A Closer Look at Group Language Guidelines

For many years, Sheena’s Place groups have used a specific set of language guidelines to structure group discussions. While some groups have amended the guidelines to allow for relevant discussion (e.g. nutrition groups, exercise support), all others have used the same general set of language guidelines. We’ll refer to these as the “Original” language guidelines. According to these guidelines:

  •  Group members are asked to avoid naming: specific foods, direction of weight changes, numbers (e.g. calories), specific eating disorder symptoms and diagnoses (including exercise behaviours), details about experiences of trauma, and suicide. Broad language can be used (e.g. referring to being more or less symptomatic, experiencing a weight change, or having a trauma history).

In response to group member feedback, we recently piloted a couple of adult support groups with “Updated” language guidelines. According to these new guidelines:

  • Group members can name eating disorder diagnoses and broad symptom categories (e.g. bingeing, purging, restricting, over-exercising); however, all other language guidelines remain the same (i.e. group members are asked to avoid naming details about symptoms, specific foods, numbers, direction of weight change, and details about experiences of trauma and suicide).

The main difference between these two sets of language guidelines is the naming of eating disorder diagnoses and broad symptom categories. Currently, we offer groups that use the “original” language guidelines and groups that use the “updated” language guidelines. You may be wondering which set of language guidelines will work best for you. To help you decide, we have compiled feedback from group members about the pros and cons of each.

Why group members like the “original” (stricter) language guidelines:

  • Naming diagnoses and symptoms can be triggering, and can promote comparisons and competition; having these boundaries in place can create a safer space, unlike other parts of one’s life/the world.
  • Naming diagnoses can alienate members without a diagnosis and can reinforce the notion of not feeling “sick enough”; naming diagnoses and symptoms can also feel like one has to provide proof of their struggle to get support.
  • Not naming diagnoses can create more room to find commonalities between people, which is one of the primary intentions of group support.
  • Not naming symptoms can increase the group’s ability to focus on where symptoms come from, related emotions, and coping strategies.
  • Not naming diagnoses can help to de-pathologize and de-medicalize these issues.

Why group members prefer the “updated” (looser) language guidelines:

  • Naming diagnoses and broad symptom categories can allow for more specific support and advice to be shared, better meeting people’s individual needs and highlighting important individual differences.
  • Not naming diagnoses can reinforce stereotypes and assumptions about what others are experiencing.
  • Using vague language can make it difficult to share, taking away from one’s ability to stay present in the group and contributing to feelings of nervousness and fear about using the ‘correct’ vs. ‘wrong’ language.
  • Not being able to name diagnoses and symptoms can increase stigma, secrecy, avoidance, and feelings of shame about the eating disorder. Naming diagnoses and symptoms can support with feelings of empowerment and liberation, moving away from denial, and decreasing feelings of shame.
  • Naming diagnoses and symptoms can help create connection with others and validate one’s experience, decreasing feelings of loneliness and isolation.
  • Not naming a symptom can cause a group member to explain it in more detail, which can be more triggering than just naming the symptom.

You may still be wondering – why can’t I share everything about my eating disorder/disordered eating? Why are there any language guidelines at all?

Based on group member feedback, research, and recommendations from other community organizations, it’s important to have some structure when navigating discussions in eating disorder support spaces. Here are a few reasons why:

  • Language guidelines help to create boundaries and predictability, which are important aspects of providing trauma-informed care and support.
  • Naming details related to one’s eating experiences can be triggering, and can promote unhelpful comparison and competition.
  • Language guidelines can help keep the focus of discussion on underlying functions of symptoms (the ‘why’) and coping strategies, which may ultimately be more helpful in supporting recovery.

Lastly, one of our community members has generously shared about their experience navigating the “original” language guidelines:

“When I first joined the Adult Support group, I was frustrated with the language guidelines outlined in the participant acknowledgement and upheld by the group’s moderators. In entering my first session, I noticed that there was a lot that I couldn’t say. As someone who has been silent about my ED for a long time, this felt censoring and restrictive. There was a lot that was considered off limits in discussions, and I had to address my symptoms only vaguely or omit certain items altogether. I found it frustrating as I questioned how I was to share my individual and personal lived experience with my ED. 

After having completed 1 full session with the Sheena’s Place Adult Support group, and part way through my second, I have come to believe that the language guidelines are beneficial. Not only for maintaining the comfortability and privacy of all group members, but it has also changed the way that I address my own ED and how I allow others to communicate with me, whether they are aware of my diagnosis or not. I started to notice that you can say a lot without delving into specific topics or employing specific words, and there are words that might be commonplace for me that are triggering to others, and vice versa. I began recognizing that some of the language that is normalized amongst my friends and family was unnecessary and even quite harmful.  

I have opted to implement into my own life these similar guidelines, and challenging others to do so as well. There are things that can be left unsaid, that in fact are better left unsaid. As a group we are still able to come together and have a meaningful conversation, exploring topics and sharing insight in a way that always leaves me feeling supported and connected.”   – N.S.

If you have any questions or feedback about our language guidelines, please contact our Program Manager, Alexandra Hanania at ahanania@sheenasplace.org or 416-927-8900 x340.