Ask Julie: My Therapist Looks Like A Skeleton

Q: I don't know what to do. I have been seeing my therapist for 3 years. I suffer with body image issues and distorted eating. My therapist has always been thin/healthy. Sometimes her weight drops and I am very sensitive to it. We have talked about it before and I am very open with it if I feel triggered by her. I saw her today and she looks like an eating disordered patient. She said she is aware of it and working on it. She said she has medical issues that make her body do things if she's not careful and stress plays a part. I believe she is OK and she will work at getting back up to a healthy weight, but its really hard for me to make sense of. Why can she look like that but I have to work to keep myself healthy? Why are such high expectations put on me that she doesn't live up to? She is my biggest role model, and all I can think of at this moment is starving myself until I look like her. She is happy, successful, smart, has a family and is pretty. She said, "I hope you're not jealous of this (her body)" and she said that she wished she was in a different place. I just can't get the picture of her out of my mind. Oh and she's been getting sick a lot recently. It scares me. I want her to be healthy. She's MY motivation to be healthy. But when she's not...my motivation goes away and I want to restrict. How do I make sense of this?

A: Wow. What a tough situation! I want to validate your confusion about how to make sense of your therapist's weight loss. It sounds like you've handled this things well so far by being open with your concern for her health, and talking about how her weight loss is impacting your recovery process. It's scary when someone close to you is obviously ill and I'm glad that you are asking for help to deal with your concerns.I can hear that on one level you trust that your therapist is addressing the problem, and on another level you're angry about the double standard -- she can be at a seemingly unhealthy weight and you're expected to be at a healthy weight. While it is normal to be concerned about your therapist, I think there may be more for you to learn about yourself and your relationship patterns.Your comment that you can't get the picture of her out of your mind may be a sign that you're too focused on her. I'm curious, have you had other close relationships where you've focused on their problems or issues in a way that negatively impacted you? Core relationship patterns and emotional wounds often replay themselves in clients' feelings and thoughts about their therapist. You may want to explore these patterns with your therapist.Just like children who idealize their parents eventually come to realize that their parents aren't perfect, it sounds like you are experiencing a similar realization with your therapist. Instead of seeing her as the epitome of health, her drastic weight loss has knocked her off of the pedestal of perfection in your eyes.  There may be some grieving that goes along with acknowledging that your role model isn't everything you hoped she'd be.It's time for you to work toward developing an internal source of motivation for health and recovery instead of relying solely on your therapist for your motivation. Ultimately, who you are and who you want to become are defined and chosen by you, not by any external source. You are stronger than you think you are.Keep the dialogue with your therapist focused on you and trust that she's aware and taking care of her own struggles. If after a few months she's not improving and you are still frequently triggered by her appearance, it may be time to talk to your therapist about transferring to another therapist.Thanks for writing in and I wish you well in your continued recovery.Take good care of yourself!Julie Hanks, LCSW