Judy called The New York Center for Eating Disorders in despair. “I need to lose weight. I’m out of control with my eating. Can I come in to see you?”
Judy came for a consultation and described her bingeing problems. She also came prepared with a series of excellent questions about the process of therapy for emotional eating which I would like to share with you.
How can psychotherapy help me lose weight? (Note: in case of emotional eating.)
The psychotherapy we offer at The New York Center for Eating Disorders helps people discover the connection between their emotional issues and eating problems. We try to discover and explore the emotional reasons that cause a person to binge, purge, or starve. Some of these emotional trigger points have to do with anger, depression, anxiety, resentment, sadness at a loss or death of a loved one, loneliness, boredom, or rejection.
Therapy for emotional eating is similar in some ways to traditional general psychotherapy: A client comes in with a problem relating to anxiety, depression, a troublesome relationship, or just feeling “plain stuck.” She tells her therapist how this problem has affected her, the history of how this issue began and what she has done to help herself. The therapist and client work together to discover the root of the problem and to bring the issues out to the clear light of day. (This is why therapy is sometimes called “the talking cure”). The goal is to help the client figure out how to avoid patterns that have been self-destructive and caused unhappiness. Therapy for emotional eating also includes in-depth discussions of food, eating, and body image dissatisfaction.
In the initial stage of therapy, emotional eaters are often relieved to hear that, in some way, turning to food may come from a good place and is actually a healthy impulse. After all, trying to make oneself feel better with food is not a bad thing. And food, as we all know, is the cheapest, most available, and socially sanctioned mood altering substance around. The problem is that, in the long run, using food to try to solve life’s problems backfires. The person is left feeling empty, unfulfilled and unhappy with his or her body.
In the early stages of therapy with my clients, I work to develop “Non-Food Nurturing” (NFN) ways they can use to soothe and comfort themselves without unwanted eating behavior.
We devise alternatives a person can use to feel better without recruiting bingeing, purging, or starving. Sometimes this means replacing “isolation with pastry with intimacy with people.” Or it may mean something as simple as taking a nap, or listening to music, or taking a shower or taking a walk or writing in a diary. Some clients will come to session and describe what they now call their “NFN successes” of the week.
The next step is to develop awareness of one’s eating problem and the “emotional triggers” that set off unwanted behavior. But this is only the beginning. We must couple this understanding with a program of behavioral change and then implement more supportive habits. AWARENESS + ACTION = RESULTS.
Should I just go to a diet program or to a nutritionist?
Going to a diet program or seeing a nutritionist are fine resources a person can use in their quest to resolve their eating problems. I often refer people to them. Commercial diet programs can be helpful by providing a structure and a way of organizing one’s food. A nutritionist can also help by custom-tailoring a personal food plan that takes into account whatever health issues you may have – high cholesterol, heart disease, diabetes.
However, if you have struggled with an eating problem for many years, it may mean you have not resolved the emotional stress that fuels your eating disorder.
All the structured eating plans or nutritional advice in the world will only last for a short time because other forces are operating within you, calling you back to the food.
Judy, for instance, believed that if she only lost weight, her self-image problems would be solved. But no matter what diet or weight loss program she tried, she was only “good” for a brief period.
What emerged in Judy’s therapy was that she was depressed in her marriage, and often felt belittled by her husband or ignored by his heavy work demands. Left alone with little support, she suppressed her anger and overate at night as a way of compensating for not getting enough love. Therapy helped Judy face her feelings of resentment. She began to see that she squashed this resentment with food. She realized that she needed to speak up more directly to her husband about her dissatisfactions. She had never previously made the connection between her nighttime binges and her stifled anger.
So, did making this connection help her eating? The answer is yes and no. Rather than running mindlessly to the refrigerator, Judy began, instead, to ask herself what she was feeling en route to the kitchen. Sometimes, this gave her a chance to stop in her tracks and think about what was bothering her and how to handle it. Other times, she had no idea what to do and she kept her rendezvous with the ice cream. And then, at other times, instead of using her mouth for eating, she went back to the living room and used her mouth to tell her husband about how she was feeling.
The point of Judy’s story is that change does not happen all at once. Improvements — especially long lasting ones — take time and patience. As she developed greater self-awareness and more reflection about the feelings that triggered her eating, Judith was able, little by little, to put a stop to her automatic eating.
We all need to learn to sink our teeth into life, not into excess food!
Next month, we will continue our discussion of Therapy for Emotional Eating.
*All names and identifying data have been changed for confidentiality.
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