5 Things You need to know before you start counseling

So, you’ve decided to start counseling and you’re ready to go.  Perhaps you’ve never done therapy before or maybe you’re looking to take a new approach.  Here are some things you need to know before you start counseling.

1.  Finding a therapist that you feel safe with is most important. 

You can line up a bunch of great therapists, but if they’re not the best fit for you, you’re not going to do the intense, deep work you’re looking to do.  The role of a therapist is to be a guide through your journey, reflect back to you what we see and help you to overcome obstacles towards meeting your goals.  If you don’t click with your therapist or don’t feel safe enough to trust them, reaching your goals with them is unlikely.  Your therapist should be someone you can relax around and speak freely without fear of being judged.  Trust and safety are of paramount importance when you’re looking to do deep work on things like eating disorders, trauma, PTSD, couples’ work or issues specific to the LGBTQIA community.

2.  Specialties mean that there’s been special training in a particular issue. 

Our training in graduate school and doctoral programs very rarely provides training for specific diagnoses like PTSD, eating disorders or addictions.  So when a therapist decides to have a particular specialty, we need to seek out training geared specifically towards these issues.  If you notice that a therapist you’re interested in has indicated that we specialize in a particular area, you might want to ask us what sorts of training we’ve done to qualify us as an expert.  This will give you a better idea of how equipped we are to help you with your specific struggle.

3.  When you hire a therapist, you are paying for a space that is yours, for you.

I’ve heard people say that therapy is like paying someone to be your friend.  This is actually not true.  When you hire a therapist and you pay money, what you are paying for is a safe, neutral, objective space and time where you can do your work.  It is an energy exchange.  You are not paying your therapist to care about you, you are paying for an hour in a room that is completely and totally about you and no one else.  In friendships, there’s a give and take, there’s a social obligation to ask how they are and be a support to them.  In a relationship with your therapist, you are taking time for yourself only and receiving support that is not reciprocated emotionally, only financially.  This dynamic can be extremely healing and empowering and for many, it is the only time and space where healing can truly take place.

4.  The more consistently you go, the more effective therapy is.

Sometimes, in an attempt to save money or save time, people want to schedule therapy sessions every other week or once per month.  While there’s nothing particularly wrong with scheduling like this, you may want to rethink the frequency and consistency of your therapy schedule.  You don’t have to be in therapy forever.  You can establish and work towards specific measurable goals with your therapist and see regular progress.  However, progress is more difficult to measure when you attend therapy inconsistently.  You may be having symptoms of PTSD, for example, and when several weeks go by without working on those particular symptoms, it is more difficult to get traction.  If you’re struggling with binging and purging and you go every week, you can check in with your therapist about the particular triggers and behaviors that may have lead to your binge and purge.  Don’t take my word for it, check it out for yourself.  Set a goal with your counselor and try going weekly, write down your progress and notice the differences between your weekly sessions over a period of at least 3 months versus bi-weekly or monthly progress over a 3-month period.  You may be surprised with the results.

5.  Therapy happens in stages.

Sometimes we think that as soon as we set foot in the door of a therapy office, we will be “cured” immediately or within a few sessions.  The reality is that there’s a therapeutic process which happens in stages.  The first stage is joining with your therapist or learning to trust them.  When we meet a new friend, we don’t usually tell them our deepest darkest right off the bat, it takes time and trust building to get to a place where we know they are a good friend.  A similar concept is applied in therapy.  Depending on the client, the level and amount of trauma and defenses, this stage can take anywhere from about a month to sometimes a year or even more.  Safety, trust and a therapeutic bond, known as a therapeutic alliance, is formed in order for the therapist to really know and understand the client and for the client to feel safe enough to open up and do their work. 

The second stage is where the work is done.  Since there’s now an underlying foundation established between therapist and client, the second stage is about vulnerability.  There is an unpacking, uncovering, examining and exploring the process that happens with the client and their trauma or their history.  This stage is where people see their patterns and make shifts and changes in their thoughts, beliefs, and behaviors.  The second stage of the therapeutic process is where clients reach their goals.

The third stage may or may not be part of the therapeutic process, dependent upon the client’s preference.  This stage is for maintenance.  The client continues therapy but perhaps doesn’t come every week any longer.  They use their therapist to check in with, get help with issues as they arise and review the goals and behaviors they established during the second stage.  Some people choose to forego this step and skip to the fourth stage.

The fourth stage of counseling is a closure process.  After attaining goals in the second stage, and maintaining new behaviors and thought processes in the fourth stage, this last and final stage is a review of accomplishments, work together and closure of the therapeutic relationship.  If the client chooses to end counseling, this practice of review and closure can be especially healing for those who have experienced traumatic grief or loss.  Saying goodbye in a healthy way, honoring the relationship without suddenly cutting it off is a beneficial process to learn about emotional maturity and sophistication. 

I hope these tips have been helpful.  Please feel free to comment below with any other tips or feedback you have on this topic.  If you’d like to speak further about starting counseling or have any other questions about some of the things I’ve mentioned, please contact me at TiffanySpilove@yahoo.com or call 610-314-8402.  I wish you luck in your endeavors and look forward to hearing from you soon!!

The 5 Secrets to Quit Binging

At times, all of us have eaten a bit, or a lot more than is comfortable in our bodies.  Holidays, celebrations or sometimes mindless eating in front of the TV can leave us feeling overly full.  For some, this way of eating is more common and happens more frequently than we’d like.  The new DSM-V, the Psychiatric Association’s manual on diagnosis, has created a diagnosis under the eating disorder umbrella called Binge Eating Disorder or BED.  Whether you meet the criteria for this disorder, for bulimia, anorexia, or you just find yourself overly stuffed at times, these tools can be helpful:

1.     Notice what types of foods you’re binging on and write them down. 

It helps to look at your behavioral patterns.  Some people find themselves eating excessive sweets, some are more geared towards fats or starches.  Some people with emotional eating tendencies excessively eat any kind of meal including vegetables.  See if you can find a pattern in your binge choices. 

2.     Notice what you DON’T binge on. 

Are there any types of foods that you’d never consider in a binge or never feel the need to over-eat?  In a recent session, a client was relaying the guilt and shame he felt after a binge.  He reported that he doesn’t usually allow pastries in the house, but was feeling strong recently and thought it’d be okay.  He found himself finishing off the pastries he had in one sitting.  Upon further investigation into what foods he was allowing himself to eat regularly, the client determined that he felt very satisfied when he ate waffles and allowed himself to eat waffles multiple times per week.  I asked him if he ever binges on waffles.  He was shocked when he thought about it and said that – no – he never binges on waffles.  Ok, great, so there’s no waffle binging going on, but how does that help?  Follow me here.

3.     Take a look at what you ‘allow’ yourself to eat regularly. 

What foods do you consider safe?  In an attempt to be healthy, lose weight, or just get control over your food choices, you may be very rigid or restrictive about what you allow yourself to eat on a regular basis.  Perhaps your choices look benign enough like chicken and veggies multiple times per week.  Write down what you’ve eaten over the past 3 days to 1 week or track your food for a week.  What do you notice?

4.     What is missing from your regular eating habits? 

Take those same meal journals and notice what you don’t have there.  If we consider all the food groups: protein, fat, starch, veggies, fruits and dairy – are there any food groups missing?  Are there lots of repeated meals without much variety?

Now I know this might seem completely insane and a bit scary, but HERE’S THE KEY to quit binging.  Ready?

5.     Allow yourself to eat the foods you binge on.

Try adding a portion or 2 of the foods you don’t allow yourself to eat and some of the most common foods you binge on to your regular meal schedule.  I know this might seem counter-intuitive.  Our society tells us to resist, have discipline, diet harder, avoid sugars and carbs and fats and this may be the only voice you’ve ever heard that encourages these things, but just give it a try for a month or even a week and see what happens.  If you are on the anti-carb kick, but then you find yourself binging on carbs, try adding a normal amount of carbs to each meal and see what your body craves after a while.

Here’s the rub – We are creatures of desire. 

Food is part of life!  It’s nourishing and delicious and sensual.  When we restrict ourselves from eating foods we love, we may lose weight in the short run, but this does not happen without consequence.  Our animalistic nature, our Id, it craves pleasure and passion and vigor.  If we force ourselves to live inside a rigid box of rules around food and body, we will always desire to break free and stepping outside of that box causes immense shame and fear.  I am not telling you to overeat or teaching you how to binge differently, but what I am suggesting is that you try to take the power out of the foods that haunt you. 

If you regularly binge on entire cartons of ice cream, see what happens when you have a cup every night for a week.  What emotions come up when you eat it?  Can you journal about them and bring them into your therapist?  What do you find yourself craving after that week of glorious freedom with ice cream?

If you live near The Main Line of Philadelphia or West Chester and want to learn more about binging and how to quit, or you’re not sure where to find support for your feelings around food, you’re not alone.  Please feel free to contact me at 610.314.8402 – I’d be happy to help you find support.

12 Clinical Interventions for Eating Disorders

Here are some tips you might find helpful when working with clients with Eating Disorders, or Disordered Eating:

1.  Find a registered dietician who specializes in Eating Disorders.  It is important that your belief systems and theirs align when working together to treat a client.  For example, most people in the eating disorder recovery field believe that there are no "bad" foods and we work with clients to neutralize food.  However, some people believe in "abstinence" from certain foods or food groups.  When I am looking for a dietician, I make sure that they're not of the school of thought to tell my clients to restrict food groups as it would go against the work we are doing clinically.

2.  Buy large desk calendar and different stickers and create a behavior chart for meals and snacks well done according to their meal plan. Celebrate successes elaborately!

3.  If age appropriate, work with parents on making "no Foods bad".  Everyone in the family can join in on recovery by coming together to share with all food groups. 

4.  If age appropriate, look into the Maudsley Method for re-feeding process.

5.  Work with your client to create an art project around beautiful people, models, actresses, friends or family and others in Pinterest or print outs who are not super skinny.  Process what they find beautiful about these people.  Encourage clients to post up these images on their wall so that they get used to seeing ideal beauty images and other than emaciated models.

6.  Make a list of all clients fear foods and safe foods and medium foods and use CBT to debunk myths of fear foods. 

7.  Eat 'normal meals' together in session - especially with fear foods - exposure therapy.

8.  Find studies that show that whatever fear foods are - are not 'bad' i.e. - sugar is not as evil as everyone says. 

9.  Use ego state work to find out which 'parts' in clients psyche are telling them not to eat and have conversations with them using Gestalt Chair Work. 

10.  Use the books Life Without Ed by Jenni Schaefer as a guilde book, everyone involved should read and the book 8 Keys to Recover from an Eating Disorder by Carolyn Costin can be used for treatment and interventions as well.

11.  The therapist can have client draw their body in the size and shape she believes it's in, then have therapist actually trace clients body and process the difference. 

12.  If there's one body part the client is upset about like their waist, have client draw what they believe is their waist size, then use a string to measure (not using numbers) the actual size and trace THAT onto the paper and process the difference. 

Hope this helps!!

What else do you use as interventions for clients?  Please comment below!!  As always, if you have any questions or concerns, please contact me at 610.314.8402 or through www.TiffanySpilove.com

Overcoming ED: A True Eating Disorder Recovery Story

I have a dear friend out in California, her name is Ashly.  We met while we were both working at an eating disorder recovery facility together.  She's beautiful and successful and she'd shared bits and pieces of this story with me when we worked together.  I was always so touched by the raw emotion attached to her story.  I asked her if she'd be willing to write her recovery story for my blog and she so kindly agreed.  I am in awe of the bravery, honesty and eloquence she put into writing this.  Ashly, you truly are a recovery warrior, thank you for allowing me to share your story here:

It’s been almost 10 years to the day (March 7th, 2007) when I first sought help for my eating disorder. I had just turned 21. I had always looked forward to my 21st birthday (as most teenagers do), but it wasn’t exactly the greatest birthday ever. My family took me out to a nice Asian restaurant, decorated with orchids, candles and plush, red velvet booths. My dad ordered expensive champagne that I pretended to drink. I spent most of dinner in the bathroom so I wouldn’t have to look at or smell the food. I got dressed up that night for the first time in a while… black satin pants, white tank top, make-up and high heels. I remember looking at myself in the bathroom mirror thinking how ridiculous I looked. What had happened to me? Why couldn’t I just be happy and normal? I went home that night and sobbed into my pillow. I had no friends, no job, no one I would let anywhere near me. I had dumped my boyfriend right before New Year’s, only because he was worried about me and wanted me to seek help. He had even given me a diamond ring months before – which I swiftly pulled off my left hand and flung it at him while he begged me to get better. I remember him telling me that he had no idea what had happened to me – but I was scaring him. I had joined him and his family on a ski trip weeks before, and looking back, I scare myself. I skied as long and hard as I could everyday, not because I loved it, but because I needed to burn the most calories possible. I wouldn’t go near his mom’s homemade cinnamon rolls, eating a diet bar instead. We’d go out to dinner to fabulous restaurants, and I’d always special order the same thing – and eat exactly half. We’d return to the cabin to watch a movie at night, and I’d sneak off to the bedroom where I’d hide in the closet to do as many crunches as I could stand. My boyfriend caught me one night, and the disappointed look on his face made me so angry. When did I turn into this cold, shell of a person? I loved him more than anything – yet he wasn’t enough for me to let go of my eating disorder.

When I think about how much wasted time I spent obsessing over food and weight, it makes me really sad to have lost those years. I’d spend hours (really, hours) in the grocery store studying every food label before a few chosen items made their way into my shopping cart. Everything had to meet a certain criteria: less than a certain number of calories, a certain ratio of fat and carbs, and no sugar. Protein was ok. For items that didn’t have a label, like produce, I’d Google the nutritional content on my phone. One day, I found this package of “seaweed pasta.” Growing up with an Italian mom and grandparents, pasta was a staple in our house – and I missed it terribly. The seaweed pasta had close to no nutritional value, so I gave it a try. I made a huge plate of it that night. It reminded me of something alien. It was slimy, a little crunchy, translucent and sticky. I topped it with this red Asian marinade since regular pasta sauce didn’t meet my standards, and it was the most disgusting thing I’d ever eaten. I was able to have a few bites before the rest of it was flushed down the toilet. I actually felt a huge sense of accomplishment – I made something taste so badly that I couldn’t eat it. Gold star.

March 6th of 2007, I saw my boyfriend again for the first time since we had broken up. We went to a movie, and I couldn’t even tell you which one because I was too busy counting up all my calories for the day, figuring out what I could eat tomorrow, and how many hours of exercise I would need to burn off that handful of popcorn I just ate. After the movie we hugged goodbye, and I remembered how good it felt to be in his arms. I wiggled my way out of them because I wouldn’t allow myself to start crying. Once home, I ran a hot bath trying to get warm. I was constantly freezing. I put on every piece of warm pajama I owned and crawled into bed. My body hurt. My heart raced. My stomach felt like an endless empty pit. I missed my boyfriend. I missed my old life, old friends, old self. Where was this going? Was this my life now? I was just going to live day by day obsessing over calories, exercise and weight? I didn’t want to live that life. I was absolutely exhausted. I prayed to God that I would die in my sleep that night.

I felt something warm on my bare face and neck. I could hear birds singing. I slowly opened my eyes and saw the most beautiful shade of light filling my bedroom. My mind was quiet and it was peaceful as I lie in my soft bed. I sat up, feeling as though I had awoken from some sort of coma. I wasn’t thinking about food, my body, or anything else. I was simply enjoying the gorgeous Spring morning. I turned toward the side of the bed and swung my legs over. There was a mirror above my dresser directly across from me. I looked at myself and realized now is the time – I don’t want anorexia to be the rest of my life.

The following days, months, and years were filled with doctors appointments, therapy appointments, support groups and days when I didn’t believe I’d ever get better.  It was really hard learning how to let go, and even harder actually doing it. Not even a year into my recovery, I met a boy at college and we started dating. He invited me to spend a week with him in Hawaii over the holidays. He was incredibly sweet, handsome, and shy around me. I had never been to Hawaii, and although I was terrified of losing control over my meals and exercise, I said yes anyway. I had only known him a month or so, but I nervously bought a plane ticket to meet him in Maui. He knew nothing about my struggle with ED. I packed all my “safe” food and had it in a bag under my airplane seat. As the plane started to descend, I could see the islands through the clouds and it was the most beautiful thing I’d ever seen. I was in complete awe. I grabbed my suitcase and walked off the plane excited to see my new crush, later realizing I left my bag of food under the seat. The relief I felt in that moment was overwhelming.

We spent the next week exploring Maui: snorkeling, hiking, surfing, swinging from jungle vines and finding hidden waterfalls. We ate fresh sushi, pineapple, bananas, and this incredible chocolate lava cake. Every. Single. Day. I wasn’t worried about my hair looking perfect or making sure my make-up stayed on. We lived that week in our bathing suits and tanned skin and I felt more beautiful than ever. He was sweet to me, and taught me that being your authentic self is the only path to true happiness. I let someone see me for who I really was, and I wasn’t rejected, abandoned or hurt. We shared the same bed the entire trip but always ended the night with just a kiss. I felt safe, protected, valued and respected. When it was time to head home, I had a true moment of sanity: After a week of having the most fun of my life, eating what my body wanted, and letting someone wonderful really see me, I was still O.K. I didn’t die, I wasn’t out of control, and I felt more like myself than I did in years. I truly believe that decision alone – a plane ticket to Maui – saved my life. Recovery was still hard and a process after this experience, but I learned - at my core - that I was worthy. Worthy of living a full life. In every sense of the word.

As I sit here proof reading this story, I can hear my toddler playing in the next room while my unborn baby moves in my tummy. I never thought I’d be here: a mom and a wife, with a career that I love. I feel incredibly lucky to be living without my eating disorder. Having the right support, sound guidance, and a professional who helped move me through the root causes of my eating disorder are what keeps me in recovery today. “We have the capacity to redraw the lines between our powerlessness and power.  We’re altered by what hurts us, but with love and consciousness, with intention and forgiveness, we can become whole again.” – Cheryl Strayed

3 Keys to Finally Make Peace With Food by Geneen Roth

Geneen Roth, eating disorder guru, discusses the following topics with Claire Zammit: 

• - How your struggles with food might be impacting other areas of your life such as relationship, finances and career
• - The common misconceptions about the root of weight issues and the truth you must embrace to finally overcome them
• - The practice that instantly changes your relationship with yourself as a foundation for creating a new relationship with food
• - Why uncovering the deeper, positive reason you've been keeping the weight on is a key to releasing it forever
• - What can become possible in your life (and in our world when we do this as women together!) when you make these 3 shifts
• - How you can make 2017 the year you reclaim your power and make peace with food forever

You can hear the 60-minute seminar here: http://bit.ly/2mdrClK

If you have any questions or need support, please feel free to call me at 610.314.8402 for a free 15 minute phone consultation.

Please comment below and tell us your story !

Guest Writer: My Journey With Bulimia by Melissa King

A brief update from the author:

I wrote the following post just over 6 years ago. I had been fully recovered from bulimic symptoms for about 4 years at the time. It’s now been 10 years of recovery and I still deeply believe in all of the words I speak in this piece. The only thing that’s changed is that I feel even further away from experiencing desires to binge or purge. There was a time when it was hard to imagine feeling completely comfortable around food, easily stopping when full, and not thinking about the ice cream in the freezer constantly. I hope this article helps some of you! Be brave. Recovery is totally possible! - Melissa

My Journey With Bulimia

December 6, 2010

About ten years ago I developed a condition known as bulimia. I never would have guessed that a smart girl like me would struggle with something like that. I knew better. I had learned about eating disorders when I was younger and could never make sense of why someone would force themselves to vomit after eating or avoid eating all together.

I think very differently about eating disorders today. You can be intelligent, self-aware, and informed about eating disorders and still struggle with the “disease.” I remember the first time I displayed signs that I was at risk for developing bulimia. I was reading a book about how bad refined sugar was, and I was doing an excellent job of eliminating it from my diet—that is until I was tempted by a birthday cake brought into work one day. I decided to treat myself to a slice, and as I was finishing it, I felt deeply concerned about how the sugar might be harming my body. I don’t know what made me think of it because I had never chosen to throw up food before (nor did I know of anyone who had), but I quickly went to the bathroom and vomited in a stall.

I felt much better after getting rid of the sugar and didn’t think of it again until a year later. I had begun a big transformation in my life. I was starting to question my faith, my choice of career, the reasons for my failed romantic relationships, etc. I decided to go to counseling, and after a few sessions the counselor asked, “Where is Melissa?” I didn’t understand what she meant, but after some back and forth, she finally explained, “You tell me everything you think you SHOULD do and SHOULD want, but you don’t tell me how YOU feel and what YOU want.”

No one has said anything that has impacted me more deeply than that statement. I realized that I had become so good at assessing what I thought other people wanted that I had become disconnected from my own desires, feelings, and opinions. It’s like they were crowded out by the noise of all the other expectations and demands I thought I had to meet.

After that session, I started concentrating on my inner world and made a lot of effort to to connect more deeply with myself. As part of that exploration, I went back to dance class. Dance was an innate joy for me. It was my childhood passion, something I knew that I didn’t do to please anyone else. I hoped that dance would remind me of what it was like to feel.

And it worked. The feelings that dance inspired in me became recognizable in other areas of my life. In an attempt to follow this, I started spending more time alone so that I could learn to hear my own voice. I stopped going to church so that I could figure out what I really believed about God, without pressure from others. I also got a second job and began saving to spend six months in New York studying dance. New York was a place I had always wanted to live and I wanted to gift myself with the opportunity. And lastly, I decided to finally lose the weight I had gained since high school. For the first time, I was choosing to take my dreams seriously and have confidence in my ability to achieve them.

Several months later the pounds were coming off and I felt amazing. I was losing weight in a healthy way and sticking to a diet plan longer than ever before. I felt like I was discovering my real body: lean, healthy, strong, and energetic. I felt beautiful inside and out.

Somewhere close to my goal weight, I gave in and ate something that I knew was higher than the amount of calories I needed. I became afraid. Seeing myself eat food that was not in my plan made me fear that I was stepping back into old behaviors. In the past, I would stick to a diet for a little while but would always end up giving into temptation, promising myself that I would start again the next day. It was a bad cycle that I didn’t want to continue. Not only that, but I was falling in love with the “new” me, the me that was living from her heart, the me that was committing to her goals, and the me who was coming out of her shell and no longer hiding under extra weight. I felt more confident. I was getting attention from boys, and I was interacting more with people. I didn’t want to lose those things. That’s when I remembered my experience with the sugar elimination diet. I realized that I could just get rid of what I ate in the bathroom and my problem would be solved. So I did.

I never imagined that I would do it again. I thought it was a one-time thing. But it did happen again. Not often, at first. But every time I felt unsure about the calories I had consumed in a meal or I knew that I had too many, I ultimately found myself in the bathroom.

At one point, I became concerned that I might have an eating disorder. I remember going online and looking up the symptoms for bulimia. The criteria noted that an individual must have a certain number of symptoms to be diagnosed. Although I thought I might need help, my symptoms didn’t match enough of the criteria. I wasn’t bingeing at all and I wasn’t vomiting enough over the course of a week. As a result, I worried that I would not be taken seriously, so I was too embarrassed to seek help.

Eventually the symptoms did grow. It became harder to vomit if I didn’t eat enough, so I started to binge. My bulimia began to look very “textbook.”

In May of 2001, I moved to NYC. I accomplished some amazing things and had some wonderful experiences. During that time, I had periods when I went for months without symptoms and others when I vomited every day. I eventually went to counseling again, and during those sessions, my counselor offered me one important insight about bulimia. She simply said, “Maybe you’re not ready to give it up.” For the first time I considered the notion that I could give myself permission to continue. What a scary idea, but she was right to suggest it. 

From the time my symptoms began, I was resistant to them. After every purge, I promised myself it would be the last time. My mind was filled with figuring out ways to keep it from happening again. By accepting bulimia’s place in my life, I was able to learn from it and understand why it was there. Since my mind was free from thoughts of guilt, criticism, and resistance, I had space to feel the emotions that bulimia was trying to bring to the surface. I started recognizing the feelings I felt when I would binge and purge and realized how they were connected to other challenges in my life. When I saw the connections, I could start resolving the problems in other ways.

It took awhile, but I eventually let bulimia go. I would stop for several months, have a bout, then stop for many more months, have another bout, then stop for a longer period of time, etc. It’s been over three years now, maybe almost four, since the last period of symptoms.

I believe my bulimia represented a step toward healing. It often felt that people around me viewed bulimia as a problem, as a step backward, as something I was doing wrong. At first, I joined them in this conclusion. But bulimia came into my life when I was beginning a fight to be true to myself and resist the external pressures around me to please others, to follow another’s lead, to do what other people thought was good rather than what I felt was good. I didn’t know how to say “no.” I didn’t know how to negotiate. For years I had been taking in, absorbing and adjusting to what others wanted so that I could gain their approval and respect, ultimately depending on them for assurance and confidence. Simultaneously, I ate all the time. That’s how I gained weight in the first place. I just consumed. I dealt with my problems by eating. I couldn’t say no to food either. 

I was finally coming to a point in my life where I wanted to trust myself, but I was scared. It was a battle. I was taking food in (symbolically, others’ opinions, desires, and expectations) but realized that I didn’t want it. So I would push it back out. I was starting to say no and bulimia represented a violent fight inside me. 

It’s hard to be yourself in this world. There are a lot of demands, many that are indirect, and it was hard for me to resist the impulse to meet all those demands. Food was my vice, so it makes sense that my relationship with food symbolically paralleled my relationship with myself and with the world.

I think my bulimic episodes ended when I started trusting myself more and worrying less about others’ opinions, worrying less about someone being upset if I told them “no.” I knew that I didn’t want to continue bingeing and purging because the health risks weren’t worth it to me. So, eventually I chose to stop, probably when I had the internal strength to make that choice for myself (rather than just to appease others). Much of it was learning how to have boundaries. Just like I had to learn how to have boundaries with people, I had to learn how to have boundaries with food.

Does this mean that I have perfect boundaries with people now, that I never overeat, that I trust myself completely all the time? No. I still struggle with these things, just like everyone does. But the experiences I had while dealing with bulimia transpired into major changes in my life, changes I certainly benefit from now. My boundaries are much stronger and clearer, and I have more awareness of when I am compromising who I am. In fact, if I ever have the urge overeat or vomit, and I do sometimes, it’s a great clue to me that I’m not dealing with something in my life the way that I need to. I know that now, so I can take a step back, look at the problem, and figure out a more productive solution. It’s funny, because that solution often means asking for help or making myself more vulnerable with someone (letting someone in), or saying what I feel and risking possible rejection - again, all connected to boundaries. 

Bulimia is complicated and very layered. I haven’t addressed all of those layers here. Furthermore, I can only speak from my own experience; I don’t mean to represent others’ experiences. Over time, I’ve learned that people’s stories and the reasons behind their personal challenges are varied and don’t all fit into a neat little defined box. But I do believe that for many people, symptoms of bulimia actually symbolize an attempt toward health, the body reacting in order to make something right. I believe the symptoms are symbolic of the internal fight of an individual trying to find their voice, to find confidence, to look for a way to move out of whatever problem they have been dealing with, a problem that existed before symptoms of bulimia showed up. It’s never just about bulimia, it’s always about something much deeper. I think that many individuals with bulimia are trying to figure out how to finally have boundaries—with themselves and with the world. If they can find support to understand and transition through it, support to trust themselves, then the stage after bulimia can be fuller health, greater self-esteem and confidence, and healthier boundaries.

ABOUT MELISSA

Melissa King, LMHC is now a psychotherapist in New York City who works with women, gay/bi men, and couples in the first 10 years of a relationship. Find out more about Melissa here. https://www.myheartdances.com

If you have any questions or need support, please feel free to call me at 610.314.8402 for a free 15 minute phone consultation.

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