Therapists with Eating Disorders
If you polled a college eating disorders group, I bet about half of the individuals would be getting a degree in psychology (or clinical social work). Of that remaining 50%, maybe 20% of them are studying nutrition.
It makes sense–you’re drawn to pursue a career in something that you have exposure to. You’re especially interested in the field because of your personal experience. Maybe you are still trying to understand your own issues. Maybe (hopefully not) nutrition is convenient because you are obsessing over food anyway. Or maybe you feel like you were really helped by a therapist and want to give back to the community. It’s all related.
I’m not saying that any of this is negative–heck, I’m a psych major. I’m not really one to judge. However, my larger question is…
How do you feel about being treated by someone with an eating disorder history?
I’ve always felt very strongly AGAINST seeing a therapist who had an eating disorder herself. I think part of that is related to the competitiveness of the eating disorder (not that I think SHE will be competitive, but that I will be), but I also think part of it is about objectivity. I don’t know if you can be completely objective having suffered from the same thing yourself. I’ve never really wanted empathy. Maybe this is weird of me? I just have a thing about people with eating disorders guiding others with eating disorders. It’s the blind leading the blind. I want to work with someone completely removed from the eating disorder world.
I keep thinking back to Dr. Drew and Celebrity Rehab, because he always says “that is addict thinking.”
In contrast, I have friends who ONLY want to be treated by someone who has experienced it herself. They don’t feel like they could possibly be understood otherwise.
I’m sure the answer to this question is largely related to the specific situation… some therapists might not be quite as recovered as they need to be. Others, with no eating disorder history, maybe CAN’T really understand or really help push you.
I felt really strongly about this until actually working with a therapist who had recovered herself. I was a little shocked when she told me (after several sessions)–but it made sense. She understood THAT well–of course she had to have lived it.
Overall, though, I am very wary of people with EDs going that route and eventually treating eating disorders. With such a precarious definition of recovery, I have to wonder if doing this as your career is just another manifestation of the disorder itself–an excuse for it to be a part of your life.
The two best therapists I’ve ever had have never had an ED- and I have no idea quite how they ended up the field. I’ve had one therapist who had recovered, but we never quite clicked.
My first therapist told me she always tells her clients to avoid the field. “You’ve given enough of your life to the eating disorder,” she said. And I think it *can* be a way to cling to the illness. Not always, but it is a possibility.
I’ve thought about it, to be sure, and I certainly “stay” in the field by writing about EDs, but it’s also not my profession, nor do I want it to be.
Every long lasting therapist I’ve had did not have an eating disorder. Each of them, in some way or another have helped me through various issues. Only one has been specifically eating disorder specialized. I actually asked her why she decided to go this route, and she said, because she felt it was needed in the area and the person who supervised her worked with EDs. Personally, I wouldn’t discount seeing someone who had a previous ED history (though sufficiently recovered), but it just depends on the situation itself.
I agree with you that it can be a way of perpetuating the illness. The ones I really worry about are those who are still active in their illness or in early recovery and treating clients. I don’t think it’s fair to the client no matter how competent the therapist may be, but that is just my opinion.
I’m of the same opinion. I think I need someone to slap me around the head continually with the philosophy that an ED is a ridiculous waste of time, and is a “sickness” . I’m not sure anyone ever gets to 100% recovery (although I would love to believe it), and therefore I’d never be convinced that a therapist with an ED history could believe what they were saying with 100% of their being. I find it hard enough to trust someone who believes in their own philosophy 100%, let alone someone who still has a degree of doubt in their mind.
Carrie–
That was very well-said by your therapist. And I think that the field does need some individuals who have personally recovered… I just hope that they have been significantly removed from their own illness so that when treating someone their own issues are not resurfacing.
I also think that there is a difference between becoming an ED treatment professional and staying in the field. I have several friends who are very involved in advocacy work… media awareness, educating the general public, etc. I think we need people who have struggled to pursue interests in health policy and continue the fight for mental health parity.
It would be very hippocratical of me to say that any involvement in the ED world is disordered (since I do write this blog). I think that there are positive outlets for integrating your experiences. I personally am a little wary of including the eating disorder as a permanent part of my identity (even if I am a shining example of recovery), and would never jump to the other side of the fence and try to treat others with this same disorder.
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Lola and Tiptoe–
Since it sounds like we pretty much agree on this point, my next question for you both is: Would you want your therapist to tell you that they had an eating disorder? (since it clearly taints at least my perception of treatment).
Just another thought
Thank you all for your comments!
This is interesting, I have thought about this a lot too. While I have never had a therapist with an ED, I don’t think I would be completely against it. I was a psychology major for a while, and I think the main reason I chose that major was so that I could cling to my disorder… I am still tempted to get my masters degree in nutrition, but I’m not sure if its what I want to do or what ED wants to do. IDK…
I also would not want to be treated by someone with a history of an eating disorder. I know that I would feel competitive, and rather then focusing on my own recovery, would constantly be wanting to know more about my therapist’s history. In addition, I just don’t know if I could trust her to be objective.
My other question though is where to draw the line. I have had friends with therapists who don’t have eating disorders, but are currently dieting or have yo-yo dieted in the past. With the growing obsession about food, calories etc, I worry that it will become harder and harder to find ED therapists that can be truly objective and are not themselves dieting. I know that dieting can be healthy, but I would have a really hard time seeing a therapist that I knew was actively trying to lose weight.
I spent almost 3 years with a therapist who had recovered from an ed, and once she moved out of state I have been seeing a psychologist who has never had an ed. I loved my old t, but believe I am making quicker progress with my new one. Why? I guess we are going right after the heart of the matter – my lack of self-worth, full steam ahead. Even my dietician has noticed how quickly I am growing.
My husband is a business analayst, and he says it’s always better if he works for a company in an industry he’s never been exposed to before – because he brings them a fresh perspective and change can happen much quicker.
Interesting post.
Kristi–
Nutrition is tricky too. Sometimes I wish I never had an eating disorder so that I COULD get a degree in nutrition and treat others with eating disorders. (Although I also feel like I practically have a degree in nutrition…)
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BL–
That is such a good point re: dieting professionals. Several of my experiences come to mind… From a therapist who’s daughter was on weight watchers, to a nutritionist who was very focused on running marathons, to another nutritionist who lost a significant amount of weight. The first example was obviously unprofessional (even if I weren’t being treated for an ED, it would be unprofessional to discuss her daughter’s diet). In the second example, I was unable to trust the nutritionist at all. She seemed disordered herself and I felt competitive. In the third, I really did trust that nutritionist and she decided to lose weight because she felt she “wasn’t as healthy as she could be”… but it is still upsetting to work with someone who is losing weight.
Grey, I think it depends on the situation. Intimate details like having had a history of an ED would only be helpful to me if it were used as a therapeutic means. Otherwise, I don’t think I’d necessarily want to know.
BL’s point about dieting professionals reminds me of a professor I had in college. She’s a well known feminist author on popular culture and body image. I couldn’t help notice that when we had classes or if we went over to her house (we had a few classes there), she was on the Atkins diet! I still admire her work immensely, but it just leaves me a little confused.
Grey, I think I’d want them to be open from the start, so I had a chance to find another therapist! I wouldn’t be comfortable working with them after that. I would not be impressed if it was something which a therapist announced halfway through treatment, the fact it had not come up before would make me think they had kept it from me intentionally. Possibly that they had their own doubts that it might effect the sessions. Especially if things were not going according to plan, i’m sure I would find their issues to be the problem! Not that I would necessarily be correct in that conclusion, but I’m not all that good with trusting therapists…
I go back to the “addict thinking” idea … people who are abstinent from drugs/alcohol and work in treatment centers often seem to do so as part of their sobriety. Additionally, a recovered-therapist might be maybe more invested in learning more about themselves/figure themselves out via working with clients (albeit probably not consciously) … than purely “for the work.”
It’s not the same as someone who has had cancer, has diabetes, etc., working as clinicians in those fields. Eating disorders have psychiatric, psychological and personality implications … and just because someone maintains remission, adequate nutrition, and/or a seemingly functional lifestyle … doesn’t ameliorate those dispositions and pre-dispositions.
If someone with an ED history wanted to be my psychopharmacologist, I probably wouldn’t have a problem with that, as long as they were just writing my prescriptions and weren’t involved in psychotherapy, driving an overall treatment plan, or engaging in patient relationships within the context of an inpatient or partial ED-specific program.
Regarding dietitians, I have worked with a couple who have had ED histories (and said so), several who didn’t declare any history, and one or two who seemed questionable but didn’t admit or deny personal history. I *can* say that, even though the historied dietitians worked well with me, there is a definite difference between the two groups.
The RDs who didn’t declare or seem to have a personal history didn’t seem to have a personal investment in me and were more generally interested in the *science* of nutrition, physical repletiona and rehabilitation, and mathematics/solving the “problem” of starvation, slowed or delayed weight gain, and physical complications.
The other group seemed more interested in *emotional* aspects of dealing with the illness.
I often wonder if all the people with ED histories who go into nutrition would be so interested in doing so if they were limited to working in more clinical environments, like hospitals and nursing homes, determining drip rates for burn patients, head-injury clients in comas, elderly patients with dementia or multiple health concerns that limit their diets … working out menus for company or school cafeterias, working in world-feeding programs. No one-to-one consults or private appointments, no gym or health-center clients.
If they would, then I think they should go ahead with nutrition and stick to those areas. If none of those other areas are of interest, then I think it is fundamentally an indulgence of a (perhaps) latent (or not so latent) eating disorder.
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An interesting and thought provoking post but I couldn’t help noticing the gender bias. The only recovered therapist I know is male.
Thinking about this post again, it reminds me of a friend who is a RD and has anorexia (recovery seems to come and go). At one point when I talked to her about my problems with seeing a dietitian, she told me she could just give me a meal plan. I politely said no. There was no comfort in that for me irregardless of how professional or knowledgeable my friend is.
Nonny Mouse,
Sorry if I offended with the gender bias. I use female pronouns throughout my posts because it’s too tedious to use he/she and his/her. I realize that eating disorders are something that men struggle with as well. Also, in this case, I’ve never really had a male treatment professional (well, a psychiatrist that I saw a couple of times, but that’s it).
Gender does add an interesting twist to the question, though. While my thoughts on the issue are similar (especially re: objectivity, “addict thinking,” etc.), I think that having a male therapist would probably change the dynamic a little bit. I think that I wouldn’t worry about being competitive or triggered quite so much.
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Tiptoe,
I don’t think I’d be confident trusting anyone (therapist or dietitian) who did not seem solid in his/her recovery. However, I will admit that I’d be curious to see what that meal plan looked like (how healthy would it be?)
I n general, I think people with eating disorders spend most of their time preoccupied with themselves, their bodies, their control, their food in-take. I would want a therapist who could help me focus on my problems. I don’t think she could do that if she had an active eating disorder.
On the other hand, I’m not sure how I would feeling seeing a fat therapist either. There would be too much fear that following her advice would lead to acquiring her body type.
I’m fat and I have an eating disorder, not all people with eating disorders are skinny. Why wouldn’t you want a fat therapist, heck I might feel more comfortable about myself if my therapist was bigger then me then I wouldn’t me thinking oh I’m so fat and she thinks I’m huge.
Just re-read this. Something I’ve been thinking about and have no idea what the answer is… is it appropriate to ask your therapist questions about themselves? My last (first, and saw her off and on for 5 years) therapist and I crossed so many boundaries… it was pretty ridiculous. So with the one I’ve been seeing when I started I didn’t want to know anything at all whatsoever about her as a real person in the real world. Well of course over time things come out, so I know she’s married and has at least one child… but I am now curious if she relates personally to my two “main topics” (EDs and LGBT) or if she’s just trained/has known people who relate in those areas. I don’t know if it’s appropriate to ask though….
And I always thought I’d want a therapist who had an ED so they would understand. I allowed myself to just assume she did, but honestly I have no idea. Which in hindsight, is interesting I did that.
i think its a really difficult issue, i don’t have an eating disorder but suffer from PTSD as a result of sexual abuse. My therapist disclosed that she went through a similar journey due to sexual abuse. our work together went really well, but then after i went through a really bad patch (deep depression) she said she couldn’t work with me anymore – i’m left wondering whether our stories were just too similar and she had lost her boundaries. its sad cos i’m left feeling a bit angry and confused about it…..and now i have to try and find a new therapist…
I think someone with an eating disorder would be a good therapist because they have been through it and understand, only someone who’s been through it can truly understand. Though I know I’m biased since I am recovering from an eating disorder and I’m studying soc and psyc and hoping to get my masters in social work. I want to help people. Not sure if it will be specifically eating disorders or something else. Though I think it’s true a lot of people study psyc and nutritian who have eating disorders, but I think a lot of people with mental health issues study psychology. Not all of them will be therapists. Though I really think I would rather know someone understands and has gone through it themselves. If i know someone has recovered from an eating disorder and was able to move on then I know I can to.
Great article. I can