Status of Women Committee on March 3rd, 2014

[Patricia Lemoine]

I think it should be included, because I think it really starts with you and what you can do to take control of your life and ensure that the disease doesn't control you. It's an internal dialogue. I have to tell myself very often, "No, Patricia, don't go there and don't think negatively.” You have to tell yourself that you have to continue, that you're on the right path.

Being able to have a dialogue with people online about that is very empowering. I have people who reach out to me and ask me what I do when I'm having a rough day. I tell myself that I thought I was having a rough day, but clearly that person is having a worse day than I am, and maybe I can help them. It's about walking people through things that have helped me. Sometimes they seem very benign for others, but that actually can really change your life in the moment, because it's all about moment by moment.

[Joan Crockatt, Conservative, Calgary Centre, AB]

The other thing I wanted to lock in is on the discussion that we've had about the connection—and I don't know if it's causative or correlative—between sexual abuse and eating disorders. Dr. Woodside, who we heard from very early on, said that 60% of his patients had been sexually abused. We also recently heard from Bonnie Brayton, who said that violence against women and girls is a cause of eating disorders.

Mrs. Stevenson, you talked about finding out belatedly that your daughter was the victim of sexual abuse. Now that you have some hindsight, and I imagine you in particular.... I'm going to address this to you and then to Valerie if I have time. Can you talk about whether you believe that it's a very strong causative? Should we be putting in best practices and putting teams together to deal with sexual abuse as well? Or is this a separate issue?

[Elaine Stevenson]

I think we need to have specialized teams who can work on the eating disorder, number one, but also on other concurrent illnesses and the issue of sexual abuse. That did not happen in Alyssa's case, although we told the doctors and the clinicians very early on that we strongly suspected sexual abuse but we had no details whatsoever.

Yet there was a program in the city that just dealt specifically with sexual abuse, and I think therein lies the problem: we need to have programming teams who can deal with the eating disorder, with the sexual abuse, and with the obsessive-compulsive disorder. You can't expect the family and the person who's suffering to go to one place for the sexual abuse, one place for the drug addiction, one place.... It's just not feasible and, in my opinion, it doesn't work.

[Joan Crockatt, Conservative, Calgary Centre, AB]

Can I ask Laura, Chair? I notice that she's nodding, and she hasn't really been asked.

[The Chair, NDP, Hélène LeBlanc]

Maybe somebody could ask the question.

Thank you very much.

Ms. Sellah, you have five minutes.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Thank you, Madam Chair.

First, I would like to thank the people who are with us, as well as those who are appearing via videoconference. Their statements are shedding light on the issue of eating disorders.

In fact, from the start of our study on eating disorders, we knew that this was a fairly complex problem. It is a biological and behavioural disorder. There should be a multidisciplinary team to work on this issue and to then work on a course of treatment.

My question is for Ms. Laura Beattie.

You said that you treated your daughter at home by way of a family therapy. I would like to know why you chose to look after her at home. Is it because it was so hard to find treatment within a specialized program? Did you deal with other obstacles which led you to look after your daughter at home?

[Laura Beattie]

Well, when I first went to the doctor he didn't know what to do. He wasn't aware of the family-based treatment that was offered in our city, and I couldn't just sit there and watch her die. I found the information online, and I realized that this happens all over the world and families don't have the access to treatment.

Family-based treatment is endorsed by the Canadian Paediatric Society, and it is the first-line treatment for adolescents, and they are using it in young children and they're starting to use it in young adults as well.

I didn't know. I had called the eating disorders clinic, but it was an intake worker who wasn't aware of the difference in adults versus children and adolescents. It was very new at the time; the treatment was only months old. So I started using it myself, and in the meantime I had to wait for a pediatric referral and an adolescent psychologist's referral. I really didn't know what to do and I knew I had to do something.

We're really trying to treat our children at home, because if you're in the treatment centre or your child's in a hospital, you have to bring them home anyway. You have to do all this anyway. It might not be as acute, it might not be as horrific as mine was, although this is a very common scenario. You still have to bring them home, and that's when children and teens relapse, when they're brought home from a treatment centre and parents don't know what to do.

I found a forum online, and there were parents doing this at home. You're basically making an in-patient clinic in your house; that's how you treat them. You put parents in charge.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Thank you for your explanations.

[Laura Beattie]

This type of treatment is where you want the parents in charge, you want to empower the parents, that's what it is.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Indeed, the patient or her family need some kind of structure. In that case, you provided it.

I heard you talk about the Maudsley family therapy. Did this therapy help your daughter get better? If so, can you tell us what this therapy is based on?

[Laura Beattie]

Sure, the Maudsley method. Maudsley is a hospital in London and this is where it started. The clinician saw that people with eating disorders would go home and relapse. They would be feeding them in the clinic, the hospital, and then they would relapse when they got home.

So they developed this family-based treatment, where they would empower the parents. It's in three stages.

Stage one is where the parents take charge of re-feeding their child, and I described it to you, I wanted to show you how difficult it was. Now, these are very set stages, three stages, they sort of blur into one another as you're doing it because it really depends on the age of the child.

Stage two happens when the child is almost weight-restored; you can see a significant difference in their sociability, in eating patterns. It's like your child has returned to you, and you're slowly giving them back the control and responsibility, and it has to be age-appropriate. What you do with a 15-year-old or a 16-year-old is going to be totally different from what you do with a 10-year-old, because most parents are in charge of their 10-year-old's food, whereas at 16 or 17, they have a lot more freedom. So you're working towards the freedoms and the responsibilities that are age-appropriate. If you have a 10-year-old, it's going to take an awful lot longer than it will with a 16-year-old or a 17-year-old.

Then you go into stage three, and that is when your family's returning back to normal, the therapist is working more with the parents and trying to get them back into what is considered a normal family dynamic. You don't talk about what caused the eating disorder; it's agnostic to what caused the eating disorder. Old-style therapy was “Let's delve into it. Let's find out what's wrong with your family.” FBT is totally agnostic: for some reason your child has an eating disorder, you move forward, and the therapist helps to empower the parents to help them get their child back on track. The problem is, the therapist can't tell you how to do it.

[The Chair, NDP, Hélène LeBlanc]

Thank you very much.

Mr. Young, you have five minutes.

[Terence Young, Conservative, Oakville, ON]

Thank you, Chair.

Thank you, everyone, for spending your time with us today.

I would like to start with Valerie Steeves.

I was very, very interested in your comments on the eGirls Project and what the girls were telling you about how they feel about themselves from sites on the Internet. We've heard the term “pro-anorexia sites” today, and we know there are sites where people actually encourage others to commit suicide.

Would you describe sites like Facebook and other social sites as dangerous for children and girls?

[Dr. Valerie Steeves]

What we found is that the architecture of the site privileges visuality or visualness, which emphasizes the pressure on girls to look a particular way.

So like I said, when we originally started this project we assumed that online spaces would be a place where it would be easier for girls to challenge underlying discriminatory patterns and tropes. And yet we found that these kinds of online spaces, like social media in particular, increase the importance of your visual look and you alienate yourself from your body and begin to manage the image of yourself and judge the image of yourself. And you know that part of the game is that other people are judging you.

[Terence Young, Conservative, Oakville, ON]

Does that create a precondition for an eating disorder?

[Dr. Valerie Steeves]

We're talking about a continuum of behaviour and a continuum of environmental factors. I go back to the testimony you've heard about the voice in my head—

[Terence Young, Conservative, Oakville, ON]

Let me ask you, would you recommend that parents encourage children to use those sites? Or would you issue parents a caution?

[Dr. Valerie Steeves]

I issue caution. Again, it's an age question.

I do a lot of research on kids between grades 4 and 11 and we're finding that a large proportion of grade 4 kids have cellphones, for example, and text. A lot of kids have Facebook accounts, even though technically they're not allowed to because they're under 13 years old. There are good reasons to be very cautious about encouraging kids to embrace that kind of social media because it does give these kinds of messages a direct path into the child's social environment.

So yes, personally I think there is a caution there.

[Terence Young, Conservative, Oakville, ON]

Thank you very much.

Patricia, I want to thank you for coming here today. And I want to thank you for your courage and giving up your privacy in working to help others who suffer from bulimia and anorexia.

When you first knew you suffered from an identified disease, a disease that could be diagnosed, what roadblocks did you have to getting care? Do you know if those roadblocks are still present today in Canada?

[Patricia Lemoine]

The initial roadblock for me was the fact that after those sessions that I was allowed, I would have had to pay $125 to get therapy. So that was a big roadblock because I had just graduated and it was really expensive. I would say that it was the financial burden. Not only was this ruining my life, but this was also ruining my finances.

At the time I was engaged; I had to talk to my fiancé about it. He was obviously instrumental in my recovery. But those roadblocks are still there from what I know.

[Terence Young, Conservative, Oakville, ON]

I wanted to ask you a couple more questions.

You mentioned you had taken the antidepressant Zoloft as part of your treatment. Was it Zoloft or Effexor?

[Patricia Lemoine]

It was Effexor XR.

[Terence Young, Conservative, Oakville, ON]

We know that they cause a lot of adverse effects.

Would you feel comfortable talking about the adverse effects that Effexor caused you?

[Patricia Lemoine]

For me the worst were the nightmares. The vivid nightmares that I had caused so much anxiety when I would wake up feeling very thirsty.

Another problem I had was that I suffered from migraines. Effexor XR should not be taken when you take Maxalt, which is something I take for migraines. And my doctor didn't tell me. So I actually had to go to the hospital when I almost fainted from the mix.

[Terence Young, Conservative, Oakville, ON]

Did you have the impression that Effexor caused anxiety or agitation?