to give her, this is a disease that girls and women should stay far, far, away from.
Sorry this is all in one paragraph, but the posting system wouldn't let me seperate them. Second paragraph starts at, After the seventeen...
Sincerely,
Mary
January 3, 2010 - 9:49amThis Comment
Anne,
What a thoughtful and generous post you've written. I agree completely. Mary's writing about her daughter proves that there is an evolution -- albeit a slow one -- going on in the ED community. Every time she writes about a piece of her journey, she relives that journey. We are all fortunate that she's willing to go there.
Thanks so much for writing.
December 29, 2009 - 9:21amThis Comment
Hi again Mary,
I'm sorry for the delay in replying to your last post, but I just saw it today.
I understand your feelings and I've battle them myself. Losing a child, even an adult child, has got to be one of the hardest events anyone can experience in life because it seems to be so out of the natural sequence of the way life 'should' go.
That pain is only compounded by the 'what if's' and 'if onlys' which parents battle post the loss of a loved one--and these parents are from many different circumstances, not just eating disorders. Right now, an aunt I have is battling the loss of her son to juvenile diabetes and the many 'if only's' that have come with his death. So, eating disorders don't have a monopoly on this painful experience.
But, I do think that the way ED's have been treated in the past often compounds a family's grief and guilt and this is terribly wrong. There is still a lot we don't know about these illnesses...why some young people get better with minimal to no treatment (as my sister did), why some don't and what the most effective treatment is at different points in the illness (especially at more chronic stages).
You are courageous, Mary. This illness has been one of shame and guilt for families. Many of us are still concerned to use our real names (partly out of privacy for our ill loved ones, but partly for self protection too...at least speaking for myself). Your willingness to say who you are and what happened to your family is indeed courageous. Channeling this into information for others that may result in helpful, supportive, hopefully positive outcomes is indeed a valuable gift to other families.
Thank you.
anne
December 28, 2009 - 1:16pmThis Comment
Anne,
I hope that your daughter is doing well.
Thank you for saying that I'm wise and courageous, but I'm afraid I feel more like a failure since I couldn't help my own daughter.
Mary
December 19, 2009 - 8:20amThis Comment
Anne and Jane,
Thank you for your kind comments. Please send me any new studies you find; I feel we are just starting to scratch the surface on these devastating disorders. We need to get the information to the people who are suffering and their families.
Best,
Mary
December 16, 2009 - 3:31pmThis Comment
Dear Mary,
December 15, 2009 - 9:33pmLet me add my condolences to Anne's. Thank you so much for sharing your story, and reaching out to help other families.
With admiration,
Jane
This Comment
Hello Mary,
Thank you so much for your thoughtful columns on Family-based therapy, or the Maudsley Method. I appreciate your help in getting this valuable information out to the public. Like you, I did not use the Maudsley Method with my ill daughter because I was not told about it. I have since become a big supporter of it as the best and right way to go--certainly one that all families should have as a first line option.
And, I am so sorry for the loss of your daughter. For every parent that has lived with an eating disorder in the family, this fear is so real. You speak from wisdom and a deep courage and I thank you for it.
I know--and research is showing-- that families do not cause this illness, but can often be a very powerful ally in helping to overcome it. By your willingness to speak up, share your personal story and advocate for others, you are offering hope and a path to action for other families that has proven the most effective to date for young sufferers. I might add that there is now a small study done using Maudsley with college age students (for the information of the general public). Hopefully more will be done in the near future.
My best,
"anne"
December 15, 2009 - 8:23pmThis Comment