Barriers to Treatment: Anosognosia

I still mispronunciation this one every so often.  For some reason I always want to put the 'g' at the beginning.  Given the amount of times I have said this term over the past 3 years I really have no excuse for still messing it up.  It is etched in my brain and should just roll off my tongue:  Anosognosia. Anosognosia. Anosognosia.  

What is it?  
It is:
- the medical term for when individuals are unable to understand that they are sick.
- often a symptom of eating disorders
- related to changes in the anatomical structure of the brain 

It is NOT:

-'denial' or a matter of being 'unwilling' to accept the illness.

It can also be one of the most confounding barriers to treatment: It can render our kids unable to acknowledge that the behaviour they are engaged in or the thoughts they experience are anything other than ordinary; it can make for active resistance and non-compliance; and, it can be a mountain we have to scale with those who talk to us about 'insight' and 'readiness'.   Insight or awareness should never be preconditions for treatment.  In fact, it is the reverse: treatment first, insight later.  

The Treatment for Advocacy Centre's links to resources on Anosognosia can be found here and FAQ's are here.
The National Alliance on Mental Illness' Fact Sheet on Anosognosia can be found here.
2010 Anosognosia in Eating Disorders piece by L. C. can be found here.


  1. Thank you for this topic. Had it not been for FEAST I would not have known this even existed, instead would have lumped in my impressions in with denial. Oh how I wish I had known this early on, I would not have spun my wheels so much. I would have been able to reframe and understand that she really couldn't see.......

  2. Lisa, a big thank you for flagging up Dr Amador's work, which I hadn't come across.
    I went on to watch more videos of his and am part-way through his book.
    I got goosepimples when I first heard him say that someone with anosognosia will not accept treatment because you argue with them, but because of your relationship.
    Yet another confirmation that connection and unconditional acceptance is crucial.


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