Nicola Rance (UWE) Naomi Moller (UWE) Barbara Douglas (BPS DCoP Registrar)

1. Eating Disorder Counsellors with an Eating Disorder HistoryAn Interpretative Phenomenological Analysis Nicola Rance (UWE) Naomi Moller (UWE) Barbara Douglas (BPS DCoP Registrar) Results Three themes were derived from the IPA: ‘Double-edged history’, ‘Emphasis on normality’ and ‘Selective attention’. The theme double-edged history represented the participants’ apparent awareness of both benefits and dangers of their ED history. They saw themselves as having “insider knowledge” that enabled them to truly understand their clients’ experiences “you can, understand .... umm why they did, what they did or said what they did umm and that, and that, can work very well” (Laura)and know that recovery is possible, but also as at risk of overidentification/enmeshment with their clients and criticism/negative judgement from others in relation to their history “[being interviewed] was sort of, a BIT uncomfortable.... because of maybe, YOU judging me” (Sandy). The participants appeared to navigate this double-bind with an emphasis on normality that stressed their lack of ED symptoms, the absence of any impact of their work on their self-experiences and behaviours “I don't think it's [body image], altered ... no it [relationship with food] hasn't changed ... my appetite hasn't changed ... my experience of my body image or my view of body image HASN'T altered.” (Sam), and firmly located their ED in the past “I know I’m never going to go back to eating disorder behaviour” (Laura). Finally, the participants seemed to employ a number of cognitive and attentional strategies to back up and justify their overt assertions of normality. For example, they appeared to hold a binary view of recovery which meant that, as ‘recovered’, they were thus safe to practise. Additionally, they appeared to have selective attention such that certain areas of their practise were unquestioned “I don't know what it would be like ....to consider how does an anorexic person .... look at you .... in a WAY that just has not occurred to me” (Julie). Introduction Some have argued that counsellors with an eating disorder (ED) history may not be fit to practise with clients with EDs; others, meanwhile, have argued that an ED history makes a practitioner working in the field more effective (Johnston, Smethurst & Gowers, 2005). Despite general acknowledgement that working with EDs can be incredibly demanding for practitioners (Zerbe, 2008) – in part because of the way it can affect their physical perceptions of themselves (DeLucia-Waack, 1999) and their behaviours surrounding food, eating and appearnace (Warren, Crowley, Olivardia & Schoen, 2009) – there is almost no research exploring the actual experiences of recovered ED counsellors. Given that the number of practitioners believed to have such a history is thought to be between one in three (Barbarich, 2002; Johnston et al., 2005; Warren et al., 2009) and one in four (Bloomgarden, Gerstein & Moss, 2003; Shisslak et al., 1989), understanding their experiences is clearly important. The study thus aimed to explore recovered practitioners’ countertransference experiences in relation to their body image, weight and relationship with food, their perceptions about the impact, if any, of such experiences and their beliefs about the effects (both positive and negative) of their own eating disorder history. Method Using semi-structured interviews, the experiences of seven female counsellors (aged 32 to 52, with a variety of theoretical orientations and 2 to 17 years practice experience) were investigated using Interpretative Phenomenological Analysis (IPA; Smith , Flowers and Larkin, 2009). Particular emphasis was given to their beliefs about the impact of their work on their own body image, weight and relationship with food. Discussion Given that society in the main is not free from disordered eating and what constitutes a good relationship with food and a healthy weight is not only culturally determined but also prone to change with the fashions of the time (Nasser, 1997), the counsellors’ apparent felt need to minimise/place far in the past their ED history and normalise their current cognitions, emotions and behaviours related to their relationships with food, their bodies and weight appeared to put them into the impossible position of claiming normality in a world where the norm is not “normal”. It is of course possible that the study participants’ recovery processes may have involved them in deep engagement with their body image, weight and relationship with food thus enabling them to develop particularly healthy relationships with each. Yet, even the healthiest of such relationships can be challenged from time to time and being able to voice this (e.g. in supervision, to colleagues) seems important. It would thus be problematic if it were indeed the case that the interviewees (and possibly other practitioners with an ED history) were in a position where they felt unable to do so. X Key reference Johnston, C., Smethurst, N. & Gowers, S. (2005). Should people with a history of an eating disorder work as eating disorder therapists? European Eating Disorders Review, 13, 301-310.