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Secret Language of Eating Disorders: The Revolutionary New Approach to Curing Anorexia and Bulimia
     

Secret Language of Eating Disorders: The Revolutionary New Approach to Curing Anorexia and Bulimia

by Peggy Claude-Pierre
 

"I feel so dirty, hopeless, no-good, fat, scared, a failure. I don't deserve to live."

"My daughter is 5'8" and 60 pounds. She won't comply with anyone. She has ruined the family."

"I can't be cured. I'm too bad. I'm going to have to deal with this the rest of my life."

"My doctor told me that I don't

Overview

"I feel so dirty, hopeless, no-good, fat, scared, a failure. I don't deserve to live."

"My daughter is 5'8" and 60 pounds. She won't comply with anyone. She has ruined the family."

"I can't be cured. I'm too bad. I'm going to have to deal with this the rest of my life."

"My doctor told me that I don't want to grow up."

"I hate myself for being the cause of all of this."

"I don't want my daughter to die. They say we are a dysfunctional family, but we don't fight and we love our daughter. Surely something can be done."

All of these statements are based on myths and misconceptions about anorexia and bulimia. Unfortunately, these myths and others not only deepen the suffering of victims of eating disorders, but shape how we regard and treat those victims. If you are a parent , family member, loved one, or caregiver of a victim, or a victim yourself, you know the punishing pain and sense of hopelessness caused by eating disorders. Now an extraordinary new book offers new hope and help to all whose lives are threatened by these scourges. In The Secret Language of Eating Disorders, Peggy Claude-Pierre, founder of the world-renowned eating disorders program at the Montreaux Clinic in Victoria, Canada, puts these damaging myths to rest and reveals her groundbreaking theories on the ultimate cure for illnesses that current medicine treats with little success.

Peggy Claude-Pierre developed her unique insights into eating disorders through successfully treating her own two anorexic daughters and hundreds of acutely ill patients at Montreaux, which specializes in treatingvictims near death whom doctors and hospitals haven't helped. She became convinced that eating disorders stem from a complex negative mindset. Often established at birth, it causes sufferers to feel an overwhelming sense of worthlessness that frequently results in a slow process of self-destruction. It is Peggy Claude-Pierre's conviction that this mindset—and the resulting eating disorder—can be permanently reversed through a program based on unconditional love, regard, positive reinforcement, easing of the victim's burdens of blame and responsibility, and objectivity training.

In The Secret Language of Eating Disorders, Claude-Pierre details her theories on the true causes of anorexia and bulimia and lays out the basis of the Montreaux program, which has an astonishingly high success rate, curing even the gravest cases. She describes the origins of the negative mindset and the five stages of recovery from eating disorders, spotlights the special challenges of coping with them at home, and offers clear, practical guidelines to working effectively with health professionals. She also shares the voices of dozens of former patients who offer their own stories of recovery as inspiration to victims, their families, and loved ones. Peggy Claude-Pierre's heartfelt message of hope is that eating disorders can be cured, not merely managed, and that deep within every person suffering from these illnesses is a loving, deserving soul who can and should be saved. As Peggy Claude-Pierre writes to victims, "You are not failures at life, merely at understanding your own value. Soon professionals across the globe will discontinue treating the symptoms of eating disorders as the cause." This powerful, compassionate book will revolutionize the way we think about eating disorders and their victims. It will literally save lives.

Editorial Reviews

Publishers Weekly - Publisher's Weekly
Anorexia is not about body image, insists Claude-Pierre, founder and director of Canada's Montreux Clinic, which has treated hundreds of patients with eating disorders since 1993. Claude-Pierre developed her innovative approach as an alternative to the harsh and ineffective treatments prescribed for her two anorexic daughters. Sensitive to the girls' anguish, she concluded that eating disorders are not about looks, selfishness or control, but rather arise from "Confirmed Negativity Condition" (CNC)a type of overly developed moral sense that causes highly intelligent and altruistic individuals to assume full responsibility for the world's ills. The result is intense pessimism, subjectivity and self-loathing. Thus regimens that impose guilt on patients are counterproductivevictims need to be relieved of guilt, not burdened with more. At her clinic, Claude-Pierre creates an atmosphere of unconditional love and support, enabling patients to develop a healthy sense of self. Once this is achieved, she claims, eating disorders can be completely cured. Claude-Pierre's compassion and dedication are evident on every page of this account, and her insights are stimulating. Yet the book, based almost entirely on the experience of Montreux patients, lacks broader documentation and historical background, and it never fully addresses the question of why victims choose food as their particular focus. But though the book's scientific rigor is questionable, its humane and caring message will reach deep into the hearts of those who suffer from eating disorders. Photos not seen by PW. Major ad/promo; Random House audio; foreign rights sold in six countries; author tour. (Sept.)

Product Details

ISBN-13:
9780812928426
Publisher:
Crown Publishing Group
Publication date:
09/01/1997
Edition description:
1 ED
Pages:
288
Product dimensions:
6.37(w) x 9.53(h) x 1.05(d)

Read an Excerpt

CHAPTER ONE

The Beginning of Montreux

My journey as a therapist for eating disorders seems, in retrospect, both planned and spontaneous. I knew from a young age that I would become a psychologist. The well-being of the world's children has always been my primary focus.

As a young woman, I was fortunate enough to have two incredible daughters. When they reached early adolescence, I resumed work toward an advanced degree in psychology at the university. I ended an incompatible marriage and moved to a new town to accelerate my studies, leaving behind a comfortable home for a small apartment. I had planned to have Kirsten, then fifteen, and Nicole, thirteen, join me, but Kirsten initially stayed behind to live with my parents and finish her school semester.

KIRSTEN

It was during those intervening months that Kirsten developed anorexia. One evening, my mother alerted me to the problem of my daughter's diminishing weight. Kirsten was studying until two or three in the morning, which was not unusual since she had always been a hardworking student. But my mother had noticed that Kirsten had large dark pools under her eyes, and she had lost a tremendous amount of weight in a short period of time. Hearing this, I asked Kirsten to join me.

When she walked off the plane, I was shocked to see that my daughter, who was five foot nine, now weighed less than a hundred pounds. She must have lost over twenty-five pounds while we had been apart. Going back to school was out of the question; she needed help--now. I told her, "Honey, you know you are staying with me."

She just looked back at me and said simply, "Yes, Mom, I know."

Under the surface, I was in a state of panic. I immediately took Kirsten to a doctor to check her electrolyte balance. He was the first in a procession of professionals. They all told me the same thing: Kirsten had anorexia and there was no cure for it. At best, an anorexic lived with it--that was called maintenance.

"How serious is it?" I asked. I knew the mortality rate was high. The doctor shook his head to indicate that Kirsten's prognosis was bleak.

I started reading everything I could about anorexia. I wanted to discover how I had failed this child. "What did I do wrong to make her hate herself so much?" I asked over and over again. Until I understood that, I would not know what the right help was. Everything I read told me that bad parenting, childhood trauma, sexual abuse, and a string of other "issues" were the cause.

Had our temporary separation caused Kirsten's illness? I felt remorse and extreme guilt. Naturally, as a single parent I assumed total blame for my daughter's illness, and the ensuing parade of psychiatrists did nothing to change my mind.

However, I balked at the psychiatrists' conclusion that Kirsten was being manipulative and selfish, that she was losing weight on purpose to get my attention. I had known this child all her life; I could not accept that she could change so radically from the kind, giving person I had always known her to be. Kirsten had always been unusually sensitive to and aware of other people's needs, in fact she was diligent about attending to them.

I asked my daughter to explain what she was thinking and feeling so I could understand how to help her. She told me that there seemed to be some other louder thought pattern in her head that made no logical sense. Yet Kirsten had always been a very logical child. It became obvious that she did not understand what was happening to her and was powerless to stop it. She said she felt she was going crazy. The medical doctors told me that she could not go on much longer in this manner.

I soon became aware that Kirsten felt terrible guilt about anything connected with food. Whenever I tried to persuade her to eat, she either refused, or tears would roll down her cheeks while she struggled to force the food down to please me. I remember taking her to a restaurant for a muffin. She ate it, but as we were leaving, I could tell she was feeling immense guilt about it. As we drove away I asked her, "Kirsten, I'm good enough for a muffin. What makes you think you're not good enough for a muffin?"

We stopped at a traffic light. She said, "Mom, see that light over there? You see that it's green. Logically, I know it's green, but my head tells me it's red, and I'm not allowed to go. That's the best analogy I can make for you about something that makes no sense to me. That's why I'm doing something so illogical."

She gave me similar clues about how her head operated. Later I realized that Kirsten's traffic-light analogy first made me understand that two minds were warring inside Kirsten's head. She was a determined person, and I kept trying to persuade her to fight against whatever force was barring her from eating in peace.

The first two months were the most frightening. Occasionally at night, while Kirsten was sleeping, I would go quietly into her bedroom to check on her. Under her blankets, she was skeletal. I would slowly replace the blankets so she would not know I had been there, and she would not be concerned about my worry for her. It was hard to believe that she could survive; she was down to about eighty-four pounds. Fear almost paralyzed me.

She told me sadly one night, "Mom, you've never lied to me in your life, so I'm going to listen to you, even though the pressure is more than I can bear sometimes. Everything in me tells me not to trust anybody or anything at this point, but I've always trusted you. I'll continue to trust you, whatever it takes." To this day, I know that's what brought her through, and I stand in awe of her incredible courage against the unbelievable negativity of her mind.

In retrospect, I realize that her decision to trust me unconditionally was the turning point. She kept going to the doctors because I asked her to. Over the next six months, I worked with her every day. She even came to my university classes with me; I was loath to let her out of my sight. Intuitively I knew she should not be alone; otherwise this negativity, whatever it was, would gain strength in her mind when she was by herself.

After every meal, she would talk to me about the illogical thought patterns she could not get out of her head. She was direct about how she felt. Sometimes, she would look at some minuscule bit of food on her plate and tell me, "Mom, this hurts so much. I shouldn't be eating it. I should be eating a quarter of it. That's all I deserve." She felt almost subhuman, less than the rest of us. She never knew why she was less deserving, but she just knew she was.

In the first three or four months of her illness, Kirsten was suicidal and frightened, as if eating had some great negative consequence. I talked to her constantly. She was gentle, never abusive. Together we tried to work it out. For every illogical word or act, I responded gently with a logical discussion of the reality of the situation.

She cut off her hair and dyed it purple. At the time I did not pay much attention because I saw it as a natural consequence of being an adolescent. She dressed in layers as though she were trying to arm herself to fight the world; her natural gentleness began seeping away. It was as if she were on a search for self as she kept trying on different modes of appearance. She would wear outside what she seemed to lack inside for strength. (I would later learn that this is characteristic of many people with eating disorders.)

Since we had just moved to a new city, initially she no longer had any friends. I noticed that this normally outgoing girl did not even try to make new ones.

She became extremely agitated. She had to move all the time. If she needed to stay in one spot, she would walk in place; she could not sit in a chair without jiggling around excessively. She exercised all the time. I did not think that was such a problem, so I was not as on top of it as I might have been. Later I would know better.

Several times Kirsten made statements that told me she perceived herself to be the adult in the situation, capable of making decisions that seemed rational to her but were anything but. At other times, she would say, "Mom, just let me go, just let me die. This is too hard; I can't fight it." I never heard, "Mom, help me." She never asked for help; I gave it to her, but she did not feel she was allowed to expect it.

She would never say that she was worried about me, but she was always trying to make life easier for me.

Then Kirsten started losing the ability to make any decisions, any choices at all; it was as if she had lost faith in her ability to choose. She second-guessed every possible decision or choice. When I asked about her preferences, she would respond, "Mom, what do you think?" "What will serve other people better?" She could not make the simplest choices about the most basic issues: what to wear, what restaurant to go to, what to eat. She was unable to create any of her own structure at all.

It was such an unrelenting nightmare. Not only was I terrified that my daughter was losing her life, but I was convinced I was the cause of her torment. Everywhere I went, I felt and accepted the stigma. The public knew that someone had to be blamed--the parent, the child, or both. I was overcome by the numbness of hopelessness. How could my child be dying in front of me? I knew I had to do something, but I did not know where to begin. The information I was getting made no sense. So little of it seemed to apply to Kirsten. Certainly, I would not accept that my daughter's anorexia was incurable. On occasion I glimpsed an idea that felt right, but essentially I felt terribly, terribly alone, left to stumble along an unfamiliar road in a strange country, whose signs were in a language I could not understand.

I found myself of two minds. On one hand, I was petrified that someone could live with such agony--I was witnessing an emotional state that was unspeakably cruel on a continuous basis. On the other hand, I was irritated that I had allowed myself to see doctors as gods; I had expected physicians to have an answer for everything. Of course doctors are not wholly responsible for this deity complex; we put them on the pedestals ourselves. But how could I accept it when they told me my daughter was going to die, that she could never be cured? How could anybody give up on a psychological illness?

The doctors' explanations of Kirsten's illness were based on happenstance and theory, not on strict experience. I had so many questions: Why does an eating disorder affect one child and not another in the same circumstance? I had read that most siblings of anorexics did not get the illness themselves. Did sexual abuse cause it? I knew that Kirsten had not been abused. Family trauma was another commonly cited cause, but I knew that my daughter viewed my divorce as a positive event, not a traumatic one. I started searching for venues that would prove these issues to be the cause because I wanted desperately to find an answer that could reverse the consequences.

Never was I convinced that anorexia was primarily about weight. When Kirsten was sick, she expressed fears about getting fat, but it was not her main focus. She was much too composed to complain about her looks. She would tell me, "I need to be thinner. I don't know the reason why," and then she would start to cry.

Given the public view that anorexia attacked adolescent girls, a group famously obsessed with looking right and fitting in, I assumed--wrongly--that Kirsten's illness was in part bound up with concerns about body image. I now know that anorexia does not depend on gender, age, or looks.

I considered taking Kirsten to an eating disorders clinic. Every one that I investigated had a program based on behavior modification. The theory was that if you changed a person's actions, you would change the person. At these clinics, the therapists taught the patients that there were consequences to their behavior. They were given specific goals, such as finishing a particular dish, and told that if they did not achieve the goal, there would be a consequence or punishment. They would be prohibited from seeing their parents, using the swimming pool, or engaging in some other enjoyable activity.

I felt intuitively that I had to separate Kirsten's actions from their consequences. My daughter was experiencing such intense punishment internally already that for me to inflict more would be counterproductive to her recovery. Logically, behavior modification did not seem reasonable, at least for this child.

For six months, I talked Kirsten through every meal and prepared all of them myself. At each meal, I would distract her with funny stories to take the onus off the fact that she was eating.

Kirsten's little sister, Nicole, was an enormous help; she did everything to please her sister. She spent every spare moment sitting with Kirsten, talking and joking with her, giving her things, trying to make a difference. Nicole became a completely selfless person during her sister's illness and stood by her with every possible fiber of her being. I would later realize that she was being inadvertently set up for her own fall.

We combated Kirsten's illness with unconditional love and support. I refused to react to any rare bad behavior except with soothing statements like "I know you didn't mean to do that." I would never get angry under any circumstances. Intuitively I felt that something in Kirsten was testing me to find out how willing I was to be there for her. Kirsten was trying to let me know that she deserved nothing, but she was so gracious that the signals were not always apparent. It was a successful day if I just kept her alive.

I was becoming more and more physically exhausted. I felt it was unsafe for me to sleep. What if something happened to Kirsten when my back was turned? I had tried to engage yet another specialist for insight, but he had neither the time nor the inclination. He was probably exhausted and disillusioned himself from the dearth of answers. "You're just one of many. I have no time," he told me, and I was devastated.

I felt that I was operating on base instinct. If I could only find the cause, then I would know how to reverse Kirsten's anorexia. I used to comfort myself with this thought, but in my more selfish moments, I longed for some respite. I lived in a void of uncertainty and desperation. The most lonely thought is that there must be an answer, but my daughter might die because I could not find it in time. I fought for my own sanity during this time as much as I did for Kirsten's.

Ultimately, it was Kirsten's incredibly logical, lawyer-like mind that helped bring her through. Anorexia knows no logic, and part of Kirsten's mind would insist repeatedly that she was not allowed to eat, or that she could subsist on some ridiculously small amount of food. I would argue her through it for hours, and she generously let me.

"Honey," I would attempt to reason with her, "what would you expect me to eat for a day?" I had to explain the logic of the situation every time. "Write down for me what you eat; would you be happy if I ate only that much?"

Later I realized that asking her to write out her daily menu may have been a mistake; I know now that in creating a written table of contents, the negative part of her mind could use it to reprimand her for her indulgence. (At some point in therapy, however, this can be a positive, even worthwhile interim structure.)

Slowly she became stronger. The dread drained from me as the days marched on and she became more confident. Eventually I realized she would make it, at least this time. But almost every book I had read warned me of the high rate of relapse, so I felt I could not really relax. My aim was not only to save her life, but to find out how to prevent a recurrence. What, then, was the trigger?

I began to suspect that relapse occurred when this negative mindset was somehow ignited; the trigger was something other than the anorexia itself. It seemed improbable that anorexia was a direct result of a single issue or even accumulated issues; perhaps it was the straw that broke the camel's back. Now I know: It is not the ten issues that finally become too much, but rather one's attitude toward and perception of the issues that brings on the manifestation of the condition. A person's negative mindset becomes increasingly pessimistic and subjective so that it searches out any issue to turn into another negative to feed itself. On its hunt for confirmation, it perverts any issue wherever it can because it is so hungry for negativity.

During that year, I continued to attend classes to become a psychologist and kept taking Kirsten with me. My field of interest was children. I was engaged in a major research project that involved twenty-six countries, studying how to prevent recidivism in juvenile delinquents released from prison. Two nations, Japan and Sweden, invited me to study with them for a year each. I was finding that kindness, not punishment, worked miracles. Later I would see this as a metaphor for my own work with victims of eating disorders.

It was another six months after Kirsten's weight had stabilized and the doctors declared her out of the woods that I could begin to feel safe about her. I know she suffered more than she ever told me. She has always had immense courage. Kirsten told me later that it took her almost another year after she had regained her weight to feel she had an assured self with internal guidelines that she could live with comfortably. Even though she was over the manifestation of her condition, she had needed that year to gain strength, to become as whole as every person ought to be.

NICOLE

Within three months of Kirsten's recovery, I started recognizing the signs of an eating disorder in her little sister. Kirsten's illness had fortunately fine-tuned my antennae. Nicole began making excuses to avoid meals, subtly at first, then more noticeably. She would tell me she had eaten elsewhere and that she was just so full she couldn't eat, or that she had had a huge lunch and wasn't hungry for dinner. She began taking extended walks, sometimes disappearing for half a day; I would later discover she had been walking the whole time to burn off calories.

Even though her illness presented itself in a different way--she was evasive where Kirsten had been mostly straightforward--I began having an unhealthy fear about her. I was unable to sleep because I knew intuitively that, although I tried to deny it, Nicole too was in the grips of an eating disorder. The signs became too many, too often, to deny it any longer. I would see Nicole opening a can of tuna and pretending to make a sandwich. Later I would find the whole thing thrown out upside down in the garbage, so I would not readily notice that the can was still full.

Once I made the decision to face my inconceivable reality, I experienced again the dread I had just released myself from--dread that permeated me to the core. I was unsure if I had the physical energy to pull another daughter back from the precipice. I had been so exhausted for so long Would I have the strength? Could I outlast this illness once more? I was frightened that I would be unable to, but certainly Nicole deserved the same efforts I had made for her sister.

Nikki's illness was a nightmare that I could never have anticipated. At the worst, I was ready for a rematch of what I had gone through with Kirsten. I now know that the severity of an eating disorder depends on the sufferer's personality. As it turned out, Nicole's condition was many times worse than Kirsten's had been. Without the work I had done with Kirsten, I would have gone into Nicole's case completely unprepared. I thank Kirsten for teaching me. I was still, however, woefully unready.

From the beginning, Nicole was intensely suicidal and she went into a downward spiral very quickly. She was in a deep depression, which I now realize is partially caused by the lack of nutrition inherent in anorexia.

From the beginning, I knew I had to be with Nicole twenty-four hours a day or she would not survive. I tried to continue with school as I had with Kirsten, but Nikki refused to come along. She did not want people to see her; she was a failure, an imposter, inadequate in every way, a fool. It was a desperate situation. I had no means to invite anybody to help me deal with Nikki's illness, no money, no confidence that anyone else would take it seriously enough to protect Nicole. I knew of no clinic that would watch my child like I would. Without constant supervision, I knew she would find an occasion to harm herself.

She hated me. She hated everybody. She lashed out while simultaneously refusing all aid. "Don't you dare help me. I don't deserve it," she yelled. Once when I was rocking her with my arms loosely around her, she cried out, "Don't ever come near me. Go away."

"You don't have to love me," I replied. "You don't need to worry about that. I will always love you."

She broke down and began to cry on my shoulder. "I don't know why I said that. I don't think it. I don't mean it. I don't know why I'm doing this. I love you so much, and I would never want to hurt you."

Shortly after that, I realized that for the both of us to survive the ordeal, I had to leave my emotional self out of the picture. I knew better than to take Nicole's remarks personally. Every night I sat up trying to devise a way to separate my emotional mother self from my daughter in order to create the objectivity I knew I needed for her survival. I decided to create concrete steps for myself to follow to keep me balanced in order to buffer Nikki's condition.

I went to town and bought myself a thick notebook of lined paper and told myself that I was doing an immense research project. My diary would record Nikki's every move, behavior, bite of food, and emotion as well as my reactions. Having a well-defined task with a beginning, middle, and end gave me some hope in a bleak situation. My rational self needed this, because my emotional self could find no end to Nicole's illness; therefore I did not know where I would find the strength to fight it. My rational self had to choke back the sobs and panic that surged through me.

At night I crouched on the bathroom floor; the cold floor tiles and the stark lighting would keep me awake. I pored over a list of everything the textbooks said about the causes and characteristics of eating disorders and compared them to what I was seeing with Nicole. Nothing in her behavior computed with the theories. I played with the "begging for attention" hypothesis for a while. The public conception was that manipulative people used self-starvation as a "cry for attention." In this sense, a cry for help was construed as futile, but why would it be? I was certainly attentive to Nikki, yet her self-deprivation continued. Anorexia was no ordinary distress signal.

Theory 2 postulated that Nicole was selfish. That certainly did not make any sense; Nikki was the least selfish person I knew. She had just helped save her sister's life, and she was just a child.

Theory 3 supposed that Nicole was another example of "the best little girl in the world," a perfectionist running herself into the ground to please me because, supposedly, that was my expectation. But how could the Perfect Little Girl suddenly turn into her antithesis, as far from obliging as she could be? I had never implicitly or explicitly demanded perfection from her. Our relationship had always been warm and loving.

I took Nikki to psychiatrists and psychologists, but they would only frighten her, telling her that she was failing fast. Before long, she was given every possible psychiatric label. Finally, the threat of their involvement would make her try to eat more than usual, but even so, she soon weighed much less than her sister had at her worst.

Every night, I continued to write in my diary, to argue the experts' theories on paper. I still assumed that anorexia primarily affected teenage girls, so I compared my own feelings at that age with what Nikki was experiencing. Like her, I remember feeling undeserving, convinced that everyone else was better; I was unworthy of being in their company. I had not wanted to inflict myself on them. Though I had not become anorexic, I could see that same mindset intensify itself in my daughter. I had had inklings of this inclination in Kirsten when she was sick.

I was becoming more convinced that there was an underlying condition that predisposed people to eating disorders, not a life issue, but an interpretation of life caused by an inherent mindset. Could this explain why many people who live apparently worse lives come through relatively unscathed? I began waiting for the moments Nikki would sleep so I could work on my theories. I started adding and subtracting. This endeavor distracted my mind from the pain and apparent futility of trying to cure Nikki's anorexia and gave me purpose.

Two months into Nikki's illness, I began to find notes from her all over the apartment in every container. Most were written in the third person: "Nicole is a fat pig" "Nicole is no good." "Nicole doesn't deserve to live." "Nicole deserves to die." "Nicole needs to be tormented." Why was she not writing in the first person, I wondered, why not, "I am a fat pig?" No sooner would I throw the notes away in horror then the jars would fill up with them again.

My own health began to suffer. I slept only an hour and a half a night. What worse torture than lack of sleep? One night I purposely disrobed in front of a mirror and looked at my reflection. At that moment, I vowed to myself that I would make sure this body would die before I would let my darling child die. It was a pledge not to commit suicide or give up for even a moment. I was truly drained, but as long as there was a breath in me, there would be in her.

I made myself the platform for Nicole's survival. Anything else I may have needed---including finishing my doctorate, which I wanted to do so desperately--I had to put aside. There was no choice. I never blamed Nikki. I never felt the need. I was not angry with her for a second. I knew my daughters had not brought this on themselves; they were as confused about their condition as I was.

Psychiatrists, however, seemed intent on fixing blame. One diagnosed Nicole as schizophrenic after a seven-minute interview. Others prescribed every kind of medication, seven or eight drugs at the same time, none of which she took--she refused them all, and I would not force her for fear of undermining her faith in me. Although I felt medication was not the answer for my child, I did not have the faintest idea what was.

Nikki's behavior became progressively more bizarre. She would throw a plate at my head after she had eaten something off it or break a window because she was so upset at eating. She trembled in fear, crouched in corners of the room. It was as if there was a presence beyond the two of us that was so negatively powerful. Nicole kept saying, "Mom, you can't fight it. It's stronger than us both." That would send shock waves of alarm through me, but I knew intuitively it was imperative that I remain composed to her, that I present only strength and serenity. I don't know where it came from.

Nikki's body somehow sensed she needed potassium, so I drove her, sometimes for hours, hunting for the "right" banana. We would stop at six or ten or thirteen stores. I thought the right banana would be medium sized, yellow, with few marks. I was terribly wrong. To Nikki, the "right" banana was unfit for human consumption: blackened, hidden under others, destined to be thrown in the garbage, with only an inch of edible fruit. She could convince herself that she was not really eating if she allowed herself to consume such a lowly castoff. It was frustrating, frightening, and exhausting

One morning at 4:00 A.M., I was writing in my journal, sitting on the cold bathroom floor, when I heard Nikki creep into the kitchen. When I followed her, she had disappeared. Then I heard a sound. I found her under the table, eating dog food out of a dog dish. We had no dog.

I did not know where the dish or the dog food had come from. She was on all fours, weeping, as she crouched down to eat. I went over to her and held her and begged, "Don't do this, darling. You don't need to do this. We will figure this out."

She just sobbed in my arms and held on. "I don't know why I do this. I'm so bad."

"Honey, why are you so bad?" I asked.

"You don't understand. I just am."

"What have you ever done that's so bad? You've been such a good girl all your life--a wonderful child."

"I don't know the answer," she replied, "but I know it's in my head all the time."

I brought her back to bed and stayed with her. I knew I had to negate every possible bad thing her head told her. I also had to assume she was hearing negative thoughts constantly. She was obviously unable to reach out for help, even though she wanted it. Something was holding her back. Certainly she did not want to die.

At first I would wait until Nikki said something, and then I would answer her with logic. Soon I began to make comforting statements even when she said nothing. I would give her positive reinforcement, assuming that what was going on in her head was silent to me but terribly loud and powerful to her. She started letting me into her game of fooling the negative voice. She eventually realized that I was strong enough to work with her against it. Her negative thoughts became an "it," because in separating "it" from her, I could fight it: United, "it" could stand. Divided from her, "it" might fall.

I presented analogies to better explain the situation of her mind to her. I pictured "it" as a wolf stalking a flock of sheep. The wolf determines which sheep is the weakest and tries to separate that sheep from the fold. I used distraction or any other means to outsmart the wolf. I had to prove to Nikki that I could do it, that she could lean on me, that I would never give in, even as her mind bombarded her with cruelty.

What People are Saying About This

Daniel J. Smith
"Peggy Claude-Pierre has created a paradigm shift in the way we view and treat anorexia. Peggy has shifted the focus of care from that of controlling the symptoms of disordered eating to healing the negativity that would otherwise plague the individual for the rest of his or her life. Through unconditional love and continual support, she enables people with anorexia to begin the journey of self-discovery by guiding them out of the cave of self-loathing and despair into a world of promise and hope. When I first met Peggy, we were both on a mission: hers, to save all children with anorexia, and mine, to find someone to save my daughter. I have developed the utmost respect for Peggy, for I realize that she has translated 'the secret language of anorexia.' Now, it is up to us to use the knowledge she has revealed."
Craig T. Pratt
"Peggy's work where attachment to the limiting obstacles of theory end. She has brought back from the dead many young lives the world deemed hopeless. Each living success at the Montreux Clinic is a testament to the energy in her commitment. There are many wo possess the title of 'doctor' who have never come close to Peggy's incredible example of the selfless healer. It is true the lights of Montreux are on twenty-four hours a day, as is Peggy Claude-Pierre, the brightest of them all." -- Chief, Division of Addiction Medicine, Grant-Riverside Methodist Hospitals
Edward Feller
"Our daughter was an aneroxic blessed with a strong, loving therapist and multidisciplinary Eating Disorders Unit whose members fought for and cared for her. Yet the right medication, the appropriate treatment, and outside experts did not work. Peggy Claude-Pierre is a warrior -- ferocious and relentless -- whose work has rescued a decade of suffers. The Talmud state, 'If you save one life, you save humanity.' This story, for me, is one of a battle using intelligence, feeling, focus on empirically verified treatment principles, delicate balancing of a complex residential environment, and definable goals to save one life at a time. Amazingly, Peggy is making my daughter a warrior too." -- Clinical associate professor of medicine, Brown University School of Medicine
Keith J. Karren
"Peggy has gone beyond the surface of eating disorders to discover their true causes and then present a valid and proven healing path. In this extremely constructive book, she offers incredible insights into the mind of the sufferer and the myths of eating disorders. It is a map to guiding professionals, families, and victims through the maze of eating disorders. Peggy's message has given me renewal faith that we can become a community of helpers and healers." -- Department Chair, Health Sciences, Brigham Young University

Meet the Author

Peggy Claude-Pierre opened her outpatient practice specializing in eating disorders in 1988; the Montreaux Clinic began its residential inpatient program in 1993. Millions have been introduced to Claude-Pierre's gentle yet positive approach to the treatment of anorexia and bulimia, thanks to her appearances on 20/20 (the first show on her work won a Peabody Award for excellance) and Oprah. She consults with health professionals and government representatives in North and South America, Western and Eastern Europe, as well as Japan, Australia, New Zealand, and South Africa. She has been nominated for the Kiwanis World Service Medal and the Institute of Noetic Sciences Altruism Award. She is currently working with the Montreaux staff to create a teaching clinic to offer professional training to others who wish to use the Montyreaux approach. She lives and works in Victoria, Canada.

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