It has been a long time since the last post, and I apologize for that. Things have been very busy, with Utah Center for Eating Disorders formally opening, and the hiring of Nicole Holt, RD. It has been exciting and good change, but comes with growing pains, of course. I have thought often of writing blog posts, but have not made the time. This week, however, I was so overwhelmed by the words of this past year's interns, that I decided trying to summarize their statements was the needed motivation to write again.
One of my passions is doing training and supervision. There is little training in grad school for therapists, dietitians or physicians with regards to ED treatment. I was trained in ED treatment many years ago by a man who was once the top of the field, and then fell, and have always felt that training graduate students or post-docs is my way to give back. I learned many things from this man, and have always referred to him as a brilliant mind who struggled deeply with ethics. Although I cannot say I do much like him, I can say he taught me the concept on which I have built my career and treatment of eating disorders. It was from him that I learned about the physiology underlying eating disorders, and this is what I have strived to teach therapists who want to treat eating disorders. I have been thrilled to have two psychology graduate students "interning" (for those in psychology PhD land, yes, this is the wrong term, but I find it more respectful than "practicum student.") at Utah Center for Eating Disorders.
This week, they passed on their wisdom to this next year's interns. And as I listened to them talk, I realized how many things about ED treatment that slide right past me after years of doing it day in and day out. I will not pretend to quote them, but instead summarize parts of what I heard them say.
They spoke of the awareness of the gravity of the work they were doing. They stated it was some of the most frightening and intimidating work they have done, largely because they learned the physiological impact of the disorders, and accepted the reality that these are the most lethal psychiatric disorders. They spoke of awareness that something could go wrong physically when neither they nor the patient expected it. They spoke of the impact of truly seeing the physical impact, and experiencing deep emotional reactions of sadness and fear as they worked to help those with EDs. I had said to them a couple of times that their reactions really impacted me; through them, I realized "my eyes don't work anymore." I don't see body size as much anymore and react less, simply due to desensitization. It was eye-opening to see EDs again from the perspective of someone who has not been doing the work for so long.
They spoke of the difficulty of taking on more directiveness in patients' lives. After all, in therapy, we are to "accept the client where he/she is at." Well, we cannot do that. We cannot accept an eating disorder, or at least that is my approach. So, we do become more involved, provide more direction, and set some hard lines. It was rewarding to me when they were able to see that this can work, that their patients did not run off and get upset with them for being firm, but instead respected their willingness to jump in and fight against the disorder.
They said many more things, but this cannot be eternal, so I will leave it at that. The bottom line is that working with them and seeing their success in helping patients overcome their disorders was very powerful and rewarding. I learned they were often intimidated by the gravity of the work they were doing; I also learned they were REALLY good at hiding that most of the time!
This is intimidating work, but also incredibly powerful and rewarding. One of the things that irritates me the most is when therapists or other professionals label eating disorders as untreatable. This is far from the truth. And what these two showed was that with a little training, supervision and support, they were able to help their patients change dramatically. And I continue to believe that a major part of that was truly understanding the physiology underlying the disorder. So, if you are a therapist that wants to treat eating disorders, my advice is to prioritize learning the physiology. It goes outside the bounds of typical therapy, but is invaluable. And, as I had to remind them a couple times, past the physiology everything else is "just therapy," and I didn't need to teach them about how to do therapy.
Congratulations Angie and Julia on your internship placements. You will be greatly missed. And welcome on board Kendrick and Larissa! It should be a fun ride!