Someone struggling with an eating disorder loses touch with reality, especially as it relates to her body and food. She will make decisions based on what she believes to be true despite the clear evidence of her declining health and the protestations of those around her. It’s as if the eating disorder has turned off the lights in the part of the brain that thinks rationally about food and weight even though she can think clearly in other areas.
The lights also go dark in the room of honesty. A normally honest young woman can begin to deceive and lie in order to lose weight, hide food or sneak laxatives.
This brings enormous challenges to the counseling relationship. It sets you up for power struggles, means that often you are working with limited information and may cause you to question the client at nearly every turn, even on issues not related to food or weight.
Darkness also comes in the form of self-hatred. A view of herself that says she is unworthy, despicable, gross and weak and, the one that you will be most tempted to believe; that she is hopeless.
Your commitment to the truth can make you the enemy and she may treat you as such. She may dismiss you because you “want to make her fat” or she may simply ignore you because the voice of the eating disorder carries more intensity and volume. This is when you need to remember that you are a bearer of light.
You must hold tightly to light and truth when it comes to issues of weight and food. You must create a safe place for her to confess her deceptions and manipulations. But most importantly you must never, ever agree with her sense of self. This is the most difficult challenge you face.
You will be tempted to give up, to think she can’t change, and to define her identity by her behaviors. But you must not forget what is true. You must not believe the lies of the eating disorder.
She is made in the image of God. Behind every decision and motivating every lie are good, God-granted longings for a life of meaning, significance, safety and relationship. No matter how twisted the means become she is seeking to meet legitimate needs. Treat her as such. See in her the image of God beneath the carnage. You must.
There are times when you are the only one holding light in a very dark place and if you leave the room the only light left goes with you.