The Choice

handle being confronted or contradicted. In our private session, I
would be impressed by her resourcefulness—she mowed the lawn and
did many of their home repairs, she made her own clothes—and the
seeming contradiction between her skills and the power she gave over
to her husband, the price she paid to keep the peace. Her habit of
avoiding conĘict with her husband at all costs was as damaging to her
daughter’s health and their family dynamic as were his domineering
behaviors. ey were partners in making control—not empathic
connection, not unconditional love—the language of the family.
“is is a waste of time,” Emma’s father ĕnally said during our ĕrst
visit, aer answering my questions about his job, their family routines,
how they celebrated holidays. “Just tell us what to do.”
“Yes, just tell us how we can get Emma to come to the table at
mealtime,” her mother begged. “Tell us how we can make her eat.”
“I can see how worried you are about Emma. I can see how
desperate you are for answers and ĕxes. And I can tell you that if you
want Emma to get well, your ĕrst job is to understand that with
anorexia, the issue isn’t only what Emma eats; it’s also about what’s
eating her.” I couldn’t just fix her and send her back, her healthy self, I
told them. I invited them to help me, to be my cotherapists, to observe
their daughter, but not with the agenda of making her do or be
anything different, just paying attention to her emotional states and
behaviors. Together we could build a clearer picture of her emotional
landscape and get more familiar with the psychological aspects of the
disease. By enlisting their help and cooperation, I hoped to lead them
toward an understanding of their part in her illness. I was nudging
them toward taking responsibility for the way they contributed to what
was eating Emma.
e following week, I met Emma for the ĕrst time. She was
fourteen years old. It was like meeting my own ghost. She looked like I
had at Auschwitz—skeletal, pale. She was wasting away. Her long,