We often wonder how the mind works with someone who has an eating disorder. It might seem like because of how emaciated an anorexic is it must be easy for her not to eat. How else could she get so thin and still eat so little? We could never do that; it would be too hard.
An eating disorder is not included in the psychiatric diagnostic handbook as a dissociative disorder but it probably could be. According to the dictionary, to dissociate means “to sever the association with oneself” or “to separate.”
There is a continuum of the dissociative experience. We all experience it to one degree or another. When you are driving and “space out” and don’t’ remember part of the trip in how you got to your destination; that is a very mild form of dissociation.
The extreme form of dissociation is when someone experiences what used to be known as “multiple personality disorder.” It means they have split off from themselves to the extent where they have multiple personalities or identities.
The person separates herself in order to manage extreme pain. Each identity carries a different aspect of the pain and trauma so no one personality has to feel all of it.
An anorexic’s ability to separate herself from hunger is part of why she is able to limit her caloric intake. She will say she is not hungry or does not “feel” hungry. This is not really true, she does feel hunger.
The problem is she gets so adept at ignoring hunger cues and dissociating from her body’s needs she may forget what hunger feels like. Reconnecting herself with her body is difficult and takes time. Even though an anorexic wants to appear like starving herself is not difficult for her, the reality is; it is very difficult.
Some behaviors you might see in her attempts to stave off hunger:
1) Sucking on certs, tic tacs and other mint type products
2) Drinking a lot of diet soda so she feels more full
3) Gum chewing
4) Avoiding places where she will be tempted to eat (with friends, parties, restaurants)
This is information for you to know as you try to help your child recover. You don’t necessarily have to confront these behaviors when you see them; just know this is probably what is going on. She is hungry. She just won’t admit it.