Prioritizing counseling for disordered eating patterns

Fullsterkur_woman

So, this is a spin-off of the "eliminating sugar" thread.

I conceded that if you can't learn moderation for a food (group), you probably should seek counseling to deal with disordered eating patterns. But as a practical matter, for people who have other much more serious issues they need to prioritize in counseling, how does that affect our discussion? Does it at all? Maybe cutting out sugar would give somebody "one less thing to worry about" while they deal with bigger issues than disordered eating patterns?

I sincerely want to examine this issue critically, because my eating got very disordered four years ago and I'm trying to make a return to moderate food and exercise logging so that I can lose unneeded fat and get stronger WITHOUT making a return to disordered habits.

I have already decided that there will be no pocket scale coming along with me to restaurants. That way lies insanity.

I have a wonderful counselor that I have a dozen years of work together with, but I'm not so sure he's the one to help me get to a more healthy relationship with food.

I understand this will be a process, so I don't expect to get "all the answers" at once.

And just to get this out of the way up front, "Just break up."

WendyTerry420

I think it's a good idea to cut "trigger foods" until a person has dealt with the mental/emotional aspects of disordered eating, then gradually add foods and learn to eat them in moderation.

corgicake

Mind you, I haven't looked at the other thread but sight unseen get the feeling it's hit cesspool status with the squabbling...

People sometimes see multiple specialists for non-brain issues, why not for counseling/therapy? This may not need to be an issue of prioritizing.

MyOwnSunshine

From my experience with a counselor who uses cognitive behavioral therapy to treat eating disorders, all of my issues were interrelated. There really wasn't a time when we worked on one issue in isolation. In fact, disordered eating/compulsive overeating was more of a symptom of my dysfunctional family of origin and lack of decent parenting, emotionally abusive relationship, horrible self-esteem, and overabundance of shame, guilt and embarrassment.

We generally focused on some concrete thinking/behavioral changes that I could use in-the-moment to deal with my compulsive eating, and then dissected the larger issues in my life.

Counseling was very, very helpful for me. I have changed almost every area of my life based on the cognitive behavioral skills that I learned. I will always have compulsive eating tendencies, but I am very successful at managing them now.

Honestly, if you choose a qualified counselor that you "click" with, you really don't need to go in to the experience with a checklist and a treatment plan. Your counselor will help you to uncover what you need to work on, and you can work together to prioritize your issues based on their significance to your quality of life and what you uncover as you work through your past and present issues.

Fullsterkur_woman

From my experience with a counselor who uses cognitive behavioral therapy to treat eating disorders, all of my issues were interrelated. There really wasn't a time when we worked on one issue in isolation. In fact, disordered eating/compulsive overeating was more of a symptom of my dysfunctional family of origin and lack of decent parenting, emotionally abusive relationship, horrible self-esteem, and overabundance of shame, guilt and embarrassment.

We generally focused on some concrete thinking/behavioral changes that I could use in-the-moment to deal with my compulsive eating, and then dissected the larger issues in my life.

Counseling was very, very helpful for me. I have changed almost every area of my life based on the cognitive behavioral skills that I learned. I will always have compulsive eating tendencies, but I am very successful at managing them now.

Honestly, if you choose a qualified counselor that you "click" with, you really don't need to go in to the experience with a checklist and a treatment plan. Your counselor will help you to uncover what you need to work on, and you can work together to prioritize your issues based on their significance to your quality of life and what you uncover as you work through your past and present issues.

My experience is much the same as your own, though thankfully husband (who has been with me since I was amidst the chaos of my FOO) is wonderfully supportive. You're right that you uncover what you need to prioritize. Right now I'm finally getting to releasing a lot of programming I had from being raised in a cult, which will probably help a lot with the black and white thinking, the shame and guilt, and the co-dependent mindset I'm still struggling with. I have a pretty good level of self-esteem, because I've accomplished a lot to be proud of, but I'm still struggling to avoid making everybody's problems my own and especially making their feelings my problem. It's crazy, and it makes me so mad when people try to manipulate me that way, but it's my problem to learn how to not let them, right?

It's kind of exhausting having to expend all kinds of energy navigating the minefields of dysfunctional families. And when you're raised having a need to control, well, food is one thing you can have control over, right? So it's so easy to eat out of a need to control, and so easy to fall into disordered patterns when the food is not really about the food.

lisamarie1780

So, this is a spin-off of the "eliminating sugar" thread.

I conceded that if you can't learn moderation for a food (group), you probably should seek counseling to deal with disordered eating patterns. But as a practical matter, for people who have other much more serious issues they need to prioritize in counseling, how does that affect our discussion? Does it at all? Maybe cutting out sugar would give somebody "one less thing to worry about" while they deal with bigger issues than disordered eating patterns?

I sincerely want to examine this issue critically, because my eating got very disordered four years ago and I'm trying to make a return to moderate food and exercise logging so that I can lose unneeded fat and get stronger WITHOUT making a return to disordered habits.

I have already decided that there will be no pocket scale coming along with me to restaurants. That way lies insanity.

I have a wonderful counselor that I have a dozen years of work together with, but I'm not so sure he's the one to help me get to a more healthy relationship with food.

I understand this will be a process, so I don't expect to get "all the answers" at once.

And just to get this out of the way up front, "Just break up."

It depends on the person really and the other underlying issues. People who have always used food as a comfort blanket to deal with problems/issues/fears etc probably would benefit from counselling as it's obvious that food has become an addiction and a coping mechanism in the same way that an alcoholic uses ... well, alcohol.

BUT.... some people can see clearly what they are doing and why and how to deal with it... they just lack the motivation... and motivation can't be bought, learnt or given... you just have to want it and do it. No excuses... no questions... just pull your socks up and put the cake down.

I was never big until I got pregnant. I took the term 'eating for two' literally and ate ALL THE FOOD. I wanted cake, I ate cake.... most of the cake. I was 182lb after having my little girl.... I had NEVER been fat. I was an athlete before having kids... I ate anything and stayed lean.... I stupidly thought I couldn't get fat. But I did...

I'm 147lbs now and still losing... Do I still eat cake? Yeah... just not all of it... and not every day. But then my reasons for eating stemmed from bad choices when pregnant rather than feeding an emotional void. Each person is different. One of my best friends was always very slight until she was raped. She's huge now. I think she got big (on a subconscious level) as a way to 'protect' herself from unwanted attention. She feels safer now that she is 'unattractive' (and those are her words not mine)....

There are a lot of reasons why people overeat... and no two are the same. 'Cutting out' won't work for a lot of people.... disordered eating is just a symptom of something else ... sometimes it resolves itself easily like it did with me... sometimes it runs deeper and has been going on for much longer and takes a lot more work to stamp out.

shivles

I find that refined sugar just makes me feel crap so I try to avoid it, natural sugars don't seem to have the same effect. It's probably all in my head as 'sugar is sugar' and all that but hey, it makes me feel better. I say as long as its not obsessive it's not a big deal, I'm a recovered anorexic and it may well stem from that but at the end of the day I'm eating healthy and not cutting out sugar completely so I don't see the harm. I know myself sometimes I get to 'in to' my diet and the habits come back, then I take a break from MFP and just eat what I want without worrying. It is hard because those niggles never really go away, it's learning how much to endulge it to keep you happy without impacting your mental or physical health that is the key

Fullsterkur_woman

It depends on the person really and the other underlying issues. People who have always used food as a comfort blanket to deal with problems/issues/fears etc probably would benefit from counselling as it's obvious that food has become an addiction and a coping mechanism in the same way that an alcoholic uses ... well, alcohol.

BUT.... some people can see clearly what they are doing and why and how to deal with it... they just lack the motivation... and motivation can't be bought, learnt or given... you just have to want it and do it. No excuses... no questions... just pull your socks up and put the cake down.

This was specifically with regard to using counseling to learn moderation, though I can see how it sounds more all-encompassing. And if you're in counseling and doing the work to make changes, I have to think the motivation is there. With cognitive behavioral therapy, you're unlearning coping mechanisms that are self-destructive and learning healthy coping skills and behaviors. If you weren't motivated, you wouldn't be there.

The people you described in "pull your socks up and put the cake down" are not who we're talking about in this thread. We're talking about people who need to learn how to do moderation. People who never developed this life skill. Lots of people were brought up with very black-and-white thinking, and they need to unlearn that.

So, this thread is about, when you're working with a counselor because of ongoing issues already, such as depression, PTSD, trauma from childhood or intimate partner abuse, etc., where does "learning moderation" fall in the list of priorities? Secondarily, if it's not at the top, what do people think about cutting out "triggers" while working on other, higher-priority issues so that we don't have to worry about them during the triage process?

Fullsterkur_woman

I find that refined sugar just makes me feel crap so I try to avoid it, natural sugars don't seem to have the same effect. It's probably all in my head as 'sugar is sugar' and all that but hey, it makes me feel better. I say as long as its not obsessive it's not a big deal, I'm a recovered anorexic and it may well stem from that but at the end of the day I'm eating healthy and not cutting out sugar completely so I don't see the harm. I know myself sometimes I get to 'in to' my diet and the habits come back, then I take a break from MFP and just eat what I want without worrying. It is hard because those niggles never really go away, it's learning how much to endulge it to keep you happy without impacting your mental or physical health that is the key

Thank you for your input.

BlessedBe23

As someone who is in therapy, in school to become a therapist and is an emotional eater/sugar addict, for me it's about taking a wholeness approach. Yes, you might need to prioritize the issues you tackle first, but they are all tied up together in one uncomfortable bundle of vulnerability.

For me, addressing the physical manifestations of my addictions are less important than addressing the issues that cause it all. It's like trying to put out a fire in the bathroom sink when the roof is on fire....If I don't deal with the roof, the bathroom will be the least of my worries. Just my 2 cents...:glasses:

Akimajuktuq

Counsellors can't treat malnutrition. It's the food that's the biggest factor in many cases. (and yes, one can be fat AND malnourished; it's epidemic in Canada and US right now). All kinds of bad things happen to our brains when we don't get the nutrients that are required.

But whatever, go get that counselling and take a bunch of meds. That's far more logical than considering one's diet, environment, contaminants, etc. (Counselling IS useful in many situations, but disordered eating cases are often the result of real physical problems resulting from poor diet. That can't be counselled away.)

quirkytizzy

I can't brain right now because of a paper making it melty, but I wanted to say: This is a very well written, very cohesive post. It lays out your situation, questions, and concerns very comprehensively.

lisamarie1780

As someone who is in therapy, in school to become a therapist and is an emotional eater/sugar addict, for me it's about taking a wholeness approach. Yes, you might need to prioritize the issues you tackle first, but they are all tied up together in one uncomfortable bundle of vulnerability.

For me, addressing the physical manifestations of my addictions are less important than addressing the issues that cause it all. It's like trying to put out a fire in the bathroom sink when the roof is on fire....If I don't deal with the roof, the bathroom will be the least of my worries. Just my 2 cents...:glasses:

Which was exactly part of the point I was making.... but for some reason she cut it in two and said I'd missed it :noway:

lisamarie1780

It depends on the person really and the other underlying issues. People who have always used food as a comfort blanket to deal with problems/issues/fears etc probably would benefit from counselling as it's obvious that food has become an addiction and a coping mechanism in the same way that an alcoholic uses ... well, alcohol.

BUT.... some people can see clearly what they are doing and why and how to deal with it... they just lack the motivation... and motivation can't be bought, learnt or given... you just have to want it and do it. No excuses... no questions... just pull your socks up and put the cake down.

This was specifically with regard to using counseling to learn moderation, though I can see how it sounds more all-encompassing. And if you're in counseling and doing the work to make changes, I have to think the motivation is there. With cognitive behavioral therapy, you're unlearning coping mechanisms that are self-destructive and learning healthy coping skills and behaviors. If you weren't motivated, you wouldn't be there.

The people you described in "pull your socks up and put the cake down" are not who we're talking about in this thread. We're talking about people who need to learn how to do moderation. People who never developed this life skill. Lots of people were brought up with very black-and-white thinking, and they need to unlearn that.

So, this thread is about, when you're working with a counselor because of ongoing issues already, such as depression, PTSD, trauma from childhood or intimate partner abuse, etc., where does "learning moderation" fall in the list of priorities? Secondarily, if it's not at the top, what do people think about cutting out "triggers" while working on other, higher-priority issues so that we don't have to worry about them during the triage process?

I was making a distinction between two separate groups of people and making the point that for some people, addiction to sugar/food is a just that... an addiction/a way of coping with something deeper that would benefit from counselling/therapy...

I don't really understand what you are disagreeing with?

BlessedBe23

I wanted to add that for some people, cutting triggers while trying to deal with more deep seated issues can cause even more distress. It depends on the other psychologoical factors you're working with. I suffer from generalized anxiety disorder so change of any kind can cause anxiety for me at times. It depends on what you're most motivated to deal with right now at this very moment and what you're strong enough to tackle. About a month or so ago I decided I was sick of being overweight and unhealthy. I started in with a big push, quite smoking, started tracking my food on here, started exercising at least an hour a day 6 days a week. At the same time I am working full time, taking 3 classes in my senior year of college and began my psychology internship. Oh, and I have a home to maintain and 3 fur kids to care for, as well as family and friends who want part of my time.

I just started therapy last week (again). I knew that I couldn't sustain the physical changes without addressing my psychological issues that are at the root of how I got here in the first place. So for me it was easier to jump in with both feet and then reach for the life perserver. It's all about what you're comfortable with and what you can sustain. I'm an Aries so sometimes it's easier for us to do it that way

Duck_Puddle

I haven't read the other thread, but in my non professional opinion, I think a lot of disordered eating is a behavioral manifestation of an underlying issue (self esteem, control, etc.). When I've had issues to address in counseling, the underlying issues generally had a number of behavioral manifestations. In my non professional opinion, working on solving the underlying issue will largely address the disordered eating (maybe not entirely). If one no longer feels a need to self-soothe or control (or whatever the issue is), they will likely no longer feel a need to use food to self-soothe or control. I don't think it's a matter of learning moderation with respect to food specifically, I would imagine it's a matter of learning moderation at all-in everything.