When I first started working with patients with eating disorders, I had no idea about the deep sense of shame that they often carry.
As an example, I remember one bright young woman who was in treatment for anorexia
in our intensive outpatient treatment program. She drove over 100 miles each way for programs, three times a week, in rain and in snow. She was a diligent “student” of the program, often showing up as a vulnerable, open and honest participant. It took her a while to reach stabilized recovery before she would return to college and a very rigorous, pre-med program.
From time to time, she kept in touch via email, sending us recovery status updates. It wasn’t all rosy. There were struggles in recovery, but she was persistent. She kept fighting and used the support of a clinician and dietitian to stay on track. About six months after leaving us, I received a surprising email that read: “Jeanne, there is something I have to tell you that is important for me to get off my chest. All the time I saw you, I was purging almost daily! I was just too ashamed to tell anyone. Now that I don’t purge anymore, I can admit to what I was doing.”
This was to be the first of many eventual “confessions” I would receive from patients, often long after treatment had begun.
A year ago, the Intensive Outpatient Program here at the Eating Recovery Center in Washington
, adopted a quarterly theme. Several times a year we choose a word or phrase to help guide our patients along the recovery journey. This time, we have chosen “HONESTY.”
We weave the concept of honesty into our groups and therapy sessions to keep truthfulness fully in the foreground.
“Honesty” brings along many companions. There is trust, courage, risk, fear, and of course, shame. As clinicians, it is so much easier for us to work with everything out in the open. But, more importantly, honesty is an essential ingredient for our patients to have. Honesty allows our patients to fully come face to face with themselves.
With honesty, our patients experience the best odds at overcoming this tenacious disease. It is through facing one’s self, facing the past, facing our behaviors, facing our thoughts and feelings, and sharing it all with truth, that the eating disorder has no place to hide.
Through this work, I have met so many courageous women and men – sometimes with heads buried, and tears streaming down their faces, sharing something painful to their very core. To quote Shakespeare: “No legacy is so rich as honesty.” And this is what we want for every patient that walks through our doors.
Jeanne Wicomb, MA, LMFT, CEDS is the Clinical Director of the Intensive Outpatient Program at Eating Recovery Center, Washington.