Was my therapist allowed to ask me this?

[passingby1234]

I have been attending therapy due to ocd/need for control/low self esteem.

Sometimes the OCD has fixated on my weight which has led to my therapist diagnosing body dysmorphia in the past. I track calories but sensibly.

My session today was about something different. Our session went well and at the end of the session he said ‘before you go. Have you been starving yourself/ do you have bullimia and been making yourself sick’ i said no and he said you have lost an awful lot of weight since I last saw you.

I understand therapy requires vulnerability but the blunt questioning at the end of the session shocked me. Was he allowed to ask me that?

Yes he's allowed to ask you a direct question I don't see a problem with that myself - either just give a direct answer back or tell him you're not comfortable answering that question.

"he said you have lost an awful lot of weight since I last saw you."

Is that correct? Have you lost an awful lot of weight since you last saw him?

Have you lost a lot of weight, have you been dieting intentionally.

Ive been constantly dieting but the scale hasn’t changed and I actually feel bigger than ever

I think she would be neglient not to ask you this. What is your BMI?

Of course he’s allowed to ask! In fact he’d be completely negligent if he has noticed that you had lost a lot of weight ( and knows you have a background of body dysmorphia) and he didn’t ask you if you had been restricting/purging. He’s doing his job. Was he correct?

yes they are ‘allowed’. Therapist’s handling seems rather clumsy. Odd though that you’re focusing on that rather than your problems.

Yes, he’s allowed to ask that. He’s just looking out for your welfare, that’s all

(I also wonder if he’s talked things through with this clinical supervisor and they’ve advised asking you outright, I know I’ve raised things with clients when my supervisor suggested it)

Yes they can ask. Might have been better if they asked you earlier in session rather than end cos what would they do if you said yes

Just because you feel bigger doesnt mean you are bigger, he sounded concerned

No Ive never starved myself or made myself sick in my life. My BMI is 22.7

Yes but what do the scales show

I think they do have a duty of care to ask. It does sound as if it could have been more tactfully handled, but as a direct question it’s fair and fine.

You mention sensible calorie tracking, would you be comfortable telling us how many calories and what your BMI is? For someone to have asked you this directly you must really have lost a significant amount of weight

Absolutely right for therapist to ask but I don't think you need to share your BMI here! .

Im not stick thin at all. My BMI is 22.7 and I eat about 1800 calories a day and exercise a lot.

What about the question bothers you OP? Are you afraid of the intention behind it? Or do you think he should not mention appearance at all - does it trigger you when people mention your appearance? You mentioned need for control and bulimia and anorexia are completely bound up in excessive need for control. So I think it is quite right to ask about someones welfare if you notice a change in appearance - for example, if you had a history of self harm and the therapist noticed marks on your arm, it would be negligent not to ask.

What kind of therapist?
Only certain types are allowed to make diagnoses.
There are some that overstep and use questionable methods. It is very unusual and imo inappropriate to bring this up in the way he did.

Because the scales haven’t moved and I feel bigger than ever so I am shocked that somebody would look at me and directly ask me if I was doing that

He is allowed. And you are allowed to decline to answer it.

But he was shit at handling it. 'Before you go, here is this huge question/potentially distressing subject to open up', that's a terrible way to end a session, something that is advised against very early in training. What kind of therapist is he?

Ok, so 3 things jump out from your reply. 1. I am sure you know that part of your disordered thinking is treating feelings as if they are factual, and responding as if they were a true reflection of what is happening around you, which then drives your anxiety up. 2. You seem overly reactive to anything about your appearance, which gently, I would suggest is also part of your anxiety thinking. Many people would be able to brush off such a comment. 3. A lot of anxiety is made worse by avoidance and distress intolerance - ie, I feel bad so I must shut this down or change what I am doing to avoid this feeling. Feeling that some things should not be discussed may be part of that?

Given what you said about your reason for being in therapy, I think your response makes sense and it would be worth discussing his question and your reactions with your therapist.

Good luck with everything.

Not much point going to therapy if they can't ask difficult questions. What you answer is up to you, but I assume the point is to try to be honest.

Of course, that's a reasonable question. That's checking on your wellbeing.

My CMHN asked me what was going on after me not seeing her for a fortnight. She noticed my weight loss, my clothes not staying up.

She said it was good I'm losing weight but the speed of it in a couple of weeks was extreme.

I am overweight at 14st. I was just shy of 17st at the start of September.

Sounds like you have an excellent therapist. Observant and on the ball.

Perhaps they don't remember how big you looked before or you were wearing really flattering clothes this time. Have you checked your scales, they are sometimes not very accurate. Are you actually heavy for your height or is it just your perception?

He was right to ask if he was concerned but he should have left enough time to resolve the conversation and give a "safe landing".

Sounds like a good therapist to me. Or would you prefer a therapist who supports you in avoiding your potential issues?

Surely you want the therapist to help you? If so let them ask whatever they think might help. Why would you put certain subjects oput of bounds unless you don't want the therapist to uncover an accurate diagnosis?