I paid my child with avoidant restrictive food intake disorder, or ARFID to eat.
Why? He challenged me. He asked if he ate all of his lunch plus a grande Starbucks Frappuccino, would I pay him. Yes, I would.
While many professionals wouldn't agree with my approach, I believe this was a great opportunity for exposure work that he brought up himself. This was huge for him on so many levels, but here are the top three.
1. He has aversive and restrictive ARFID. He has fear and anxiety about vomiting and believes if he eats too much he will throw up. For many years, he continually restricted his intake. His anxiety kept telling him to eat less and less to avoid vomiting. So, for him to eat everything on his plate and a Frappuccino is a huge success. He pushed past his comfort level and dealt head-on with his anxiety.
2. We were at a restaurant. Eating at restaurants is another anxiety of his. This is a common anxiety for most people with ARFID. This can be due to a variety of reasons, such as not being able to find safe or familiar foods, feeling uncomfortable in an unfamiliar setting, or worrying about being judged by others for their restricted eating habits. These anxieties can lead to avoidance of restaurants altogether, which can limit social opportunities and lead to feelings of isolation.
3. I wanted him to prove to himself that he can do it. Anytime you push past anxiety, you are providing evidence that the anxious thought is not true. He will now be able to pull up this memory (evidence) when his anxiety is high. Remember, avoidance increases anxiety. The reverse is also true. Confronting fear decreases anxiety.
He did try to make this deal again at dinner and I told him no. I don't plan to make this a reoccurring event. Continually paying a child to eat is not an effective or sustainable approach to managing their ARFID in the long term. However, I will add it to my toolbox if we ever need to use it.
So, how did it go? He ate everything. He was proud of himself for pushing past his discomfort and achieving something that a year ago he thought was impossible. He was also happy he made $15.
Overall, a big success.
