The secret language of force-feeding

Peggy Claude-Pierre has treated the most severe anorexics in the world. Now she faces allegations of incompetence and brutality.

ALL IS quiet behind the wooden doors of the Montreux Counseling Center in Victoria, a small sleepy city on Canada's westernmost shore. Few people come and go. There is no sound from windows open to relieve the early summer heat. There is no hint of the controversy swirling around the centre: the site of either regular miracles, or of a potentially fatal scam, depending on who you believe.

Montreux is the clinic founded by Peggy Claude-Pierre in 1993 to treat eating disorders. For the past three weeks, a licensing hearing by the province of British Columbia has laid open the debate that has simmered about the clinic for years, as its success with anorexics and bulimics has spread. The hearing follows reports from former staff members, who complained to health authorities about practices including force-feeding and forcible confinement. This is in sharp contrast to the therapy the charismatic Ms Claude-Pierre says she practises, such as "bathing my girls in unconditional love". An 11-month investigation led to 28 charges under the Community Care Facility Act.

Five former staffers and two medical experts on eating disorders have testified that the clinic has failed to meet minimum standards for health and safety, that no trained medical professionals are on the full-time staff, that six critically ill patients who should have been hospitalised were kept there. Every day, the hearing has been packed with dozens of Ms Claude-Pierre's supporters, who hiss "Lies!" at former staff members, and cheer or weep when patients tell their stories.

Ms Claude-Pierre began counselling those with eating disorders in 1988, after "saving" her two then-teenaged daughters from anorexia. She opened the clinic in 1993. She disputes the conventional wisdom that eating disorders have their root in obsessions with body image or suppressed sexual or physical abuse, and instead coined the term "confirmed negativity condition" (CNC). This, she wrote in her book The Secret Language of Eating Disorders, is present in some children from birth and means they do not feel they are worthy of anything good, including the food that keeps them alive. The solution, she says, is to love them, and remove from them all responsibility for eating.

The clinic charges up to $9,000 (pounds 3,860) a week and treatment can last 18 months. Ms Claude-Pierre has claimed a 100 per cent success rate, although she refuses to participate in follow-up studies. She has also said that Diana, Princess of Wales summoned her to London to discuss her problems with bulimia. After Ms Claude-Pierre was featured ontelevision programmes such as 20/20 and The Oprah Winfrey Show, dozens of American and European families made the trek to Montreux, bringing emaciated children who had failed to get better at conventional clinics and hospitals.

Anorexia has a devastating mortality rate. One and a half per cent of the population has full-blown eating disorders, and of 100 people suffering from anorexia today, one in five will die within 20 years. Dozens of patients have come from the UK, including Samantha Kendall, one of a pair of twins from Birmingham afflicted with anorexia. She died at home in 1998, after a stint at Montreux that was supposed to have healed her. Another young British woman to seek help is Diana Van Maasdijk, who took the stand to testify in rapturous praise of her earlier this week.

Ms Van Maasdijk, 23, said she arrived at Montreux last July, after battling anorexia and bulimia for eight years. She said she was suicidal and vastly bloated, had been through 11 English treatment centres, and her anguished parents had disowned her. Through unconditional love, she said, she is now completely healed, living happily in Victoria, thinking about emigrating there and starting a business, and fully reconnected with her family.

"Most doctors," she said, "had said `we can't help you'. Peggy said: `Your parents are not to blame, I love your parents, and I can understand the voices in your head, I can get you better and I WILL get you better.' I just fell into her arms." Ms Claude-Pierre was like a "mommy figure" to her.

Today, 11 months later, Ms Van Maasdijk is an avid skier and in-line skater, who says she does not even know how much she weighs because she can't be fussed to look at scales. She is effervescent and cheery, almost manically so. Indeed, talking to her highlights the Montreux dilemma. She says she is completely recovered: "It really is over for me." And yet her "best friends" are a former careworker and a counsellor from the clinic. Her boyfriendis a careworker, driver and "security man" at the clinic.

"Except for food and weight, it's all behind me," she chirps - a fairly significant exception. When that is pointed out, she backtracks hastily into Montreux-speak. "Every negative can be turned into a positive."

The strangest moment in the hearing to date was the testimony of Margaret Bruce, who brought her three-year-old son Bruce to the clinic from New York in 1996, after she saw Ms Claude-Pierre on television. She told how Ms Claude-Pierre diagnosed him with CNC and symptomatic anorexia, lovingly hand-fed him, and treated him for more than a year, after dozens of doctors had been unable to do anything; Bruce, she said, would eat only cold cereal from the age of one. Today he is a robust six-year-old.

Health officials charge that the child was separated from his parents for months at a time; force-fed (with a spoon shoved into his mouth until it bled or he vomited), sometimes in Ms Claude-Pierre's presence; verbally abused and treated "as an experiment"; and that the clinic lied about his treatment during the initial investigation in 1997, changing its story after its own records showed force-feeding. Outside the hearing, medical experts have said it is impossible to diagnose anorexia in a toddler.

Ms Claude-Pierre declined to be interviewed for this article. She has not been present at the hearing. Her husband and Montreux co-owner, who has attended all of it along with her two daughters, says this is out of a desire not to corrupt the integrity of the hearing process; her lawyers say she is just waiting until she testifies. However, former clinic workers have said she loses control whenever she is challenged in any way, and that her legal team saw the danger in having her present in court as her critics testified. Her defenders say Ms Claude-Pierre has done nothing more than challenge a medical system that is resentful of her success.

There are no criminal charges against the clinic. It is still treating two patients, but has been prohibited from taking any new ones until the hearing is over. It has been adjourned until 5 July and, when the hearing resumes, Ms Claude-Pierre will take the stand. So will 40 more of those who say they owe their life to her; there is no precedent for that kind of argument in Canada's courts.