Two weeks ago as Portland's record temperatures were ascending into the relentless 90s, I was in the mall shopping for sweatpants. Sweatpants are the daily dress code for the partial hospitalization program we enlisted to provide comprehensive, evidence-based inpatient care for my 12 year old following a diagnosis of anorexia nervosa. The notion was scary, but being balanced by relief and information beyond the height of nerves and accommodations I realized I had been providing my daughter for nearly a year, it was also welcome. At the clinic we could expect a team of pediatricians, psychiatrists and therapists to get us aimed at remission - starting in less than a week after confronting the diagnostic reality of illness. We didn't love all the parts of the plan, but with the advent of eating disorder understood as a neurological condition, it's treatment is also often covered by medical insurance, including this clinical approach.
When every day slows to a therapeutic momentum, when you're 12 and you
have an illness you don't feel, when healing doesn't feel right, when
nobody can tell you when you can play freely again, when there's a new
normal from here on out, when you miss your summer. When you are the parent with this child. When you want to apply logic to illness that defies logic. When most people have no real understanding of the complexities of your new normal's disease.
When you have an illness you do not feel.
That's what happened to us in the last two weeks. As lengthy as it was getting connected to the right resources, as hard as it was to accept a possible minimum scope of 8 weeks in treatment, as excruciating as it is to work therapeutically with a co-parenting adult who challenges my emotional safety with Olympian skill, I think the real work of this journey is uncharted and ahead of us yet. How do you heal an illness you do not feel?
In clinic, the first priorities are medical stabilization and weight restoration. They are a relatively easy buy-in cognitively, but then again, cognition isn't always functioning logically within eating disorder. Some patients struggle with this restoration. Some less. As I understand it, many take years to acknowledge illness because they don't view their disordered behavior as harmful. The goal of intensive therapy is remission of active eating disorder behavior through cognitive therapy and practice. It's a unique journey for every individual. It's not shameful to have disease like cancer or diabetes. Whoever heard of a child experiencing any kind of shame or judgement with such a diagnosis? Yet eating disorder isn't widely understood as the complex neurological condition that it is, so there's often an underlying assumption that environment has created it or people have chosen it. It's not shameful to have eating disorder either. But it's an exceptional challenge to bridge that misconception.
And it's an incredible feat to confront an illness you do not feel.
