We’re excited to introduce you to the always interesting and insightful Em Rubenstein. We hope you’ll enjoy our conversation with Em below.

Em, thanks for taking the time to share your stories with us today How did you get your first job in the field that you practice in today?

I began working in the field of eating disorder treatment 10 years ago: July 2014. I was a month out of my Bachelor’s and 2 weeks into being a California resident after I packed my car in Boston and drove cross-country to start a career among palm trees instead of snow. I was young, but I took a windy road to my Bachelor’s, so I was just shy of 28.

While I started college as a musical theatre major, being in the mental health field had been on my radar since I was in high school. I had always been a little different, a little more therapy-inclined (there’s really no wrong way to interpret that, so take it however you like), and interested in the struggle of the human experience. I took the scenic route to a Bachelor’s in Psychology, stopping off not only at musical theatre but also completing professional programs in photography and graphic design along with some additional side quests. I was 23 when I realized my work would be in the eating disorder field. As is common in this field, I have lived experience with an eating disorder that brought me to this work. Though it was not a straight path, the walkway out of my final intensive outpatient program led directly to the front door of my first job.

By the end of 2013, two things were certain about my future: I was driving to California as soon as I had my degree in hand and I was going straight to treatment when I got there (on the staff side, for once!). This is when my job search started. My process is something I frequently share with anyone at varying points in their academic/career paths through consultation and guest lecturing in programs where students are trying to figure out what their job prospects might look like.

I wanted to be in eating disorder treatment in Southern California, so I looked up every treatment center I could find. I didn’t care if they were hiring or not; I didn’t need them to be for another 6 months. I wanted to get to know what the options were and get my name in their inbox so they would know it by the time I moved out there. (My mom, a born businesswoman, always told me to make sure the people I wanted to work for knew my name.) In 2014, there were a small handful of well-known eating disorder programs in the area I planned to be in. I emailed my resume to all of them and told them I planned to move to the area by the following summer and I wanted to learn more. None of them responded. I was, after all, 2,500 miles away seeking a job that, at the time, paid $14/hour. Maybe they’d at least seen my name.

In April 2014, I reached out again to tell them I was crossing the Cali state line in a month and a half. Again, no one responded. If I was lucky, they were starting to go, “Why is this Emily girl in my inbox so much for only $14/hr?” In June, I found myself on my great-aunt’s floor with no job and barely an address. I emailed them again. One of them called me in for an interview the next day.

The interview went something like this:

“It’ll only be a few hours a week right now, and it’s on-call.” It became closer to 50 hours per week within my first 2 weeks. To be fair, I didn’t have anything else going on and was in a new state, so I took every single hour they could offer me.
“It’s only $14/hr, and you’ll never get a raise.” That was perfectly accurate; 2 points for honesty.
“Have you ever driven a 10-passenger van?” I hadn’t. “Well, then good luck.” She handed me the keys. I was terrified. I also felt an overwhelming sense of, “Holy shit, I finally did it.”

My first job was a lot of things I wasn’t warned about (not sure who would’ve warned me, but still). Sometimes I loved the work I was doing, many days I felt like I was banging my head against a wall with my hands tied trying to have the slightest affect on a hugely systemic issue with minimal skills in my pocket. I stayed for 8 months until a manager told me she had a better work environment for me elsewhere and we both left. Everything about this job was necessary for where I am today. I’m grateful for every aspect of it.

As always, we appreciate you sharing your insights and we’ve got a few more questions for you, but before we get to all of that can you take a minute to introduce yourself and give our readers some of your back background and context?

I am a Licensed Marriage & Family Therapist. My primary specialty is food relationships and eating disorders, though I also work with many individuals dealing with daily stressors, phase-of-life transitions, as well as couples and families. A large percentage of my treatment style is education. When people ask what my “theory” is, the first thing I emphasize is that I am an autonomy-focused therapist.

Many of my clients come to me after receiving support through other avenues (whether individual providers or corporate treatment facilities) where they felt they were directed to blindly trust their provider over themselves. My goal is to help my clients rebuild their autonomy, to encourage them to make their own educated decisions about their bodies, and to offer support with only what they want to change. I offer my clients the knowledge and expertise I have regarding the human relationship with food (and all the ways that it is externally impacted by the world we live in) and then explore with them how they would like to use that information.

Learning and unlearning are both critical parts of growth – can you share a story of a time when you had to unlearn a lesson?

Recovery does not need to be a goal in eating disorder treatment and removing recovery language does not mean that a person is not progressing in their work.

Hot take: “Recovery is POSSIBLE!” is cringey. It’s not the statement itself; recovery IS possible. It’s the image of this written across art paper with Crayola markers posted on the wall of every treatment center I’ve personally ever walked into. (Between being a patient and a clinician, it’s a lot.) It has lost meaning and feels more like a plea of “Just trust us since you shouldn’t trust yourself right now!” It’s intended to instill hope and I think for many, it does. In a different lifetime, it did for me. It also misses the mark for a lot of people who enter treatment when the idea of recovery feels entirely like a personal responsibility and ignores the external systemic injustices that contribute to eating disorders.

Recovery is drilled from day one when you seek help from an eating disorder. “It’s possible!” “It’s waiting for you!” “It’s beautiful!” Recovery is talked about like a Disney cruise ship that will appear from over the horizon as soon as you let go of the sinking lifeboat that’s keeping you alive in the middle of the ocean. The sinking lifeboat feels certain and (sorry, SoCal friends) not everyone even wants a Disney cruise. Some people just want a lifeboat that doesn’t have a hole in it, but they’re always told it’s not enough. It doesn’t “count.” The very first question that many clients get asked in their assessments is: “On a scale of 1-10, how motivated are you for recovery?” Neither recovery OR “motivation” are defined, but it certainly sounds like something you should have and to be achieved; it’s an end goal.

The ambiguity of recovery being a destination is supplemented with lines like “recovery is not a straight line” and “recovery looks different for everyone.” These things are also technically true, but they feel like throwaway lines when we don’t take the time to explain why it’s different for everyone. If it’s not a straight line, where else is it going? Is it supposed to go there? There’s a big difference between telling your client, “It’s different for everyone because you’re all different people!” versus “It’s different for everyone because people have varying levels of privilege in this world. Because people have varying levels of access to resources from healthcare to clean water. Because people have different neurotypes that allow some to completely leave unhelpful behaviors in the dust while others will require tools to simply learn to accept that those behaviors come from how their brain is wired.”

Unlearning the static language of Recovery took a lot of work. Now I’m moving to help clients who have never found it helpful to unlearn it–even drop the word altogether if it hasn’t been helpful language–and find what fits for them.

Other than training/knowledge, what do you think is most helpful for succeeding in your field?

Every healthcare field is fighting an uphill battle within diet culture and the eating disorder professionals are at the front lines. However, that doesn’t always mean that we know better or that we aren’t perpetuating more harm. To assume that any of us has done enough work in addressing our own relationship with food and our internalized weight stigma is negligent at best. To do right by this field and those we support, the ongoing work on ourselves and how we are impacted by these narratives never stops. We have to be able to challenge our own biases and acknowledge our privileges, especially in a field that is overwhelmingly comprised of thin, white cis-women.

Contact Info:

• Website: https://www.TalkWithEm.com
• Instagram: https://www.instagram.com/em.does.therapy
• Facebook: https://www.facebook.com/emdoestherapy

Image Credits

Viktoria Horbach, Emily Rubenstein