"I expect a part of you welcomes the thought of change and a part of you might be concerned about it"
"Who will I be without my disorder?"
"How else will I cope with life?"
"If I stop purging I will gain weight"
"Part of me does not want to change eating disorder rules"
As your Counsellor I will consider the whole of you and this will be reflected in the approach to the multifaceted aspects of your eating disorder. We will work collaboratively and at your pace. However, I will challenge and use the resistances, deflections and excuses of the eating disorder as they occur as part of your therapy.
The following is a brief outline of the work involved in the eating disorder therapy.
We will use motivational therapy to assess and encourage your Willingness and Motivation to engage in the therapy. You may not think you have a problem or you may be scared about what will happen if you do things differently. I understand that change may seem very daunting and unsafe.
There may be a huge amount of ambivalence to change. Your eating disorder may have been a significant part of your life. We will acknowledge and explore this Ambivalence and Resistance to Change by looking at the pros and cons of your eating disorder. The aim is to acknowledge that in spite of the cons of the eating disorder there may be eating disorder Payoffs. We will explore both the pros and cons of your eating disorder as well as the pros and cons of change.
Therapy at the beginning aims to attend to the Physical side of the Eating Disorder addressing your Relationship with Food; your food world and the food scripts, nutrition, dieting and weight conflict. Work will proceed towards the gentle establishment of Nutritional Rehabilitation
The Psychological aspects of the Eating Disorder will then be incorporated into the therapy focusing on the eating disorders mindset such as faulty perceptions and thinking and the emotional dysregulation and its management.
We will hope to explore:
the Predisposing
the Precipitating and
the Perpetuating factors
and work on the maintaining factors in the present.
This will involve exploring self-esteem, body image, eating disorder mindset and rules, habits and rituals, perfectionism, interpersonal skills of relationships, assertiveness, lifestyle and stress, emotional resilience and regulation of the many emotions involved such as anxiety, guilt, shame and depression.
There will be Psycho-Education throughout the therapy looking at blood glucose curves and the physiology of the body plus the de-mystifying and reframing of eating disorder myths. There will be homework tasks and on-going monitoring of food diaries.
We will also undertake work on Relapse Prevention. The journey does not promise to be easy and encountering setbacks is part of the learning and recovery. Attention will be paid to self-care, mindfulness therapy and compassion therapy as you undergo the healing process.
Therapy will enable you to have autonomy and to free yourself from the Eating Disorder
