This year, my 20-year-old son is skipping Thanksgiving.
I texted him to ask how he would explain ARFID to a friend who didn’t understand eating disorders. “It’s like a fight or flight response with food,” he replied. “People with ARFID have a small amount of “safe foods” that they can eat without any adverse psychological effects, something they default to on a daily basis. There is vomiting only with certain foods.”
Avoidant and restricted food intake disorder (ARFID), a new and poorly understood diagnosis, is a type of sensory processing disorder that affects 3% of the population. It often coexists with anxiety, attention deficit hyperactivity disorder, and neurodivergence.
When he was little, his mother and I thought our son was just a “picky eater.” At family meals, he preferred to drag out the conversation, his charming personality, forgetting to touch the food. When one of us nudged him into trying the broccoli, power struggles ensued, often leading to tears and tantrums.
As he got older, his food preferences narrowed. The amount of safe foods (white bread, cheddar cheese, green apples, noodles, bagels) had to be specific brands from particular stores, one of ARFID’s hallmarks. Concerned, we bother, we even criticize, as if it were a matter of personal will.
She was at risk of nutritional deficiencies and anemia, had blood tests done at every pediatrician visit, and was often prescribed vitamins and supplements that made her gag. It all felt like punishment.
When we first started seeing nutritionists, they recommended different ways to fit nutritious things into the few foods she liked, chocolate zucchini birthday cake will never be forgiven, which always failed.
It’s not until you have ARFID, or have a child with ARFID, that you realize the extent to which human relationships are organized around eating together. Holidays like Thanksgiving are the worst.
When well-meaning people notice that my son is eating his safe foods (it happens every Thanksgiving), they default to responding to young children who are picky eaters: cajole, encourage, talk about new foods ( sometimes more direct and critical ways of responding) .
During food-centric holidays, people like my son face a barrage of awkward corrections when they just want to be left alone with what is essentially an invisible handicap. You can smile and tolerate the questioning, educate the person, which is tense because it’s sad to have ARFID, or run away from the situation. Any conversation about food is associated with shame and the reminder that there is something “wrong” with you.
On previous food-focused vacations, my son would reluctantly join us after we insisted, either tolerating alarmed attentions from others or running away and not coming back.
A specialized nutritionist told us that he had ARFID. The proteins in her taste buds didn’t communicate with her brain the way ours did. As a teenager, he worked for several years in “exhibitions”.
“Since taste buds change every 30 days or so, ‘exposures’ get your body used to a food in the hopes it’s safe,” he texted me. The logic is that continued exposure to new foods eventually changes the communication between taste buds and the brain. It’s a frustratingly slow process.
Each month she chose a “food challenge.” He took one or two bites a day and kept track of his reactions. One summer month he chose strawberries. While he took a bite and made a face, I had several. (Okay, I ate the rest of the pint, delighted with the juicy sweetness.) On his record, my son wrote words like “bitter” and “unpleasant.” Strawberries never became a safe food.
The sad reality hit me: food did not give him happiness.
As a psychotherapist, I often find myself playing this cognitive game: What if the “disorder” that demands “cure” (shame-infused words that become part of the problem) is just an exception to the usual ways of being social, putting the “victim” in the position of having to adapt, adjust, minimize, rationalize, or deny legitimate feelings of discomfort, when the real problem is that the world is organized around other people’s ways of doing things? What happens? if the problem is other people with their insistence on social conformity?
When he told us he wouldn’t be attending this holiday, my son brought up the persistent grievance about Thanksgiving: it celebrates what is essentially the genocide of native populations. To enjoy it, you have to stop seeing, or at least take into account, a tortured history, an ignored reality in the warm colors and ambient light of Norman Rockwell’s painting. The insistence on a narrative, an imposed meaning, eludes other realities. As we talk about Thanksgiving with friends with specific and marginalized identities, we realize my son won’t be the only one doing something else.
Even so, I was disappointed that he didn’t join us, secretly hoping he’d change his mind.
Last spring, when his older brother finished university, our family traveled to Berlin for his graduation. Historically, traveling abroad has been terrible because of the lack of familiar foods. This time, armed with self-awareness, we packed a suitcase full of safe foods: macaroni and cheese, peanut butter and jelly, her favorite crackers. But we still wanted to have a special dinner.
My youngest son, who hates restaurants but loves his brother, reluctantly admitted. He fears the waiter’s attention when he only asks for a bland dish. Inevitably, they ask questions like: “Are you sure?” They either talk about other items, or other members of the dinner party launch into correction mode.
At our hotel before dinner, we checked the menu online to confirm that there was a safe food item. As we entered the bustling restaurant, the yellow glow on the tables, the happy diners chatting, the beautifully plated dishes being brought to the tables, my son looked pained. The waiter mentioned that there was a fixed price “Family Party”. A chef’s selection of dishes would be brought to our table. No one had to order an individual meal. we were excited. My son would not be asked any questions.
“And will there be fries?” I asked the waiter. “We all want to try them.”
“There are always French fries,” he said.
My son’s expression relaxed. He even ordered a fancy cocktail: bourbon, sherry, cranberry syrup, and lemon, and he liked it! It was a rare moment when we had a family dinner in a restaurant. It was the best dinner we’ve ever had, and he didn’t feel like there was anything wrong with him.
At the beginning of my journey as a father, I could have said that I loved my three children unconditionally, but that is a lie. Discovering them as complex individuals with their own ways of navigating a difficult, unfair, sometimes cruel world has revealed that conditions exist: my own needs, attachments and fantasies about who they could be, which are sometimes unclear, unconscious, but powerful. . .
Continually letting go of expectations, I move closer and closer to a purer form of caring: that ideal of unconditional love. That self-discovery is the real joy of being a parent.
This Thanksgiving, some of us are having dinner with our neighbors. We’re in charge of the cakes—chocolate pecan, traditional pecan, and pumpkin—and my partner is bringing a new gnocchi and Brussels sprout dish for my daughter’s girlfriend, who is vegan. My son will stay home where he wants to be, away from the attention of others (and the bad memories that brings up), play video games and watch movies, and talk to his grandmother who is in a different time zone.
He will be missed, of course, but I trust he will be fine.
Later we plan to come home for dessert with him. Through a bit of holiday magic that I don’t pretend to understand, but for which I’m grateful, pumpkin pie is a sure thing.
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