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?

Its not out bounds but our whole session hadn’t been relating to my weight and in my opinion there has been no change to my weight from what I can see and on the scale

It’s not very skilful of him to dump that on you at the end of a session

You say you eat 1800 calories a day, so weight loss could be very slow. And depending what you eat you could feel bloated as a result. Do you exercise a lot? Maybe you've toned up. A BMI of 22.7 seems well within a healthy weight.

I do 10,000-15,000 steps a day and go to the gym 5x a week

Yes, he is allowed to ask. And sometimes therapists can be confronting and say things we don't want to hear or that don't sound right. It can make us angry at them or even feel we hate them. A good therapist will work with that and realise there's big emotions there that need to be explored. The best thing you can do is be honest at the next session and tell him that you were so perplexed by his question you even took it to an online forum to see if he was allowed to ask. Then you can both work through why it caused that reaction.

You have a diagnosis of body dysmorphia. He needs to be asking you blunt questions if they think you are self harming

The scales may not be showing it but obviously your appearance is concerning him.

Of course! 🤨

He can see that you've visibly lost a lot of weight but you 'feel' bigger than ever. As you have body dysmorphia I think that sounds like a worrying combination.

I would throw the scales away if I were you. You're doing a lot of exercise so I would stop counting calories and just concentrate on eating well now.

I don't think it was wrong of him to ask but I think it was wrong of him to end with such a loaded question.

You say he’s diagnosed body dysmorphia, so even though you feel bigger than ever, he might not be seeing that. He’s concerned so has said something to you.

Well a psychiatrist could ask it so why not a therapist? I guess the language is blunt and crass. Like even if you were you're not going to be framing it as 'starving yourself'. Many people with anorexia find it hard to admit it even to themselves.

Anyway you're not and you said so just don't talk about it again. If they mention it again say you're not interested in talking about weight or eating.

Not only is he allowed to ask you that, he has to. He has a duty to ensure your well being is not at risk and if he feels you are a risk to yourself he can break confidentiality and refer you to other services.

Therapist’s aren’t perfect and we get stuff wrong sometimes. I personally refrain from commenting on appearance but in this case it seems he was concerned and the intention was therefore good.