Content note: this article includes discussions of eating disorders that readers may find upsetting. 

Two years ago, I went to residential eating disorder treatment for the third and final time. There, my assigned – and unlicensed – counsellor said I couldn’t discuss my trauma if I was going to cry.

While it may seem shocking for a patient to receive such a cruel comment, it certainly wasn’t the worst thing this woman did to me. And unfortunately, I’m not the only one who has endured harm while seeking help. Whether in treatment or outpatient care, many mental health professionals preach compassion – until it comes to eating disorder patients.

Treatment programs may be helpful for some, but I know from experience that defaulting to a one-size-fits-all method for patients is not only harmful but also disrespects our individual needs. For some patients, myself included, treatment not only intensifies the eating disorder but also our shame around it. As a result of my time at higher levels of ‘care’, I felt I was left with more trauma than before I had ever attempted to get help for my disorder. 

Being at a residential centre or hospital involves placing yourself in an environment where triggers are not only unavoidable but appear everywhere you look. At my first facility, despite the fact that I had a history of purging, I was assigned a roommate who often vomited in the middle of the night. When this happened, I was ushered out of the room while staff members went in to clean. I would sit on the couch and wonder why they had disregarded my purging history when assigning roommates. Shouldn’t an eating disorder facility understand better than anyone that seeing someone vomit might be triggering to someone who spent years making themself throw up?

I was often left staring at a terrifying plate of food and trying not to cry while the patient next to me openly sobbed. Patients would also get up from the table and run away in tears, distracting everyone from the already arduous task of finishing our food. And in an environment where one behaviour becomes less accessible, it’s easy to pick up new ones from fellow patients. I quickly learned, for example, how to hide food before meal checks when I first entered treatment. 

I’ll never forget one of the worst times at the table, when a new patient asked me invasive personal questions about my diagnosis, including requesting specifics on how I starved myself. Staff members are supposed to redirect comments like this – in this case, they did nothing. Like in countless other situations in treatment, I was left to fend for myself.

At these facilities, what sparked my disorder in the first place was often ignored – or made worse. For example, maintaining control played a major role in the development of my disorder, but in treatment, all control was taken from me, from access to my medical records to the ability to use the restroom (which was locked at all times) in private. A staff member hovered outside the door while I used the restroom and then entered the stall after me each time to ensure I hadn’t discarded food or made myself throw up – a genuinely humiliating experience no matter how many times I had to endure it. The demand that I relinquish control of every aspect of my life exacerbated the disempowerment I already felt. 

The problems can continue even after someone leaves inpatient treatment. During my last stay at a residential centre, I met all my goals and had an official doctor’s note to prove my success. But my counsellor told my outpatient therapist that I hadn’t met these recovery guidelines. As a result, my therapist abruptly cut all contact with me. Experiencing abandonment by the systems meant to support me created a trauma of its own. My recovery has had to take a backseat while I’ve processed being blindsided by the person I trusted the most.

Now, I’m taking steps to find empowerment in things that do not involve round-the-clock care. Harm reduction, which focuses on lowering symptom frequency or engaging in helpful counter-actions when behaviours occur, was a better and more realistic next step for me. And community care, which shifts the focus to how other aspects of life can aid recovery, is another more compassionate option – one I’ve found life-changing in a positive way.

While I survived treatment in the end, it has left scars that I’m still not sure how to heal. Hearing others discuss therapy and treatment spaces is still incredibly triggering, but I’m working on healing through healthy distractions, such as volunteering to help animals in need or revisiting hobbies I’ve always enjoyed, like reading for fun. I’ve also taken time to process my treatment trauma through writing, and I’m committed to sharing that the current state of eating disorder treatment doesn’t work for everyone – a perspective rarely told.

There is much progress to be made when it comes to the right approach for eating disorder care – and it starts with ending the practice of shaming clients for struggling to embrace recovery, and instead, taking a more tailored approach rather than a one-size-fits-all solution. Had I been able to experience genuine care in treatment, I think my recovery would have felt much more in reach.

Frame Of Mind is Stylist’s home for all things mental health and the mind. From expert advice on the small changes you can make to improve your wellbeing to first-person essays and features on topics ranging from autism to antidepressants, we’ll be exploring mental health in all its forms. You can check out the series home page to get started.

If you or someone you know is struggling with their mental health, you can find support and resources on the mental health charity Mind’s website and NHS Every Mind Matters or access the NHS’ list of mental health helplines and services.

If you are struggling with your mental health, you can also ask your GP for a referral to NHS Talking Therapies, or you can self-refer.

For information and help on eating disorders, visit eating disorder charity Beat’s website.

For confidential support, you can also call the Samaritans in the UK on 116 123 or email jo@samaritans.org. In a crisis, call 999.

Images: courtesy of Brooke Metz