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Saturday 26 May 2012


It seems that anosognosia is the topic of the week and has been distracting me from the whole horror of Caloric Conservation.  I have covered anosognosia before but I have learnt a lot about it and had a bit of a brain whirl jump this week which has finally made me understand it.

So Laura started it with this blog.  A rash of comments followed and a debate about whether people with an eating disorder really do have anosognosia, how long it lasts and whether it is to do with the creative side of the brain.  I had found this website, about problem solving some time ago and it all seemed to fit.

There then followed a fiery debate about anosognosia on F.E.A.S.T.'s Facebook page, which descended into "Do, Don't" argument in the end.  It is very hard not to be emotive when talking about one's personal perspective on eating disorders.  It is vitally important to remember that everyone is different and has fallen down the rabbit hole for different reasons.  It is also important to remember that one's personal road to recovery is not everyone else's.

Then ELT produced a cracker of a blog last night.  I hope both ELT and hm will forgive me for copying and pasting here what I think sums up anosognosia in eating disorders perfectly.

“persistent lack of recognition of the seriousness of the current low body weight”
I would say this applies both to the person on one extreme who is literally unable to recognize their illness and to the person on the other end who recognizes they are ill but the need to appease their anxiety outweighs that proper response to that recognition. Either way, the “seriousness” is not receiving the weight that it should in the person’s head- b/c they either don’t see it at all, or they see it but can’t make it matter. Does that make sense?
If whatever is causing the low weight is getting the most internal support from a person, then that person is obviously unable to healthfully process the seriousness of their condition. Because healthful recognition and processing means seeing something AND being able to respond to it appropriately. Also, being able to look at the long-term consequences of something as opposed to being stuck handling things on a moment-to-moment basis only- when the momen-to-moment need to manage anxiety outweighs the long-term consequences, then I think there is lack of recognition and processing going on.


  1. I've not been taking part in either the SP or anosognosia discussions on Facebook because despite the fact that I love FEAST and enjoy debating, I've been making a concerted effort to step back from engaging in online ED discussions in preparation for my counselling placement. I can't live and breathe ED activism in my spare time if I'm going to do this for a career - I know some therapists are involved with FEAST but as a newbie, I'm going to need more time to do unrelated stuff so my brain doesn't explode :P

    That said, I wanted to reply to this post because I still think there are holes in the definition/discussion, some practical and some philosophical. This still doesn't describe my experience, or that of many of my friends. I knew I was anorexic AND that it was killing me - I fully appreciated the severity of my situation. I was unable to change because I was terrified of trying to live without the numbing effect of being underweight and starving, which was actually a pretty rational fear given how close to suicide my anxiety disorders have driven me in the past. I am still very much affected by my anxiety, which neither medication or therapy has ever managed to touch, and on bad days I wonder if recovery was worth it - if maybe I am just somehow brain damaged and incapable of living a peaceful life. This is the sort of philosophical issue I mean: if someone has experience of life being unmanageable at a higher weight, if there is no support for them to try to overcome this and if they recognise that their anorexia will kill them, can you still call them irrational? Obviously I found a way around it, but I was not the sort of anosognostic (?! Is that a word?) described here or in the traditional sense.

  2. But but but Katie (and, boy, I miss you!) I don't think anyone is saying that everyone eating disorder patient has anosognosia. Nor is anyone saying that a patient has it all the time.


  3. This is true :) the transitory theory makes sense to me. (I miss you too!)