From Where I Sit

We Are the Hope-Holders

By May 2, 20124 Comments

Working with women in eating disorder treatment, I can experience an emotional roller coaster ride throughout the course of a day. I rejoice with my ladies when they meet a goal, my heart hurts for them when they share stories of trauma and abuse, and sometimes righteous anger arises within me for injustices they’ve suffered. It’s my clinical duty to maintain a non-anxious composure and professionalism despite whatever emotions show up for me, and usually I am able to leave work at work, switching gears at the end of my workday – until recently.

Because you’re clinicians and non-judgmental by trade, I feel safe enough to make this confession: I’ve been holding resentments against you. Okay, maybe not you, but against other eating disorder therapists. Despicable, I know – but hear me out.

In recent weeks, I’ve heard several women recount tales of past therapists telling them they were, essentially, at a loss as to how to treat them. Words followed, such as “chronic”, “treatment-resistant”, “entrenched” and “hopeless” – and I hope the latter was a perception and not a direct quotation. Regardless, the others carry the same connotation if one reads between the lines – and women with eating disorders are experts at finding hidden negatives.

How do we undo damage from such judgments? How do we challenge confirmed negatives, persuading a client that there is hope for recovery? What will it take to remove the damning clinical label of “chronic” and nurture a client to a state of openness and willingness? How do we help the hopeless to hope?

It‘s not an easy task, and it’s impossible without the life-giving Word of God, which is higher than any “expert” opinion. It’s our secret weapon in this war we wage against hopelessness, deception, and defeat. The question is, do we believe God’s Word is true for the women we treat? Or are we, too, prone to fall for the lie claiming that some are just “too far gone?”

Eating disorders are a real bear to treat, but we knew this when we entered the field. Are you still up for the challenge? We work with some of the brightest, kindest, most sensitive, strong-willed, creative clients in the world. Working with them may be especially challenging, but we know it can be especially rewarding, too.

Many have already been referred out (“given up on”) by a therapist before sitting across from you. And because EDs thrive on feelings of unworthiness and shame, it’s easy to see why clients often arrive hopeless. You are the hope-holder. You must bring that client before God daily, asking for fresh hope to impart.

God will enable you to view her through His eyes, aware that nothing is impossible (Luke 1:37), that she can do all things through Christ who gives her strength (Philippians 4:13). But before she takes hold of these truths for herself, she’ll need you to believe on her behalf, treating her accordingly.

As the hope-holder in this alliance, you carry precious cargo. Guard it carefully. Protect it against deception; nurture it as you pray for your client.

God’s promises are true. His word won’t return empty. And if you persevere in holding the light of hope in the darkness of battle, your reward will be great.

Join the discussion 4 Comments

  • Eugene Hung says:

    Hi Jena, it’s Eugene over at +Parenting. I’m not a therapist, but I’ve spent plenty of time as a pastor sorting through really difficult stuff with parishioners. Yours is a good word not just for therapists, but for anyone who is entrusted with the care of souls. Thanks!

  • Michelle Watson says:

    Hello, I’m a client of Michelle’s and just read what you wrote. I want to thank clinicians for all that you do. I just had a thought that as a client, I have heard many women say that their therapist will not see them anymore. They have given up on them. They need more care then they can give them. I think that this gives clients a strained relationship with the clinician because it makes us feel like we have to lie or put on a happy face about how we really are doing. I know I would lie about the work I’m doing to keep therapy. I have done lots of treatment (inpatient and day treatment) in my recovery and those choices have been my own. Not because my therapist had given up on me. Recovery can be a slow process, one that you can’t even see happening unless you look back across a month or even year, but it is happening. You just have to stick with us. Thanks


  • Hi Jena. Thank you for bringing such a helpful and informed perspective to this issue. It is easy to give up sometimes if the hope we hold is our own. But if we consider God’s hope/plan for each person, and lean into that, then we have something to hold on to even in the darkest of times. Thanks for sharing!

  • Michelle Watson says:

    Jena…this is excellent! Thank you so much for giving a voice to this dynamic between therapists and the impact of their “forever statements” to clients that get embedded into the psyche’s of those who already have mental torment. Those words never leave and it’s vital that we therapists carefully guard what we say to those whom God puts in our care.

    As a therapist myself I’m so glad you also highlighted the fact that a therapists own “stuff” gets mixed into the counseling dynamic and it can get a bit messy (as you know, we call that countertransference!) for both the client and therapist…but it’s a real issue.

    Great post! Thanks, Michelle