Overcoming Anorexia
Peggy Claude-Pierre's controversial eating-disorder cure
In one-on-one counseling sessions, patients concentrate not on how they got sick--little attention is paid to early childhood, for instance--but on practical strategies for getting well. They keep journals with two columns on each page: one for recording the self-hating voice of anorexia or bulimia, the other for the voice that argues against the negative thoughts. After months of this "objectivity training," patients learn to distinguish the "negative mind" from the self and to put things in perspective. "Hospitals put weight on me but they never did anything about the voice in my head," says Mary Kavanaugh, 25, who's been at Montreux just over a year. Before she entered the program, Kavanaugh not only starved herself but exercised compulsively. After her parents took away her sneakers and locked up her bike, she tried sit-ups--so many she wore away the skin covering her tailbone. She was hospitalized more than 10 times over the years but each time quickly shed the weight she'd gained after being discharged. "My parents were frantic and I didn't feel anything," says Kavanaugh. "Now it's like I've been reincarnated in my own lifetime."
No hard numbers. Montreux, which costs roughly $1,000 a day (a fee comparable to that of many private hospitals) and is covered by some insurance plans, is full of stories like Kavanaugh's. The walls are lined with pictures of former patients. What's impossible to know, however, is how long these patients stay well after they leave the clinic's atmosphere of unconditional support. Claude-Pierre claims that Montreux has a nearly 100 percent recovery rate for patients who complete the program. (Not all do.) But there are no scientific studies to support her claims; no independent outcome evaluations to determine which patients responded best to which treatments or how long a patient remained well--mentally and physically--after treatment. Most eating-disorder experts agree that a patient is only cured after spending at least five years at normal weight and free from compulsive thoughts and behaviors. "By saying she can cure any patient with anorexia, Peggy Claude-Pierre, by definition, delegitimizes what she does," says Dr. Allan Kaplan, director of the Toronto Hospital's eating-disorders program, who has treated former Montreux patients. "In the best hands, you will still have people who just do not get better."
Critics find other aspects of the Montreux program troubling as well. Claude-Pierre holds no advanced degree. Few, if any, of the clinic's more than 100 counselors and care workers (they include Claude-Pierre's two daughters) have any outside training as therapists. Many counselors are former patients and all received their training in-house at Montreux. Some patients complain that the clinic's counselors lack professionalism and that the atmosphere can seem almost cultlike. "There is no such thing as confidentiality at Montreux," says one former patient, citing instances when other patients were discussed during her private therapy sessions. Others at Montreux complain that the clinic's emphasis on positive thinking is sometimes used against them. "Any problems you may have with the clinic are dismissed as the workings of your negative mind," says one patient. Confronted with complaints about Montreux, Claude-Pierre responds that victims of eating disorders can be irrational and tend to distort reality.
Yet whatever Montreux's shortcomings, they matter little to those who have put their trust in Claude-Pierre. "We have our daughter because of Peggy," says Carol Iantorno of San Francisco, close to tears as she describes her 23-year-old daughter Erica's past 12 years: hospitalized 50 times, weight down to 44 pounds, so lacking in muscle mass that she had to crawl, her family torn apart emotionally and nearly ruined financially. Erica has been at Montreux for eight months and is progressing. She is still afraid of dessert, and she calls ahead to the hairdresser to make sure the full-length mirror is mostly covered when she gets there. But she has moved "off care"--she lives and gets counseling at Montreux but can come and go freely. She takes voice lessons, attends classes, and often eats in restaurants. "Erica's being alive now is an absolute miracle," says Iantorno. Erica, who is writing a book about her battle with eating disorders, sees things a slightly different way. "It's over," she says. "I will never be that tiny person in the hospital bed again."
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