Past articles have exposed the financial dangers of private equity ownership of treatment centers. Peer review doctors and shady practices have been illuminated. Unfair and fraudulent practices perpetrated by insurance benefit providers have been exposed. Sexual predators in the field have been identified.
The disconnect between research doctors and clinicians has been explored. The “pay for play” evolution of the EDCoalition and its resulting loss of integrity and moral advocacy has been highlighted
Dysfunctionality aplenty. Dysfunctionality for all. And yet, there is more. And mores’ the pity.
And so we will address our therapists. To begin with, this article is not an indictment of all counselors or even a majority of them. Many therapists give life saving treatment and save lives. To those life savers, thank you.
Our counselors and therapists, those “soldiers in the trenches,” hopefully utilizing the best “evidence-based” therapies in the industry, have direct, hands on interaction with our loved ones, those who are afflicted with this deadly disease. They are the ones we entrust with our most precious love. We often come to them in our greatest hour of need, when our despair and fear are at their highest. They have a sacred duty. And they do not have the luxury of treating our loved ones like guinea pigs or science experiments for their own spurious, off the wall theories.
Counselors need to research and stay abreast of the latest break throughs, if any, regarding treatment regiments. They must be able to discern which therapies are supported by authentic, objective, and scientific or evidence based research. And which therapies are little more than snake oil pipe dreams perpetuated by quacks and charlatans.
Of critical importance is that the therapist must not and cannot treat therapy as if it is their own counseling session. Their personal biases, experiences, afflictions and past struggles they may have had with eating disorders, yes in part defines who they are. But those same attributes CANNOT be allowed to form the fundamental basis of the counseling sessions. For if they do, the patients, the persons suffering from this insidious disease will suffer the greatest. Counselors … therapists … It is not about you or whatever social agenda you wish to pursue. And if you make it about you or your “social engineering project,” you fail those whose lives have been entrusted to you.
“Rich Little White Girl’s Disease.”
That term, or words to that effect have been used far too frequently. The perception that eating disorders only impact skinny, teen-aged white girls. That perception, in part, has resulted in this disease not being taken seriously be mainstream society.
“White privilege.” There also appears to be a movement among some counselors and advocates that their own self-perceived bias or “privilege,” must be addressed before they can more adequately render therapy. Counselors parading self-aggrandizing terms like, “I must first discover my own [more often than not, white] privilege so I can be a better counselor” are misguided, self-serving and just flat out wrong.
I am still searching for that first authoritative, independent research study indicating that therapists must first discover their own “white privilege” to properly treat this disease. Similar research regarding the specific manner in which the concept of “white privilege” impacts the biological aspects of the brain as they pertain to eating disorders seems to be missing.
Does white privilege impact the manner in which micro biomes in the gastro-intestinal tract process the complex messages it receives and sends the brain? Does white privilege impact the manner in which on-going genetic research is beginning to discover the way in which this insidious disease could be passed through generations? Does white privilege impact the manner in which certain “high risk” genes in the brain regulate oxytocin levels?
Recently invented terminology like “micro-aggression, macro-aggression, Trauma with a ‘Big T,’ trauma with a ‘little t,’ and ‘eating disorders are disorders of systemic oppression’,” are being bandied about by some as if they had just discovered the cure for cancer. Unfounded speculation that social injustice, “white privilege,” and latent racism in society [all of which undeniably exist and need to be fully addressed in other venues] are the direct cause or grossly exacerbate the severity of eating disorders is not supported by any ethical, independent research studies.
Counselors and therapists, you do not have the right to impose your own personal views of society’s ills upon your patients. And yet, studies are showing that this is precisely what is happening. We are speaking of Countertransference.
An article written by Trish O’Donnell, of EDCare, states:
“Transference is the unconscious tendency of our clients to shift their emotional interest toward new persons or objects in the hopes of re-experiencing old persons or objects, often with the subconscious hope of succeeding where formerly they feel they have failed. For example, a 23-year-old bulimic female arrives for therapy under the influence of marijuana. She is vaguely aware that she wishes the therapist to be irritated with her, angry enough to set limits on her behavior and control her. This is soon revealed to be a repetition of her adolescent behavior, which was designed to get a response from a remote and distracted mother. Rather than the client’s remembering, she presents the memory by transference. Transference may be adaptive to the extent that it reflects the urge to master the past and provides repeated opportunity to do so.
In the strictest sense, countertransference is the therapist’s counterpart to the transference of the client. It is not simply the multitude of varied reactions we have to stories and behaviors presented by our clients. It is the unconscious tendency of the therapist to shift his or her emotional interest from persons and experiences of the past onto the client. [emphasis added] It may be damaging to the therapeutic process when there is resistance to conscious awareness, and therefore an acting-out on the part of the therapist. For example, a therapist who has unresolved adolescent rebellion issues may have difficulty in setting limits for the multi-impulsive eating disordered client.”
Research doctors conducted an extensive study of Countertransference. Their findings were published in the International Eating Disorder Journal in 2015. In this study, six patterns of reactions were identified: Angry/Frustrated, Warm/Competent, Aggressive/Sexual, Failing/Incompetent, Bored/Angry at Parents and Overinvested/Worried feelings. The factors showed meaningful relationships across clinician demographics, patient characteristics, and treatment techniques.
This study then concluded that overall, clinician’s reactions were most frequently associated with the clinician’s gender, patients’ level of functioning and improvement during treatment, and patient personality style.
Counseling sessions are not your opportunity to address your views on society’s ills. You are not there to rectify the many wrongs of society. You are there for one reason and one reason alone, that is, with all of your abilities, to help the struggling, perhaps even dying soul sitting in front of you.
So, do you want to be a better counselor? A more evolved therapist? Review the latest research regarding the latest biological aspects of this disease. Exhaustively research the brain, the gastro-intestinal system and the manner in which these aspects of the human body are inextricably intertwined. Research the genetic components of this disease. Read scientific journals on eating disorders. Absorb case studies. Make appointments to speak with local scientists and research doctors. I guarantee they would embrace the opportunity to speak with you. Get up to speed on the latest evidence based treatment regiments. Stay current on the latest thoughts on Family Based Therapy and Cognitive Behavioral Therapy. Yes, review the charlatan based therapies. Not to implement them but to dissect them and reason why they are not appropriate. Arm yourself.
Your calling is not merely a business. It is not merely a job. This is your career. This is your life’s calling. This needs to be your passion. Lives depend on you. Parents, living with terror, depend on you. You must be bigger, stronger, smarter, more insightful than you could ever possibly imagine.
And if you refuse … if you cannot, we parents will not abide. Our loved ones lives depend on you. Our most precious commodity is entrusted to you. This sacred duty is not for the faint nor the weak of heart. And we parents, the families suffering from this disease will not abide “crackpot ideas being thrown against the wall to see what sticks” when our loved one’s lives hang in the balance.
It is your sacred duty. It is our life and the lives of our children.