The Choice

awareness of her self-sabotage and of how far she had taken it. And it
was an effort to help her answer the most important questions at the
outset of any journey toward freedom: What am I doing now? Is it
working? Is it bringing me closer to my goals, or farther away? Emma
didn’t answer my question in words. But in her teary silence I could
sense her recognizing that she needed and wanted to change.
When I met with Emma and her parents all together for the ĕrst
time, I greeted them with enthusiasm. “I have very good news!” I said.
I shared with them my hope, my conĕdence in their ability to work as
a team. And I made my own participation in the teamwork conditional
upon their agreeing that Emma would also be in the care of the
medical staff at an eating disorder clinic, because anorexia is a serious,
potentially fatal condition. If Emma ever got below a certain weight,
which would be determined in consultation with the staff at the clinic,
she would have to be hospitalized. “I can’t risk you losing your life
over something that can be prevented,” I told Emma.
A month or two aer I started working with Emma, her parents
invited me to their home for a family meal. I met all of Emma’s
siblings. I noticed that Emma’s mother introduced each of her children
with qualiĕers: this is Gretchen, the shy one, and Peter, the funny one,
and Derek, the responsible one. (Emma had already been introduced
to me: the sick one.) You give children a name, and they play the
game. is is why I ĕnd it useful to ask my patients, “What was your
ticket of admission in your family?” (In my childhood, Klara was the
prodigy, Magda was the rebel, and I was the conĕdante. I was most
valuable to my parents when I was a listener, a container for their
feelings, when I was invisible.) Sure enough, at the table Gretchen was
shy, Peter was funny, Derek was responsible.
I wanted to see what would happen if I broke the code, if I invited
one of the children into a different role. “You know,” I said to
Gretchen, “you have such a beautiful profile.”