The timing was terrible this morning. N wants to go camping tonight. It's also the last day in the term to turn in his math assignments (which are done, but just need to be recorded). I also added a generic version of "ensure" to N's shake this morning (of which he was aware). So, it all added up to another meltdown this morning. He spent an hour or more crying and refusing to go to school. I really think the extra calories in the shake were at the root of the issue. In the end, he changed his shirt to one that makes him look "skinny" and then he was fine. I'm sure that he was also motivated by the knowledge that there would be no camping if he didn't go to school.
N has been spending extra time after school catching up on his assignments. I like having him stay after because it serves as a natural consequence for being late -- and it increases his interaction with other students (who are still in class once he is done with school). I know that he didn't want to stay after today because he wanted to pack. But, again I felt like it was a good natural consequence (and he will still have plenty of time to pack). N really functions fine at school. He has neglected his studies and his grades have gone down. I'm not worried about either of those things. I am concerned, however, about his developing bad habits. And when he can, I think he should still be responsible as much as is reasonable. I know that some kids with anorexia can't handle school at all and need to be pulled out. I think, though, that he needs to be there. School truly serves as a distraction for him.
N and his Dad saw the therapist last night. I got the recap later on -- but there were some interesting comments. 1 - Dr. R. was surprised that we weren't getting simultaneous medical care from N's pediatrician. There have been 2 or 3 other things that Dr. R. had also taken for granted. I need to make sure I mention everything to him so this doesn't happen again. 2 - I was surprised that Dr. R. was not aware of the Maudsley Approach. I took him the summary from the http://www.maudsleyparents.org/whatismaudsley.html website. He browsed the article and said that it was credible research. For the most part, the Maudsley Approach is similar to the approach that Dr. R. advocates anyway. He said if it is working then keep doing it. 3 - He said it was okay for N to go camping (just overnight: dinner and breakfast). But he said it was important to get a medical evaluation today (especially since he hasn't been seeing his pediatrician regularly). So, we've made an appointment. His scout leader is aware of the anorexia. He'll have instructions to call us if N isn't eating (and we'll go get him). We won't make the scout leader responsible for making N eat. So, I'll pump N full of calories before and after. N has been good about eating away from home (but a little conservatively) so I really think this can work.