Wednesday, 8 February 2012
Calm in the face of the storm
I was having a purple patch yesterday. I was trying to explain how to remain calm in the face of extreme anxiety, when refeeding an eating disordered patient. However, I think this advice could apply to all parents of teenagers, when faced with the maelstrom of a teenage meltdown.
Two things to bear in mind with the reaction to the ed anxiety. Firstly the Maudsley team have done some interesting experiments on the way ed patients perceive people's facial expressions. They have a much clearer view of anger, sadness, depression etc and are almost unable to see happy, smiling faces. This explains why a neutral and non-aggressive stance is more likely to get the best response - it is sort of like patients perceive smiling as snarling, ergo find smiling as aggressive as anger.
The second aspect is more difficult and that is modelling effective behaviour. It is something I learnt about on one of the Janet/Gill training days at the Maudsley. This is what, I suspect, Mamabear is getting at. No one is perfect. With the perfectionist tendencies of an ed patient, it is very difficult for them to accept anything other than perfection for themselves - they think they should be happy ALL THE TIME. We all know that is impossible - life happens! However, the slightly skewed perspective of ed means that if they can't be happy all the time, why bother to be happy at all? They cannot be perfect at being happy, so why go there?
Modelling effective parenting shows that it is all right to have the occasional meltdown, to cry, to laugh at inappropriate times etc. However, I would be cautious about doing too much modelling of inappropriate behaviour - stability and consistency seems, to me, to be the key to nurturing the emotional recovery of the patient - we all tend to muddle along without massive highs and lows every day. A sort of bland tootling along the path of life, encountering occasional hills and valleys, rather than scaling the Grand Canyon every day.