As a therapist, treating an eating disorder is complex, multi- faceted, and non- linear. It requires the ability to collaborate with a strong team of both professionals specialized in treating eating disorders as well as the loved ones who are integral to the individual’s recovery. It is this experience and more for an individual who is contemplating seeking treatment or beginning treatment.
An individual in the early stages of recovery may be confused by where to start and whether now is the right time for them to commit themselves to treatment. It is common for individuals to delay seeking help due to distorted comparisons and questioning whether one is “sick enough.” An individual who is initially seeking treatment may be more externally motivated as friends and family begin to notice changes in behavior and/or physicality; and begin to express concern. It may be difficult to reveal the secret of an eating disorder to others due to fear of judgment and loss of control. An individual therapist and support group can provide a non-judgmental space to talk about symptoms and successes.
Therapeutic rapport and trust is frequently challenged and must be attended to throughout treatment as an eating disorder therapist likely is providing conflicting information from all the environmental, physical, intellectual, and emotional sources that are reinforcing the eating disorder. Friends, family and sometimes even other health professionals not specialized in the treatment of eating disorders may be praising weight loss and exercise stamina. Nutrition websites provide convincing information on diets that should be strictly followed and foods that are to be avoided. Media and marketing provide endless messages that maintain core beliefs of not being “good enough.” As a therapist, it is often an uphill battle to fend off myths that are coming from multiple sources.
Eating disorders are compelling and are maintained for a reason. They provide incredible amounts of visible reinforcement in a world that often lacks clarity. They numb individuals who are escaping emotions that are uncomfortable. For many making oneself feel physically empty or filling an emotional void becomes a coping skill for dealing with depression, anxiety, and trauma. It is controllable, measurable, and precise unlike the emotions that are being avoided.
The important work in eating disorders is about addressing the ability to cope with emotions, yet one must be nutritionally nourished first in order for this to occur. Individuals with an eating disorder then must be practicing new behaviors and integrating new information about their health while gaining insight into thoughts and beliefs that have maintained their eating disorder.
As a therapist, we have some real big asks of the individuals brave and insightful enough to start treatment. My hopes for the people that I have the opportunity to work with are that they are able to increase the ability to trust in order to ask for help, to embrace being flawed, and to increase emotional and physical balance in their lives.