Blame Has No Place in Eating Disorder Treatment

The inception of blame as a pillar of an eating disorder is rooted in our collective idealization of thinness. Body size and shape has become an ever more central factor in defining achievement and success, control and determination, willpower and attention. Society dictates that we should all strive to be as thin as possible at all cost. Any failure is our own fault.

The issue in eating disorder treatment is the expansion of the idea of blame about not being thin enough to blame about all different types of disordered thoughts and behaviors. The types of blame providers use morph throughout treatment to match the current symptoms but inevitably point back to personal failure as the cause of the disorder itself and the reason for any obstacle towards getting better.

A person with an eating disorder is blamed for being vain to want to be thin, even though our entire culture focuses on weight and thinness; blamed for having thoughts to restrict or believe they are fat even though these experiences are practically universal; blamed for debating controversial topics around body in session even though that type of discussion is integral part of any therapy; blamed for not being able to eat a full meal plan or avoid behaviors even though that’s exactly why they are seeking help in the first place, and blamed for almost every other part of their illness and treatment.

The blame that starts with idealizing the unattainable goal of perfect thinness expands to all aspects of an eating disorder so that the illness itself becomes a reservoir of endless blame and often self-hatred.

It’s clear to me that openness in treatment towards understanding the person seeking help is necessary to understand the nature of their eating disorder and also the torment of being endlessly ignored and misunderstood. Treatment needs to involve the psychological wellness of the person in a kind, generous and caring way. Without that step, any chance at improvement is impossible.

Many people without this support talk about being labeled chronic which is intended to instill more blame and hopelessness, but how often does this label only reflect inadequate and uncaring treatment?

Blame does not belong in eating disorder treatment any more than it does in any psychiatric treatment. People with eating disorders ended up in their illness, like anyone else, without intention, and they need help. Our society has both increased the incidence of these disorders through a culture of chronic dieting and then coined a label to isolate a swath of our population and saddle them with an illness without much of a path to recovery.

Every person with an eating disorder has their own experience that led them to be sick, to their trials of treatment and to a course of healing. There is no place for blame but only for understanding, help and the hope that they can live they want to live.