At least once a week, a family member or friend will and I will have a discussion that goes something like this:
Family member: Surely L realises if she doesn’t eat, she will end up back as an inpatient?
Me: Erm, Yes, I guess so.
FM: Why doesn’t she get it, do you think she wants to go back? Is it scary being out, do you think?
Me: No, I think she loves being home. It’s just eating that’s a problem and how it makes her feel
FM: But she must know she has to eat? Does she really want to stay that thin?
Me: (Finally putting iPad down) The thing is, she doesn’t feel thin, she feels huge, fat and disgusting and eating just exaggerates that.
FM: (Horrified look of shock) No!!! Surely she doesn’t still feel like that.
Me: yep, she does. She told me so herself an hour ago, while she was crying after I made her have unsliced bread as toast.
FM: But that’s crazy..
Me: Well, actually, that’s kind of why it’s called a mental illness…
FM: Would it help if we got her some professional photos done?
Me: No, she’d just obsess about all her fat areas
FM: What fat areas????!!!
Me: Her legs, her stomach, her face – according to her.
I pick up the iPad again to break the puzzled silence. I’m not sure why the others don’t get it yet. Wondering why L doesn’t see how thin she is, or where resisting treatment will lead, is like plucking a peasant farmer out of the depths of South East Asia and wondering why on earth he doesn’t understand English. Because, at present, L cannot see how thin she is and she finds it impossible to comprehend how irrational her behaviour is. As she weeps because this morning I made her bran flakes with banana and raisins rather than allowing juice, there is no point me telling her how few calories there are or the fact that this is really not enough for any significant weight gain. Her anorexic brain cannot comprehend that information. All I can do is hold her, all the time feeling her tense resistance as I coax in every tiny mouthful. When the crying carries on after breakfast, I can hold her again, but my words that it will get better one day are meaningless to her. To be honest, they are pretty meaningless to me. Because one day has no real meaning except what it doesn’t mean. It doesn’t mean ‘Now’. It doesn’t mean ‘soon’. It means an indeterminate time in the future. It is the “We’ll see” of the vocabulary of time.
I long for us to speak the same language again. I am tired of the shutters coming down as soon as food is discussed. Even more, I am worn with the effort of being her interpreter to the outside world. No, she doesn’t realise how seriously ill she is, I want to say, but she has an excuse. Why don’t you realise? But I know too, how difficult it is. And how hurtful to L, potentially, because the puzzlement is a short stop away from disbelief, from a view that she just needs to pull herself together. If we want to help someone with an eating disorder, we all need to learn to speak ED language first.