Keep loving. Keep going.

Eating disorder patients often suffer from a difficulty interpreting emotions - their own and those around them. Why? Is this an adaptive response to malnourishment - enabling certain individuals to leave the family group to seek nourishment? Is this a background trait in certain people that is ramped up by low nutrition? Is it permanent?

This we know: it helps with the "maintenance of the disorder" and cannot be dismissed as a choice to isolate or just a case of poor social skills. Parents facing an angry, resentful, frightened loved one need to know that this may be a symptom of the temporary brain state of the active eating disorder, not the real potential and personality of their loved one. Parents need to know not to give up or give in - with anger or argument - and to press for full recovery regardless of the present dysfunctional responses of their ill child.

I cannot tell you how many times I see a parent paralyzed with fear that their beloved child will hate them forever. I want them to know how often I see a family who pushes through that - and "keeps going" - and ends up with a loving child who often doesn't even remember those thoughts and words. Knowing this, a parent can summon the courage to be hated for a while, to cause temporary distress, to keep the long view.


  1. I want you to make a book out of your wonderful blog columns. But maybe books are just too old fashion now. Self-publish it?

  2. I just got off the phone with my recovered AN daughter, who signed off with a cheery, "Love you, Mom!"

    This same daughter loved me for 17 years, then hated me deeply for 15 months during refeeding and recovery. She was 'forced' to have a relationship with me in the same way she was 'forced' to eat--that is, she wasn't allowed to isolate herself from me. We were active in her emotional recovery just as we were active in her physical recovery, and I think that was key.

    It's terrifying to have your child hate you, but the thought of my daughter's life distorted by her ED perceptions, whether about food or about her mother, were unacceptable.

    She remembers hating me and the 'reward' she felt for hurting me. She described it recentlyas being the same kind of feeling that she got when she stepped on the scale while she was starving: rewarding and punishing at the same time. Rewarding--it felt so good to hurt me. Punishing--if she could have been meaner, could have done 'better'.

    It's anorexia, just in a different form.

    Any parents out there in this situation, take heart. My daughter is back and yours can be too. That hatred usually goes away with weight gain, but you can work actively with love to get your daughter back.

  3. In terms of the difficulty in interpreting one's own and others' emotions in AN: I think this can be state or trait, depending upon the individual. However, in those with trait difficulties in this domain, starvation makes the symptoms much worse.

    When I was a teen trapped in AN, the most important thing to me was that I engaged in my diet and exercise rituals, come what may. I simply HAD to do these rituals, so if anyone interfered with them I would behave in a way that seemed to express anger. However, the apparent anger I displayed wasn't driven by hatred whatsoever; it was driven by fear. I feared not doing my diet and exercise rituals, but I didn't know why. Also, the anger I seemed to display wasn't actually anger, but combined frustration and fear.

    I never hated my parents for trying to re-feed me in my teens. I actually felt guilty that I was upsetting them. I remember when I was 14 yrs old my mother crying when she saw me wearing very few clothes. She said "people will think I am an awful mother who neglects her child and doesn't feed her properly." That made me feel terrible, but I reacted with frustration and asked her to leave me alone.

    Ugh, I hate that I did that to her... She is a lovely person who has always wanted the best for me.

  4. Thank you, Anne! Thinking about it. Seems to be the way of the future.

    Colleen, you offer the very best example of the cruel emotional and cognitive symptoms of this mental illness. I can only imagine that countless parents were convinced to let go and accept those symptoms and lost that opportunity - we need to let parents know that this is NOT inevitable!

    Cathy, please please don't blame yourself or feel responsible for your mother's situation. You were all caught up in the same storm and not offered other opportunities. I hope you know that when I go on these rants trying to exhort parents to see things differently I am not in any way putting down those parents who did not! Your mother and you suffered because the illness wasn't as well understood.

  5. Thanks for the feedback Laura :) I didn't, in any way, feel that you were putting down anyone. I wanted to explain that, I, as someone who suffered from AN, didn't actually hate my mother for trying to help me. I don't think I have ever 'hated' anyone in my life - except myself at times. But hate is a strong word. I think frustration is more accurate.

    Sometimes the anorexic child cannot see why someone is trying to help them. Despite my apparent ToM difficulties I actually fully understood why my mother was upset and why she was trying to help me. I wasn't anosognosic. I could see I was ill, but I was frightened of changing. And because of fear I would react angrily. But there was no hate in me at all.

    So I guess that what I am trying to explain is that sometimes what looks like hate in a sick person with AN isn't hate at all; it's fear or frustration.

  6. Cathy,

    I completely agree. In fact I believe it is ALWAYS fear and frustration. All the other stuff that we attribute it to strikes me as window dressing to the real issue of overwhelming anxiety.

  7. Anxiety... definitely... YES! And, I totally agree with a lot of the 'window dressing', as you know!


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