Caring for an Anorectic – Trying to keep up

At the end of the nineteenth and start of the twentieth century anorexia nervosa was rarely diagnosed which does not necessarily mean that the incidence of the disease was nigh nonexistent. The dress code of that era determined that women wore dresses covering the body from the neck to below the ankle thus hiding many flaws in their anatomy. By the end of the century the diagnosis of this disorder had reached an alarming 0.1% of the population of industrialized countries. Studies have shown that only 2 to 3 out of 10 patients with anorexia nervosa recover completely. A further 1 to 2 out if 10 will die from the disorder, which makes Anorexia Nervosa the Psychiatric disorder with the highest mortality rate. Although much research (DSM lV, Diagnostic and Statistical Manual of Mental Disorders) was done during last century no definite consensus was reached regarding the critical diagnostic criteria for Anorexia Nervosa. A draft proposal for updated criteria for the diagnosis of Eating Disorders has recently been published for revision and it is hoped that a final publication (DSM-V) will be released in 2013.

2007 Just before the onset 12 months starvation

When I realized that Mouse could not process compliments and always interpreted them as being fat, I would cringe whenever anybody said something good to her. It used to stress me and I would try to avoid any situation where she would be subjected to any positive remarks about her appearance. Realistically, many who do not know what an anorectic going through, mentally, who do not speak their disorder language will unintentionally set off a trigger. It is very hard for Mouse to accept that these "triggers" are a reminder that her perception of her own body is totally different from what everyone else sees. Intellectually Mouse understands that but the Anorexia will not allow her to accept it.

Fortunately I soon realized that my role here was not to heal her but to support her when she spiraled out of control and allowed Monique to take over her life. She needs to know that she can talk to me without being judged. A desire to succeed and be perfect is what drives anorexia. There are times when I cannot deal with it and get very frustrated at the thought that Anorexia is bigger than I. Although I try not to show her my disappointment, frustration and pain, I know that I sometimes fail. Mouse cannot deal with me showing signs of weakness and it leaves an opening for Monique to take charge. After dealing with Monique's abuse, bad mouth and uncontrolled anger, it takes a day or two for Mouse to resurface and take control of her life again. These episodes of Monique have, over the past few years become fewer and shorter. She is managing to suppress Monique much quicker. Unfortunately it does not mean that she has overcome her fear of eating and gaining weight, a constant battle when she wants to be healthy but she doesn't know how. When others compliment her, I try to rephrase their comments for her to see that, looking healthier, does not mean looking fatter. It is very difficult to convince her that many thoughtless remarks are the truth and sometimes she needs to walk away and cry if she needs to but she must not be consumed by the comments.