进食障碍:神经性厌食症、神经性贪症、不典型进食障碍
这两天作为在 National Eating Disorder Information Centre(NEDIC)登记的心理治疗师花时间参加NEDIC的学术会议,感到收获还是蛮大的。参加各种讲座和讨论的过程中,开阔的自己的思路,与最先进的治疗进食障碍的理念和技术保持与时俱进,增加对进食障碍的理解和同理心。很多人的讲座都使我心生感动,有时鼻子酸酸的,为很多因为厌食症失去健康甚至死亡的人和他们的家人难过;有时又破涕为笑,充满信心。
进食障碍的发病率比人们想象的要高很多,因为,有进食障碍的人都会尽量隐瞒他们的情况,不愿意寻求帮助。比如,我有个患有进食障碍的客人,跟我一起做治疗三年之后(开始因为忧郁症而来),才犹犹豫豫、吞吞吐吐地告诉我她的进食障碍,而这一点对我理解她是那么重要。我也见过很多客人因为进食障碍严重地影响了身心健康
在Toronto Public Library 出版地《Young Voices》(2012)里,有一首一个十六岁的女孩写的一首诗《My Friend Ana》,描述了非常典型的厌食症患者对食物的态度,如果你自己或发现周围的人有诗中描写的情况,就应当加以重视了。
My Friend Ana
Wake up.
What did you eat last night?
Check your stomach.
It’s not flat.
Of course not.
You ate all your dinner yesterday.
How could you?
Get on the scale.
You need to be punished.
Get up.
Lying in bed won’t burn any carbs.
Take a shower
Make it hot.
Sweat your fat away.
Scrub harder
Make your arms ache
You didn’t do any pushups last night.
Get dressed.
Put your tank top on
None of your bras fit anymore.
Remember your sweaters
You’ll be cold if you don’t.
You need stockings.
Don’t let anyone see how your knees are thicker than your thighs
Eat breakfast.
You’re too weak not to eat.
Just like a fat person
You think you need the food.
You can survive without it.
Don’t put that toast in your mouth
I’ll talk to you about it all day if you do
You did.
You just put one hundred calories into your already big stomach
Those calories will turn to fat
You’re fat.
Always.
Go to school.
Look at everyone eating
Looks good
No.
They’ll pay for it later.
You don’t want a muffin.
450 calories that you won’t burn
Where will they go?
To your thighs
Ugly.
But, then again, you always were.
You’ll never change.
Eat lunch.
You better not eat the other half of that sandwich.
Think of that toast you had this morning.
Told you I’d bug you about it.
You really want to eat that cheese string?
Think of that toast.
That butter.
In you.
Go home.
What time is it?
Don’t eat too late.
You’d better get going.
Open the fridge.
Take out the cucumber rolls.
Only two pieces tonight
Remember that toast.
An apple is all right
A small one.
Think of that toast.
Do homework.
You’re not hungry.
No more gum.
Each piece is five calories you don’t need.
Go on Boston Pizza’s website
Think about eating a whole slice.
The cheese, the sauce, the crust.
And a milkshake.
But never do it.
You never will
Not with me.
Go to bed.
Listen to that rumble.
It’s the sound of champions.
But are you really a champion?
Remember,
You ate that toast.
Good night.
See you tomorrow.
Witten by Maddy DeWelles, age 16. Copied from “Young Voices, 2012)