Lies and Deception

E's dad found out she was no longer at UCLA last Wednesday because when he returned her phone call, another patient who answered said she wasn't there.  R immediately called back and reached the nurses station, where he was told that she had left that morning and that he'd have to contact her mother for more information.  When he attempted to call her mom, her phone rang and rang (usually voice mail picks up).  He heard nothing from his daughter for the next few days, which is extremely uncharacteristic of their relationship.  For the 5 1/2 years that I've known R, he has talked with his daughter at least once a day.  Often they speak in the morning and in the evening.. 

Friday evening, she finally left a voicemail for him at home, which said something along the lines of, "Hey Dad, it's me, call me when you get a chance."  Saturday morning, she called again, and left a long but odd message.  She basically said, "Hey, Dad, it's me, E, I'm calling you with good news.  Because I'm doing so well here at UCLA, they want me to go to Partial. I'm really proud of myself.  Mom and I are taking care of it, so don't call me or come visit me today because I'll be leaving.  I'll call you when I get situated in the new program."  In other words, she left a message indicating that she was still at UCLA (lie #1), that she had been recommended for partial hospitalization (lie #2, I think).

"Partial" is short for Partial Hospitalization-- this is a much lower level of care.  When a patient is in a partial program, they have typically met a minimum BMI/ body weight and are in more of a maintenance function for their disorder.  They have enough tools to be able to withstand the pressures of being in their normal home evironment during the evening, and spend only the day in treatment. 

E is still miles away from her minimum BMI.  The last time we saw her, she was perhaps 80 pounds.  It is extremely hard to fathom any provider recommending her for a partial program, unless of course the provider had been told by E that it was the only type of treatment she was willing to participate in.  Even still, most programs will not accept someone at her weight and level of health.  So what is going on??  Once again, we have no idea.  It's frustrating.  Clearly she is lying (about her timeline for leaving UCLA, if nothing else).  I understand that she doesn't want to disappoint her dad.  He takes things hard.  If I were a 19 year old young woman wrestling with such serious problems, I might be tempted to lie, too.  But doesn't she see that she's only further breaking down the fabric of their realtionship?  How does one have a healthy relatiohship where there is no trust?  I can't imagine a recovery for her until she can be honest-- with herself first, and also with the people she is close to. 

Since she seems to have decided that UCLA is not the right treatment right now, I can only hope that she will put the effort in to get the most out of partial hospitalization.  She has a contentious relationship with her mom, and decided long ago not to live with R and I, so it seems like being at home during the evenings would not be a good idea.  Further, her Anorexia has at various times morphed into a binge-purge disorder (Bulimia).  This is not unusual.  The starving body so craves food that the Anorexic, despite their amazing willpower, breaks down.  When she was younger, she briefly went through a period in which she would eat serveral hundred dollars worth of groceries in one binge, then purge it all.  At the time, she was staying with her Aunt and Uncle in Palm Springs... Her Aunt is a former ICU nurse, and had visions of helping her niece recover-- she couldn't handle it.  Then Emily went to stay with some very religious relatives in Utah, who also had visions of healing her.  They removed her from psychotropic medications, feeling that her problem could best be tackled in the spiritual realm...  Their efforts failed, too.  Even if one can handle the emotional toll (no small feat), it becomes too expensive.  What does one do when a weeks' worth of groceries suddenly disappears?  Who can afford that?  These relatives were a cousin, his wife, and their small children.  They resorted to locking up the food, which only served to enrage E.  From there, she entered a top treatment program in Utah, and although she was still a minor at the time, she couldn't be compelled to stay.  She either ran away or was thrown out of the program, I don't remember the exact circumstances.  That was just one of many failed treatment attemps.  It has been a tough, exhausting journey not just for E but also for all in her life who love her.