Anorexia: I could see that my beautiful daughter was starving herself. But we beat it together. . .
In an exclusive extract from her new book Brave Girl Eating, Harriet Brown recalls how she nearly lost Kitty, 14, to this insidious illness
Before Kitty got ill, I thought eating disorders happened to other people's children. Not to my daughter, who was savvy and wise, strong and funny. Before my daughter got ill, I thought kids with anorexia or bulimia wanted attention, that they were screwed up and tuned out, bored or acting up or self-destructive.
But my daughter was none of those things. She would never choose to have anorexia. She was safe. I was wrong about many things, but I was right about that one thing: Kitty didn't choose anorexia. Anorexia chose her.
And it nearly killed her.
I'd left the room at Kitty's 14-year-old check-up, worried about her weight. She'd always been on the small side, but she'd grown an inch and put on some muscle after joining a gymnastics team, yet she weighed less than she did the year before.
Four months later, on a family outing, she cried continuously and told me that she couldn't stop worrying. "Worrying about what?" I asked her.
She shook her head, her eyes still hidden from me, and said no more.
Most parents of an anorexic child can look back on a day when they should have done something but didn't. For me it was the next day, the Monday after Mother's Day, when Kitty called me at work to ask what we were having for dinner on Friday night -- five days later. I wish, now, that I'd paid attention to the frantic tone in her voice, to the anxiety driving this odd and insistent questioning.
Over the next month, Kitty's mood continued to deteriorate. She cried more; she was testy one moment, clingy the next.
I started watching her. Watching what she ate, and didn't eat. How her head suddenly looked too big for her body.
At her end of year graduation in early June, Kitty wore an orange halter dress. In an auditorium crowded with 14-year-olds, she was by far the thinnest girl in the room. The next morning I booked the first appointment I could get with Dr Beth, Kitty's paediatrician.
I knew what was going on now. I couldn't help it. I saw that Kitty was starving herself. I just didn't know what to do about it. I cooked her favourite foods and watched in frustration as she pushed them away, or took two bites and insisted she was full. Once upon a time, family dinners had been a ritual I looked forward to, a time when we came together to talk and laugh. Now I dreaded them.
At the appointment with the paediatrician the lab technician lifted Kitty's sweatshirt, and for the first time in weeks I saw my daughter's naked chest. The sight made me want to howl. Her skin stretched tightly over her sternum. I could see the arching curve of each rib, each nick and indentation of her collarbone.
Her elbows were bowling balls set into the middle of her matchstick arms. My bright, beautiful daughter lay broken on the table, her eyes dull, her hair lank. I could not bear it.
A few weeks later, Kitty woke me up one night to tell me that her heart felt "funny". There was fear in her deep brown eyes, different from the anxiety I'd been seeing since this nightmare started. I knew that this was serious.
On the way to A&E, Kitty sat next to me in the front seat, looking small and lost in the oversized sweatshirt that fit her six months ago.
"I'm dizzy, Mummy," she murmured. I kept one hand on the wheel, the other on her, thinking "Don't die. Please don't die".
When we arrived, her heart rate was dangerously low and she was taken to the intensive care unit. The doctor told me he wanted to use a feeding tube, but Kitty became so distressed I asked for an hour more; he agreed on the condition that Kitty must eat some food.
The nurse brought a chocolate protein milk shake and a straw. She helped Kitty sit up. Kitty reached for the milk shake, held it in one hand, lifted the straw to her lips.
Tears slipped over the sharp cliffs of her cheekbones. Her whole body trembled. For five minutes, 10 minutes, 15 minutes she sat, holding the milk shake and crying, while my husband Jamie and I murmured encouragingly.
Kitty, crying steadily, consumed the shake. Between bites she talked out loud to herself. She seemed beyond caring that we could hear, or maybe she was so deep in her own nightmare that she didn't know we were here.
"Come on, Kitty, you can do it," she said. "You don't want to go back to that scary place."
Jamie and I were crying then, too, as we understood for the first time exactly how courageous our daughter is.
One afternoon about five days after Kitty came home from hospital, I was sitting on the end of her bed, holding a frozen protein milkshake. Kitty sat propped up on pillows, crying.
It took half an hour to get three spoonfuls into her mouth. I waited for Kitty to be able to eat, but she said she couldn't eat, she couldn't drink.
She said her throat was closing, that she was a horrible person, that she was going to get fat, that she was the worst person in the world.
"Kitty," I said firmly, "You have to drink this milk shake. The doctor said so."
Amazingly, Kitty sat up. She lifted her tear-streaked face toward me and I nearly dropped the spoon. I know my daughter's face far better than I know my own. I know every look in her repertoire, but I had never seen this face before. Her eyes had gone blank; her mouth turned downward in almost a caricature of a pout.
Her tongue poked out, and for a second I thought she was sticking it out at me. Then I realised with horror that it was flicking like a snake's forked tongue.
Then she opened her mouth, and her voice, too, was unrecognisable. She spoke in a sing-songy, little-girl tone, the creepy voice of the witch in a fairy tale. "I'm a pig," she said, not to me, exactly; it was almost like she was talking to herself. "I'm a fat pig and I'm going to puke. I'm going to puke up everything because I'm such a pig."
The hairs on the back of my neck stood up as the words poured from Kitty's mouth. No, not from Kitty's mouth, because this was not Kitty.
It was not my daughter who looked out of those dead eyes, who rocked on the bed, her bone-arms wrapped around her flat chest, who said the same words over and over as if her brain was reduced to a single thought. It was if a demon had possessed her.
That night I spent hours online, reading everything I could about treatment for anorexia. Kitty's illness wasn't about the food -- but she was starving to death. What I really wanted to know was: How was Kitty going to get better?
Eating disorder specialists often recommend physical and emotional separation between parents and a child with anorexia. But that felt wrong for us. We decided to follow something called the Maudsley approach, or Family Based Treatment, an approach that originated at the Maudsley hospital in London.
Rather than send Kitty away to a special facility, this meant tackling the anorexia head-on and together, in our home, with weekly supervision from her paediatrician.
We made a plan, Jamie and I. We'd take charge of Kitty's eating.
We'd serve her breakfast, lunch, snack, dinner, and snack, starting at about fifteen hundred calories a day, and we'd bump up the calories by three hundred every couple of days, until she was getting enough. We would carry on like this -- 're-feeding' her -- until she started to gain weight.
Day after day, we lived under the tyranny of the scale. Our lives had narrowed to a few basic activities: shop, cook, eat, clean up, watch movies, do it all again.
After that terrible year of re-feeding, things gradually got better. We let Kitty live away from home for the first time. She was 18, and part of the point of this was for her to become more independent. But two months later we brought her home, after she relapsed, and began again the work of loosening the demon's claws.
One of the worst moments this time around came when Kitty confessed that three years earlier, she'd sewed weights into a bra, and wore it every time we weighed her.
Kitty has just started college, a term later than planned. She's not fully recovered from this relapse but she's made good progress. She knows that if she doesn't continue to recover, we'll bring her home to finish the work here.
We'll do whatever it takes to make sure Kitty gets well and stays well, whether she's 18 or 38.
That's what families do.
Copyright (c) 2010 Harriet Brown, extracted from Brave Girl Eating, published by Piatkus.