To specialize or not to specialize? That was the question.
At some point during my graduate program for counseling, I had to decide whether or not I was going to pursue eating disorders as a clinical specialty. If I chose to go that route, I had the job of my dreams waiting for me. With an invitation to join a private practice in the central Ohio area, I’d be working primarily with children and adolescents suffering from anorexia, bulimia, and binge eating disorder.
It seemed like a no-brainer, but as you probably know, I’m not really a no-brainer kind of a girl. I’m more of a crack it open, slice it and dice it, and stir-fry it up until there’s no thought left unanalyzed kind of a girl. This was no exception; I had a lot I wanted to process. While I felt excited and grateful for the opportunity, I didn’t want to make a rash decision.
In the pondering of this question, I decided to meet with a well-respected psychotherapist in the field of eating disorders. When I explained to her my dilemma, she simply replied, “Well, eating disorder treatment is a lot like playing the slots.”
I wish I could tell you she said it in a thrilling “what happens in Vegas, stays in Vegas” kind of way, but unfortunately, it sounded more like “you’ll spend all of your money and go home broke” kind of way. I’ll never forget the emotion I carried with me as I left her office: discouragement, confusion, and grief. Folded and tucked away in my back pocket was a dream that almost was.
My mind started to ponder a new question: why would she tell me that?
The story I made up in my mind was that she didn’t think I had the chops to diagnose and treat eating disorders. She knew I was recovered myself, and maybe she thought I was too tender, too vulnerable, and too green. Maybe she took one look at me and assumed I was still caught in the wake of my own eating disorder. Maybe she saw an inadequacy in me that my potential new employer had failed to see.
It was my story, and I was sticking to it.
As time passed, however, I followed Brene Brown’s words of wisdom, let my story become, instead, my SFD (my “shitty first draft”) and allowed other stories to get drafted too…
Maybe she was protecting me.
Maybe she was protecting the field.
Maybe she was using reverse psychology.
Maybe she was feeling discouraged herself.
And, finally, after all of these drafts were scribbled on the scrap papers of my fictional senses, the final draft was written on the tablet of my non-fictional soul. Maybe the reason she told me that eating disorder treatment is a lot like playing the slots is because she was just being honest. Eating disorder treatment is a lot like playing the slots.
Eating disorders are ego syntonic illnesses, meaning it feels better to have an eating disorder than not. Asking an individual to give up their eating disorder is like asking them to give up their life preserver when they are already drowning. In the middle of the ocean. In shark infested waters. While a storm is brewing.
Recovery is absolutely, positively possible, but treatment is long and grueling. Progress is slow and never linear, and backwards progress is, unfortunately, typical from time to time. As a therapist, I provide the most data-supported, evidence-based, and client-centered interventions I can within the context of a relationship, but yes, it can feel like I’m putting quarters in the slots, only to pull the lever and yield…cherry, cherry, lemon.
There’s something about it, though. Putting quarters in the slots. There’s hope. Anticipation of a breakthrough. Imminent reapings of all that was sewn. And those jackpot moments, those ice cream sundae with a triple cherry on top moments, make it all worthwhile.
When a client reports she was up late, sitting in the hallway of her dormitory, eating Nutella and pretzel sticks with the girls: jackpot.
When a client says he went to the Ohio State football game, had a beer before noon, and enjoyed a hot dog while cheering on the Buckeyes: jackpot.
When a client tells you she let her new groom feed her wedding cake without thinking about its caloric content: jackpot.
When a client brings two grande mocha frappuccinos to his appointment, one for each of us: jackpot.
When a client sets aside the armor of perfectionism enough to connect with others: jackpot.
When a client calls the shame monster to the mat and gives it a brain ninja high kick to the groin: jackpot.
These are the moments that keep me engaged and patiently playing the slots.
It’s funny, though. I didn’t yet know the joy of the jackpot when I was still in grad school. So the only question left is: why did I do it? Why did I decide to specialize in eating disorders? When discouragement, confusion and grief were ruling the decision making process, why did I trust and say yes?
Because the tucked away dream was unfolded and slapped on the table in front of me with a love note attached that said, “I want you to comfort others with the comfort you have received from me. I want you to play the slots. And I will be at the machine right next to you the whole time. It will be an absolute blast. Just remember: what happens in Vegas, stays in Vegas!”