When patients graduate from the Kartini Clinic I am often asked by the anxious/happy parents how they are to deal with any eating disorder symptoms going forward. What if they refuse to follow their meal plan? What if they lose weight? Should they see a therapist for this? A dietitian for that?
What I tell them is this: You are the expert in your child’s meal plan. You know far better than any professional what degree of mealtime supervision is still needed (100% at first). You know what their meal plan looks like and why it looks like it does. Trust yourself, trust your teaching. And recently I have begun to use the phrase “Life stops until you eat” for any situation of food refusal they might encounter.
I’m not sure where I first heard this phrase or who the original author of it was -- please let me know if you know, so I can quote it with proper attribution. After all, how many people know that Kartini Clinic was the originator of “parents don't cause eating disorders and children don't choose to have them” or “without weight restoration you will get nothing”. Or that I was the originator of “State not Weight”. And the pithy and apt “life stops until you eat” is too great not to share; I would like to tip my hat to the author.
Sometimes a child who has graduated from treatment will need to see a psychiatrist for medication or complex mental health management, or sometimes see a therapist to deal with school anxiety, social anxiety, trauma or adolescent adjustment issues. But as far as the meal plan is concerned, parents: you are the experts.
The only spine-stiffening motto you need, should your child leave treatment and try to return to restricting is this: “life stops until you eat”, no friends, no going out, no cell phone, no parties, no car, no clothes shopping, no college visits. The first job is to nourish the body and all else comes after that.