mistakes along the way.
“I just wanted to be normal,” Kitty told me on her first day home. “I didn’t want to have to think about food or anorexia. I just wanted to live like a regular person and not always be worrying about how much I was eating.”
I could understand her longing to leave anorexia behind, to not worry about it, to be “normal.” I told her if she had diabetes, she’d have to test her blood sugar every day; at first it would be a pain, but she’d get used to it. It would become just one of the things she had to do, like brushing her teeth. It would become part of “normal” for her. Nearly all of us have some aspect of our lives that we have to track like this.
One of the worst moments this time around came when Kitty confessed that three years earlier, she’d sewed weights into a bra, and wore it every time we weighed her. That’s why she needed to know ahead of time before a trip to Dr. Beth’s. Jamie was right about the weigh-ins all along.
I didn’t even know she could sew.
She said she’d sewed five or six pounds of weights into the bra, which meant she was never even close to the target weight we set. Which explained why she so often seemed too close to the edge. And, maybe, how she lost so much weight so fast.
It was harder, this time around, to separate Kitty from the illness, harder to tell the demon’s voice from her own. Kitty was eighteen, not fourteen, more sophisticated, more grown-up, both more and less aware of the fact that she was ill, of the distortions the illness imposed on her thoughts and actions. Last time, I’d worried that going through the refeeding process would damage our relationship irrevocably. It didn’t, a fact I knew only from overhearing Kitty tell the mother of another girl with anorexia, “You need to do what my parents did. They saved my life.”
This time around, she was stronger and more resourceful; so was the illness. This time even more than the last, Jamie and I had to block our ears to the demon’s imprecations, stay calm, and keep feeding our daughter. I thought of Ulysses tied to the mast so he couldn’t change course, seduced by the song of the Sirens. The metaphor seemed apt, only instead of Sirens we heard the voice of the illness: I could recover much better somewhere else. You’re making it harder, not easier. I can take care of this myself; give me another chance! We considered sending Kitty to some kind of residential program. Cost was an obstacle, but even more than money was the knowledge that what she really needed was food and the patient scrutiny of people who loved her. Who knew her better than anyone else. Who weren’t fooled, or at least not as often, by the demon’s tricks and manipulations.
Many parents of teens with anorexia—especially older teens—are accused at some point of hanging on to the disease too long. Of not wanting to let go of their adolescent. Of missing the feeling of being needed, or the attention they got from doctors, or…fill in the blank. In my experience, this is rarely if ever true. Everything I know about eating disorders—that they’re anosognosic, ego-syntonic, that they cloud the mind and alter the body’s chemistry—is still true now that Kitty’s over eighteen. The essential nature of the illness doesn’t change once your child crosses the magical age line.
This is a big part of what makes family-based treatment more challenging for families with older teenagers. We’re more vulnerable to the criticism of being overly controlling, because eighteen-year-olds in this culture are supposed to go off, be independent, take care (more or less) of themselves. FBT goes against the cultural grain even more for an eighteen-year-old than it does for a twelve-or fourteen-year-old.
And yet I’ve come to learn, through hard experience, that people with eating disorders as well as other mental disorders aren’t always (or even usually) best suited to make choices about their recoveries or lives. I know this is a statement that will make some sufferers angry; they’ll say, as Kitty said to me, that I’m not respecting them. That I’m pooh-poohing their feelings, sweeping them all into the box labeled eating disorders. That’s not my intention at all.
In December 2007, the NYU Study Center caused a firestorm of protest with a public awareness campaign about childhood psychiatric