Things to watch out for and to keep in mind:
How able is your patient to actually identify her feelings and tell you how knowing her history may be impacting her? I have learned some very interesting things from patients via follow up surveys about my disclosure after they have left my care.
Be aware of the potential for splitting – patients may say something like “only the ones with an ED can understand” which is not true. Some of the most impactful and powerful therapists I have ever known have not had an eating disorder!
Be aware that there are things going on in the patient’s mind about your body and food and your life, regardless of whether you have an eating disorder or not. And keep in mind that even a clinician without an identified eating disorder history can be dysregulated with food and / or body. In some cases this can be even more potentially damaging than working with someone who has had an eating disorder and is now recovered.
I believe because of my own eating disorder, I had to completely change my approach to food, and learn the principals of mindful/intuitive eating. Ultimately, this led to a much freer relationship with food than many people I know who have no prior history.
Most patients report that knowing of the history of an eating disorder in a clinician is a powerful and motivating experience. I often define for patients the Webster definition of work. Work is defined as “mental or physical energy directed toward a goal.” I share the reality of recovery having taken work.
Having had an eating disorder and being in a position where I had to walk the walk of acceptance of my natural body weight (which is an essential precursor to having a relaxed relationship with food,) I think it is important to let patients know that taking the leap toward acceptance of one’s natural body weight is THE most important component of my recovery.
They have to work on this each day. Meaning that each day they have to put forth “mental and physical energy” toward the goal of accepting their natural body weight. I think the fact that I live in my natural body weight has a positive influence on my patients.
I believe the story of my recovery, when shared in a thoughtful way, has been effective and helpful.
Self-disclosure can provide hope, humor, connection, inspiration, and perspective. This can be powerful! There have been times when my talking with a person with a severe eating disorder, and being able to talk a little bit about my history in a thoughtful way, has made the difference as far as that person packing their bags and entering treatment. And recently, our medical director “Dr. J,” has told some of the more mature women we work with about his sister’s late recovery from her eating disorder, when she was in her mid-40s. This was very impactful for our more mature patients.
In therapy, a key piece of treatment is authenticity in both the patient as well as clinician. This authenticity is the foundation for connection, and all of the wonderful things that follow when authentic connection unfolds in treatment. In my mind, it is not so much about whether the therapist has a history or doesn’t have a history. It is about the truth, connection, and being emotionally available, and most importantly emotionally honest in a loving and directed manner.
My own history of an eating disorder and being recovered helps to inform me about some of the thoughts and feelings my patients may be experiencing, and gives me hope for my patients which I pass on to them.
If a person who once said (and meant) “I see no reason to have bread in this house,” is eating a bagel and cream cheese with some sausage and not thinking twice about it, this informs me that full recovery is possible – being recovered, not “in recovery.”
This truth of my recovery motivates me personally in my work with patients. It leaves me feeling that one cannot ever give up, and that every stone must be turned for every single person we treat. I would never want to hide why it is I feel so strongly about this.
So I have chosen the path of self-disclosure. I now see many reasons to keep bread in my house, and for that I am grateful.