You Didn’t Choose This and You Didn’t Fail

I spent the majority of the last 10 years convinced that my eating disorder was a thing of the past. In a culture that reinforces and even praises disordered eating behaviors, I thought my quasi-recovered state was the best I could hope for. After all, the rest of the world is engaging in restriction, “clean eating,” and vilifying entire food groups so it was hard to recognize my relationship with food as problematic when our culture encourages and reinforces disordered eating.

I was working as a therapist and loved my job, my body positive style blog was continuing to grow, and outwardly, I appeared to be successful, confident, and happy. Sometimes I even believed it.

But what I presented to the world was very different than what was actually going on. This is because while I’m a therapist, I’m a human being with a mental illness, too. And knowing what to say to others as a trained professional and being able to integrate it as a survivor are two very different things.

Looking back now, I can see that not only had I not even come close to recovery, but I was sicker than I’d ever been. I was desperate to shrink my body to feel safe but in the process, I ended up shrinking my entire life as well. My eating disorder prevented me from social connections, traveling, participating at holiday meals and events. 

While I could go through the motions of my day-to-day life, there wasn’t much living to be done outside of it.

And because my body didn’t look like the stereotypical underweight body we see portrayed in the media, my weight loss was praised and even encouraged. To be clear, I was in the depths of hell with my anorexia and being congratulated for it. 

Meanwhile, my blog had grown a lot at that point, which meant that my relapse with anorexia was happening very publicly. I didn’t want to share what was going on because I was terrified of the judgement that would come along with it. Being a therapist in the eating disorder field while also struggling with my own eating disorder is often met with confusion and even judgment — and I didn’t want my clinical skills and abilities being debated. 

Ultimately, I decided to share my story after 7 years of keeping it secret because I wanted to use my public platforms to dismantle some of the stigma, challenge the public perception about what eating disorders look like, and work on bringing much-needed change to the state of eating disorder treatment.

I stepped away from my career and I went back to treatment in May 2018. I spent a year and a half going in and out of treatment. Unfortunately, I wasn’t finding traditional treatment helpful and I did one of the hardest things I’ve ever done: I reached out to my colleagues for help instead of trying to do it all on my own.

I’ve worked a lot these last couple of years to confront the deep shame I felt about struggling with an eating disorder while also being a therapist and advocate for Health At Every Size ® and body positivity. 

I’ve since come to terms with the fact that knowing all there is to know about eating disorders is not enough to erase lifelong trauma. Recovery is not a class that you can study for and ace — it’s a long process for all of us, clinicians included, and one that can be messy and complicated. 

Since publicly sharing my story, there has been a lot of debate around whether or not clinicians who live with mental illness — and eating disorders in particular — should be practicing in the field. But I think this (discriminatory) question misses the point. It’s no different than asking, “Should therapists be allowed to be human beings?”

Instead, we should be asking how we can make it safe for eating disorder professionals to disclose when they’re struggling with relapse without repercussions. 

While we seem to expect professionals to be perfectly healed and “fixed,” the reality is, we are not magically immune to struggling with a mental illness. And I believe that it’s those same struggles that allow us to become empathetic, perceptive, and skilled clinicians when given the proper support.

It’s also true that there are plenty of therapists without a diagnosis who are still steeped in diet culture, retraumatizing clients and even prescribing weight loss and disordered behaviors under the guise of “treatment,” who remain oblivious to the harm they’re doing — harm they’ll never personally have to experience the consequences of. 

All therapists approach their work with their own set of challenges and biases. But I’ve witnessed firsthand the ways in which therapists with lived experience can be remarkably attuned to their clients because of their shared struggles. This should be viewed as a strength — not a weakness or liability.

If we care about the future of eating disorder treatment, it’s vital that we support survivors who are passionate about entering the field, rather than discouraging them and questioning their capabilities. No one understands an eating disorder as intimately as someone who has endured one, and this unique insight can transform the field for the better.

But for that to happen, we need to make it safe for all people to access the help they need, providers included. And we need to respect each individual, along with their treatment team and supervisor, to determine when they may be compromised as a professional.

If you’re a fellow provider in the mental health field currently struggling, I want you to know that there’s nothing “hypocritical” about suffering with a mental illness. You didn’t choose this and you didn’t fail — and you deserve help and support in your healing.

As both a survivor and a clinician, I applaud you for making the courageous decision to choose this work. Now more than ever, this field needs us. And on the days that I struggle most, this is the fire that keeps me in the fight. It’s not just for me; it’s for all of us. 

Shira Rosenbluth, LCSW, is a licensed clinical social worker in New York City. She has a passion for helping people feel their best in their body at any size and specializes in the treatment of disordered eating, eating disorders, and body-image dissatisfaction using a weight-neutral approach. She’s also the author of TheShiraRose.com, a popular body positive style blog and you can find her on Instagram, @theshirarose. Find more about her therapy practice at ShiraRosenbluthLCSW.com.