“WOW. You worked hard today Constance! I know what it takes to get through the hard-core resistance of an eating disorder into the real and vulnerable person with whom you can then make a compassionate connection and TOGETHER move toward the decision for treatment. This is SO scary for them to make on their own because their only sense of self and control IS the eating disorder. You worked a little bit of clinical magic today with her, a move that very few clinicians know how to, or are willing to do, with these clients.
It's a real art form to get through the resistance into the vulnerability and then hold, support and reassure their fragile decision and ambivalence with the kind of follow up you did. This is what it takes, really walking WITH them into these first aversive, seemingly impossible decisions and steps into the proper level of treatment. If there is not enough built in, they can't do it, it's too hard. And if they drop out of treatment because there is not enough structure, support, reassurance, holding etc., to get them through that difficult first symptomatic step, they give up on themselves, their treaters, feel like they failed and feel hopeless about the possibility of ever really getting rid of this torturous disorder.
It takes a LOT of structure, support and time.
But most importantly it takes someone like YOU who believes in them enough to dig in there and find them, feel/talk compassion for their plight and loan them your hope and belief in them and in the fact that recovery IS possible!
This is special work, Constance. You have to be very brave, bold, believe in yourself and in them and have the strength to hold them through their ambivalence, resistance, fight, testing, anger etc.
But this first step is the biggest. She will never forget that you cared enough to fight through her resistance.
This is God's work, really! And you have a calling!”