Guest Post: Melissa on Seeking out Counseling for ED Recovery
December 28, 2010

Hey guys!

It’s day one of my vacation, and with any luck, I’m en route to some peace and quiet right now. For my first special guest post, I want to welcome one of my favorite bloggers: Melissa from Trying to Heal.

I met Melissa when I was in Miami last year, but I had been reading her work for well over a year before that. I love her simple recipes, her environmentalism, and her humor, but most of all I love how courageously and honestly she discusses the long, bumpy road to ED recovery. I especially admire her side note series, in which she talks about the post-recovery struggles so many of us have had — weight gain, weight maintenance, giving up obsessive habits. Few people can discuss what it means to live with an ED history as honestly as she.

For that reason, I wanted Melissa to write on the topic of ED recovery today, and I gave her the choice of what to say. She wrote back with the following post on the importance of counseling/therapy, and I could not be more thrilled. Outpatient therapy was a huge part of my own recovery–more than anything else, it was what helped me to realize that I did indeed have a problem–and as a nutritional counselor who now works with many women with ED pasts, I see how crucial the therapy experience is in others’ healing experiences, too. When women who are actively suffering from EDs ask me for help, my first order of business is to recommend not my services, but formal counseling and therapy. One day, I say, I’ll be able to help them with recipes and meal planning, but for now, they need the support and exploration that only therapy can offer.

I’ll let Melissa tell you more about what to seek out in a good counseling experience. Enjoy!

Hi Everyone, this is Melissa from Trying to Heal and I’m so excited to be writing for Gena!

I am, as I’m sure you are, I’m a huge fan of Gena’s blog. And of course meeting her in person goes to show how gracious and amazing she is.  I love the variety she provides on her blog from recipes for raw foods, nutritional information and most of all, recovery/issues on eating disorders.  The later can be a very sensitive subject for many, but I believe the more we talk about it, the more awareness is spread about the myths over how difficult eating disorders and recovery can be and that yes, you really can recover.

Alas, I’m here today to write about the part of recovering from an eating disorder that I think is the most vital and important: COUNSELING.

Many people shudder at the thought of going to a counselor or therapist, because they’re afraid it means there is something really wrong with them.  Well, in retrospect there is something wrong with you if you have an eating disorder: you’re torturing your body, mentality and not living your life in a healthy manner.  I went through the same stages when my eating disorder first started back in 2003.  When I was at my lowest weight and struggling the most, a friend of mine in college threatened me about telling my parents that I was in trouble, or go to the school counselor.  I reluctantly went to the counselor and cried the entirety of the first session because I felt so ashamed, embarrassed and guilty.  At the time I was in denial, as I didn’t believe there was anything wrong with me other than I had lost some weight since I had brought my exercise back after slacking off at the beginning of school.  But in reality and after warming up to my counselor, I was able to dive into what was really going on in my life causing me to harm my body and walk down the path of a slow suicide.

As much as this first bout of counseling helped me open up to my disease and confront it with the effort of recovery, it didn’t go about the way it should have, and the way that would have made me most comfortable.  I think there are several things you should look for when you decide to seek counseling as a step in your  recovery to make it the most effective.

1. Comfort

This can come in many different forms.

The Counselor/Therapist:

  • Since you have to spend an hour plus a week with this person talking about some of your deepest issues, you want to make sure that YOU are comfortable with your therapist.  When I sought out counseling for the second time this summer, I wanted to make sure mine was a woman (since my first one was a man and I didn’t have a choice) because I feel more capable of relating to and being at ease with a woman.
  • You also want to make sure that they put you at ease and talk to you, not at you.  I have talked to quite a few counselors in an effort to find the right one and some of them talk to you like they automatically know what is wrong with you and can fix it up fast by telling you what to do instead of listening to the details of what is bothering you.  I believe talking about issues is one of the most essential parts of counseling and will get you the farthest in your recovery.

The Environment:

  • Make sure you are comfortable in their office or session room.  If it seems to small, overcrowded or just something you’re not comfortable with don’t be afraid to not accept this counselor.  This area needs to put you in a good place and provide you with the comfort you need to talk about the things you need help with.

2. Certification/Experience

  • When I was looking for my counselor, I made sure they had experience with eating disorders.  The first one I had was more of a general life issues counselor and knew very little about the issues, effects and difficulties someone with an eating disorder has.  By choosing someone who has experience with the issues you’re dealing with, whether it be anorexia, bulimia, overeating, over-exercising, etc. you are providing yourself with more knowledge and support than by talking to someone who has no real knowledge of how to help you recover.

3. Availability

  • Depending on where you live, this can turn into a hassle.  I live in a very small town and knew there wouldn’t be many options of who to see, but also how often I could see them depending on how I was doing.  In a big city this may not be much of an issue, but it is one to be aware of.  When I first started I wanted to see my counselor once a week and luckily we had no problem making that work.  After a while I went to an appointment every two weeks and now an appointment every three weeks, but when I need to at the end of a session, I might tell her that I’d like to see her in two weeks instead of three because I have something coming up that I might want to talk about or prepare myself for.

One thing I didn’t include on this list but that most people worry about, is MONEY.  Yes, counseling can be expensive, but you know what, I believe it’s the best money you’re going to spend.  I remember being terrified at the amount of money that I was going to have to spend to talk to this woman, but I bit the bullet and made adjustments to my living expenses to make sure I could get the help I needed (I also got a bit of help from my parents, which was nice and something you can always look into if you want).  To this day I don’t regret a single penny that I’ve given to her because in the half year I’ve been seeing her, I have made more progress in my recovery than I have in the past 6 years trying to recover on my own.

So all in all, I highly suggest looking for a counselor if you are recovering from an eating disorder.  Having an unbiased person to talk to about your issues and even just the little things going on in your life can make such a big difference.  I can see how my life has changed by talking my way through things like social events that cause me high anxiety, walking into a new relationship with a guy, and dealing with my guilts over eating and overexercising.  And even if you don’t decide to seek help like this now, I think it’s something to always consider!

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    21 Comments
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  2. Thanks, Melissa, for sharing pieces of your journey, and congratulations on your recovery. I know it’s a long haul. I too was helped, immensely, by a few good therapists, and just wanted to let folks know that where eating disorders are concerned, there are low-cost resources. I saw one of the best ed therapists in New York City, and because she was affiliated with CSAB (The Center for the Study of Anorexia and Bulimia, a division of the Institute for Contemporary Psychotherapy), I paid only $15 a session. Which meant I could see her twice a week. That was the early 90s and I’m sure the rates have gone up, but I’m also sure they’re still reasonable. The advantage to going through a place like CSAB is that you work with an intake coordinator who will help you to find a good match. I think I rejected two or three therapists – and was about to give up – before agreeing to “meet one more please” who turned out to be the one.

    I’m not sure it’s the “counselling” aspect is as vital or important as the therapeutic relationship, which basically provides a context in which healing can happen. So I agree with Sophia that help can come in other ways. You can, with some effort, replicate the holding space of a therapeutic relationship. What you’re looking for is an experience of sustained empathy (possible in some friendships, maybe in a 12-step kind of group, a yoga sangha, etc.) and access to the unconscious (this you can find through writing, art, etc.). It’s probably better to start with a good therapist, and some knowledge of how it works, so you know precisely what you’re trying to achieve.

    I’d be cautious about relying too heavily on a family member just because I think for most people with eating disorders, the family dynamics are not healthy, and part of healing involves shifts in those dynamics (which is why with girls still living at home, they involve the family). It doesn’t mean it can’t work, as it did for Sophia. But I think as many times, when family bonds are damaged, healing involves extricating ourselves from those toxic environments. No easy task, as we tend to replicate the relationship patterns we learn as children. So even though the impetus in each of us is to heal, and in the right environment, we will heal, creating that environment, especially while we’re ill, is nigh on impossible. Which is why therapy is almost always a necessary component of recovery, at least in the beginning.

    I think for many anorectics, the woundedness we’re dealing with is pre-cognitive, meaning we can’t access it through ordinary talk therapy. The damage, if we can call it that, is not in the way we think; it’s more primitive, more existential. So changing the way we think (about our bodies, etc.) is simply not sufficient to heal. Which is why recovery is so frustratingly slow, even as we gain awareness, through therapy, of what we’re doing to ourselves. And psychotherapy, as it’s mostly carried out, except by a good, analytically-oriented therapist, tends to be a mostly cognitive process. We can, of course, access the associated feelings and work through them in therapy, as remembering later events (for which we have mental representations) tends to evoke primitive emotions (usually, if you find yourself touched by a work of art, a poem or a painting, this is what’s happening), but it’s slow going.

    Fortunately, there’s a short cut, because our bodies hold the memories that our minds cannot access so yoga and bodywork are helpful adjuncts to therapy. I think yoga has done far more than therapy in helping me to find a kind of body confidence I lacked when I was younger and skinnier!

  3. I’m so proud of you, Mel…for taking these steps for yourself and for sharing them with others. You are beautiful, in the true meaning of the word.

  4. Melissa, you are amazing. Thank you so much for sharing your journey – it is such a comfort to so many knowing that they aren’t alone and that, even though it is one of the hardest things you can ever do and there are lots of ups and downs, recovery IS a reality and accepting help is the best gift you can ever give yourself.

  5. Thanks so much for sharing – as someone who has both been to a whole lot of counseling sessions and will be working as a school psychologist (with a particular interest in counseling), I really appreciate your openness about the benefits of therapy and about your experiences. I think that it is really empowering to know that it’s okay to decide a particular therapist isn’t a good fit, and that that is something that isn’t always discussed openly (maybe because of the stigma some associate with therapy?). I also wanted to mention that some health insurance will cover therapy, so it is definitely worth checking with both your insurance company (if you have health insurance) and your therapist to see if s/he takes any insurance. If insurance isn’t an option and price is a primary factor, counselors with Licensed Professional Counselor (LPCs) and/or Masters'(MSW, MSC)degrees may be more affordable than counselors with PsyD or PhD degrees. Thanks again Melissa and Gena!

  6. I love your preludes to your guest post, Gena. It always gives such a personal touch, instead of just tossing it to the guest poster. And great choice on the guest poster!!! I’ve always enjoyed Melissa’s side notes, and this post is again true and insightful.

    I personally did not have a “real” counselor. But I was lucky enough to find one in my dad. He may not have been certified, but he certainly had enough experience as a pastor dealing with mental disorders. And he was definitely available as I needed him, I was the most comfortable with him, and best of all, he loved me. For who I am, even though I was (and am) extremely vulnerable and flawed.

    Just wanted to give my two cents that sometimes, counseling can come in other ways. But it is definitely necessary in recovery. It’s so therapeutic to finally admit to our problems, and have someone listen.

  7. Thank you, Melissa. I’ve used counseling, group therapy, self-help books, and journaling/blogging, and found all of them to be useful. Counseling and group therapy were the most beneficial, though reading the book “Life Without Ed” was transformative and was what made me finally *want* to get better. Thank you for sharing your experience.

    Regarding money, if the ED patient is employed, they might ask their employer if the company offers an Employee Assistance Program for counseling – my counseling visits are 90% covered this way, and I only have a 10% co-pay. Alternatively, if the patient qualifies, the county or city Mental Health services might be able to help out or provide financial assistance. Yes, it may be scary to walk in and make the application, but it will be worth it in the end. Getting the help you need is definitely worth facing your fears.

    In my own struggle, I’m facing weight gain and refeeding that is going faster than I am ready for, though I’m not sure that “Ed” is really ready for ANY speed of recovery – he would rather keep me sick forever. So, thank you for the reminder that I need to keep getting well. And thank you, Gena, for bringing Melissa on as a guest blogger. 🙂

  8. Thanks for your insights. I’ll bookmark this to pass on to people, as I do get questions of this sort too. I have benefited from therapy not for an ED but other issues. It took me a long time to get the right fit for a therapist. I tend to just stick with someone because it’s an investment in time telling them all your back history and such. I have to say also that I’ve had therapists that I leave feeling WORSE and that’s no good. For me, I want to leave having felt like it was worth my time and energy even for one session.

  9. thanks for writing on such an important topic. i would add, though, that group therapy can also be an extremely effective route, in conjunction with or after a great deal of time in individual therapy. it also may be more cost-efficient (or free), especially at local colleges/ universitities.

    • I definitely agree. I’ve never been to group therapy, but I’ve talked to my counselor about it (because they have it where I go to see her) and she says when she thinks I’m ready she’ll have me try it out. I also had the option to try it out in college but I was way too ashamed to go to it.

  10. A lovely post.
    I think having someone to talk to can be priceless. Some nights I wish I had close friend to share things with and to unload the burden on my shoulders (not ed-related). I’m dealing with a physical breakdown from a host of issues and sometimes I just can’t bear it. Like things are whizzing by and I stand still. Somehow I need to break from the fog and come back up. I truly admire you. You’ve come through so much, yet you are so strong and capable in your job, your fitness, everthing. Opposite of me. You are a great girl Melissa.

      • Gena,
        Do you have books you would recommend regarding: making firm goals (the how-to’s, not abstract); ending self-sabotaging; looking to be confident and feel like you are completely independent and no one can hurt you or damage you any longer; to develop character and feel like a ‘good” person; to be tough in the face of sad situations….I’ve seen some “No more excuses” or “Feel the fear and do it anyway”…I never know what is good and money is tight…

  11. Wonderful job, Melissa! You hit on some really important points. In the blog world, I see so many young women in recovery who didn’t mention anything about therapy, and they seem to be the ones with the most disordered behavior on their blog. Therapy is SO crucial to recovery!

  12. Thanks for your insight! I have seen over a dozen different therapists and been in 5 treatment centers. I have to agree with you that finding the RIGHT therapist is key to making progress. I have definitely had a lot of guilt having spent so much of my parents’ money on treatment, but it has always been worth it and porbably saved my life a few times. Hope things continue to go well for you!

  13. Thank you Melissa for helping Gena out with this awesome post. I am so happy for you for your own recovery!

    I love what you said about being comfortable with your therapist. For ANY type of therapy relationship, ED, marriage, family, etc it’s fundamental. It’s next to impossible to make progress if you and the therapist just dont click. SUCH a great point: to be comfortable!

    I was getting my masters in marriage & family therapy when I got pregnant and so all this jazz is near and dear to my heart!

  14. Thanks so much for sharing, Melissa! I’ve followed your blog for a while now and I always appreciate your honesty, and I’m so glad Gena chose you to write a guest post while she’s away. I’d like to start therapy in January for my food issues as soon as my insurance changes, so this post couldn’t have been more timely!