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ED Therapy Seems to Be At a Standstill

By January 9, 2013

I am 48 years old. I have had bulimia for over 30 years. I have been in “recovery” for about three years now. I have been going to the same therapist that does not specialize in E.D. I have been on the heavy side all of my life, but recently I finally lost a lot of weight on a diet. I am at a new place in the E.D. in that I found out that being thin does not cure the E.D., but makes it worse. ED Therapy seems to be at a standstill. I don’t know whether to just throw up my hands and give up or continue with the same therapist who has helped me in the past. I live in a small town and there are no E.D. groups. I want to get over this disease and I don’t know where to turn next. Please offer any ideas that you may have. Thank you. – D.

D,

Sometimes people move from therapist to therapist for reasons that are not particularly healthy. However, this is obviously not a problem for you as you have been seeing your therapist for three years. On the other end of the continuum, people sometimes stay with a therapist out of loyalty and/or feeling guilty for leaving.

The therapy is 100% about what’s good and right for you. A good therapist knows this very well and the vast majority of therapists understand that there are times when referring a client to another therapist or resource is the right thing for the client.

I say this to encourage you not to make your decision based upon how your therapist might feel. As a psychologist, I know that there are times when someone might terminate with me and, although I may feel badly about it, I know it is the right thing and I am glad the person is seeking to do what is best for him/her.

Having said this, I would neither recommend that you quit your current therapy nor stay in it. I believe you should discuss it with your therapist, but ultimately you should be the one to make the decision.

When terminating therapy it is always good to openly discuss it with the therapist. A large part of a healthy recovery is talking through and resolving issues directly with the individual with whom we have the issue. In this case it doesn’t sound like you have problems with your therapist; you are just not sure s/he is the one who can take you to the next level of recovery.

I suggest you tell her/him exactly what you wrote – “Therapy seems to be at a standstill. I don’t know whether to just throw up my hands and give up or continue with the you [your therapist] [because you have] helped me in the past.”

That way you can process it with her/him. It is possible s/he doesn’t know you feel stuck. Sometimes talking about “being stuck” with your therapist helps the therapy become “unstuck.” If this therapist has helped you before this discussion may move the therapy forward.

You have to be the one to decide. If the discussion does not result in improvements in the therapy – within the session and in your life – you might want to consider another therapist. Even in a small town there is usually more than one therapist who might have a different style that can help you, even if s/he is not an expert with eating disorders.

If possible, consider traveling even an hour or more one way if that would mean you could move forward in recovery and have a better life. You could consider going to an inpatient or residential program depending upon how severe your ED is and then return to the therapist who has helped you before. Such a program may help you become move forward.

I would not recommend that you give up on therapy altogether. The only time to do that is when things have been going well for at least a few months and you feel you are at a good place in dealing with the issues that fueled the ED. Given that you are struggling, I highly recommend you keep some form of regular support and treatment. See “Finding Treatment” for more information.

David Wall, PhD