Once, I had a therapist for depression who assumed that I had binge-eating disorder because I am fat. It took me over a year to realize this. From the beginning of therapy, I made it clear that I was not there to talk about my weight, and it was off-limits as a topic. So, for over a year, I paid her lots of money and we never talked about my weight.
Then, while I was still in therapy for depression, I began to see a dietitian who specialized in Health At Every Size, and treated people with eating disorders. My eating was all chaotic and out-of-whack years after a bout with food restriction (aka “dieting”), and I was unhappy about it. She assessed me and told me that I did not currently have an eating disorder, binge or otherwise, though she agreed that my dieting episode, years
previously, had been on “the slippery slope” of anorexia nervosa.
After a few weeks, I felt more comfortable talking to the dietitian than the therapist. We talked about body image, which had been off-limits in therapy since I did not feel like paying by the hour to educate my therapist about fat prejudice, and the topic of sexual harassment came up in one of our conversations. It rattled me with surprising force. The dietitian looked at me and said, “I think you need to talk about this in therapy.”
So, I went to the therapist and told her I wanted to talk about body image and sexual harassment, as a corollary to the work I was doing with a dietitian. She told me she was not experienced in this area, but she checked with the head therapist of centre, who was, and who gave her the go-ahead to proceed, with indirect supervision.
We talked about body image stuff. Then we talked a little bit about eating, and I tried to explain why I was seeing the dietitian. She started to say, “Now, when you binge…”
I stopped her. “I don’t binge. I don’t have an eating disorder.”
She nodded. We talked a little more about eating. Again, she started to say something about psychological techniques to use when the urge to “binge” came up. I told her again that I didn’t binge, I did not have an eating disorder, and I’d been assessed by a dietitian who specialized in eating disorders. Besides, the closest I’d ever been to an actual eating disorder would have been anorexia nervosa, not binge eating. While the two are sometimes connected, getting advice for binge-eating disorder when your problem is food restriction is totally backward. And the psychologist had never even assessed me for an eating disorder. She just assumed I had one, and she assumed it was binge eating.
In an even, professional, and quietly condescending tone, she explained to me that, while “dietitians may know a lot about nutrition and possibly even have some counselling skills,” it was not wise to depend solely on the advice of a dietitian when it came to psychological matters — like eating disorders. Even if the dietitian specialized in treating them. Even if she, the psychologist, had no experience with eating disorders. Even if I didn’t have an eating disorder.
I left feeling funny. I’d known this woman a long time. I paid her money, but in a way, we were almost friends. We were of similar ages, similar cultural backgrounds, and both interested in the same academic fields. Sometimes she told me brief, personal stories from her own life to illustrate a point. I liked hearing them. At the end of a session, I’d write
her a cheque and she’d print up my receipt, laughing and chatting easily all the while.
That day, I went home. We’d booked another appointment for a few weeks hence, as usual. After a day or two, I called her voicemail and cancelled it. I told her I’d reschedule, probably the following month. I never called her again.