Being liked is overrated, too

I hear a lot of complaining about eating disorder clinicians. I do a fair bit of complaining myself. But at least some of the time I remind myself that being disliked for doing your job isn't always a sign of doing it wrong: it is often a sign of good practice.

A doctor I admire wrote something on an ED message board this week: "You do not need to be the patient's friend, or confidant, and you shouldn't be someone she wants to bring home for dinner right now, as anyone that is doing their job with her will be working against the ED behaviors, and that is bound to make her angry"

Too true - and it goes for parents as well. We are so used to being liked for what we're doing well, to have our kids want to feel better, and at the least to understand we're doing things for their own good. With an eating disorder the patient has to pass through some pretty rough flying before they get to safe ground and as their escort to unhappyville we're like perky bright-faced flight attendants: in charge but not friends. As parents we can usually take that in stride. OK, sometimes.

When I hear complaining about treatment providers it is important to remember that patients and their parents don't always want to hear what the providers are saying - even when they're right. In fact, what providers have to do and say is rarely welcome and never easy. These doctors, therapists, nutritionists, and other providers are humans, too, and although being criticized is part of their job it is also not fun for them. And they can't fight back.

I admire them for taking on this illness and our kids. I am in awe of those who do it well and keep optimistic and keep learning. We're all on the same team - family, patient, clinicians. The other team is ED.


  1. It's interesting - that I have liked about half of the clinicians who have treated me for my AN...

    The first clinician (who diagnosed me with AN at age 12 in 1977) was a Consultant Paediatrician. He was kind and sympathetic, although it p**sed me off that he was making me change my behaviours and forcing me to see a dietician who made me 'contaminate' my body with 'bad' foods. Nevertheless, I saw him for the kind and conscientious person he was.

    The first psychiatrist I ever saw was when I was 16, in 1981. He was all but useless. We never had any dialogue and he showed no interest in the person (i.e. me) behind the illness. I concluded that to him I was just an illness. He prescribed medication that gave me awful side-effects and did nothing for my AN or OCD (such medication is rarely used nowadays) and I grew to dislike him.

    In my late 20s I was referred to a female therapist who had had an ED herself. She was ignorant. She had a fixed idea of what AN is and what sufferers think/feel. She merely projected her own experiences onto me and couldn't 'think out of the box' - i.e. that every ED patient is an individual and that not everyone experiences AN in precisely the same way. I dumped her after a few months because she left me feeling well and truly p**sed me off.

    I started to see my current psychiatrist when I was 40. Initially I was rather suspicious of him because although I wanted to get better, I was terrified of changing. The first few sessions were rocky. At least, I didn't say much and sat there rigid like a banana. But as I gained weight he gave me tremendous support, congratulating me on every pound. We had in-depth conversations and he treated me as a real person and not just as an illness. Once I had gained enough weight to engage properly with therapy I felt confident to tell him 'everything' - and 'everything' was not always nice to hear (i.e. rape, molestation, bullying, self-hatred, fear, a desire to disappear etc. - i.e. all the triggers for my restriction at the outset). The advantage was that unlike my parents he was not emotionally involved and I knew that nothing I said would upset him. That helped a lot. Never did he 'put words into my mouth' or tell me what he thought I was thinking/feeling/fearing. We worked out (and work out) solutions to problems. He listens patiently, helps me develop constructive solutions and is kind - all of which are terribly important.

  2. True. But it is also important to remember that just because patients don't like you doesn't necessarily mean you are doing something right. I wonder if perhaps clinicians have that bias. I do know that most of the time when I have complained, they have decided that it was the illness fighting back. I don't deny that that has been the case, but not always. More often, for me, I have fought back because I was being treated in ways that made me sicker and that made me so distrustful of mental health care professionals and the "treatment" they had to offer, that it made it harder for me to get help when I finally started seeing a therapist that actually can help me. I think professionals need to be willing to consider that patient complaints may also be legitimate.

  3. This is so true! I'm a pretty sensible grown up with kids of my own and I am seeking treatment volunarily but sometimes even I have to remind myself that my Dr is not trying to take something special away from me. I have asked for her help, and when I'm upset she is not the problem. I'm just thankful that she is so patient.


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