HOW I WORK WITH EATING DISORDERS

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/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 to 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 so true.

How does an Eating Disorder Specialist work?

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 with you begins even before you come for the first assessment, as ideally you have returned a detailed life style 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 you. I will also then be able to prepare assignments and information appropriate for the your needs which they will take 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 you, which are;

  1. low self esteem
  2. poor assertion
  3. low blood sugar
  4. thrush
  5. other biochemical reasons
  6. stress
  7. lifestyle
  8. feelings (show/hide)
  9. attitude traps
  10. faulty food script
  11. malnutrition
  12. habit
  13. poor body image
  14. allergies
  15. addiction process
  16. Fat/thin conflict

After the assessment which lasts at least two hours or more, a 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 it is both mine and my your remit to work together in order to challenge and begin to disarm the maintaining factors.

Nutritional, educational and practical advice are routinely given,

  • You are given information and guidelines on motivational changes, menu planning and education on super foods and portion control.
  • Direction is given regarding life style changes.
  • An important part of my work is working with my you to support you in developing a healthy relationship with food.
  • Educating and supporting my you in how to balance your blood sugars which are essential for both physical and mental well-being. Balanced blood sugars stop food cravings that often lead to binging and an addiction to sweet foods in order to raise blood sugar again.
  • I work as a coach, a mentor as well as a sponsor for change throughout my work with you.
  • Food diaries are worked with as a therapeutic tool at, as it allows the us to begin to understand patterns of behaviour and highlight feelings/or indeed lack of feelings which trigger dysfunctional eating.
  • A comprehensive life line is compiled focusing on age and weight which is often an extremely effective intervention.
  • Assignments are routinely given (according to each your personal requirements), addressing all the maintaining factors and other contributing obstacles (if applicable) such as obsessive compulsive disorder, anxiety, depression, body dysmorphic disorder (BDD) and substance abuse. The latter factor often treads a weary path alongside the eating disorder and need to be dealt with as a part of a your recovery.
  • A nutritionist who works with me is often a necessity and occasionally a non-negotiable part of the therapeutic package.
  • I will use, (if appropriate and if a client desires) the Emotional Freedom Technique which can disempower the addiction to certain foods (chocolate for example).
  • Work is directed in supporting you in developing stimulus control,
  • Relapses are routinely accepted and indeed considered useful in order to support long term changes.
  • I am more likely to be in contact with GP’s or medical professionals (if necessary).
  • Use and misuse of exercise is addressed and activity guidelines supplied.
  • Family therapy, especially for clients under the age of consent is often a therapeutic requirement.
  • Educating and therapeutically supporting the family and caregivers as to how to deal with a loved one with an eating disorder is often an important part of my work.
  • Counselling clients who are considering or about to embark on Bariatric surgery is a significant part of my work, as is post operational therapy.
  •  Finally, my training has taught me amongst many other things that it takes only two things to support a successful therapeutic journey, a willing counsellor and a willing client, therefore if together and committed we can only succeed!