Unique Challenges for Professionals
Treating Eating Disorders
By
Abigail Natenshon, MA, LCSW, GCFP
We’re all a bit confused, and none of us are perfect. Health
professionals are as susceptible as
parents to subscribing to the wholesale
myths and misconception are eating
disorders, about parenting children in
trouble, and about what defines healthy
eating. Professionals join parents in
the misconception that children are born
competent, capable of making smart
decisions about food choices and
self-care all by themselves. They,
like parents, are apt to subscribe to
the notion that intervening parents are
interfering parents; that parents need
to bow out of their child’s eating
lifestyle and food choices, to turn the
other cheek prematurely in deference to
their sick child’s budding
independence. Too many medical doctors
operate under the misconception that if
a patient’s weight falls within the
range of normal, one can safely rule out
an eating disorder; that normal medical
lab tests are indicators of a clean bill
of health; that all anorexics are thin
are easy to spot just by looking; that
teens normally do not have normal and
regular periods, that prescribing birth
control pills to teens with amenorrhea
will reverse bone loss and restore
healthy reproductive function; that
parents need to stay out of their
child’s food and eating. Too many
nutritionists believe that when weight
is restored to normal according to the
charts, recovery has been achieved.
Compounding these problems, because the process of eating is a
normal function of daily living, many
professionals assume they are
sufficiently expert on the subject of
eating dysfunction simply by virtue of
their own personal experience and
perspectives about food, eating and
weight management. Everyone eats;
everyone knows what he or she considers
to be healthy and normal behaviors with
regard to eating and weight control; and
everyone harbors his own personal
biases, attitudes, issues and concerns
about the same. Beyond that, we are
all a little disordered in the ways
that we eat; a person needn’t be eating
disordered to overeat at times or
under-eat at other times, to eat in
response to stress, sadness or boredom.
It is an increasingly difficult task to discern the precious
thin line that distinguishes an
otherwise benign pattern of disordered
eating from the start of a lethal
clinical eating disorder. Easily 40 to
50 percent of girls on American college
campuses are disordered eaters, dieting,
skipping meals, binge eating and
drinking, putting many of them at risk
to develop anorexia or bulimia. As a
result, “normal” eating is no longer
healthy eating and it becomes
increasingly difficult to consider such
behaviors as pathology in light of their
prevalence.
Professionals are people first. It is natural for them to
carry eating-related biases and personal
baggage into their professional
practices. Such concepts can threaten
to taint the quality of their working
relationships with eating dysfunctional
patients. A unique phenomenon peculiar
to this specialty is the vast number of
professionals in this field who are
recovering or have recovered from
clinical eating disorders themselves.
Having personally experienced the
disease and the emotional issues
underlying and driving them turns out to
be a great motivator for
specialization. Relating to these
issues from first hand experience can
potentially be a boon to a
practitioner’s sensitivity to eating
disorder issues; by the same token,
where personal emotional issues remain
unresolved and at large, they can lead
to mismanagement of cases through a
transference phenomenon, clouding the
professional’s capacity to observe and
respond.
The variety and intensity of personal and professional issues
that ED evoke in their treaters clearly
and ironically parallel the emotional
tasks and challenges of their
patients…these include, accommodating
the murky realities of functioning
through feelings of powerlessness, out
of control, unpredictability,
frustration, impatience, pessimism,
confusion, and the entrance into family
systems, traversing borders, while
maintaining clear and definitive
boundaries. A healthy connection with
the ED patient requires the
professional’s clear, honest, and
healthy connection with his or her
own self first. Professionals need
to learn to listen not only to know the
patient, but to know themselves.
In so doing, he/she ultimately fosters
the patient’s capacity to listen to know
her own self.
Psychotherapist Abigail H. Natenshon has specialized in the treatment of eating disorders with individuals, families, and groups for the past 36 years. She is the author of When Your Child Has An Eating Disorder, A Step-by-Step Workbook For Parents And Other Caregivers, Jossey-Bass, 1999. Based on hundreds of successful outcomes, this book shepherds concerned parents step-by-step through the processes of eating disorder recognition, confronting the child, finding the most effective treatment for patient and family, and evaluating and insuring a timely recovery. A guide to eating disorder prevention, this book is useful to parents, health professionals and school personnel alike in countering the pervasive epidemic of unhealthy eating and body image concerns, and destructive media and peer influences. Her work can be reviewed further at www.empoweredparents.com and www.empoweredkidZ.com.
