I rarely blog about work related topics, in particular trying to stay away from constantly reporting on new and exciting information in the world of eating disorders. There are many wonderful blogs out there that serve as more direct, educational resources for that kind of thing, and generally I prefer to write about everyday occurrences that I feel promote ways to live healthy and happy, whether in recovery or not. But eating disorders are my field, and sometimes it feels right to reflect on that a bit more.
I recently read a journal article titled “Resistance to treatment in eating disorders: a critical challenge” (Abbate-Daga & Fassino, 2013). The authors detail a number of reasons that eating disorders have gained the reputation – a well-justified one I might add – for being notoriously treatment-resistent. Among other things, there isn’t a lot of evidence-based treatment out there that has shown to effectively treat ED, there is a high level of denial, lack of awareness, and active opposition to treatment in those that are ill, and to top it off there is this little thing called biological vulnerability to think about. Messy, eh?
Abbate-Daga and Fassino posit that effective treatment for eating disorders must take into account more than just the eating and food related symptoms as outlined in the DSM (duh), and need to take a look at the link between psychology and biology, i.e. what is the neuroscience behind developmental and relational experiences, patterns and beliefs. Basically, the authors are looking at ED as a developmental disorder, and one that should be treated accordingly. The key message here is that there needs to be a therapeutic alliance between the patient and his or her providers. With this should come an understanding amongst providers that the suffering their patients are experiencing is real, and even more importantly, a means of conveying this deep understanding to our patients and clients. Fostering a means to keep someone engaged in treatment at all is the first step in a very intense journey… because a therapy dropout isn’t (likely) to get better, now are they.
As I read this article and absorbed what was being said, words screamed across my brain. EMPATHY (yes!) VALIDATION (yes yes!!) CONNECTION (yes yes YES!!!) As trite as it seems, these are the reasons I do what I do, and the reasons so many of the talented clinicians I know are able and willing to help people regain their lives. Eating disorders are among the most complex, mystifying illnesses out there, and at times it feels like a thankless field to be in. “Treatment Resistance” is the stuff of nightmares when your field is, well… treatment. But before we bang our collective heads against the wall, we can remember that research and science is supporting the fact that yeah… what we do is hard. And guess what? We can still do it. because we all know friends, family members, former clients, and fellow helpers who have fought, resisted, and eventually recovered. They are now happy, healthy people, and that’s what makes it all worthwhile.