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Athletes and Eating Disorders: Redefining an Injury and Expanding Identity in Treatment
Contributor: Riley Nickols, PhD Counseling and Sport Psychologist, Director of the Victory Program, Reviewed by Kimberli McCallum, MD, Medical Director and Founder of The McCallum Place
In the Victory Program at McCallum Place, athlete-patients are regularly reminded that an eating disorder is an injury – a metabolic injury. Similar to most physical injuries, eating disorders require proper treatment before it is safe to return to sport.
It is important to recognize that an eating disorder is an injury so that expectations during treatment and upon return to training or sport can be discussed.
Upon return to sport, a false sense of health can be attributed to an athlete-patient after treatment. Although metabolic injuries can be covert, individuals are in danger of relapse if treatment, support, and parameters upon returning to sport are not appropriate. It is essential that coaches, athletic trainers, etc. are informed by the athlete-patient’s treatment team on how to best support an athlete-patient’s return to sport.
Athletes and Integrating Sport Training Into Treatment
Similar to musculoskeletal injuries in sport, there are risks when sport training is incorporated too aggressively during eating disorder treatment. A risk for re-injury or relapse exists if sport training is introduced in an inappropriate or unsupported manner. As such, it is imperative that a treatment team is informed of how to facilitate sport training into treatment. Providers should remain current on research and, if needed, obtain consultation from experienced providers.
For athletes who define their self-worth by their performance, a serious injury can be devastating. An athlete can experience a loss of identity as a result of halting sport participation. Specifically, if perceived value is largely contingent on sport participation and accomplishments, an individual’s identity can be threatened when sport participation is either disrupted or ends.
Understanding Factors Involved With Injury
Before identity is explored, it is critical the athlete-patient is able to mourn the loss of sport. Individuals who are not able to participate in sport can perceive their identity as “an athlete” to no longer exist since they are not currently competing in sport. The factors that characterize an athlete are enduring traits that persist during an injury or after sport participation ends. Recognizing that “being an athlete” is a trait, rather than a state, can be powerful.
In conjunction with supporting an athlete-patient’s identity as an athlete, an athlete-patient has an opportunity to develop a more expansive identity during treatment.
With the help of an attuned clinician, an athlete-patient can develop other parts of his or her identity that might have previously been superseded by an all-encompassing athlete identity.
After obtaining an undergraduate degree in psychology and a master’s degree in sport psychology, Riley realized that he wanted to work with athletes’ clinical issues along with their sport performance. That led him to obtaining a Doctorate Degree in Counseling Psychology. Further, he became interested in athletes with eating disorders, so he sought out a doctoral internship at the Center for the Study of Anorexia and Bulimia in New York. Never losing his interest in athletes, his doctoral dissertation examined the relationship between self-confidence and anxiety among triathletes and runners before and after competition. His research also focused on the psychological experiences of athletes returning to competition after experiencing season-ending injuries. Riley now specializes in treating athletes with eating disorders and is sensitive to the unique demands of recovery in relation to training and competing in sport. In addition to competing in endurance sports for over 15 years, Riley is a running coach and a USA Triathlon coach.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on May 14, 2019
Published on EatingDisorderHope.com
