Can People with Eating Disorders be "Treatment Dependent"?

I heard a new term in the treatment of people with eating disorders this week: treatment-dependent patients. I was flabbergasted by the judgment and blame associated with this label, especially since it came from a program well versed in the need for kindness and compassion. 

The overt message appeared to be that patients should not be dependent on their treatment to get well while the implied message is that chronicity of an eating disorder is the patient's fault. 

For those who read my blog, it's clear that dependence on treatment is a necessary part of recovery. The eating disorder serves as a constant companion, comfort and salve for all the events of daily life. Weaning oneself from such a critical part of life demands a drastic shift in lifestyle. Depending on treatment can be a bridge towards learning how to depend on close relationships in daily life while learning how to eat normally again. That dependence makes the eating disorder less necessary over time. The relationship serves as a jumping off point for independence, not a reason to remain ill. 

The chronicity of an eating disorder is not the failure of the patient. The implied message is that the person just needs to try harder or to learn to stand on her own two feet. Anyone knowledgable in eating disorder treatment knows this message only sends someone to relapse because it reinforces self-criticism and self-blame, the cornerstones of the eating disorder.

The eating disorder thoughts and behaviors become so ingrained and automatic that only sustained support to change these patterns over time will have an impact. Urging someone to just figure it out implies a lack of ability on the treatment providers to manage the illness. 

This is certainly not the first time I have heard clinicians blame the patient for her illness. Usually inexperienced therapists will state uneducated opinions which only show a lack of understanding of the nuances of eating disorders. That's not surprising since it is hard to find thorough training for treatment of these illnesses. 

However, the term treatment-dependence comes from an established and esteemed organization. When patients are blamed for their illnesses, it's time for the treatment providers to delve into their own motives to be sure they have the clarity needed for this type of work.