In therapy, it can be quite normal to experience negative emotions towards your therapist. In episode 261, I received a question from a listener who felt angry, hurt, and vulnerable after their therapist told them they meet the criteria for an eating disorder. In this post, I dive into these feelings a little more and take a look at what you can do to help move forward.
During my last session my therapist told me I meet all criteria for an eating disorder. I hated him the moment he said it- why do I feel so mad, hurt, and vulnerable?
This is a really good one. I can’t say exactly why you felt this way in this situation, since you have your own reasons. I’m not sure if there is history involved here for instance. Maybe you have a family history of eating disorders or some form of negative association toward them due to people that you know. Maybe you’ve been accused of it before. Things like that – that’s context that I can’t know. BUT, I will say that this is probably a more common reaction than you might think.
One interesting element of eating disorders is how private they are. By nature, they are often something that is hidden. Everyone is different, but in another way, they are sometimes held and kept safe. Like this is something that belongs to you and you don’t want it to be exposed because then it maybe has to go away. This doesn’t mean that you think that these behaviors are good things, but it very well may have been something that you have lived with for a long time and that you have used as a means to keep yourself going.
Just like self-harm, eating disorders are often about control. It is sometimes about exhibiting control over your body in some small way. When that is threatened, it can feel like someone is threatening your autonomy. This is deep-rooted stuff and when it is talked about or suggested, it can certainly draw out a more primitive response from you.
Now, if you feel like you are being treated inappropriately, that is a different story. There is certainly a chance that you are fully justified in being pissed about this. From the sound of it, your therapist is not being vague about things – he is talking about the criteria and actually doing his due diligence rather than just wantonly throwing diagnoses out there, which is good. However, even if he is clinically skilled, there could be a chance that he is not the best at pacing or how he broaches these topics. If you guys don’t have the therapeutic relationship to support this heavy of a topic or he simply doesn’t realize the gravity of it for you and doesn’t ease you into it – that would be an understandable reason to feel offended.
I also find that eating disorder diagnoses carry a lot of stigma both externally and internally. It’s similar to a personality disorder like BPD. A lot of people that have diagnoses like these maybe have an inkling that the signs are there, but due to the way that they perceive other people with these disorders, they dread the possibility that it could apply to them. Furthermore, without knowledge of the treatments available and how you can indeed live a good life with an eating disorder, it can feel more like a death sentence than a mental health diagnosis.
What can you do?
This should be a good prompt for you to do some self-reflection. I think that you should take his information and do some research on your own. See if you agree that you meet the criteria and that this fits your experience. Perhaps there are others that you can talk to in your life that might be able to give their opinions about whether this sounds like you. You can also do some pondering (maybe journaling) about why you feel so upset, vulnerable, and angry toward your therapist. This might take a few attempts. The more you reflect and process, the more clear it should become. Once the immediate sting and strong feelings fade, you will be able to better evaluate whether you guys are on the right track.
Never be afraid to challenge your therapist or tell him your needs. If you need him to slow down and maybe approach this more tentatively and gently, ask him that. If you think he is off base and might be missing the point, tell him that in whatever way you can. Say that you have been looking into it and you’re not totally sure. This would probably generate some productive conversations for you guys to further narrow things down. I have definitely had situations in therapy where someone doesn’t agree with my diagnostic hunches, so that causes us to dive deeper, look at the criteria etc. In the end that is always helpful. It allows us to move forward with more detail.
So, I hope that things have already started settling a bit for you. I know it can be hard to be slapped in the face with information like this. I don’t blame you for reacting strongly. Time and reflection will allow you to think with a bit more clarity and then you can make decisions about whether you have a legitimate reason to be concerned about your therapist’s skill or care.
You can listen to this on Episode 261 of the podcast!
Thank you for the great question!
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