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hopenz

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Reply with quote  #1 
I've been thinking a lot about some research by Janet Treasure and thought it might be helpful for those who haven't come across it before.

She (and others) have looked at how people with EDs interpret social situations, and facial expressions, as being more negative and judgemental towards them, than people without EDs.

This paper compared about 30 adults with AN with a sample from the general population.  Participants were asked to complete sentences relating to a social situation (eg 'as you walk into a group of people, they stop talking because they were talking about...').  People with AN were significantly more likely to interpret the conversation as being about their weight or the way they looked.  They were more likely to detect rejection from other people. 

https://www.researchgate.net/publication/311615096_Biased_Interpretation_of_Ambiguous_Social_Scenarios_in_Anorexia_Nervosa

I also heard Dr Treasure discuss research where participants were shown photographs of faces with different facial expressions.  The AN group were much more likely to interpret the expressions as being negative (as opposed to neutral or positive) than the 'normal' group.

I think this helps us as caregivers to understand the world our loved ones with EDs live in, and how distressing it must be for them.  And also some of those infuriating times when you're trying your hardest to be calm and positive and all they can see is disapproval and anger!

Unfortunately I haven't been able to find discussion of whether this effect persists after WR.  Perhaps someone else can?
Mamaroo

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Reply with quote  #2 
So true, any comment about my d's appearance was interpreted as she was fat. She is much better now, but still very sensitive and can pick up any impatience in my tone of voice.
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D became obsessed with exercise at age 9. Started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for a year and WR at age 11 in March 2017. She is back to her old happy self and can eat anything put in front of her. Now working on intuitive eating.
Foodsupport_AUS

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Reply with quote  #3 
This is very interesting work. I remember Janet presenting this at the At home with eating disorders conference a few years back. My D has this too. It was way worse at her sickest, she interpreted nearly everything in a negative light. Even now she does seem to be overly sensitive to negative facial expressions and interpret things as negative when many others would not. At the same time it tends to make her very empathetic and caring, she picks up on others distress earlier than most others. Although still present is it so much less of an issue than it was. 
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D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
Kali

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Reply with quote  #4 
Hi HopeNZ,

This is interesting, and I remember when my d. was in treatment (at a research facility) she mentioned that they had given them some "tests" as part of the research where the patients had to identify facial expressions because they were trying to learn more about this. She thought it was very difficult at the time. I don't know whether it is a symptom of starvation or whether it continues afterwards. I think I'll ask her about it and see whether she notices any difference now that she has been nourished better for awhile!

Kali



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debra18

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Reply with quote  #5 
My daughter is going through this now. I want her to start eating lunch with the rest of the class again. She says everyone will be looking at her and nobody else eats lunch. There is some truth there that girls don't eat lunch. How can I help her with this?
tina72

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Reply with quote  #6 
If it is a mixed class and she has boys as friends too I would ask her to eat with the boys.
No better friends to eat with for an AN girl... Plate will always be overload and no talk about dieting.
Tina72
debra18

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Reply with quote  #7 
No it's an all girls school. Her class is made up with a lot of thin girls that often talk about weight and what they eat. They are always praising my daughter that she is so skinny.
tina72

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Reply with quote  #8 
In that case, I would not allow her to eat lunch with them if possible. Can´t you take her home for lunch or eat with her in a seperate room in school?
She will not eat what she must eat with all these girls around that only eat salad and tell her that she is looking great and she should not eat that much. So if you need lunch counted (and lunch is normally one of the bigger meals), you need to think about that.

It would be hard for her to stay with these girls and her talking about food and diets. I was really glad that my d was together with boys and some bigger girls so she was not the one with the fullest plate and that made eating in a group easier for her. Is she happy in that school? Does she have good friends that could help her with eating in school? If not, any possibilities to change school?

Tina72
debra18

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Reply with quote  #9 
She has been eating in a separate room where she was supervised for the past few months. I feel like she is ready to move on to the next step.
tina72

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Reply with quote  #10 
Ah, ok. So maybe you should give it a try. Is there any possibility that someone in school can tell you what and how much she ate?
Tina72
tina72

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Reply with quote  #11 
What helped my d with the "everybody is looking at me": I told her to sit at a table in a corner with her face to the wall so she cannot see the girls/boys behind her and how they are looking at somebody. That helped a bit.
debra18

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Reply with quote  #12 
I am going to start with having a few girls eat with her in the room she was eating in and say they are working on a project. Hope it works.
Foodsupport_AUS

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Reply with quote  #13 
Debra that is a good idea. My D was quite popular at one point as she graduated from eating with the nurse to eating with friends but all inside in eye shot of the nurse, in the midst of winter when everyone else had to eat outside. 


As for the facial expressions I asked my D her thoughts about this. She is not fully recovered as yet, but a long way there. She feels that even now she still notices many of the expressions but feels that she is much better able to rationalise what may be going on. As she said her emotions at the time were so powerful and strong they often felt overwhelming and out of control. Now she sees things but has nowhere near that visceral reaction.

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D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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