Topic Tuesday: ED Professionals
“Insider Experience: Working in the Field as Recovered Professional” (By: Jessica Setnick, MS, RD, CEDRD-S)
In the early 2000’s I wrote an article about my eating disorder and recovery for a national magazine. It was published as a cover story under the sensational headline, “An RD Confesses: I Had Bulimia.”
At the time I wrote the article, I didn’t realize being a recovered professional was sensational. Most eating disorder professionals I knew at the time had experience with their own eating issues and spoke about them freely among colleagues.
Monika Woolsey had created a handout I distributed at my student presentations called, “Am I Ready to Counsel Others?” and eating disorders among pre-professional students weren’t even hidden enough to consider an open secret.
Yet when I told an audience of professionals at a conference that I was sharing my story in a magazine available to the public, I received a flurry of feedback: Your patients are going to read the article. You won’t be able to take it back. It’s harmful to your career.
I took some time to be concerned. Should I rescind the article? It hadn’t been my idea. I received a query: Did I know a dietitian who would write about their eating disorder? And I had volunteered myself. Had I been lured into a mistake?
And then I remembered who and where and what I am: complete and whole and a work in progress. A great dietitian and also an eater. A teacher who learns within a learner who teaches. A witness as well a testimony. And I made the easy decision to stay the course.
Once the article was published, I had another moment – the editor had removed any mention of my treatment for anxiety, something I felt had been crucial to my recovery. “We don’t want the article to be about that,” was the explanation I received. I pushed back and was overruled. It was no longer my story. I started to understand that once it was “out there,” my story belonged to someone else – the person who read it would interpret it and take it in through the lens of whatever they were looking for.
If they wanted a dietitian with a shared experience, they would read my story and either connect or discard, depending on their belief that we were alike or different enough.
If they wanted a dietitian with a “perfect” eating history, they might not even make it past the headline.
On the other hand, this was a fitness magazine. There was an article for diet pills on the very next page. Perhaps the people who needed my story were the exact people who read this magazine. If it raised their awareness, helped them identify a problem, or moved them to ask for help, then nothing else mattered.
I decided to neither hide nor broadcast my story. I let it out to the universe, not knowing how it would land. I heard from a college friend who read it getting a pedicure. A couple of colleagues offered unconditional support. The occasional patient mentioned it, either in passing or with appreciation for reading a message of hope. Some said they felt closer to me. One said they came to see me specifically because of it; she wanted to do whatever I did to help me recover. We had a nice conversation about meeting her needs and working together on that basis instead.
Eventually the article faded into history. It’s no longer available online; a few copies in my attic are all that remains. Also fading away, but more slowly: the idea that eating disorder professionals must keep their recovery history secret from patients. Along with the recognition that lived experience can bring assets to a patient/treater relationship – empathy, hope and experiential knowledge – I’ve noticed a shift away from expecting treating professionals to be blank slates who leave their personal histories at home.
The decision to share information about your eating disorder or recovery may be made for you based on your workplace. Some have policies that discourage personal disclosures – both recovery-related and other aspects of your life – and require a sole focus on the patient’s situation. They may reprimand someone who shares personal details. Other places appreciate and try to hire recovered professionals while at the same time not expecting you to actually discuss your life with patients, while others expect staff to share their recovery testimony on purpose, as an inspirational message.
I believe that whether or not you ever speak with a patient about your illness or recovery, the fact that you’ve had the experience and lived through it can be an asset to your work.
It can also put your own recovery in jeopardy.
There are many facets of eating disorder work that can prompt unexpected or unwanted reactions in you. Talking about food and eating all day, focus on weights and bodies, boundary violations, trauma, shame, comparisons… the eating disorder professional carries a heavy load because we carry our own burdens along with our patients’.
Professional supervision on countertransference, collegial support, and what Dayle Hayes once called “exquisite self-care” are all essential aspects of maintaining perspective on the responsibilities and challenges you’ll face in this field. And yet they’re rarely framed as the necessities they are.
I don’t believe that an eating disorder history rules you out as a competent professional. At the same time it’s crucial that – as with anything that may impact your recovery, health and mental well-being – you talk it over thoroughly with one or more trusted advisers. If you haven’t ever spoken with anyone about your concerns, now is the time. You don’t want your eating issues to impair your career path by cropping up when you least expect them.
Some suggested additional reading:
- de Vos, J. A., Netten, C., & Noordenbos, G. (2016). Recovered eating disorder therapists using their experiential knowledge in therapy: A qualitative examination of the therapists’ and the patients’ view. Eating disorders, 24(3), 207–223.
- Accessed here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873721/
- Williams M, Haverkamp BE. Eating disorder therapists’ personal eating disorder history and professional ethics: an interpretive description. Eat Disord. 2015;23(5):393-410.
- Accessed here: https://pubmed.ncbi.nlm.nih.gov/25719397/
- Trailblazer in the field Carolyn Costin shares her thoughts on her website for Recovered Eating Disorder Professionals, https://www.carolyn-costin.com/recovered-eating-disorderprofession
- Eating disorder dietitian Marci Evans offers a downloadable quiz, Is Eating Disorders Work a Fit for Me? on her site, https://marcird.com/_resources/is-eating-disorders-work-a-fit-for-me/
- Therapist Heather Hower writes on this topic on the National Eating Disorder Association website in an article called Stigma Towards Recovered Eating Disorder Professionals: https://www.nationaleatingdisorders.org/blog/stigma-towards-recovered-eating-disorder-professionals
- Get advice and encouragement from experienced eating disorder professionals in a variety of roles at https://eatingdisorderjobs.com/category/advice-from-experts/ and download the Guide to Your Career in Eating Disorders e-book here: www.EatingDisorderJobs.com.
About the Author
Jessica Setnick is best known for her pioneering work in eating disorder nutrition counseling, including the Universal Precautions for Eating Disorders and her Origins of Dysfunctional Eating Behaviors model. Thousands of professionals worldwide have learned from her Eating Disorders Boot Camp, Eating Disorders Clinical Pocket Guide, and hundreds of presentations and articles. Now retired from patient care, Jessica provides consultation to dietitians and treatment programs worldwide. She dreams of a world where no one is ashamed to talk about their eating issues and insurance discrimination and harmful stereotypes are no longer obstacles to care. Contact Jessica at Jessica@