1. Common psychological states at the beginning of hospital admission (1) Courage and determination: Nowadays, more and more patients enter the inpatient unit with great courage and determination. They have usually been brewing for a long time, suffering from deep illness and pain, and are sure they have ‘had enough’. When they enter the inpatient unit, they are in a ‘fight to the death’ mood. In this case their communication with doctors is often positive and smooth, and they are more willing to accept help and bear the pressure when they encounter difficulties. (2) Expectations and fantasies: Even with courage and determination, hospitalization can be stressful in ways that patients may not expect. It is normal to have expectations of treatment, but some unrealistic expectations and even fantasies can lead to negative effects, which are often unavoidable. Many people expect doctors to eliminate their extreme fear of fatness through professional psychological counseling, so that they can eat without pain, that is, they expect a ‘painless therapy’; some people expect doctors to help them eliminate their ‘bad’ Some people even imagine that being in the hospital is like being on ‘vacation’. Such psychology is often followed by negative emotions and behaviors such as disappointment, fear, anger, blame, and rejection. (3) Disappointment, anger, blame: the natural reaction after the expectation or fantasy is shattered. It is usually strongest at the beginning of hospitalization, but will soon subside, although it will ebb and flow many times as treatment progresses. As long as it can be expressed, it is not something to be feared and can even be used as a resource for treatment. (4) Anxiety, fear, and denial: These are also natural reactions in an inpatient setting that can no longer be avoided. Like other emotional reactions, these emotions are not scary and are tolerable. Given time, they will gradually recede while giving the patient a whole new experience of victory – the victory over emotions. (5) Relaxation and relief: Unlike the previous two emotional reactions, many patients experience a sense of relaxation and relief after hospitalization. Because the treatment plan is already set and there is no room for change, they do not have to think hard about what to eat, how much to eat, and what to do when they are done, so they feel a great sense of relief. This is more common in patients who are re-hospitalized and in patients with bulimia. 2. Common psychological states in the middle of hospitalization (1) Gradual relaxation and adaptation: As time passes, if the treatment setup is stable and solid (including the decision to be hospitalized, the implementation of the treatment plan, and the contact with the doctor), patients experience a certain degree of relaxation, knowing what they have to do and what they can do, and the restrictions of the environment are not so difficult. At this point the patient may begin to focus on treatment, gradually becoming open to actively exploring his or her distress. (2) Emergence of ‘sense of illness’: Many patients who initially refuse treatment, citing reasons such as ‘I am not that serious, I don’t need such restrictions’, ‘I promise that I will be able to control myself when I get out of the hospital’ Patients who wanted to ‘escape’ from the hospital began to say during this period that they ‘realized they were really sick’, and their observations of other patients prompted them to reflect on themselves and to stop denying the existence of their problems. This ‘feeling of sickness’ is a sign of the beginning of true self-insight, signaling the opening of a new page in treatment. (3) Ups and downs and the ‘patient discharge effect’: A characteristic of hospitalized patients is that they welcome new patients and are eager to help, while their reaction to their discharge is extremely mixed. Envy and jealousy – she’s free and I’m not; doubt and confusion – is she well? Why is this happening? Worry – she is not well yet, what will happen when she is discharged? –what makes you think so? All the reactions provoked by the patient provide resources for treatment, which can be explored to learn how to be self-aware, how to cope with negative emotions, how to express emotions positively, how to evaluate objectively and self-evaluate, etc. 3. Common psychological states in the late stages of hospitalization (1) Longing and fear for discharge coexist: longing for freedom, but not knowing if they can cope without the clear framework of the hospital; longing for affection, but not knowing if they can change the poor family interaction patterns of the past. (2) Attachment to the hospital: Attachment to a doctor, a nurse, a patient, or even a tray to serve food. Some patients feel ‘at home’ in the hospital, feeling safe, warm and peaceful, like a baby finding its mother. This bond is the cornerstone of deeper treatment, and often patients need to maintain a stable therapeutic relationship with a particular professional after discharge to allow treatment to continue. (3) Waiting for discharge and stagnation: When discharge is on the agenda, some patients slow down their treatment and experience treatment stagnation. For example, they do not gain weight and avoid further discussion of personal problems. This may be a phenomenon of instinctive self-protection as the patient realizes that he or she is leaving the treatment setting and that his or her sense of security is threatened. Timely detection and intervention are needed. 4. Psychological state of treatment interruption Many patients do not experience the above process in its entirety after hospitalization, but interrupt at a certain point, commonly at the point of anxiety and fear at the early stage of admission, the point of expectation and disillusionment, the point of ‘patient discharge effect’ in the middle stage, and the point of stagnation in the late stage. Interruptions mean that treatment is only partially underway, but they are not the same as failure. And the psychological impact of treatment on patients is not always negative. (1) Hospitalization is too scary and one must get better in order not to be hospitalized: this makes it possible to make some progress with outpatient treatment interventions. (2) Do feel the power of hospitalization: try to recommend other patients to be hospitalized although you are afraid. (3) As the negative emotions subside and the benefits of hospitalization are gradually realized, hospitalization is slowly included as a possible option.