Let's Say. . .
Scenario 2: Let's say that another woman who has been in therapy for many years for anxiety, depression, and a sub-clinical eating disorder, is seeing a relatively new psychiatrist. We'll call her Sharon. Sharon likes her new psychiatrist because she seems compassionate and responsive to her. Like many psychiatrists she's had in the past, Sharon's current psychiatrist is eager to try out new medications and doses of medications with her, in order to alleviate her symptoms. During one appointment, Sharon, who is "at a normal weight" (whatever that is), expresses concern about her psychiatrist's recent recommendation that she up the dosage of her medication in order to address her residual anxiety. "Doesn't that cause weight gain?," she asks. Sharon is concerned because she has a history of binge eating, and she doesn't want to be on anything that exacerbates this condition. "It could," her psychiatrist replies, "But that's when you just need to focus on portion control." To Sharon, who again has a history of binge eating, hearing the phrase "portion control" creates such anxiety in her that she actually wants to binge. She's had many attempts at trying to restrict what she eats (in fact, that's what led to her binge eating, according to her understanding of it all), and this does not seem to be an adequate solution.
Do you have any reactions to these scenarios? They can and do occur, highlighting the importance of consulting with professionals who have specific education and training in the field of eating disorders. A simple, innocuous comment as processed by someone with an eating disorder can do significant, unintended damage. Ideally, those struggling with eating disorders can arrive at a place in their recovery where a single comment isn't so threatening (as they may come from various sources), but until and unless this happens, it's important to select a treatment team sensitive to these concerns.