How I Work With Eating Disorders
“To actually accept that you have an eating disorder or a mental health issue is actually a sign of great, great strength. It is not a sign of weakness at all.”
“A cultural fixation on female thinness is not an obsession about female beauty but an obsession about female obedience.”
Eating Your Emotions
How many of us use food to regulate our emotions either by overeating (refined carbohydrates and refined sugars) or by restricting our eating? How many of us use food or semi /starvation or starvation in order to numb our emotions in a desperate attempt to silence the nagging voices resulting from our own internal pain? Finally, how many of us have an unhealthy and obsessive relationship with food often to the detriment of our own personal relationships?
As a counsellor specialising in Eating Disorders and Obesity I am often moved whilst observing the constant battle my clients have endured in order to have the courage to say goodbye or indeed change often the most intensive relationship they have ever had! Time and time again whilst working with this client group it is in my experience that at one stage, food or the controlling refusal of food, became a friend before it then became a relentless and punishing enemy.
Helena Wilkinson, a therapist, who wrote ‘Insight into Eating Disorders’, asserts that “an Eating Disorder is like an iceberg and it is what is going on below the tip of the iceberg is what is maintaining a dysfunctional relationship with food”.
I also read somewhere that people often use food and their body to tell a story for which they have no language and I have found that to be so true.
So, how can I as a therapist support these clients fighting this battle, with food, weight & shape?
Working with this client group is however very different from how I work as a general practitioner as it is directive and at first I found this transition challenging.
The differences are:
Work begins even before the first assessment, as ideally I have a returned a detailed life style questionnaire and food diary and in the case of children the parent or significant other will have also completed and returned a detailed history. Once I have received all of this information I will then have an overview and an idea of how I can most therapeutically support the individual’s presenting issues. I will also then be able to prepare appropriate assignments and information that can be if deemed suitable be taken away at the end of the first session.
During my training at the National Centre of Eating Disorders we were taught that there are sixteen factors that maintain an eating disorder and therefore it is my job to understand, work with and address all of those maintaining factors, which are applicable to these cleints, which are;
-low self esteem
-low blood sugar
-other biochemical reasons
-faulty food script
-poor body image
After the assessment which lasts at least two hours or more, we will have completed a comprehensive life/weight line and pie chart is then compiled which will highlight the main areas which keep the iceberg intact and the bullying voice of the eating disorder in power. Following on from the latter, if is therapeutically viable then the clients and my my remit is to work together in order to challenge and begin to disarm the maintaining factors.