When someone enters into residential, day treatment, or intensive outpatient treatment for their eating disorder, it is understood that they will be eating their meals and snacks with staff. However, this staff is not always their therapist. On the other hand, eating together is something that is not done very often in outpatient treatment.
What training is involved in eating with a client with an eating disorder?
It seems simple, doesn’t it? You eat every day; what would be different about eating with these clients?
The Value of Eating with Your Clients
There is great value in eating with your client—this is where their anxiety, struggles, and vulnerabilities emerge. We know that an eating disorder is about much more than the food.
In treatment, we are taking away clients’ abilities to take comfort in food, push food around their plates to feel in control, or engage in food rituals that make them feel safe. When we remove the comfort and safe place of their eating disorder, we are left with their raw emotion, and long suppressed feelings begin to emerge.
As a clinician, wouldn’t you want to be a part of this experience? So much connection and trust can be created over eating a cookie together.
I strongly encourage all clinicians to eat with their clients. Whether you are their therapist, coach, dietician or physician, you and your client will benefit from this experience.
Setting an Example of Healthy Eating for Your Client
If you choose to eat with your clients, you are taking on the responsibility of being an example of recovered, healthy, and normal eating. Everyone has their opinions of what this looks like. I am grateful to have learned this while working at a healing and soulful treatment center in California.
Yes, I had to learn how to eat with clients. Sure, I knew how to eat—but eating with a client is a different experience; a new skill.
A person struggling with an eating disorder is often hyper-aware of what others are eating, how they are eating, how much they are eating, and their reactions to what they are eating. Keep this in mind when sitting down to your snack or meal.
When eating with a client, whenever you can, you should eat what they are eating. Maybe not the exact foods, but the same exchanges (fats, protein, carbs, vegetable, fruit, dairy). If you cannot eat the same due to allergies or food sensitivities, you should eat as close as possible to the same exchanges or meal as they are.
If you ate a big lunch and are too full for your dinner, you need to eat it anyway. Your client is full from her lunch, too.
If you don’t like the food choice for dinner, you need to eat it anyway. Your client is struggling with eating what is put in front of her and needs to see that you can do it with ease.
If you are struggling with your own eating issues, I guarantee you that your client will notice. If food is an issue for you, please get your own help prior to treating someone with an eating disorder.
I promise you that if you are not able to mirror healthy eating, it can have a negative impact on you and your client.
Try Not to Let the Eating Disorder Join You at the Table
When eating with someone with an eating disorder, remember that she is having countless negative and eating disordered thoughts while sitting with the plate of food in front of her. She may be able to smile and engage in conversation with you, but don’t let that fool you. She is also engaged in a conversation with her eating disorder, and that is much louder that any conversation you may be having.
She is having thoughts such as: “This will make me fat; maybe I will just skip my next meal; I am going to need to purge if I eat this; I feel guilty for enjoying this; my clothes feel tighter than they did when we started eating; there is too much on my plate.” That is just a short list. She will also have thoughts of comparing herself to you and what you are eating.
You should absolutely talk to your client about food and food challenges. However, please try not to do this while you are eating this meal. This can serve to talk to and engage her eating disorder, and you may lose her in her in her plate of food. The eating disorder wants to talk about and obsess about food, so if you are focusing on the meal in front of you, you are talking to her eating disorder and not to her.
We need to try to engage her—not her eating disorder. Keep meal conversations on light topics and stay aware from talk of major life stressors; there will be plenty of time to talk about those things.
Eating mindfully is a skill. Taking time to ground yourself prior to any meal is very important. Doing this is even more important when eating with your client. If you are not grounded, you will not be able to engage with your client in a mindful way.
It has been an honor to share countless meals with clients over the years. Please eat with your clients; it is a piece of treatment that is usually missing in outpatient treatment.
Please make sure you are mindful of your client’s need and remember that you are there to be an example. It can be a powerful experience to help someone eat a meal and be a part of their journey to normal eating.
Eat! Enjoy! Connect!
Photo courtesy of Fixers on flickr