Anorexia in excellent students: understand, help, do no harm

“I want to understand my daughter,” I heard from Katya’s mother in response to a question about the purpose of the meeting. Katya is a smart, beautiful and academically successful girl who decided to “lose weight better than anyone.” It is rare to hear such an answer from the mother of a girl with anorexia. Usually, by the time she visits a psychologist, she is in a state in which she thinks only about the survival of her daughter. This time, the woman explained, “She’s smart. She can’t want the stupid things she talks about.” Katya’s mother was able to notice what is considered one of the basic rules in psychiatry: the content of delusions and hallucinations does not matter. It doesn’t matter what kind of illness it is: schizophrenia, obsessive-compulsive disorder or anorexia.

With anorexia, the girl declares that she wants to be thin, because it is beautiful. She frantically tries to lose weight by refusing food, exhausting herself with sports, taking laxatives and diuretics. The content of delirium in anorexia is hatred of one’s figure and the desire to be a thin beauty. This desire has absolutely no meaning. Thinness is just a clue that fits well into the context of the girl’s life and her social situation.

What then matters? Understanding the mechanisms of the disease provides clues to treatment. The most important thing is to understand the background of what disease a violation in eating behavior appeared. Anorexia is not a single disease, but a complex of interrelated symptoms. It blooms against the background of various other diseases: neuroses, psychoses, personality disorders. The anorexia of excellent students has its own mechanism, in which there are three main gears.

1. Addiction to Achievement

Katya, like many other anorectics, can tell that she wants to please her classmates who bullied her for being overweight. Or she will remember that she was offended by her father’s remark about her figure. If so, Katya would have achieved a figure that her classmates and dad like, and stopped there. But she goes much further. The girl, emaciated to the state of a skeleton, is also bullied at school and her father is also offended. And the weight loss process continues.

There is no target weight and volume in patients with anorexia. The goal is daily victories in the form of weight loss, numbers. Where else do numbers become the subject and criterion of achievement? in the school diary. Anorexia of excellent students develops against the background of dependence on achievements. This feature distinguishes her from other types of anorexia: sacrificial, demonstrative, etc.

High achievers are most often anxious children who do not believe that other people can love them unconditionally. Achievement in studies, sports or arts becomes a way to receive love. By the way, parents may not be to blame for this. At first, the child receives grades in order to receive encouragement. Gradually, evaluation for the sake of evaluation comes to the fore. And now the race for grades is no longer for the sake of praise, but to drown out the irrational inner horror from the threat of becoming unworthy of love.

In anorexia, this process is repeated in the beauty industry. At first, the girl dreams of becoming beautiful. Starts to lose weight and gets the result – weight loss and compliments. Gradually there is a “shift of the motive to the goal” and in the first place there is weight for the sake of weight, numbers for the sake of numbers. So a girl weighing 35 kg can say: “I like how much I weigh now, but I go crazy if the weight is the same as yesterday. I need to lose at least a couple of grams.

Dependence on weight numbers without reference to appearance can be easily confirmed if the girl is asked to measure body volumes with a centimeter tape twice a day. For appearance, measuring volumes is more important than weight. However, when a girl sees that the weight has decreased, and the volumes, on the contrary, have grown from edema, then there is no concern. And if the volume figures decrease, and the weight has grown by a couple of grams, this causes hysteria.

After several days of synchronous measurement of body volumes and weighing, a therapeutic effect appears: the sharpness on weight is significantly weakened. The main thing is to give the girl the opportunity to draw a conclusion on her own. After that, it is better to suggest using only a centimeter tape.

2. Refusal of food develops willpower

Excellent students work hard. Fatigue accumulates, grades begin to fluctuate. In adolescence, you want to communicate with peers, try new things, and just be yourself. Where do you get the strength to give up all this?

People have long noticed that willpower is trained by abstinence. All world religions include such a method of subduing the spirit. Blessed Augustine says: “If you are asked: why do you fast and torture yourself? Answer: a mad horse that cannot be tamed by a bridle must be pacified by hunger and thirst.

Right now, there are hundreds of tips for building willpower on the internet that boil down to one thing: training to refuse something you really want. This is effective, because the psyche blocks desires not pointwise, but all at once. Through the refusal to enjoy food, a person gains power over all his “unwanted desires”.

This leads to the choice of tasteless dishes. Girls can also eat large amounts of low-calorie food, but only unloved. If the food becomes at least somewhat pleasant, it is ruthlessly removed from the diet, leaving not a crumb. And at the same time, all the crumbs of pleasure are removed from life. Such girls often condemn classmates for their passion for parties. At home, they require household members to “not interfere” with their homework by laughing cheerfully, watching cartoons. In therapy, girls are given the task of eating half a teaspoon of the most delicious food a day, but strictly not a crumb more. This task causes the strongest fear. Calories have nothing to do with it: it’s scary that pleasure will break through the dam of hard willpower at once in all areas of life.

It is necessary to explain to the girl that true willpower is not manifested in the rejection of what is desired. While trying what they want, a strong person may stop and decide not to continue. She should try not to break loose and gain weight to the delight of her parents. This is necessary to learn to truly control yourself.

If after a while the girl comes to the conclusion that she is able to control herself, the feeling of control is restored. There is a willingness to try more. The same procedure can be in the professional work of a psychologist with the fear of gaining weight. The girl is not afraid to gain one or even five kilograms. She is afraid that she will lose control and the weight will grow indefinitely. Therefore, she is terrified even from a couple of grams, because this is a sign of disaster.

The girl can be offered to gain two hundred grams evenly and keep the weight without hesitation during the week. It gives a magical feeling of control. She agrees to put on a few kilos. After all, now she feels that everything is under control: both losing weight, and maintaining weight, and gaining weight. If anything – drop it!

3. Hunger Reduces Anxiety

Anxious A students with anorexia often say, “I’m on my toes all the time. And when I notice that the stomach is completely empty, I feel so calm.” A similar phrase, only in reverse, is said by those suffering from bulimia: “When I feel that my stomach is full to capacity, I feel better. And only then do I worry that I overate again. ” It’s the same mechanism, just turned inside out.

Girls can achieve a similar feeling with the help of an evening diary. It describes all the events of the past day and the emotions associated with them. You need to write until there is nothing left in your soul but emptiness. After two or three weeks of such therapy, a lot changes, the psyche has an alternative. The beaten track of emotion regulation through hunger is becoming less popular.

The road to freedom

Anorexia in excellent students is treated quickly, if we mean by this diagnosis only disturbed eating behavior and start work in the early stages of the disease. It can be said that this is a non-cancerous type of anorexia. The methods of short-term strategic therapy by the Italian doctor of psychology G. Nardone and paradoxical therapy allow stopping the pathological process in three to six months maximum.

But after breaking the vicious circle of the race for numbers on the scales, it is necessary to pull the young squirrel out of the wheel of useless success. Katya got a wonderful mother. When parents really understand what’s going on, everything becomes clear. The environment that still has the greatest influence on a teenager, the family, is invisibly changing. With her help, the girl is much easier to understand herself, and she agrees to go to a psychologist, “if they don’t force her to eat.”

Anorexia is an eating disorder, and treatment should not turn into food punishment. Katya decided to be treated. And if an excellent student undertook something, then she achieves her goal! Of course, there are hundreds of subtleties in the treatment, and you should not hope for effective self-treatment. But even the mere understanding of the problem by relatives helps the girl to return to herself. There is no cure for anorexia. They treat a person.