Stepping out with stories to educate eating disorder clinicians

Today, I pushed another hole in the prison wall that an eating disorder erected in my brain at age 11. That wall effectively disconnected my healthy self from my body until I was 55. Thirteen years on, eating three meals and three snacks a day without guilt, shame and self-loathing is a daily joy. But the effects of an eating disorder run deeper than food. Reintegration with one’s healthy self requires ongoing dismantling, connecting and healing.

Today, I ticked a large box on my ‘to do’ list – I attended a line dancing class at the local Senior Citizens’ Clubrooms; I have been wanting to do this for years. As I neared the building, I could hear the leader calling instructions and thought, ‘Oh, I am late!’. Fighting an urge to turn and run, I opened the door into the dance room. The women paused, smiled and waved – ‘come and join us’. The leader explained that now is a good time to start, because I will become familiar with the steps prior to Christmas and will start the new year ‘on the right foot’. Indeed.

Today, therefore, I have broken an old unhealthy pattern, stemming from my eating disorder, of not allowing myself to do activities that I know will be good for my wellbeing and that I know I will enjoy. Well done, healthy June!

To someone whose mind and body has been incarcerated by an eating disorder, doing ‘ordinary’ things like attending a line dance class, is an extraordinary achievement. Doing ordinary things promotes feelings of connection, of belonging and acceptance; of being ‘ordinary’. 

I am grateful to the people who have helped me to reintegrate my healthy self  – my psychiatrist, psychologist, dietician, minister of religion, family and friends. Little was known in 1962, when I was 11, but rather than feel sad about that long time without support or understanding, I feel happy in the knowledge that the recovery of children who develop an eating disorder today, has every chance of being measured in months rather than decades. With early intervention, an eating disorder developing in a child today is likely to be a limited short stay; and the child will get their life back on track quickly. In Australia, the introduction this month of Medicare changes that provide increased access to evidence-based treatment, adds to this brighter outlook for people who develop an eating disorder.

The Medicare changes, introduced on November 1, give patients rebates on up to 60 consultations – 40 for psychological therapy (up from 10), 20 for dietetic support (up from five).  Importantly, the 40 sessions of evidence-based eating disorder psychological treatment (in a 12-month period) must be with a suitably trained clinical psychologist, registered psychologist, accredited mental health social worker or accredited mental health occupational therapist, or with an adequately qualified general practitioner.

This raises the question: how do you know if a practitioner is suitably trained? It is vitally important to seek clinicians who have the necessary experience.

The Australian New Zealand Academy of Eating Disorders (ANZAED), as the peak body in Australia for eating disorder practitioners, is working with the National Eating Disorders Collaboration (NEDC) and other sector partners to ensure the services are delivered by credentialed practitioners.

According to InsideOut Institute senior clinical dietitian, Gabriella Barclay, who is based in Sydney, any healthcare professional involved in the treatment of someone with an eating disorder must be skilled in the preparation, review and provision of eating disorder treatment and management plans.

“We expect the Medicare changes will trigger an increase in Australians searching for qualified healthcare practitioners with specific training and expertise in the treatment of eating disorders,” Gabriella said.

ANZAED president, Dr Kim Hurst said effective treatment requires well-coordinated teams of skilled mental health, dietetic and medical professionals. “We encourage people to consult practitioners who are ANZAED members, as having experience and expertise in the treatment of eating disorders is essential,” Kim said.

Concerningly, many healthcare practitioners feel ill-equipped to treat eating disorders, necessitating targeted training in the identification, assessment and treatment of those with eating disorders.

Share Your Treatment Story – as a Patient, as a Caregiver

One way we can educate and help our clinicians to better understand and to feel more equipped to treat eating disorders, is through sharing our stories – through describing our inside experience. Over the coming months, The Diary Healer will share  stories to help raise awareness – after all, it takes a village of care to heal from an eating disorder, and we all need to feel like we belong, and that we are not alone on this journey.

Here are some questions for you to consider:

  • What has your treatment experience been like?
  • What lessons would you like your clinician to take on board?
  • What lessons would you like to share with others?
  • What would have been helpful?
  • Did your GP identify your symptoms at first?
  • In what ways has a dietician been helpful for you?
  • In what ways has a psychologist been helpful for you?
  • Have you had experience of receiving treatment from someone who has claimed to ‘treat eating disorders’ but instead has made your illness experience worse?
  • What do you suggest to a parent, today, who is concerned their child is at risk of developing an eating disorder?
  • What do you suggest to an adult, who has been struggling for years with an eating disorder, and has yet to find the courage to access health services?

Send your story to june@junealexander.com

Your name, and no part of your story, will be published without your permission.