In Person Sessions are a Necessary Part of Eating Disorder Recovery

The further the pandemic recedes, the more our lives are virtual. So many aspects of daily life had digital components in 2019, from work to personal to social. Virtual professional meetings or conferences, virtual time with friends eating or watching movies or playing games, virtual appointments were already common. It’s clear the pandemic accelerated the transition to digital lives to the new way we live.

I wrote several posts about the pros and cons of virtual treatment for eating disorders during the pandemic. In the short term, the pros and cons balanced each other and didn’t seem to decrease the opportunity to work on recovery and get well.

Now, several years later, virtual treatment is also the norm. Many therapists, forgoing to hassle and expense of office space, have fully remote practices. Many treatment programs offer virtual outpatient options. Some new treatment programs are solely virtual.

As with all eating disorder treatment, no systematic studies exist to study various forms of treatment to figure out if virtual options are even effective.

Patients who have struggled with residential treatment or who are ambivalent about recovery choose virtual programs because they are easier to attend. Similarly, patients more ambivalent about care choose virtual therapy for the same reasons.

The transition to this type of care still offers easier access and convenience for everyone while focusing on the promise of equally good care. However, my initial assessment was based on two factors during the pandemic that don’t apply now. First, most patients were continuing care established in person. Previous in person care already broke down barriers towards progress and ways patients with eating disorders hide that strengthen the illness. Second, we were all sequestered so sessions occurred usually without many distractions.

Now people seek treatment solely virtually without ever meeting the therapist in person. They are distracted by many things in life and even on their screen. It’s too easy to show up for therapy but never fully engage. Being in person forces the kind of intimacy that can be overwhelming but also insists that the conversation addresses the fundamental issues of recovery. Virtual sessions enable the eating disorder to remain hidden.

Weaving virtual sessions into recovery can and will always be useful. Allowing people with eating disorders to enable their illness by using the virtual room to hide does people a disservice. However, balancing in person and virtual sessions can be the norm.

As I have written extensively in this blog, recovery necessitates finding things in life as or more important than the eating disorder. That process always involves personal relationships as well, the therapy relationship representing the first step towards engaging in the world. A virtual relationship alone won’t be enough to make that transition.