This is something that kind of punched me in the face (in the best possible way) in a recent supervision session with Fiona Sutherland.
In the context of working with disordered eating in clinical practice, I asked her:
“What’s the most common way harm happens in communication?”
I expected something about saying the wrong thing. Messing the wording up. Or accidentally reinforcing something, affirming something disordered.
But her answer caught me off guard:
Harm doesn’t usually happen because we say the wrong thing.
It happens because we say nothing at all.
In the context of working with disordered eating in clinical practice, I asked her:
“What’s the most common way harm happens in communication?”
I expected something about saying the wrong thing. Messing the wording up. Or accidentally reinforcing something, affirming something disordered.
But her answer caught me off guard:
Harm doesn’t usually happen because we say the wrong thing.
It happens because we say nothing at all.
Noticing What We’d Rather Ignore
Lately, I’ve been thinking about this a lot. Not just in clinic, but in life more broadly. I've had a lot of my energy return after ending a relationship, and have been getting back into running and Muay Thai. And I'm in the PLANNING stages of getting my bike fixed to start mountain biking again! All of this feels exciting and spicy because currently my other forms of movement are very slow - mostly weights and yoga.
The kids are back at school after the chaos of holidays, which means I can actually go for walks and runs again, and do the work I want to do without having my attention hung drawn and quartered in three different directions (fellow self-employed solo parents, I know you get me!). It's that weird mix of freedom and pressure that comes with being self-employed and rebuilding your rhythm again.
Basically, there’s a lot of noticing happening. Noticing what feels off. What needs attention. And what would be easier to just ignore.
There’s been a fair bit of this in my personal life lately. Backing myself to create this course after sitting on the idea for way too long (we're talking years). Getting back into movement because it actually feels good in my body... not because it’s “optimal.”
And also recognising something a bit harder: that avoiding what’s not working doesn’t actually make it go away.
I’ve had a few crossroad moments recently where I’ve had to face things I probably would’ve preferred to keep brushing past... even though it was harmful.
Different context, same pattern.
Avoidance can feel soooooo much safer in the moment. But eventually, you’re brought face to face with what needs to be addressed.
The kids are back at school after the chaos of holidays, which means I can actually go for walks and runs again, and do the work I want to do without having my attention hung drawn and quartered in three different directions (fellow self-employed solo parents, I know you get me!). It's that weird mix of freedom and pressure that comes with being self-employed and rebuilding your rhythm again.
Basically, there’s a lot of noticing happening. Noticing what feels off. What needs attention. And what would be easier to just ignore.
There’s been a fair bit of this in my personal life lately. Backing myself to create this course after sitting on the idea for way too long (we're talking years). Getting back into movement because it actually feels good in my body... not because it’s “optimal.”
And also recognising something a bit harder: that avoiding what’s not working doesn’t actually make it go away.
I’ve had a few crossroad moments recently where I’ve had to face things I probably would’ve preferred to keep brushing past... even though it was harmful.
Different context, same pattern.
Avoidance can feel soooooo much safer in the moment. But eventually, you’re brought face to face with what needs to be addressed.
Why This Is So Hard for Practitioners
It's the same in practice. As naturopaths, nutritionists and herbalists we have clients coming in with gut issues, hormone concerns, fatigue, critical life transitions, and metabolic stuff to name but a few. The presenting complaint might be severe PMS or the low energy or anxiety.
But underneath, there can be:
And we see it. We get that quiet nudge of “Hmm… something’s not quite lining up here.”
And then we hesitate because we don’t want to upset them, get it wrong, say too much, or step outside our lane. Because I'd be remiss to mention that a lot of us in this space are wired in a way that makes this even harder....
We tend to be the empaths. The ones who care deeply. The ones who read the room, anticipate needs, want people to feel safe. Add in a bit of perfectionism (putting my hand up here! 🙃) and suddenly the bar becomes: say it perfectly, or don’t say it at all.
We don’t want to upset people. We don’t want to rupture trust. We don’t want to be “that practitioner” who got it wrong.
So of course we hesitate. It makes sense.
But it also means we’re more likely to stay quiet in the exact moments where something actually needs to be named.
But underneath, there can be:
- restriction
- food fear
- chronic dieting
- disordered eating patterns
And we see it. We get that quiet nudge of “Hmm… something’s not quite lining up here.”
And then we hesitate because we don’t want to upset them, get it wrong, say too much, or step outside our lane. Because I'd be remiss to mention that a lot of us in this space are wired in a way that makes this even harder....
We tend to be the empaths. The ones who care deeply. The ones who read the room, anticipate needs, want people to feel safe. Add in a bit of perfectionism (putting my hand up here! 🙃) and suddenly the bar becomes: say it perfectly, or don’t say it at all.
We don’t want to upset people. We don’t want to rupture trust. We don’t want to be “that practitioner” who got it wrong.
So of course we hesitate. It makes sense.
But it also means we’re more likely to stay quiet in the exact moments where something actually needs to be named.
What To Say Instead (Without making it worse)
So we soften it. We skirt around it. Talk about the “safe” stuff… literally anything but naming what’s actually sitting there.
And to be fair, it’s not because we don’t care! It’s usually because the opposite - it's because we don’t know how to say it in a way that feels safe, respectful, and within our scope.
This is something I spend a lot of time on in my course and in practitioner supervision, because it’s not about having one perfect script.
It’s about learning how to open the conversation without shutting it down.
That might sound like:
And to be fair, it’s not because we don’t care! It’s usually because the opposite - it's because we don’t know how to say it in a way that feels safe, respectful, and within our scope.
This is something I spend a lot of time on in my course and in practitioner supervision, because it’s not about having one perfect script.
It’s about learning how to open the conversation without shutting it down.
That might sound like:
“I’m noticing a few patterns in your eating that I think are important. Would it be okay if we explored that together?”
Or:
“Can I share an observation with you about what I’m seeing?”
Sometimes it’s softer and more reflective:
“I’m hearing a lot of effort to eat ‘well’… and also quite a bit of stress around food. What’s that been like for you?”
Or gently linking it back to their presenting concern:
“Sometimes when I see gut symptoms like this, they can be linked with how regularly or adequately someone’s eating. Would you be open to looking at that together?”
And sometimes, it’s simply naming it... without over-pathologising:
“Some of what you’re describing can overlap with patterns I see in disordered eating... not necessarily a diagnosis, but patterns that can really impact health. I’m wondering how that lands for you?”
None of these are perfect. They might still feel a bit (or very) uncomfortable to say.
But they’re honest, grounded, and open enough for the conversation to begin.
Because the goal isn’t to diagnose or confront. It’s to create a moment where something important can be seen, named, and explored instead of quietly avoided.
And even with words like this, it doesn’t always make it easy! Because in the moment, when you’re sitting across from someone and you can feel the weight of what you’re about to name, it’s still vulnerable.
And that's why often, practitioners say nothing at all.
But they’re honest, grounded, and open enough for the conversation to begin.
Because the goal isn’t to diagnose or confront. It’s to create a moment where something important can be seen, named, and explored instead of quietly avoided.
And even with words like this, it doesn’t always make it easy! Because in the moment, when you’re sitting across from someone and you can feel the weight of what you’re about to name, it’s still vulnerable.
And that's why often, practitioners say nothing at all.
Silence becomes the Risk
But the uncomfortable truth is that saying nothing isn’t neutral. It’s an omission of care.
Somewhere along the line, we’ve learned that conflict equates to harm. And that harm equates to someone getting upset. And us empathetic, compassionate practitioners have been taught that this isn't ok. That if there is anger, tears, defensiveness, or shutting down, we think “Shit… I’ve handled that badly.”
I know I've definitely been there with clients responding in every single one of those ways and more.
But that’s not necessarily what’s happening. Sometimes, it just means it’s new, it’s confronting, it wasn’t what they expected, or perhaps the timing caught them off guard.
That’s not the same as harm. That’s often just discomfort meeting something important.
Of course, how we say things matters. We can:
All of that helps. But even when we do everything “right”, it still might not land comfortably.
And that doesn’t mean we’ve caused harm.
The bigger risk, most of the time, is this:
If there’s one thing I keep coming back to, it’s this:
Courage in practice doesn’t look like having the perfect words.
It looks like: noticing something, staying with it, and being willing to name it, even if your voice wobbles a bit.
Because avoiding the conversation doesn’t protect your client. It just delays what actually needs care.
Somewhere along the line, we’ve learned that conflict equates to harm. And that harm equates to someone getting upset. And us empathetic, compassionate practitioners have been taught that this isn't ok. That if there is anger, tears, defensiveness, or shutting down, we think “Shit… I’ve handled that badly.”
I know I've definitely been there with clients responding in every single one of those ways and more.
But that’s not necessarily what’s happening. Sometimes, it just means it’s new, it’s confronting, it wasn’t what they expected, or perhaps the timing caught them off guard.
That’s not the same as harm. That’s often just discomfort meeting something important.
Of course, how we say things matters. We can:
- choose our timing
- be thoughtful
- stay grounded
- actually care about how it lands
All of that helps. But even when we do everything “right”, it still might not land comfortably.
And that doesn’t mean we’ve caused harm.
The bigger risk, most of the time, is this:
- seeing clear signs of disordered eating… and not naming it
- continuing to optimise or restrict without addressing what’s underneath
- going along with something because it feels easier in the moment
If there’s one thing I keep coming back to, it’s this:
Courage in practice doesn’t look like having the perfect words.
It looks like: noticing something, staying with it, and being willing to name it, even if your voice wobbles a bit.
Because avoiding the conversation doesn’t protect your client. It just delays what actually needs care.
What Courage Looks Like in Practice
So what does this actually look like?
Not being blunt or forceful. But being willing to say:
“Hey… I’m noticing something here, and I think it’s important we talk about it.”
That takes courage. And hell yeah, sometimes it might land super awkwardly. But that’s very different to harm.
If this is something you’ve found yourself navigating in practice (that moment where you know something’s there but aren’t quite sure how to name it), I’ve put together a free guide on:
7 red flags of disordered eating practitioners often miss in clinic.
It’s a simple starting point for recognising these patterns earlier and responding more safely.
👉 You can download it here.
With courage,
Casey
Disordered Eating Dietitian | Naturopath
Not being blunt or forceful. But being willing to say:
“Hey… I’m noticing something here, and I think it’s important we talk about it.”
That takes courage. And hell yeah, sometimes it might land super awkwardly. But that’s very different to harm.
If this is something you’ve found yourself navigating in practice (that moment where you know something’s there but aren’t quite sure how to name it), I’ve put together a free guide on:
7 red flags of disordered eating practitioners often miss in clinic.
It’s a simple starting point for recognising these patterns earlier and responding more safely.
👉 You can download it here.
With courage,
Casey
Disordered Eating Dietitian | Naturopath
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