Here's a bit of a confession: I have a hard time believing people like me. Why? There are the obvious self-esteem issues, but there's also my whacked-out interpretations of what other people must be thinking about me. When I'm talking, are they bored or do they just have a really full bladder? Is it a bad day or something I said? Are they offended or just not amused? Are they mad at me? Are they? Are they?
I usually conclude yes, they are mad at me, and then go about wracking my brain to determine what I did that could have caused them to hate me (note that being mad at me automatically translates into "you hate me" which is a cognitive distortion in and of itself). When I can't find anything, I assume it's just, well, me.
As I interact with people, I tend to hyper-interpret everything. An arched eyebrow becomes a stiletto through the heart. The flick of a wrist can toss cold water down my back. This isn't to say that I'm always right--nor that I'm always wrong, seeing as I've pissed off a few people in my time--just that I'm always aware, always looking for meaning.
So when I first read of the similarities between anorexia and autism, I arched an eyebrow of my own. My cousin's son is autistic, and though behavioral therapies have made a world of difference, he still has problems understanding other people's emotions, even just understanding that other people have emotions. Clearly, I didn't have this problem. I was almost too aware of what others might be thinking and feeling.
But the more I think about it, the more I realize that they are just (oh dear) mirror images of each other. Both my second cousin and I have difficulties in recognizing emotion. Whereas he doesn't interpret enough, I seem to interpret too much. And this issue only becomes worse when I'm malnourished and starving.
the acceptability of emotions and recognition of emotions are important factors, so specifically practising emotion recognition and examining the function of emotions might be useful treatment targets. Building skills in emotion functioning may enable the client to feel more confident about social interaction and reduce isolation. It might also be useful to involve the family to build a shared understanding of emotional functioning.