Two weeks into inpatient treatment and things are not going well. L frequently does not complete meals and her weight starts to drop. She is passive and quiet and often tearful. I know that she doesn’t want to be an inpatient and I feel frustrated that the unit staff repeat the mantra that she has to want to get better. When you have an illness of the mind, that affects every emotion and distorts every thought you have, how can you be expected to want to get better? L wants to have a life that isn’t about anorexia, but seemingly not enough to do the actual work of eating or restoring her weight. She tells me she is huge compared to the other inpatients, who also refuse to eat and I can sympathise with how hard it must be to eat while someone pushes food around a plate.
Over a week passes and I have still not heard from her case co-ordinator. I have no idea what their approach is and whether there is any scope for amending or flexing their approach. For example, could they change their regime to insist that she has a Fortisip after a non-completed meal? Would they give her more time than the allotted thirty minutes. The answer is No, each time, and at the end of last week, I lose patience. I tell the staff I will take her out for a few hours on Saturday,leading to a heated exchange where I tell them that at least she will be made to eat. When I tell L that I will take her home for a while, her face falls and she tells me she can’t get into conflict with the unit staff. This makes me cry, but I hope that it is a turning point and she will realise she needs to eat to move forward.
But it doesn’t happen. Today,I have a call from the unit to say they agree; this isn’t working. She isn’t making progress. We are due to meet tomorrow, so I don’t know whether this means they may discharge her, change their regime or send her to the ‘hardcore’ unit, ninety miles away. K and I go to see her and I try to talk to her about it. I want to make it absolutely clear she has no exit route from recovery, that restoring her weight is essential. I have written down rules to govern what her life would be like if she came home, to make clear that my regime would be tougher. She tells me I can’t enforce this as I am at work. I tell her of my GP’s continued urging to take some time off in order to find a way of getting better myself and to help L recover in order to move forward. She starts to get angry and tells me she doesn’t want home to be a treatment unit, that she can do this herself. All my instincts are to back down and soothe but I stand firm and state this is non-negotiable and a condition of returning. Her only other alternative is to live with her father. Bitterly, she says that she will, that I don’t want to spend time with her anyway, I just want to feed her. I hear Ed turning her voice to a hostile tone, sneering and angry. She accuses me of making her life a prison, of the unit being a prison and wanting to run away. Trying to stay calm, but aware I am talking to Ed, my voice is raised (K tells me later, “It was ranting, but good ranting”) and I tell her that the prison is anorexia, and we all live in it, but her most of all. Does she think I want to be writing rules for my 16 year old daughter? Does she imagine for a second that this is the life I wanted? I expected to have more freedom at this point in my life, to be able to possibly, just maybe, go out for an evening. Do I enjoy waking up at 2.30 am crying at the loss of my daughter? I am angry but at Ed, not L. He has imprisoned all of us and whether in hospital at home, on holiday or on the top of a mountain, he will be there, twisting L’s every thought, mocking our attempts to win her back and whispering in her ear. It is a prison without parole, portable enough to accompany her wherever she goes. Sometimes, trying to beat anorexia feels like trying to tunnel through concrete with a plastic spoon, impossible and hopeless.