Three days after our daughter came home from hospital, we took her to our local child and adolescent mental health service for assessment. This was the appointment we had been waiting for all summer.

The person who saw us was a psychologist. Her manner could have been less patronising, but she adapted as we went along, speaking more naturally to our daughter when she realised her level of intelligence and articulacy (no boast intended).

The main things to come out of this session, which disappointed our daughter because she had been hoping for much more definitive and practical guidance on what we need to do to manage this condition day by day, were the suggestion that all-or-nothing thinking may have played a part in her succumbing to anorexia and her recommendation that our local eating disorder service take up our case.

All-or-nothing thinking means that if anything (a friendship, an outfit, a meal, a day, an outing, a school) fails to tick every box, it is worthless. In other words, in the eyes of someone indulging in all-or-nothing thinking, everything in everyone can only be either perfect (unlikely, impossible even) or useless. If everything is useless, you’re bound to get a bit down.

The psychologist told us that normally a lengthy, multi-disciplined interpretation of the result of her assessment would be necessary before determining the best next step. She seemed to see quite clearly that our daughter was anorexic and pushed the move to the next stage through quickly.

Our first appointment with the eating disorder specialists will be the subject of the next post.

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