Hope your weeks are off to a good start.
Today I wanted to talk through some of the things my therapist had picked up from our first weekly session. I thought this might help anyone wondering whether to go to therapy, as hopefully it will make it less scary (!), and also I think some of the things my therapist will pick up on with me will be relevant to a number of people, disordered eaters or not :) I thought I knew myself pretty well, but she pointed out a few things that really resonated that I'd never noticed before.
I was super nervous about this first session. I didn't know what to expect, and I'd had a really bad few days of eating which I thought we'd have to analyse in great detail. I was so nervous I almost didn't go...
But I'm so glad I did.
One of the things that I'd been asked to complete in advance of the session was a food diary for a few days. It was relatively simple, and asked you to log:
- The time you ate
- What you ate, and quantities (doesn't ask you to go into calories or anything - just asks for a rough estimate)
- Where and who you ate the food with
- How hungry you felt on a scale of 1-5
- Your mood beforehand
- Whether you purged in any way
- Comments and thoughts afterwards
I actually found this really useful - I've never really sat down and analysed my mood before and after eating, and I don't really use hunger signals to judge whether I should eat or not. Identifying feelings makes you realise sometimes it's not just negative emotions you feel, and hopefully over time patterns will start to emerge as to specific eating behaviours/situations and emotions.
My therapist picked up on a few things from my food diary:
- I leave it quite a long time to eat after I've got up - mostly this is due to me exercising first, which she's fine with, but there are times I'll put off eating for as long as possible
- Quite often there are no distinct meals, just constant snacking
- I was eating a lot of sugary foods on my "binge" days
- I wasn't eating enough - which she was obviously aware of any way
- I wasn't rating myself as particularly hungry
I'd never really thought about how late I leave it to eat in the mornings, and I'd never really realised how to an outsider I don't appear to be having any definable meals. And the fact that she said that I wasn't eating enough on days I considered myself as binging was a) mind blowing and b) scary - that meant I was eventually going to need to be eating heaps by her standards!
The part about not rating myself as hungry was interesting. There are times when I do feel starving, but often, especially at the end of the day, it's kind of a numb feeling to food. Or I just feel bloated. Either way, she said I wasn't feeling as hungry as I should have been. She explained how when we don't eat large enough meals, the stomach muscle can weaken, and it becomes less effective at pushing the food through the digestive system. This can sometimes explain why we feel bloated and less hungry.
I'd also been asked to complete a lifestyle assessment, which asked a whole range of questions. A few things she raised from that was:
- I rate my relationships with my family and boyfriend as good, but my friends as poor - apparently it's usually the other way round
- I answered the question "how would I rate myself" on various qualities by thinking of what other people would say I was. That wasn't the question!
Related to this last point is that I very rarely use the word "I" when talking about my feelings. I'll say "you", a
bit like "one". So I'll say "you want to do a good job, so you feel the pressure to provide excellent outcomes", rather than "I want to do a good job, so I'll feel pressure to provide outcomes". She says this is a method we use to detach ourselves from emotions and shirk responsibility.
Another snippet of information she passed on was a write up of the Minnesota starvation study. It's so interesting! It's where they did an experiment to see the effects of starving young men, and shows the effects to their physical and mental health, both during and after the study. The link above is to the BBC write up she gave me, but there's heaps of other information on the web. Most importantly, it suggests that to really recover from any form of disordered eating, you need to be getting sufficient calories right at the start to support the mental aspect of recovery.
So I was given a number of things to work on this week:
Eating proper meals
I've been ok with this. I find it a lot easier if I'm in a routine and not working from home, but I'm making a conscious effort to keep eating all in one go at a mealtime. I've also been trying to include more carbs other than veg, as she said I wasn't eating enough of these. I've started including brown rice and went for a wholemeal pizza the other day to try and boost this.
Eat earlier in the day
Whilst my therapist was quite happy for me to exercise before eating if it upset my stomach, I'm trying to make sure I eat as early as possible. For example on Saturday I would normally have gone into town first and then eaten a very late breakfast when I got back, but this time I did the opposite. I think this stems from wanting to leave it as long as possible to eat so that it avoids late morning snacking and helps me feel fuller til later in the day.
Use "I" instead of "you
This is a tricky one as I don't even notice I'm doing it! However when I have noticed it it's been surprising how hard it is to say "I". It makes you feel so much more vulnerable!
It's been amazing how much she picked up that I was unaware of just in 50 minutes. After dealing with my disordered eating for many, many years
Have you ever kept that kind of food diary?