We really don't know what to do about Amanda’s anorexia at this point. We saw the nutritionist on Tuesday and Amanda participated reluctantly. She tells me she’s been eating everything but her sister told me privately that Amanda barely eats when I am not around and that this morning she didn’t have breakfast.
We know she's lied to us plenty in the past few months. I can tell her that I think she's not being truthful with me but, if she denies it (she can really put on an act), I'm not sure what else to do. I can't put her sister in the middle of this but I feel like we have to tell Amanda that we know that she has lied.
At this point, she's decided not to take anti-depressants, she isn't complying with the eating plan, and I’m worried she’s going to end up right back in the hospital. Basically, she has to choose to start trying to actually get better.
Do you think I should confront her with her behavior?
It’s really hard to know what to do sometimes...
Why don't you tell Amanda that you have doubts about her commitment to getting better and that you need to know where she stands on her own treatment and recovery. If she says she's committed to the process, don’t try to confront her with any lies or hearsay. Encourage her to continue trying; and let it go. If Amanda is lying, the truth will eventually emerge because she will be weighed during her medical appointments and any weight loss will become apparent over time. If Amanda responds that she is not committed to getting better or is struggling, let her know that she may be hospitalized again if she loses more weight, and that this will merely postpone her recovery.
Either way, you have to let Amanda face the consequences of her choices and behavior. Ambivalence around autonomy is a major struggle for anorexics and Amanda has to work it out in order to move forward. If you take it upon yourself to get her to eat, you will perpetuate an unhealthy dependency on you. I know it’s tricky because her behavior is irresponsible and, as her mom, your instinct is to step in; but she has to own her life.
In terms of her sister, you are right to not involve her. Amanda may be baiting you by telling her sister “secrets” that will make it back to you, and it is best not to encourage any indirect communication. What Amanda says is less important than what she actually does.