The Review

I made it to the review meeting, after another day spent in bed with flu and the accompanying self pity. L told me the night before she was terrified of the review, she is worried about the big changes coming up, becoming a day patient, going back to school one day a week and taking more responsibility. The review always starts with introductions, even though we all know each other. We then begin with weight. That morning, L weighed 54kg, a BMI of 18.5. A new number in kilograms, but most of all, a BMI that is In The Healthy Zone. My heart leaps, but I look at L. Her eyes are downcast, as if she knows how pleased we all are, but can’t share the joy. We then talk about how things are, and I share the thoughts I wrote about in my last post. If anorexic minds could be measured in BMIs, L’s would be about 14. Her body is getting better, but her mind belongs to Ed. I talk about the challenges she faces, the Advent Calendar chocolates, the restriction at every level, the overwhelming control and resistance to change. Her case co-ordinator shares her thoughts too, based on her conversations with L. I then learn that she has made herself sick in the last two weekends, that she is worried about getting better, because she has loved the special time we have spent together and thinks she will lose this once well.

Mothers reading this will know how my brain translates this. It is filtered through the blameworm in my brain and comes out as this: Your daughter has anorexia because you didn’t spend enough time with her. You were always too busy with work and she didn’t feel loved. She starved herself to get your attentions and that makes you a bad mother. I feel this, but know enough now to reject it. Actually I did spend enough time with my daughter, but would have had more time if other members of the family also took some responsibility for helping in the house. I have also spent the most time with L, as J is away and K lives in the batcave that is her bedroom, from where she oversees her Potter/Sherlock/Whovian fan girl blog empire, emerging occasionally for tea or to question us intensively about politics or history.

Going back to L and the attention issue, I figure this is more like Ed whispering to her that if she gets better she won’t be ‘special’ any more, she won’t be loved any more. But the news that she has made herself sick at home fills me with horror. When I ask about when it was, it turns out it was when I went to work, leaving her with C. I do feel guilty about that, but also hopeless. I have a job I need to do and as much as I would love to be able to give it up or work part time, it just isn’t financially possible.

Then, the future. The unit want L to move to the day patient programme. She will spend her last night at the unit next week, Christmas at home the week after and the day programme will begin the following week. She will start on extended days, having more meals at the unit, but will move to just having lunch at the unit. We will have a meeting with the school at which the issue of a phased return will be discussed. She will spend Mondays there as the day programme runs Tuesday to Friday.

I ask about the 3 meal/4 snack routine. I want to tear up the snack list and have different things. I suggest that if I make crumble for pudding, that will negate the need for a snack later. L reacts with alarm. She tells us that she can’t eat crumble if she is now in The Healthy Zone. She claims ignorance of the 58kg target set for her some months ago. This is a new departure. L’s approach to reviews and meetings is to nod, smile and agree. She is openly challenging. While this is good, it is also a new departure for Ed. He normally hides inside her, telling her to keep quiet, to just say yes and to resist quietly and carefully, not to provoke confrontation. Perhaps he knows we really mean this. We don’t want L to live with anorexia. We are not looking for a negotiated settlement. We want victory over Ed. We want Ed driven out of her life for good and just being inside the healthy zone of weight is not enough. We want her periods back, so she can have children in the future, which I know she wants. We want her stronger and fitter than she was before so she can resist Ed’s guerilla tactics of trying to jump back into her life when we are not watching.

Later, at home, L is so troubled. She doesn’t want to gain any more weight. She refutes that this is anorexia speaking. I hug her and tell her that I can’t agree, that we have troubled times ahead when I know she will fight me and it will be hard. I say to her that when she fights me, I will know that she still loves me and when I fight back, I will still love her. I have enough gallows humour left to think, It’s Christmas, your doctor and I know you need to put on another half a stone, what’s not to love about that? But I don’t say it. Christmas. And Anorexia. Bring it on.

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