Hey Jillian when my ED was raging out of control last year my T was extremely confronting about it every session and referred to it as an addictive behaviour and im afraid to say i think he's right. and i had parents who were addicts and i don't like the association either and there is a lot of shame wrapped up in it. i did have a very solid alliance by this stage though. Although it can seem harsh and awful, I think when Ts get on our case they have our best interests at heart. You know the other day i was screaming and crying at my T to stop attacking me and after i composed myself he said he knew he seemed harsh but that he was trying to save my life.

EDs are a form of self injury and self attack. Until they stop we can't own our younger, traumatised parts, grieve and really heal.

It sounds like you have some extraordinarily difficult family circumstances to manage. and while i understand completely the sense of obligation you have to your mother and your family, you also have an obligation to yourself - you deserve to have a good life and deserve to spend time looking after yourself and disengaging from damaging relationships whether they be with friends or family.

First -thank you for the honest response. I just HATE it!

I have been fighting going back to medication (was on Prozac 20 years ago). I told t I can see the effect my current relapse and depression is having on my kids (15'13'10). I told her I would see the P for meds because they deserve a more functioning mom. She said what you just did, that I deserve to feel better and be more functioning.

So have you been able to get to a place of remission Greeneyes? Did you keep talking about it in session? I tried to not bring it up a couple of times but she always saves time at the end to ask about it if I haven't mentioned it. I'll try so hard not to purge so I don't have to tell her about it but then I'll go days with out eating just so I won't have to purge. I'm starting to have chest pain but I'm too scared to talk about that with her. I think she'll just be more frustrated with me. I know I'm frustrated with me . The self talk in my head is so dark and hateful and so drives me.

Jillann

My T broke my confidentiality last year and wrote to my GP about my ED. That set off a whole string of referrals. I was under an ED nurse specialist but my mood was low, they tried to regulate my mood so I could be in a better place to sort out the eating. I have not got very far. I don't purge, I restrict then exercise. Can you be referred to a specialist?

Hi Jill. I see two therapists (the 2nd one will change to another ED specialist soon, I hope). When I first started therapy with T1 I told her about my ED - I called and admitted it just to get everything out in the open. A month later she referred me to an IOP facility who took me in and I went something like 8hrs a week, I also had a T there (T2 - who I currently retain but will be switching to someone else at the same ED place).

T1 has experience with EDs but its limited. She'll say the wrong things on many occasions, not meaning to... she's just concerned. In general her dealing with my ED is to give her care and support that I take care of myself, as sort of a reminder that I am hurting myself. I think she also uses it as sort of an indication for how I'm doing emotionally, but I'm not sure. T2 does a similar thing but also works with active skills to reduce the behavior and we talk about the emotions specifically tied to the behavior, the chemicals in the body involved, how to talk and release my feelings somehow else... typical stuff she just understands my ED and knows when "it" is talking to her or wants something. I also see a P and the combination of drugs changed some of my behaviors a lot. At the treatment place I was at I also had to see a registered dietitian who would help me with food, talk about food, make meal plans... and monitor any compensatory behavior (ie: SI going up while another behavior went down).

EDs are draining, and they do take a lot of time, sometimes money, pain, etc to maintain. Like your T is doing, both T1 and T2 suggest I limit my triggers with my family. It does sound like you have so much on your shoulders, and are also carrying around the guilt and stuff there too. I can imagine your T just simply stating you are hurting yourself is hard, it's more than that. When a T sets up a place of shame, or disapproval it is impossible to work well with it. That's one thing I can say for both of my Ts, I feel safe talking about anything I'm doing or have done. Instead of disapproving they help me work with it (if I want to). Their only intervention would be if I required hospitalization, otherwise they understand and accept me and my behavior and give me options to reduce it, help monitor it and ultimately follow my lead on healing. They do remind me it's hurting myself, but I never feel shamed by them.

That's the problem with Ts who are not super trained in eating disorders. T1 is an amazing T, she was born to do what she does but sometimes she will say things that feed my eating disorder or hurt my feelings and I'll have to tell her, and she backs off where she needs to... but it's because she's got a partner, ya know? This is going to sound easier than it is but, I think the best thing to talk about if you can may be the dynamic that is set up. Explain to your T you don't want to hurt yourself but cannot deal, and you feel shame and guilt when you are lectured and would rather work with the feelings there. You'd think Ts would know this but some honestly don't - and some people do respond to lectures or sympathy or whatever their T will give them that CAN work but isn't really ideal... I'm not sure what my T does but my behavior never feels right or wrong, how I look is never mentioned, what I weigh is never mentioned, what I eat or don't eat doesn't matter... what's addressed is the trigger and that I needed to calm down, or I'm depressed, or... etc etc depending on the behavior. Even when I don't know sometimes they dig and we find it (oh! I was angry... oh I was sad... oh my Mom wrote me). Then we work on how to deal with those. Maybe I should feel shame, but I don't. I am as honest as possible because if I'm not, I can't fix it. I do hide things from them, that's the nature of an ED... and they know when that is happening too and they will ask and I'm a horrific liar.

So... Anyway... if there is a shame dynamic being set up it has to stop some Ts refuse to see patients who are "hurting themselves". I regularly SI, and engage in my ED and it sound weird but my Ts still embrace ME, never the behavior, but me... and don't judge or put down crazy rules (if they did, I'm such a defiant little creature it would be awful). It doesn't open up the behavior as acceptable, what it does instead is open it up as a possibility to change, something to explore. So, I hope in talking to your T you can find a strategy that works better because it sounds like you are just dealing with an awful lot right now and judgement on top of that is the last thing you need to feel A referral to a group or a registered dietician may be super helpful.

Ladies I can't thank you enough for responding to my post. It helps so much to know that I am not alone in this ED world.

Greeneyes- your t seems to have a similar method to mine. It helps to know that perhaps there is a good reason for how she is treating me. I believe she is really concerned for my health. I wish I could find that same concern for myself.

Scars - it is frightening to think that she might break my confidentiality. I believe if she did though it would have to be because she felt it was life or death. I wouldn't mind her sharing information with doctors. I would have a real problem with her sharing info with my H. She keeps trying to encourage me to open up to dear H about the ED but I haven't been ready to as yet. I fear having him follow me around trying to police my behavior.

Cat- I so value your input. Especially in light of recent troubles. Thank you for reaching out to me. I believe I really need to talk with t about the way I feel. I want to be able to look at my purging episodes to understand what is driving me to do this. I just am finding that hard to do. she asked me if i would try to stop purging in one of our first sessions . (like you i was honest about this from the beginning ). I told her no because it was the only way I knew how to cope with what is happening to me. I think she is frustrated that I have not made more progress in ending these behaviors. You are right that t is not trained in ED. She specializes in sexual abuse therapy which unfortunately is something I'm also dealing with.

It is just so helpful to not feel alone in all this. Thanks so much for helping me think about this today.

Jillann

Hi Jillann,

Never alone in the ED world... there are (unfortunately) a lot of us out there. There are a lot of really supportive communities out there too. I've been part of the same one for 8yrs have made great pen pals and friends for life. I find most of us are pretty well natured creatures.. just hurting a lot.

It sounds like you're communicating great with your T, being honest is... especially with purging the hardest thing. I think... (and again this is just me musing here) but that EDs get a big reaction sometimes, it does seem like a choice... and in a way it is... it's regulating yourself enough to make a choice at a peak time but you can't do so without... having the resources there, or other things to do. Both of my Ts work with sexual abuse, too (and I'm sorry you are working through that stuff and have that history) and with many survivors... we have the best coping skills we can. You can't take a coping skill away and not replace it with something. It's the same as SI or any other sort of thing like that it's just people I think sometimes get all bubbleheaded about it because it seems so deliberate. You can't make progress without tools I hope you can explain stuff to her or like... at least talk to her about her approach so maybe she can draw her own conclusions and start working with you rather than against your ED through shame and stuff.

Sorry to ramble... I wish... sometimes I could put to words what exactly it feels like to have an ED but it's so impossible, there really isn't anything else to equate it to :/