If you are going to work as a therapist in the field of eating disorders you will do well to remember two things; 1) your client lives much of her life in the dark and 2) you are a bearer of light.
Someone struggling with an eating disorder loses touch with reality, especially as it relates to her body and food. She will make decisions based on what she believes to be true despite the clear evidence of her declining health and the protestations of those around her. It’s as if the eating disorder has turned off the lights in the part of the brain that thinks rationally about food and weight even though she can think clearly in other areas.
The lights also go dark in the room of honesty. A normally honest young woman can begin to deceive and lie in order to lose weight, hide food or sneak laxatives.
This brings enormous challenges to the counseling relationship. It sets you up for power struggles, means that often you are working with limited information and may cause you to question the client at nearly every turn, even on issues not related to food or weight.
Darkness also comes in the form of self-hatred. A view of herself that says she is unworthy, despicable, gross and weak and, the one that you will be most tempted to believe; that she is hopeless.
Your commitment to the truth can make you the enemy and she may treat you as such. She may dismiss you because you “want to make her fat” or she may simply ignore you because the voice of the eating disorder carries more intensity and volume. This is when you need to remember that you are a bearer of light.
You must hold tightly to light and truth when it comes to issues of weight and food. You must create a safe place for her to confess her deceptions and manipulations. But most importantly you must never, ever agree with her sense of self. This is the most difficult challenge you face.
You will be tempted to give up, to think she can’t change, and to define her identity by her behaviors. But you must not forget what is true. You must not believe the lies of the eating disorder.
She is made in the image of God. Behind every decision and motivating every lie are good, God-granted longings for a life of meaning, significance, safety and relationship. No matter how twisted the means become she is seeking to meet legitimate needs. Treat her as such. See in her the image of God beneath the carnage. You must.
There are times when you are the only one holding light in a very dark place and if you leave the room the only light left goes with you.
This is so beautiful. It made me cry. I’m 27 . . . I’m smart . . . I have a good job, etc but I just didn’t know.
The voices in my head were deafening. It’s been about 8 months and just lately I feel like I can think clearly enough to recognize some of the things I was believing. It’s like it’s quiet enough . . . not quiet just quieter that I can pick out things now . . . for example last week I was able to share with my therapist two things that I didn’t even really recognize before. Before I totally personified my scale it makes me feel crazy but I totally believed that it lied to me . . . on purpose. I would be so angry at it both when it was up and when it was down because I didn’t believe it. Also I didn’t know that showers were hard for me I just thought I was stupid and lazy but now that I can think clearer I can recognize that I hate them! . . . both of these things are still issues for me that we will work on . . . and I’m sure there are more I don’t know yet but I’m just so thankful for my counselor and being where I am even though it’s incredibly hard I can finally see that it is so much better than being back where I was. I had to work so hard to not lie. I went to therapy willingly not only willing but wanting to go but I still had to work hard not to lie because it’s just been my way of life for so many years. I told her I won’t lie but I just don’t know if I can always can tell you. Sometimes I leave a session and realize later a day later that I lied about something and send her an email. Also I think one of the hardest things were hearing the health risks and not believing that they would happen to me and not caring if I did die. This morning for a moment I can actually believe that I’m not hopeless maybe it will last all day.
Hi Travis,
It’s Eugene over at the +Parenting blog. This was definitely educational for me! Thanks!
Thank you for this, Travis. Very well said — and such a needed reminder. Appreciate you!
Hey Jena – let me know if you want to post anything re: your role there at TK… we want to share all points of view from those of you in the trenches.
I would love to, Constance. Please email me details as to how to go about it, whenever it works for you. Grateful for you!