5 Considerations for Finding the Right Eating Disorder Therapist

photo-1493150134366-cacb0bdc03feIf you have ever sat down with a counsellor you may have stories of support and good feelings about your experience.  On the other hand, based upon your first experience, you may have vowed never to step foot in a therapist’s office again….and based upon the stories I hear from my clients, I don’t blame you one bit.

I have had many opportunities to interview and get to know a wide variety of therapists. All have their own unique approach and style to therapy that suit some but not all.  The trick is finding one that speaks your language and helps you feel at ease and supported.  Unfortunately, when it comes to therapy paid for by the medical system, the choices are limited and the social workers are hand cuffed to the “best practice” and not what may be suited to the clients needs.  This care results in what is best for the medical system without much consideration to the clients needs.  I get that. Our system sucks and there isn’t enough funding to fully support those who need it.

So it got me thinking…when it comes to supporting people struggling with disordered eating, exercise, and body image what are some of the most important characteristics of an effective counsellor? Here is what I came up with.  Please note: these are characteristics and not theories.

Person-Centered:

If a therapist is able to meet the client where she is instead of expecting the client to meet the therapist, that is a person-centred approach.  It’s a combination of validation, empathy, and absolutely no judgement.  This approach may include listing all the good things or benefits of staying with self-harming behaviours like anorexia or bulimia.  She will approach these behaviours with curiosity, patience, and validation instead of working to stave off or move towards healing without getting a picture of what these behaviours mean to the client. A person centered counsellor sits with the client in their stuff.  She wades in it, she rolls around in it, she is interested in it, and she learns to understand it’s worth to the client. When you are working with a person-centered counsellor you know; it feels safe, protected, non-biased, and supportive.

Talks Your Language:

There is nothing that pisses me off more than, what I refer to as, “counsellor-speak”.  Words like “emotional regulation” or statements like “breathing through your heart space” can really burn my bridge. I was attending a week-long workshop with 800 other counsellors when the counsellor on stage asked us to stand and “breath through our heart space”. I turned to my neighbour and said, “I’ve been formally trained as a kinesiologist and never learned that the human body has a heart space…where the hell is it?”

Maybe I just don’t get it or I’m another type of counsellor, but no matter how hard I have tried, I cannot get behind  that type of talk.  In my opinion, a good fit is a counsellor who attends to your language and uses words that relate to you. If I am working with a client who swears like a trucker, I’m not going to ask them to connect with their soul and breathe through their heart space (sorry, I’m really stuck on that one).

Understands the Many Influences of Disordered Eating:

Today’s disordered eating is not your grandmother’s disordered eating. Today’s influences of eating disorders, exercise abuse, and negative body image have roots in a wide variety of factors.  Social media, school based health promotion programming, increased prevalence of food allergies, all those diets mom and dad are on, the sociocultural beliefs that fat is the enemy and thin is healthy….and I could go on and on.  An effective eating disorders therapist must be aware of these factors and must elicit a conversation around the stigma of fat and our culture’s obsession with thinness.  The health, diet, and exercise industry is now on steroids and can reach us at any minute of every day. To ignore this is to try to ignore gravity as you jump off the cliff.

Walks the Talk

I have a theory that all kinesiologists have exercise addiction issues, all nutritionists have eating disorders, and all counsellors have mental health challenges. So if this is the case (which of course is more my belief than fact) it is safe to assume that eating disorder counsellors are born from their own experience with eating disorders and/or body image issues.  Therefore, it is more important than ever to find a counsellor who has done their own work and practices what she preaches to be able to support you in an authentic manner.  Asking you to work towards body acceptance when she goes home and berates her belly will slowly show up in sessions (this stuff can’t be contained; our beliefs show up in our non-verbals).

If you are curious about your counsellor’s beliefs, there is no harm is asking your counsellor how she feels about her own body. I have had a few clients ask me this question. Each time, I have been completely up front and real about my own experiences with body image and the challenges I still have today (albeit mostly worked through), but you can’t be a person in the world without being influenced by our culture’s hate-on for fat. Authenticity is about being transparent with your clients (in my opinion). This establishes a stronger sense of trust and relationship that can only further support the work you do together.

Freedom from Judgement

Sometimes it is inevitable. I may hear a story that rocks my faith in humanity and without thinking give off a little facial tick that suggests judgement. Even though we, as therapists, try to sit with our clients in their shit (so to speak) sometime we are hit across the face without warning. Although it may take some time to establish a sense of trust, it is important that you feel heard, understood, and not judged by your counsellor.

The example that comes to mind is talking about suicide. It takes clients courage to even hint at thoughts of suicide so if you feel a sense of panic or fear coming from your counsellor it tends to shut communication down.  Conversely, if one is feeling comfortable and invited to talk about reasons to die, it is the first step towards life.  It is vital to work towards a judgement free and trusting environment with your counsellor and it is equally important to find a new one should this not be happening after a few sessions. It may take one or two to establish that sense of trust, but if it doesn’t happen it may simply mean it isn’t a good fit.

Of course there are other important qualities but here’s the thing.  There are counsellors that practice Narrative Therapy and some that all about the Cognitive Behavioural Therapy while others are firmly planted in Solution Focused Therapy…in the end, it doesn’t matter.  In the end, it is all about the relationship you have with your therapist that will move you towards healing and good health.  The rest of it is icing on the gluten enriched, fat laden, pro-biotic, chocolate cake.

That’s all I got.

Kathi

 

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