“Bringing and Removing Self from the Table”: Therapists’ use and management of eating disorder lived experience in the treatment of clients with eating disorders

Abstract

Therapists report significant countertransference reactions when treating clients with eating disorders (EDs). Countertransference may be pronounced among therapists with eating disorder lived experience (EDLE). Minimal research examines how therapists with EDLE negotiate their experiences while treating ED clients. Informed by the person-of-the-therapist philosophy, this study sought to understand how therapists use and manage their EDLE when working with ED clients. Using constructivist grounded theory methodology, semistructured interviews (M_time = 89 min) were conducted with 22 therapists with EDLE. Results revealed that therapists engaged in two interconnected systems. The Central System helps therapists transform their lived experiences into clinical guidance. The Checks and Balances System allows therapists to find a balance between connecting with the client and allowing for differences in experiences to emerge. Lastly, three personal processes existing outside of these systems were found to impact therapists’ use of self. Findings provide novel ways that therapists can use their EDLE.