until now how much I’ve missed this side of Kitty, the part of her that’s so good at reaching beyond the borders of her self.
Later, she sits on the floor with Emma and inspects each piece of candy with her, turning it over in her hand, setting it neatly into its appointed spot. She’s tender with Emma, and attentive. The two girls lean their heads together—one blond and curly, one dark and straight. Kitty pulls her curls up into a ponytail and whispers in her sister’s ear. Emma bursts out laughing, her face open and vulnerable. Despite everything that’s happened, she trusts her sister, a fact that astonishes and humbles me.
That night, tucked into bed, Emma says, “I like my hair, my body, and my feet.”
“Good,” I say. “Because you’re perfect just the way you are.”
“But what if I had feetalimia?” she continues. “What if I thought my feet were too fat, and I cut off all the circulation to them, on purpose?”
I look at her in the light from the hallway. Eyeliner smudges each cheek, like the dark half-circles football players draw under their eyes. I worry about Emma, who doesn’t say nearly as much as she feels.
“What if you did?” I say. “What do you think?”
She slides one leg out from under her blue-and-green biscuit quilt and considers it, turning it this way and that, looking at her pale toes, the slight swell of her calf muscle. Finally she says, “I think that would be ridiculous.”
“Me, too,” I say. I tuck her leg back under the quilt, smooth the fabric under her chin, kiss the spot on her forehead where her hairline dips into a heart shape. Emma has always had this knack of holding a mirror up to reality, showing us her own quirky, frank take on whatever’s going on. She’s only ten, an age when children are still literal thinkers and trauma can overwhelm their psyches. Plus, I haven’t forgotten that Emma’s more vulnerable to developing an eating disorder herself. So I’m not just amused by her analogy; I’m relieved. She gets it, and maybe that will keep her safe on both fronts.
Of course, I thought Kitty would be safe because she’d written a research paper on eating disorders, because she knew so much about them. Now I wonder if knowing can actually trigger anorexia in kids who are susceptible.
Keep Emma safe, I think—to myself, to the universe, to anyone who’s listening.
From the beginning of this refeeding process, Jamie and I have been watching Kitty, day and night. We watch every bite she puts in her mouth and every bite she doesn’t. We watch her in the bathroom after meals—that is, we require that the door be partly open if she uses the bathroom, and one of us hovers nearby, listening. We watch to make sure she eats, she drinks, she doesn’t hurt herself. We check on her to make sure she’s not exercising at 2:00 A.M. We watch because we’ve learned the hard way that the demon will exploit any moment of inattention or trust, like that day in the park when Kitty tried to throw away part of her protein bar. I’d guess there have been other moments we’ve missed.
On the whole, Kitty accepts our watching. On some level she seems to realize she’s not capable of making good decisions, at least when it comes to food and eating. On some level, she still trusts us. Not just trusts us but relies on us to keep her safe.
One of the biggest criticisms of the Maudsley approach is that no teenager would willingly give up so much autonomy (or should be asked to), especially to her parents. And if you believe that anorexia is a choice, the last resort of a growing child who’s been denied self-determination, then I can see how the refeeding process might seem like a further violation of a child’s independence.
But I think this perspective fundamentally misunderstands the nature of anorexia. When I observe Kitty at the table I don’t see a child who’s expressing herself, who’s exerting control over her environment. I see a child who’s the prisoner of compulsions she doesn’t understand—that no one understands—and that she can’t control. I see a terrified hostage yearning for rescue. And there’s no cavalry on the way. Only us.
If I need persuading (which I don’t), the gradual shift that starts at the end of October—about three months into refeeding—convinces me we’re on the right track. As eating has become easier for Kitty,