push back from clinicians is a warning sign

A short, essential message:

 if parents are getting "push-back" about their

involvement in treatment, "that's a warning sign."


  1. I agree that parents need to be worried if an eating disorder professional pushes back against parental involvement in treatment. In many cases the push-back may be the product of the professional's own mental illness. A recently published survey of 300 eating disorder professionals, for instance, found that 47% of the ED professionals had themselves a history of an eating disorder, and 54% had a history of mood disorder, such as depression or bipolar. See, A Qualitative Analysis of Job Burnout in Eating Disorder Treatment Providers, Eating Disorders, 20:175-195, 2012
    (Full text available, online, free)
    Personally, as a parent, I am not surprised by these alarming statistics. It is the secret of the eating disorder profession that most people are not willing to acknowledge.
    I encountered many eating disorder professionals who were clearly
    suffering from a variety of mental illnesses while they were treating our daughter. It became increasingly apparent to me that the relationships with these professionals were not healthy, that these professionals were doing more harm than good, and that my wife and I had better take charge of our daughter's recovery rather than allowing the professionals to do so.
    When the professional pushes back against you, it is clearly a red flag.

  2. I agree that the high number of ED clinicians who have themselves experienced mental illness does have an effect on the field. A high ratio of humans have mental illness, and parents, of course as well. That experience can be an asset for a clinician just as it can be for a parent -- but only if the patient has come out the other side with insight and good information.

    Context matters. Clinicians who have an automatic negative view of parents as a group need to be called out. By the same logic, we need to also know that push-back by parents against professionals may be a red flag, too, under certain circumstances.

  3. I'm not sure I agree with you on this, Laura.
    While it's certainly true that a significant percentage of humans have mental illness, the percentage among eating disorder professionals (approx 50%) is higher than the average for the general population and is a cause for real concern.
    I also don't understand how a history of mental illness is an asset. How, for example, does a history of bulimia give a clinician special insight or knowledge into treating restricting-type anorexia nervosa? It doesn't make sense to me.

  4. I said can be, not that it necessarily is. Having known the experience from the inside can be an asset, certainly, and for a range of reasons. For clinicians AND parents. I certainly wouldn't want my own recovered daughter to be barred from choosing to treat eating disorders if that was her interest (she's thoroughly uninterested). I also don't think recovered parents or those that have had other mental disorders are less qualified.

    Some of the most forward-thinking and skilled therapists I know of have had an eating disorder, though not most. By the same token, most of the most dogged Old School, anti-parent, low science literacy clinicians I know are former sufferers.

    What worries me, and I think you too, is when people are not really well and that affects their judgment and alliance to their approach to treatment and to advocacy.

  5. I would be very troubled indeed if people with mental illnesses were barred from working in any field - after all my beloved first born has a mental illness and so does my husband. I myself have "anxiety" at the top of my medical records too.

    I do think though that people who are unable to think creatively and are so blinkered by their history (be that of illness, care giving or training) that they cannot move beyond outdated views and practices hamper the field, but recognise that this is so in all walks of life. I am fortunate not to have come across many totally blinkered clinicians. Our system in the UK TRIES to ensure that clinicians, at least those paid by the NHS, keep up with the science. It SHOULD also give sick leave to those who are ill, whether that illness is cancer or anorexia nervosa. In general, despite enormous strain, the system works.

    I have met some older clinicians who have genuinely believed old school ideas about controlling mothers and hostile parents. It has been salutary to hear them out. Their history of fighting for patients against a system that gave no credence at all to the views of the sick is a useful one to study. They too were once at the cutting edge of treatment and it is important not to throw the baby of their skills and learning out with the dirty bathwater of misunderstanding and blame of people (parents) who they really don't know an awful lot about not having met them in their hospital based practices where the patients were delivered to the door by the men in white coats and there were gates on the establishment to keep families out as much as to keep the inmates in. "Are you enjoying your retirement?" may be the most politic thing to say to them, although "I welcome the fact that your pupil involves parents in the care of his/her patient nowadays" might work too.

  6. Oh, Marcella - so well and wisely put!! These are the lessons one only learns by staying around long enough and actually meeting and interacting with these folks. I adore your response.


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