The Role of Self-Disclosure in Eating Disorder Therapy

Contributor: Staff at Carolina House

In individuals with active disordered eating behavior, there is often an absolute lack of motivation to recover. This insidious nature of eating disorders is a well-known aspect of the illness and a common barrier to change for those entering treatment.

Interventions have been designed to increase recovery motivation. However, these have not always proven especially fruitful. Nevertheless, a recently published Harvard University study showed that there is an often-overlooked role that self-disclosure plays in motivating clients to recover. It was discovered that hearing from other eating disorder patients who had recovered or were further along in their healing, or even from one’s therapist who was in recovery themselves, helped motivate individuals in their own personal recovery journey [1].

In this particular study, traditional motivation enhancement techniques were found to be less effective than recovery self-disclosures. Of course, this is why many programs that are designed to treat eating disorders highlight the importance of the group, of peer support, and of putting men and women at different stages of recovery in community together, even in outpatient treatment.

Peer Self-Disclosure

Peer support programs, including peer mentors, are helpful for those who are struggling with an eating disorder. When those in recovery get to interact with individuals who have already recovered from an eating disorder or are further along in the process, they enjoy social support, are able to see others’ coping skills in action, and have an opportunity to build their self-confidence in a supportive community setting.

In addition, they gain hope for the future because they see firsthand that recovery is possible. Peer self-disclosures are impactful because many who struggle with an eating disorder believe that recovery is undesirable and unattainable. Hearing from others who are further along (and who are not the therapist and, therefore, don’t have “ulterior motives” for one’s change) can help put the problem in perspective.

Setting up a formal or informal peer mentorship program is also important and essential for recovery. Clients need to see proper eating behavior modeled by others they respect, and to hear from those who have struggled with eating disorders and come out on the other side with a more positive relationship with food that they can, in turn, emulate.

A huge aspect of treatment in this way is that clients often believe that they are alone in the specific thought patterns that regulate their disordered eating behavior, or in the specific fixation that they may direct toward all of their body’s perceived flaws. Hearing others admit that they experienced those very same destructive thoughts can be incredibly healing.

Therapist Self-Disclosures

Utilizing therapist self-disclosures, therapists share their own feelings and personal experiences related to a client’s symptoms. It is believed that therapist self-disclosures help strengthen the therapeutic alliance by conveying genuineness, openness, and positive regard, and are even known to influence treatment outcomes positively [2].

The use of self-disclosures is an opportunity for a therapist to be seen as more human and to reduce power dynamics that are at play in the relationship. This helps clients see therapists as people they can relate to and not as perfect individuals on a level that they cannot attain. In this way, self-disclosure is used to improve client perceptions about therapists.

Self-disclosures can be an important tool in:

• Helping normalize individuals’ experiences so that they don’t feel incapable of recovery
• Feeling understood by and connecting with therapists
• Modeling helpful behaviors that those struggling can emulate
• Providing fresh perspectives on issues that often arise in the recovery process

Often, patients who have self-disclosing therapists view them more positively and believe that the therapists hold their clients in high regard to have shared with them. Therapists’ self-disclosures are common in clinical practice because they tend to be effective. However, there is a shadow side to this practice as well.

Sometimes, therapist self-disclosures can break professional norms and violate the boundaries of the relationship. This could happen when the therapeutic relationship begins to feel like a friendship, or the therapist takes up more time talking about themselves and not having clear relatedness back to the client. Thus, the content of self-disclosure is very important and influences the effects on the therapeutic relationship.

Self-disclosures that are intentional, planned, and appropriately timed will have very different effects from those that are spontaneous and unplanned. Self-disclosures are not just open statements about the past. One must be careful about what they say and how they say it.

There needs to be an information filter in terms of what is relevant and what is not so that a client is not left in a state of confusion. In these cases, it is always recommended that clients seek out honest conversations where they are able to communicate with their therapist about what is helpful and what is not.

There is still a lot of research to be done regarding the interrelationship between therapists’ self-disclosures and eating disorders since many eating disorder treatment centers lack guidelines for hiring or supervising therapists who have recovered from eating disorders [1]. Whether the therapist uses appropriate self-disclosure or not, it is through trust and a well-built therapeutic alliance that the real work of change takes place.

If you or someone you love is entering eating disorder treatment, it is important to remember to surround yourself with others whose perspective can help illuminate areas of needed growth. Whether it’s by learning from others in the program or from your therapist’s personal journey, self-disclosures play an important role in therapy for eating disorders – they inspire motivation and make the unachievable seem possible.

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Sources:
[1] Wasil, A., Venturo-Conerly, K., Shingleton, R., & Weisz, J. (2019). The motivating role of recovery self-disclosures from therapists and peers in eating disorder recovery: Perspectives of recovered women. Psychotherapy. doi:10.1037/pst0000214
[2] Ziv-Beiman, S., Keinan, G., Livneh, E., Malone, P. S., & Shahar, G. (2017). Immediate TSD bolsters the effect of brief integrative psychotherapy on psychiatric symptoms and the perceptions of therapists: A randomized clinical trial. Psychotherapy Research, 27, 558–570. http://dx.doi.org/10.1080/10503307.2016.1138334

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About the Sponsor:

Carolina House is an eating disorder treatment center that serves people of all genders, ages 17 and older, who are struggling with eating disorders.

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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 a 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.

Published on April 19, 2019.
Reviewed & Approved on April 12, 2024, by Baxter Ekern, MBA

Published on EatingDisorderHope.com