Ophelia, Odilon Redon

"I will go mad!"
"Good idea.  I went mad for a while, did me no end of good."
(Arthur Dent and Ford Prefect, Life, the Universe and Everything)

Sometimes it really is the best option when reality refuses to behave.  But here we're going to just briefly mention both kinds of "mad."

Restricting, bingeing, purging, etc. have a measurable, physical effect on the brain's workings, and when you try to rearrange the wiring again, it really does feel like going mad, especially if you don't particularly believe in anxiolytics for your particular situation.  The irrational reactions that recovering anorexics/bulimics/what-have-yous experience when rebuilding an appropriate nutritional platform is cited as difficult for ED-inexperienced therapists to empathize with.  These reactions are also one of the most common causes of relapse, giving up on pulling out of a relapse, etc.  Relapse and refusal to comply with treatment are both, naturally, frustrating for a treatment team (just as they are for the patient, mind you).

One can see why a therapist who doesn't specialize in EDs (or who doesn't have much experience yet) would balk and fume, if the frustration got to be too much.  I mean, what does such a reaction look like to a casual observer?  Some chick freaking out about cheese (e.g.).  Eating disordered patients (especially anorexics) are cited as provoking some of the most negative responses, including anger, in therapists across the psychological board.  

Boy, that's an achievement, isn't it?  You've got your psychopaths, your sociopaths and your Narcissistic Personality Disorder patients, but anorexics and bulimics are the patients who provoke some of the strongest reactions, including anger and revulsion?  That is interesting.  That is interesting to me on a sociological level.  To me that says that even trained professionals at a very real level have problems perceiving eating disorders as not, essentially, a choice.  Yes, if you want to get Existential about it, every action we take is a deliberate choice, but the point is: when you get into eating disorder symptoms (like an addiction), after a certain point your brain takes over and it is demonstrably chemically and physically harder for you to pull out of those choices.  And professionals who treat anorexic and bulimic patients know this.  And still, the madness.  It's interesting.

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