Although what follows happened more than forty years ago and although eating disorders such as anorexia nervosa do not receive the same attention as they once did, they still occur in 30 million Americans/year and are still one of the most frequent chronic illnesses in adolescence.
She weighed in at 85 lbs and looked beyond skeletal on her 5’8” frame.
I was the psychiatric resident on call in the UCLA emergency room forty-two years ago when a deathly twenty two year old young woman, who I will call Jane, came in who was an obvious admission to the famed eating disorders in patient program at our Neuropsychiatric Institute.
Jane looked as if a strong – or even mild – wind could knock her over as I could see her sunken skin between the two bones of her forearms while her long legs were straight out of a concentration camp.
I conducted a usual protocol ER level psychiatric assessment and evaluation, and it was clear that she did need to be admitted to our In Patient Unit that focused on eating disorders particularly anorexia and bulimia. It was not something I felt particularly happy about inasmuch as I knew that the likelihood of tube feeding being among the modalities awaiting her upstairs.
It was a Saturday night and there were no other psychiatric patients lined up behind her. I could have left her with the nursing staff to check on her while her bed was being readied upstairs. I decided instead to keep her company as she was seated on one of the emergency room grayish brown leatherette covered chairs in our small room that was part of the ER.
The sadness in Jane’s eyes that were as sunken as the skin on her body screamed out to me for some kind of emotional comfort in addition to my professional assessment role.
At UCLA we had access to a number of non-medication modalities in our training. One of those was called Guided Imagery which was taught to psychiatric residents by one of the most kindly, warm and loving people you could ever meet at the NPI. Her name was Marielle Fuller. Guided Imagery was a process in which you guided a person with their eyes closed into various scenes and they would tell you what they saw and their telling of that would symbolically reveal a number of the psychological and interpersonal issues they were dealing with. Another modality we had been trained in was hypnotherapy.
For some reason something about Jane’s waif-like state mixed with her sadness spoke to me to try something. Intuitively I combined elements from several of the modalities I learned into the following.
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