Being able to trust your therapist is vital to any sort of successful therapeutic work, but it is especially true for those in eating disorder treatment. Throughout my years as a therapist treating eating disorders in various settings, including residential treatment, day programs, and outpatient therapy, I have learned the significance of trust and vulnerability within the therapeutic relationship.
As someone who went through eating disorder treatment myself, I know the thoughts that went through my head and the thoughts that my clients now share with me. There was the common thought, driven by the dark voices of the eating disorder, that I should not trust or listen to my providers. I mean, how did they know what was best for my body? How could I trust that restoring weight would actually be helpful in a world that was telling me the opposite? My therapist and dietitian kept telling me that life would be better without the eating disorder, but how did they know? Had they been through an eating disorder? Throughout my treatment I never heard from someone who had actually recovered from an eating disorder. This made it hard to believe that recovery was worth it, let alone possible at all.
Eventually, after years of struggling and for a variety of reasons, I decided to give full recovery a shot. And, my providers were indeed correct, as I learned living without fear of food and weight gain was utterly freeing. However, I think it would have been easier to believe this in the first place if I had heard from someone with first-hand experience. I was always wanting to meet someone who was on the other side of an eating disorder.
This desire of my own eventually led me to speak publically about my recovery. I began to give speeches to educate the public about eating disorders and share my story. I was on radio shows and spoke at community events and recovery groups. After several years of sharing my personal narrative, my passion to help others and eradicate eating disorders continued to grow. I decided to carry out this passion further by becoming a therapist and working to help combat eating disorders professionally.
This brings me to my work as a therapist and how my own journey has influenced my current work. At the forefront of this work is my goal to thoughtfully use my own experiences to benefit clients.
In the world of substance use treatment, discussing one’s own recovery status as a professional is fairly common. Within eating disorder treatment, it is less so. However, it is my belief that hiding it just gives way to the stigma and shame that exists in our culture regarding eating disorders. Pretending and lying are not part of my repertoire. This is not what I want to model to clients. Thus, I model vulnerability by sometimes sharing with clients that I too have been through an eating disorder and the intense treatment that accompanies it.
However, at the forefront of my mind is always the question: How do I share in an ethical way in order to use self-disclosure in a helpful way?
First, I do not announce my story to every client. I do not share it in the first session or even the second. I use intuition and discernment to know when it might be helpful or unhelpful to share. I am also sure to keep in mind and tell clients that everyone’s journey to recovery is different, including mine. Something that is helpful for one person, might not be helpful for another.
So far, when I have decided to be vulnerable and use self-disclosure as a therapeutic technique, it has made a world of difference within the therapeutic relationship and for my client’s recovery journey. First of all, I notice right away that clients become more at ease in my office. There is less shame and more acceptance immediately felt, which allows clients to be more open to sharing.
Furthermore, the client’s ability to trust me as their therapist increases with self-disclosure. The eating disorder has less credibility and I gain more credibility, which makes recovery that much more possible. Trust and credibility need to be high because I am trying to convince my clients to do the things they have come to hate most – eating food and taking care of their body.
Clients report my self-disclosure has also increased their hope because they can start to believe full recovery is possible. This is one of the hardest things to believe when in the midst of an eating disorder. Some doctors, therapists, family members, and friends have even told my clients that they will probably struggle with eating their entire lives. I also heard this message while in treatment.
These comments lead to discouragement and often cause clients to ask, “What is the point of even trying?” I can be the person to tell them that trying is the best thing they can do because they do not have struggle for the rest of their lives. I tell them not to fall prey to this lie, and I use parts of my own story as proof. Yes, the journey is difficult, but the resulting freedom from an eating disorder is more worth it than I can ever express with words.
Ashley Baird Urbanski, LMFT is the current MAMFT Administrative Coordinator and also has a private practice, Holding Hope Therapy, LLC in Osseo. Ashley specializes in treating eating disorders, body image issues, and disordered eating. She is passionate about challenging cultural narratives about food and body in order to help others restore or create positive relationships with food and body.
