Monday, November 24, 2008

treating from experience.

Over at GreyThinking, an interesting topic has been raised. Here's a little summarizing excerpt from her entry:

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.

Before this, she raises the obvious point that a large part of our community is hugely interested in pursuing degrees in psychology and nutrition (guilty). This, of course, is based on the fact that we are drawn to what we are exposed to.

Now, my therapist is absolutely incredible. I don't know what it is about him; he has never personally struggled through an eating disorder, nor did he ever imagine that he would even be in the field. He was just lucky he had a psych degree to fall back on after his first career choice [in sales] did not pan out.

However, there were two women that really played a huge part in my recovery. One was my best friend from college, who had recovered herself. Her role was very important because I was unable to fully accept recovery until I could see that it was possible, which she showed me while sitting on my hospital bed one night last fall.
The other was a counselor at one of my treatment programs. I knew, long before she was able to tell me, that she had recovered. Many of the counselors were very good, but she knew how to communicate with us on a different level than most of the other doctors. She knew how to talk and how it felt and how to word the things she said, as she had experienced it all. Nothing was more comforting than being able to talk to someone who really knew what it was like.

I am hoping that's how people will feel when I am able to get more involved, personally, with others' recovery. I want to be in treatment, but from the other side because I feel like I could make such a huge difference having gotten through it. Patients have such a difficult time trusting doctors as it is; I think it would be easier if they knew where they were coming from. No matter how good of a therapist you may be, you can never get into someone's head. Someone who's already experienced it is already there. That is as trustworthy as it can get.

Now, GT raises the point that treating patients may be risky to both the patient and the provider based on how recovered s/he may or may not be. I do not believe that anyone who is not absolutely fully recovered should be treating anyone, as I would think it would be detrimental to both parties' recovery and treatment. I assume that goes without saying. You cannot help anyone until you receive the help you need, first. I would hope employers would double check information like this before hiring treatment staff? I don't know how that works, but wouldn't any treatment center - eating disorder, drug, alcohol, etc - check for a background history of behaviors before allowing someone to treat others for it?

What are your thoughts on it? Would you prefer to be treated by someone who has never personally had ED in their life, or someone that totally gets what is going on with you and the way your brain works from the inside?


Anonymous said...

Hi Emmy,

Thanks for the pingback. If you going into treating others, will you tell your patients that you personally have recovered?

Just curious,

licketysplit said...

One of the only therapists that was able to actually help me and motivate me toward recovery was my IP therapist that had recovered. Personally I prefer seeing someone that's been in my shoes, as long as they are FULLY recovered, but I understand the other perspective as well...

saa said...

I have heard horror stories from people who felt competition with a "recovered" counselor. I would be very wary of a recovered in making sure they are truly RECOVERED. However, my therapist is 56 and she had an ED when she was 12. She is totally recovered, yet does have some insight and I am thankful for that.
As we know, ED's are not one size fits all. Some disordered behavior is more rooted in environment than biology and some not so much. (or this is what it seems like to me). I think certain patients could be more triggering to a therapist than others and vice versa. I guess I'm saying that I really think it should be a case by case basis. Food is not just a bad situation you can remove yourself from and then help others, you drug addiction or domestic violence. I think it is noble to want to do so, I just think it could be very dangerous and one must be careful. Also, Im not sure why but I have trouble seeing male doctors and always try to find a woman. I could not imagine seeing a male therapist. Hmmm not sure what that means. Maybe i feel just feel like I could relate to a woman more? Do you ever feel a disconnect, due to gender, when seeing a male therapist?

saa said...

Wow, sorry that was so long!

Labyrinith said...

I am wondering who this person was and if I know her because...hmmm (mind is churning). Anyway, yes I do like knowing that my nutritionist has been down a road with an eating disorder, not the same as mine but one just the same. And, another one I had in the past. For as phenomenal and wonderful as my doctor is, and we know S is open that she doesn't 1) have a history or 2) consider herself an expert there is a struggle there where I feel I do more educating on "what eating disorders are". There is a fine line between the client/therapist/etc relationship where the treater can't "go over the line". What is that line? I guess it depends for each individual. I love your therapist. Dammn him if I could get him to call me back! LOL! Love you Em!

rerobbi said...

It's kind of like seeing a male gynecologist. They’ve studied a woman’s body for years and understand all the parts; however they can never understand fully what it's like to be a woman. It's like being a doctor for a guy. I can study the penis for years, but I will never understand fully what it's like to get kicked in the balls. Personally I prefer someone that's been there done that. If you're with a true professional they will recognize a patient’s behaviors and help the patient work through thier issues. In therapy it’s about finding someone you can connect with and feel safe with. Actually that’s true for anything isn’t it? :)

emmy. said...

GT: you're welcome :D i'm not sure if i would tell my patients or not.. i've put a lot of thought into this. i know there are many places (as i have experienced) that have very strict boundary rules against that sort of thing. i think it would be difficult for me to not just be like, "OMG I TOTALLY KNOW, right?!" yanno in a less.. 12-year-old format. however, i think the important part is not that they know.. which is where it gets dangerous. that's why there are such strict boundaries some places. maybe patients *shouldn't* know when their therapist is recovered.. i think the biggest importance is that they can feel ultimately related to.

saa: it's interesting that you bring that up. i have seen many therapists of both genders and it took me years to find the one i have now. i have only seen 2 women and i had terrible experiences with both. one was a giant b!t@h who, legit, told me i would be best of dropping out of high school because i clearly didn't care; the other liked to hear herself talk more than me and never cared to dig deeper, which drove me insane. in general, i have always related to men much better than women. i have mostly guy friends and, in general, love their way of thinking much more than women. i find they tend to be far better listeners than women, as chicks seem to always feel the need to inject their own thoughts into every one of mine and i can't get a full sentence out (from my own experiences with.. ALL women..) so, in short, i feel actually feel a much *greater* connection with a male therapist. i relate to that gender much more comfortably. (haha, you thought YOUR comment was long ;)

kierst (lab): i totally agree. those boundaries are there for a reason, which is sort of what i referred to in my first response up top. i find myself sort of struggling with that. is it better to tell your patience that you've recovered? will they not feel the same connection if you don't, or is it just about how you can relate to them without them actually knowing?

mom (rerobbi): leave it to you. all these serious comments and then.. "it's like seeing a male gyno," hahaha ;) however, your comment is perfect. that's exactly how i feel, on a less personal level. i mean, i would never see a male gyno just like i would (outside of B) prefer to talk with someone who's recovered.. but there's no hiding that you've never been a woman. (well.. in most cases..) love you ;)

[wow, congrats if you read all those, haha.]

Michelle said...

I honestly don't think I would actively choose a therapist who is in recovery. I think that shouldn't be criteria for choosing one. Do I think it would be helpful to some people yes, but I am not sure about disclosure on the therapists part. Some therapists may be recovered of a mental illness, but not all of them disclose this when treating a patient with the same mental illness.

I am not saying it's a bad idea. I would love to help people with eatind disorders but how do you fully hold professionals in the past accountable to their issues that might come up, and not transfer to the patient, which could happen either way.

They have treatment centers fully run by people who recovered from alcholism so I guess it's not too far off the topic.

I see or read alot about people calling there therapist, emailing, becoming too reliant and boundaries being over stepped, I wonder if the variable of being a recoverd therapist, would have a higher incidence.

One of my first therapist's daugher was recovering from anoerxia, and the daughter was also going to school to be a therapist. Now she was one mindfucker, and told me I could actually lose 5 pounds...but i think as my primary diagnosis of bulimia going to a recovery anorexic would bother me, i wouldn't want to know. Weird, my issues.

I still have that yarn if you want it.

Cristina said...

It's like... I already know my thinking is messed up, but I don't want someone else that I'm putting my feelings into have the same sort of mindset. I don't want someone to treat me who had a disorder. I don't see that being a healthy recovery based relationship.

emmy. said...

i know what you're saying, but when you're being treated by someone who HAD an eating disorder, they no long have the same thought pattern.. they just understand what it *means* to have that thought pattern. couldn't that be helpful?