Help
Talking
to someone you trust is an important part of recovering from an eating
disorder. Covering up the symptoms, disguising the amount you eat and
the way you feel, can become such a habit that talking openly about the
issues in your life can seem almost impossible. Many people make excuses
such as ‘now is not the time’ or ‘there is no one I
can trust’; or ‘they may tell my partner or my parents’.
It is extremely difficult to recover from an eating disorder without help
from other people. Often partners and parents are grateful when they finally
understand why you have been behaving so strangely.
Ironically, the person with the problem often mistakenly believes their
problems have been completely undetected. The secrecy and denial of eating
disorders can make it difficult for you to acknowledge your problem when
someone who cares, talks to you about it. This creates a barrier which
only you can bring down, a task that may seem an impossible challenge.
The ‘inner voice’ which many people experience can make decisions
about making a move towards recovery very difficult. Often your fear of
gaining weight is very frightening indeed. It also affects the way you
feel other people will react, and you may think their reaction will always
be negative or lacking in understanding. This is the disorder distorting
your thinking process, but it can be very hard to realise this. In order
to recover you will have to be ready to challenge this negative thinking,
and really want to move towards recovery before you will be able to respond
to people who can help you.
Regardless, you will need support, because eating disorders are so strong,
it always needs professional or guided help to beat them.
Eating
disorders can be beaten. Recovery is always possible even after many years
of illness.
Eating disorders are complex conditions, and it can take a number of different
professionals working together to treat them. Your GP should be able to
make a diagnosis and tell you what sort of eating disorder they think
you have. They may ask for a specialist to see you and make an assessment
of your treatment needs.
Eating disorders affect you physically as well as emotionally and your
treatment needs to address this. If you are a very low weight, then starting
to eat again will be a priority, and your treatment may focus on this.
You should be offered some psychological therapy
- talking to a counsellor or therapist to help you with any emotional
difficulties the eating disorder has caused. A Dietician
or Nutritional counsellor can help with meal plans and food choices.
If you are a young person, you may be offered family
therapy. This isn't because all your family is ill too, it is because
having your family involved in helping you get well is proved to be the
most effective.
If you need to see a specialist, most treatment takes place as an out-patient.
Only the most seriously ill people and those who are also physically very
frail should need to become an in-patient and stay
in a hospital ward or special eating disorders unit.
The types and availability of treatment varies and different types of
help may be
offered. Treatment should include dealing with the emotional as well as
the physical issues but this must be done quite slowly so that you can
cope with the changes. Help with eating and simply regaining weight is
usually not enough by itself.
If someone is so ill their life is at risk, they can be treated even if
they don't want to be. This is very rare, and there are legal safeguards
in place that doctors have to follow very carefully.
Effective
treatment often involves working with families, carers and friends. The
impact on the family of someone with an eating disorder can be enormous;
families may also need support for themselves, and advice on what will
help and what may hinder an individual's recovery; helplines
and support services are also there to help.
It is very important to remember that eating disorders flourish if they are ignored and they get worse very quickly. There is strong evidence that the sooner you seek treatment the easier it is to recover. It is extremely rare for an eating disorder to just ‘go away’.
You
can find information about eating disorders on the internet, or in many
books
on the subject. However, you may prefer to talk to someone about your
particular circumstances on a confidential helpline.
Confidential helplines are there to offer a listening ear. They can help
you to seek out local services, including self-help
groups where people support each other, or individual self-help,
support by phone, mail or email. Helplines can offer more information
about specific issues which may concern you. If you are worried about
talking to your General Practitioner (GP), they can suggest some
strategies which may be helpful. Helpline services are there to support
anyone who is concerned about themselves or someone they care about.
If you are living away from home or are at college or university there
may be additional support available through the student union as well
as the health centre or student counselling service.
If you would prefer faith based support there are organisations that offer
this. It is possible that your cultural background or faith makes seeking
secular help difficult, in which case a confidential helpline can still
offer support and information.
There are different types of people who can provide you with therapy, including counsellors, social workers, psychologists, and psychiatrists. Most of them should have some kind of degree representing the type of education they have received. The therapist may or may not be licensed, but should have a degree in the theories of psychology, psychotherapy, social work or counselling. Whether a license is important or not comes down to your own decision. There are many good counsellors and social workers who are not licensed medical doctors but who can still provide you with good therapy. As long as they have a degree, the only technical difference is that they cannot prescribe or administer medications. What is most important is that you are in a comfortable and safe environment, condusive to recovery, and with someone who can counsel you effectively.
Psychiatrists (Ph.D) are generally more expensive and tend to focus on admissions, diagnosis, evaluations and medication adminstration. There are psychiatrists who do and do not provide psychotherapy. Not all psychiatrists are trained in practical psychotherapy unless they have sought some kind of post-graduate education.
Psychologists (Psy.D. or Ph.D.) are the ones who are trained in the theories of pyschotherapy. A licensed psychologist can prescribe and administer medication if it is necessary.
Marraige, Family and Child Counsellors (MFCC), Marraige and Family Therapists (MFT) and Licensed Marraige and Family Therapists (LMFT) are not very different from psychologists and most can provide the same level of counselling as a psychologist.
Marraige, Family and Child Interns (MFCI) or Marraige and Family Therapist Interns (MFTI) are exactly that - interns. They are working in clinical practice to fulfill requirements they need to be licensed. They can see clients and all work is usually supervised by someone already in a licensed position.
Licensed Clinical Social Workers (LCW) have a degree in social work with a strong clinical focus. They can make very good therapists because of the strong focus on psychoanalytic and pyschodynamic theories in their education.
The different types of counselling therapists can provide are:
Individual Counselling -
The ultimate
goal of your therapy should be to recover! To learn to be more confident
in yourself, to make your voice heard through communication, to validate
your own emotions, to learn to love yourself, and to learn better ways
of coping with anger, sadness and stress (and not rely on your Eating
Disorder). You will spend many hours talking to your therapist about
your childhood, your experiences, and your day-to-day life, and all of
this is important for your recovery. There are many ways a therapist can
work with you individually, and different therapists have different methods.
The name of the approach is not as important as the methods used, so it
will be important for you to discuss with your therapist your goals in
working towards recovery.
Psychoanalytic
-
This is a clinical approach through interpretation,
dream analysis, free association, analysis of resistance and transference.
This all assists the client in gaining access to their subconscious, to
the internal conflicts they may not be aware of and in gaining new insights.
There is a strong focus on repressed conflicts and less focus on social,
cultural and interpersonal factors.
Nonpsychoanalytic
(Jungian) Therapy -
Self-realisation and learning to accept
yourself as an individual, and to be an individual is part of what this
type of therapy is all about. It incorporates the idea of spirituality
as an important role in discovering who you are. Generally, this approach
is about making connections with your feelings and motivations and learning
who you are. There is more a focus on the "big picture" and
less of a focus on each day-to-day problem.
Cognitive-Behaviour
Therapy -
This type of therapy works on the belief
that thinking, questioning and doing (with practice) leads to the changes
needed for recovery. Learning to change the way you think about yourself
will result in changing the way you treat yourself. There is a combination
of cognitive, behavioral and emotional techniques - changing negative
thoughts to positive, and pessimistic words to optomistic words. Using
humor, role-play and homework and word-work in attacking shameful feelings
and feelings of guilt are combined with the effort to make changes in
thinking and behaviours. The focus with cognitive-behaviour therapy is
that it is a "move-forward" approach and often lacks exploration
of the deeper emotional issues that led to negative behaviours and thoughts
in the first place. There can also be Behaviour Modification Therapy on
it's own where the client focuses on changing behaviours through practice.
Eclectic
Approach -
This approach combines many aspects of
all the above theories. A therapist that uses this approach will be able
to attack many different issues over your course of recovery, including
self-esteem work, past and present emotional issues, and day-to-day coping
strategies.
Marraige
and/or Family Counselling:
This type may also play a role in your
recovery depending on how important it is overall to involve your loved-ones.
Some level of counselling can help you all learn to communicate with one
another so that you will feel heard and be able to express your emotions
to each other in a safe environment. Once you have started your own therapy
you may wish to discuss these options with your therapist and whether
or not you both feel it will be important.
Group
Support:
This type of therapy can take place within
an inpatient program, an outpatient program, a therapists office or within
an independent support group. Support groups can vary in their objectives
and it is important to find out the goals and methods of the group you
wish to attend. Group support may be aimed at the sufferers getting support
and understanding from peers, or it may be aimed at incorporating members
of the family.
Support groups can be hosted by a professional therapist, intern, recovered
person, loved-one of a person living with an Eating
Disorder, or someone else interested in working to help others (and
maybe themselves) recover.
The goal of the Dietician will be to help improve your health and eating habits through nutritional counselling services. They will help you to incorporate healthy behaviours into your everyday life. Their goal should not be to "change" your habits overnight, but to teach you over a period of time how to promote a healthier relationship with the food you consume.
Dieticians can also play a role in the amount of exercise you do. They may work with you to slowly introduce more into your life, or to help you into realising that you are overdoing it.
It is important to find a dietician who has had experience in treating people with Anorexia, Bulimia and/or Compulsive Overeating. They should be sensitive to the issues that you are facing and should be aware of your history. It is usually best to go into a relationship with a dietician under a "team approach", meaning that your therapist, medical doctor and dietician are all in contact with one another, either directly or indirectly, about your progress.
When a person is an "inpatient" it means that they will be living in a treatment centre for Eating Disorders for a certain period of time. This can range from a couple of weeks to several months. The facility usually has medical doctors, registered nurses, therapists, dieticians and volunteers who work with the people in recovery on a daily basis. It is intended to provide a safe environment in which to help recovery from an Eating Disorder. Depending on the facility the routine can vary but it may include the following: group sessions, one-on-one therapy, medical evaluations, weigh-ins, nutritional counselling, art therapy, medication administration, spiritual exploration and prayer, meal times, and social or leisure activities. You make have weekly sessions with nurses, medical doctors, social workers, case managers and/or nutritionists. There may be involvement in projects, or times alloted for continuing education. Some programs may be more restrictive than others in their allowances for free time, and some may focus very highly on individual care (as opposed to a group approach). You will have to get information from each treatment centre to find what works for you. Most programs will expect you to be somewhat medically stable before entering, meaning that if your health is extremely poor, you may require hospitalisation before admittance.
Being an "outpatient" means that the patient does not live at the treatment centre. Outpatient programs are sometimes run by centers that do inpatient care but can also be offered at Eating Disorders Clinics or Mental Health Clinics. Again, there is often a "team approach" with medical doctors, therapists, and dieticians, with scheduled daily or weekly sessions depending on each individual's needs. One-on-one therapy and group sessions, daily activities and classes, art therapy, medication and medical evaluation and weigh-ins may all be part of your schedule depending on the facility. You will have to get information from each treatment centre to find what works for you.
Generally,
these types of facilities are meant to address treatment from a broad
approach, not only teaching sufferers how to eat healthily but to address
corresponding self-esteem issues, psychological diagnoses, coping mechanisms,
behaviour issues and emotions. Each facility has its own treatment philosophy
so it's important to ask a lot of questions and review as much information
as you can about each program you are considering.
The first phase of the Maudsley Method (Sessions 1-10) puts the parents in charge of the eating behaviour of the adolescent, making food the medicine to be administered to a patient. The first two sessions engage the family to determine their eating habits and assemble a picture of the impact of the Eating Disorder on all family members. The therapist externalises the illness by presenting the Eating Disorder as controlling the patient, freeing parents and patient from blame. The therapist then encourages the parents to find their own method to control the adolescent's eating behaviours without using force or punishment, but rather through a system of creative measures that include functional rewards, such as "I cannot let you get your driving licence while you are too weak."
The second phase (Sessions 11-16) transfers the control of the feeding process back to the adolescent and addresses related family problems.
The third and final phase of the treatment focuses on encouraging the processes of adolescent development that unfold as the Eating Disorder wanes, and establishing new family relationships disentangled from the Eating Disorder.
Used
appropriately, and as intended, the Maudsley Method is based on the foundation
that where an Eating Disorder started matters
little in it's treatment. This isn't to belittle the issues a sufferer
may feel in relation to their (possibly dysfunctional) family. It is to
stop playing the blame game, and instead, for all members of the family
to accept responsibility in "fixing what is broken".
When sufferers often feel "invisible" in their families, this
type of intense involvement may suddenly act as a psychological facilitator
in improving the overall relationship. It may help to make the sufferer
feel seen, to feel cared about and loved.
While it seems on the surface that the focus of the Maudsley Method is to treat just the symptoms of the disease (behaviours/eating), you could make a lot of arguments that the impact of such involvement in teen treatment carries many hidden psychological messages. Getting family members (ie. parents) this involved in their child's treatment obviously carries many hidden psychological messages and lessons.
As stated, this treatment is meant for dependent teens who suffer primarily from Anorexia. It is important to determine if this is the right treatment for your child. It is important to consider your entire family dynamic when making this decision. Click here for further information on The Maudsley Method
Twelve-Step programs, such as Alcoholics Anonymous or Overeaters Anonymous, are based on twelve "quotes" that are accepted and believed in moving towards recovery. The groups are typically spiritually based in nature and follow a tradition of finding "sponsors" who work as recovery mentors. It is a group atmosphere that meet once or more per week.
The Twelve Steps are (this is a generalisation): 1. admitting powerlessness - that life is unmanagable; 2. believing that a greater power could restore sanity; 3. deciding to turn will and life over to the care of a Higher Power; 4. making a searching and fearless moral inventory or self; 5. admitting to a Higher Power, self, and another human being the nature of our wrongs; 6. being ready to have the Higher Power remove all these defects of character; 7. humbly asking your Higher Power to remove our shortcomings; 8. making a list of persons harmed and being willing to make amends with them; 9. making amends with people hurt except when doing so would hurt them or others; 10. continuing to take personal inventory and admitting our wrongs; 11. improving the relationship with our Higher Power through meditation and prayer and praying for knowledge of the will to carry out the power of your Higher Power's knowledge; 12. having a spiritual awakening as a result of these steps, and carrying the message to other addicts to practice these principles.
Twelve-Step groups provide help all over the world, for all different types of addictions. A twelve-step program may or may not be for you... as with anything else, it's not for everyone. Click here for more information on Twelve-Step recovery programs.
The following is a list of alternatives that can be used in addition to more traditional methods of treatment. They have been helpful to quite a number of people:
Physical
Therapy -
This type of therapy consists of the evaluation and
treatment of injuries and disease with the goals of pain relief, restoration
of function and the return to your fullest level of activity in school,
work, recreation and sports. The initial evaluation examines your posture,
biomechanics, ROM and flexibility, strength and balance. The treatment
is based on this evaluation and includes an individualized program of
progressive exercises and activities, in conjunction with the use of physical
modalities as needed.
Click
here for further information on Physical Therapy
Occupational
Therapy -
Occupational therapists (OTs)
help people improve their ability to perform tasks in their daily living
and working environments. They work with individuals who have conditions
that are mentally, physically, developmentally, or emotionally disabling.
They also help them to develop, recover, or maintain daily living and
work skills. Occupational therapists not only help clients improve basic
motor functions and reasoning abilities, but also compensate for permanent
loss of function. Their goal is to help clients have independent, productive,
and satisfying lives.
Click
here for further information on Occupational Therapy
Art
Therapy -
This type of therapy is a human
service profession which utilises art media, images, the creative art
process and patient/client responses to the created art productions as
reflections of an individual's development, abilities, personality, interests,
concerns, and conflicts. Art therapy practice is based on knowledge of
human developmental and psychological theories which are implemented in
the full spectrum of models of assessment and treatment including educational,
psychodynamic, cognitive, transpersonal, and other therapeutic means of
reconciling emotional conflicts, fostering self-awareness, developing
social skills, managing behavior, solving problems, reducing anxiety,
aiding reality orientation, and increasing self-esteem.
Click here for further
information on Art Therpy
Movement
Therapy -
This therapy is based on the assumption
that body and mind are interrelated, dance/movement therapy is defined
by the American Dance Therapy Association as "the psychotherapeutic
use of movement as a process which furthers the emotional, cognitive and
physical integration of the individual." Dance/movement therapy effects
changes in feelings, cognition, physical functioning, and behavior.
Click here for further
information on Movement Therapy
Yoga
-
Yoga is taking on a wider role
in modern life; an expansion beyond the Yoga classroom into all areas
of our community as a vehicle for wellness, healing and personal transformation.
Trained Yoga professionals help bring the ancient insights of Yoga into
mainstream wellness programs. Because health is seen as a unity of body,
mind and spirit, Yoga is a vehicle for deepening this experience of unity
and bringing it into the world as a resource for personal growth, healing
and awakening. Click here for further
information on Yoga
Spiritual
Guidance -
This can be anything from counselling
with a priest or pastor to exploring your beliefs with the help of someone
versed in your spiritual area of interest. Spiritual Therapy assists you
in this process of inner healing and spiritual growth. It leads you on
the path from self-doubt to self-empowerment. It involves your beliefs
surrounding the meaning of life, a higher-power and your own faith.
Sensory
Integration Therapy -
This type of therapy encourages each of
the senses to work together. Each sense works with the others to form
a composite picture of who we are physically, where we are, and what is
going on around us. Sensory integration is the critical function of the
brain that is responsible for producing this composite picture. It is
the organisation of sensory information for on-going use. Sensory Integration
Therapy seeks to encourage the nervous system to process and integrate
sensory input in more organised and meaningful ways, which will ultimately
enhance the ability of the nervous system to function with more efficiency.
Each adaptive response, as it provides feedback into the nervous system,
encourages maturation and organisation of the nervous system at increasingly
higher levels. Ultimately, the individual is able to interact with his/her
environment in more successful and adaptive manners.
Click
here for further information on Sensory Integration Therapy
Reiki
Healing -
Healing is not the popular conception of
removal of symptoms. Healing is full and complete resolution of the causes
of the disease. Healing is returning to a state of alignment with your
Higher Self or true way of being. In its simplest form using Reiki is
simply the practitioner placing their hands on the recipient with the
intent of bringing healing, and willing for Reiki energy to flow. There
is a set of hand positions traditionally taught which give good coverage
over the recipients entire body. It is not necessary to follow those positions,
they are merely taught as a starting position from which the practitioner
can learn. If there is a specific area of concern the practitioner can
keep his/her hands right there for as long as necessary.
Click
here for further information on Reiki
Meditation
-
Meditation Therapy is a bold approach to finding
lasting solutions to our deepest problems and concerns. Combining the
power of deep meditation practice with the insights of psychology, Meditation
Therapy will help you to experience healing transformation in powerful
and lasting ways. Genuine healing occurs only when we are willing to examine
the deepest parts of ourselves and create positive new patterns of responding
to life. You will learn how to transform your mental attitudes and activate
your own innate healing power. Click
here for further information on Meditation Therapy
EMDR
(Eye Movement Desensitisation and Reprocessing) -
This is an innovative clinical treatment
that has successfully helped over a million individuals who have survived
trauma, including sexual abuse, domestic violence, combat, crime, and
those suffering from a number of other complaints, including depressions,
addictions, phobias and a variety of self-esteem issues. EMDR is a complex
approach to psychotherapy that integrates many of the successful elements
of a range of therapeutic approaches in combination with eye movements
or other forms of rhythmical stimulation in ways that stimulate the brain’s
information processing system. With EMDR therapy it is unnecessary to
delve into decades-old psychological material, but rather, by activating
the information-processing system of the brain, people can achieve their
therapeutic goals at a rapid rate, with recognisable changes that don’t
disappear over time. Click
here for further information on EMDR
Life
Coaching -
A Life Coach listens to you when you most
need it and will give you non-judgemental support and the tools to guide
you to help change your lifestyle, love the life you are living, find
your unique purpose in life, identify your true vocation, find the tools
to relax and enjoy life and bring out your spirituality. A Life Coach
will help you discover what's really most important to you in your life,
then help you design a plan to achieve those things. They'll work with
you to eliminate any obstacles or blocks that stand in your way and partner
with you all the way to success. Click
here for further information on Life Coaching
Touch
Therapy -
Through both light touch and the clearing
of your energy system without touch, you are assisted in the release of
stress and anxiety. You are also provided a safe and relaxing healing
space. Touch Therapy is a wonderful assistance in your personal growth
and self fulfillment. The positive effects of this type of therapy have
been experienced by many people worldwide.
Click
here for further information on Touch Therapy
EEG
Biofeedback -
Neurofeedback, also known as EEG Biofeedback,
is a learning procedure that enables participants to improve mental performance,
normalise behaviour, and stabilise mood. Neurofeedback is a technique
in which we train the brain to help improve its ability to regulate all
bodily functions and to take care of itself. When the brain is not functioning
well, evidence of this often shows up in the EEG (Electroencephalogram).
By challenging the brain, much as you challenge your body in physical
exercise, we can help your brain learn to function better. A better functioning
brain can improve sleep patterns. When you sleep more efficiently, you
are more alert during the day. It can help with anxiety and depression,
and with syndromes like migraine or chronic pain. Secondly, it can be
helpful in managing attention - how well you can persist even at a boring
task. Thirdly, it can help you manage the emotions. Emotions may feel
like the real you, but your brain has a lot to say about how you feel
and react. If the emotions are out of control, that's trainable. If they
aren't there, as in lack of empathy, for example, that, too, is trainable.
Click
here for further information on EEG Biofeedback
This
may be useful as the first phase of treatment, or alongside other treatments.
There are many different styles of self-help publications and you need
to find the right one for you.
Self-help groups can be a useful adjunct to treatment but, with a very
few exceptions, they are not an alternative to professional treatment.
However they can help sufferers and families understand they are not alone
with the illness and offer valuable support and practical advice.