We are so excited for the Academy of Eating Disorders International Conference on Eating Disorders and our Chief Executive Director Dr. Wendy Oliver-Pyatt’s participation on the Residential & Inpatient and Professionals & Recovery Special Interest Group Panel today, discussing “Opportunities and Risks with Recovered Clinicians: Ensuring Well-Being in Residential/Inpatient Facilities and the Eating Disorder Community.”
In the theme of the SIG panel, we are kicking off a very special four-part series from Dr. Wendy Oliver-Pyatt on the understanding, importance, and process of self-disclosure within a treatment setting. Our first post will introduce you to the topic and focus on truth in disclosure, and will provide the most important steps in Dr. Oliver-Pyatt’s book, Fed Up!
“I see no reason to have bread in this house!” These were the words spoken to Vicki, my co-founder of Oliver-Pyatt Centers. At the time we were college roommates at the University of Denver. Both of us struggled daily with food and our body, frequenting the popular diets of the times. The most coveted was the TWA Stewardess Diet, with pork chops and cauliflower on day one, fish and squash on day two, and my favorite day – day 3 with the hamburger patty and apple.
Little did I know where this was all heading. Once at a NEDA conference we were asked whether Vicki and I were “competing” to be sicker during our college years together. Vicki explained that for us, we were both literally trying to be our best. And that is what a person with an eating disorder thinks they are doing. The only problem is that the road to hell can be paved with good intentions. No truer is this than when dealing with an eating disorder.
In no way do I think that one must have been impacted by an eating disorder in order to be a fully effective clinician. I know through experience that this is not the case. However, my experience of an eating disorder does inform me in just about every treatment decision I make, and has informed me in how I have set up the structure and environment of Oliver-Pyatt Centers.
When I was first asked to start an eating disorder treatment center, I had not previously worked in any other eating disorder treatment unit. My only experience was my own history and my experience working on an outpatient basis. I truly felt unable to say yes to the offer to start this program. The thoughts in my mind were: “How can you do that Wendy? You’ve never worked in an eating disorder unit, who are you to do such a thing?”
I had the good fortune of having a few people in my life who really encouraged me, despite my lack of exposure to an inpatient setting. And eventually I opted to open my first residential center. Over time, I came to realize that what WAS my self-identified “weakness” (having only worked on an outpatient basis with eating disorder patients) became my strength. I could more organically create an environment and program that made sense, which used natural (vs artificial) consequences of the eating disorder and a principled approach to navigating the psychological issues, in addition to a foundation in exposure therapy, psychiatric management and medical/nutritional protocols.
Why I am giving you this back-story? I had a choice to make it right from the beginning. Would it be known to outsiders that I had experienced an eating disorder in my past? How would I manage this?
One thing I have discovered over time is that when faced with a dilemma, one can always make an argument for the truth! The truth was that I had a history of an eating disorder and it had informed every decision I made! Vicki, my co-founder, also had an experience of an eating disorder, which made our joint partnership in our creation of OPC fluid. And so we created OPC with the truth in mind, which was that we had both experienced eating disorders.
Fortunately for us, a few brave others had already begun to carve out a path for disclosure. Carolyn Costin was the first. Initially, Carolyn and I did not speak a great deal about this shared experience, but there was a common thread and a mutual understanding of what this experience felt like. For me, it was easier because Carolyn had already done it. She had chosen to tell the truth. And I owe her for being brave enough to speak this truth.
Additionally, I had already faced this dilemma and “come out” with the truth when I wrote my book “Fed Up” which was published by McGraw Hill in 2002. In writing Fed Up, it was my intention to use my experience to help prevent eating disorders. It was my intention to self disclose for the purpose of adding credibility, authenticity and hope to an approach that could lead to mindful eating and mindful living while emphasizing the importance of acceptance of natural body weight.
Four of the steps described in my book that were built on my own experience and are most helpful to my patients are:
Step Three: Decide you are good enough today to love yourself today. This step emphasizes acceptance. I ask my patients to wake up each day and live the way they would if they were in the ideal body that would make everything so great. I want to emphasize the importance of not waiting to live, and the importance of choosing the loving behavior (what I call CTLB) each and every day. Choosing the loving behavior is a way to guide people through the torment of the competing inner thought battles that occur with an eating disorder.
Choosing the loving behavior means you deserve to take care of yourself, you deserve to eat, and you deserve to take up space. And if ever in doubt about this, as can be the case when going through the recovery process, you can always simplify things and distill it down to something more simple, remembering there is never a reason to not add love to the world, even if it is adding love into your own world. And what is love without loving behavior?
Step Eight: Break through the Secrecy. This step emphasizes the release of destructive shame which I think is pivotal in the healing process.
Step Nine: What’s more important than dieting? Finding meaning outside of the eating disorder, and getting connected to your values and purpose beyond the values and directives of the eating disorder is life-changing and takes a lot of work! This chapter fits well into an ACT model- thinking big picture, and connecting to your values.
Step Ten: Preventing eating disorders and obesity in children. I have some regrets about the title of Step 10 with the use of the word “preventing.” What I didn’t realize at that time was how incredibly complicated it is to raise a child and how it may not even be true that we can actually prevent an eating disorder, if the environment and genetics all are heading the person in that direction. But I am trying to do something about how weight is approached and managed in our society and in our schools. This is where the activism comes in. In co-authoring the Academy of Eating Disorders’ Guidelines for Obesity Prevention Programs, my hope was and is to have some input on where our society is heading with the “war on obesity,” which I see as destructive and misguided. Having my own two daughters makes me even more passionate about this!
All of this is so connected to my own experience, that if I were not to disclose, it would be inauthentic. I would be compartmentalized and unable to speak the truth.
Check back every Thursday for the next month to enjoy the full series.