Oh, but I have bad news, too. Because in both cases the reason the topic came up was not a celebration but a backlash. These protests lodged against the orthodoxy of these ideas were a call for “balance” and “rational analysis.”
I must have missed the memos. I didn’t realize that Maudsley was in widespread use and now in danger of being so over-prescribed that the optimism is causing harm. I don’t live in a world where parents are routinely OR EVEN OFTEN being offered this alternative.
I definitely missed the inter-office edict that we all agree on calling eating disorders “brain disorders” and I fear many others have as well since plenty of people remain solidly ignorant of the idea not to mention its acceptance.
I asked a major brain guy, and then a major Maudsley guy, what they think of these developments. The brain guy was exasperatingly sanguine and patient with his colleagues: “It takes time.” The Maudsley guy was inexplicably amused and even pleased: “They’re right. People are taking it too far.”
I’m sorry gentlemen. I admire your minds, your clinical work, your research, and I like you personally more than I can say but I don’t think you are seeing how this stuff plays in the real world. I don’t think you realize how it affects advocates and families who aren’t fortunate enough to get care at your own clinics. As far as public health and policy and the broader discussion even in the field context matters: and the context at present is that the larger field doesn’t believe in or understand Maudsley and do not understand or act on the idea of a brain disorder.
It makes my job harder when the Ivory Tower discussions lose touch with real life consequences. Those conference sessions were held in the real world, where most people don’t start with the premise that Maudsley is assumed nor that brain disorder is understood. In the real world the take-home – and consequence to parents out there – is that Maudsley is now Old School and this brain science thing is hokum. There are a lot of people, institutions, and careers invested in rejecting these newer paradigms, and they are relieved and comforted by reasons to fall back on safer ideas. Those of us out here trying to get families to speak up to get choices in care and get families to take action on behalf of their children who are suffering from a brain problem and not a poor lifestyle choice need the field to be aware of the context of their words.