Sunday, June 16, 2024

Struggling with unsupportive... therapist?

So, I assume like many do on this subreddit, I use food to self-soothe. Bad day at work? Treat yourself with some junk food. Fight with a friend? Hit up the closest fast food place. Have to run an errand that I just don't want to do? Go out to eat afterward, you deserve it. The problem is, when every day becomes a "self-soothe with food day", nothing is really a "treat" anymore. You're just eating way too much calorie dense, low quality food. A few years ago, I ended up doubling my weight with the whole "self-soothe with food" method of eating.

I started therapy in December of last year. One of my goals, among others, was to try and replace my "eating to self soothe" with something less destructive to my body and mind. I wanted to be able to go out to eat with friends, or enjoy a nice meal with family during the holiday or birthdays, or whatever. But then also be able to treat food like fuel for my body instead of a mental crutch to get through the day.

I had brought this up with my therapist a few times in our first few sessions, and she seemed to brush it off. I thought, okay fine. My self-soothing behavior probably stems from something deeper anyway and if we make progress with whatever that is, then surely I will feel less compelled to self-soothe in this way. We went months without really talking about it, but I trusted we were getting to the root of some of my other problems so I didn't really push the issue. And to be honest, even though it's felt slow going, I do feel like we were making some progress.

In May, I made it into a weight loss study through Research Match, which I was extremely excited about. There's nothing fancy about the study. We meet once a week to discuss progress with other group members, you complete modules on what healthy activity looks like for different ability levels, what a well rounded diet looks like, how to read nutrition labels, etc. We were given a calorie goal based on our BMI which we're allowed to change at any time, no questions asked, and we were given a weekly "activity" goal which can be achieved doing anything we want. The activity goal is basically the same active minutes the ACA gives for good heart health. The whole program revolves around health education, being mindful of what you're putting in your body, and making an effort to move a little every day. Nothing is "off-limits" and there's no pressure to lose a certain amount of weight. They essentially just want you to track what you're doing, see how to feel at the end of each week, and then practice adjusting your diet and exercise based on your personal goals.

When I first got into this study I told my therapist about it, and to be honest, I don't even remember what her reaction was. I think by this point I was so used to her not really talking much about the food/weight thing, even though for me, it feels like such a large part of my life. I had mentioned to her previously about how I had a bad couple run ins with the healthcare system ignoring complaints I was having several years back and how I never really reached out for help again because I was being told my complaints were "probably due to stress" and "nothing to worry about." This included when I gained about 30-40 pounds in the span of a few months. To me, I felt like something was wrong, but my clinician seemed to think it was "just stress" and brushed it off. Low and behold, a year or so later, when I was about twice my body weight, I don't think it mattered whether it was "just stress" or not. There were a couple of times after this when I considered reaching out to a group like Overeaters Anonymous or similar support group but part of me felt like "I wasn't fat enough to be taken seriously" so people would judge me for even being there. I'm kicking myself because I now have health problems related to being obese so LOL. Who even has imposter syndrome about being obese? Me, apparently.

So, when I divulged to her about the weight loss study, I already felt worried about judgement or rejection. When she didn't make that much of a fuss about it.. I suppose that was a little bit of a weight off. Two or three sessions ago, I felt like we actually had a really good session because we had explored where some of my eating to self-soothe came from. I had an "oh wow, I had never connected these things" before moment. I was excited to continue down that route in later sessions. I had been getting a lot better at identifying moments where I wasn't actually hungry, but was feeling some other emotion that made me want to stuff my face. This was a huge win for me as I do not even remember the last time I was able to identify "hungry" vs "upsetty spaghetti."

Last session, she asked me about how my study was going and I explained to her a little bit about how things were structured. I thought it was going well despite the struggles and I felt like I was making progress. It was at this point where she started (what felt like) an interrogation of the study methods: how many calories did they put me on? Who was conducting the study? Were the people running the study "nutritionists?" Did they tell me how many grams of protein I should be eating? Were they incorporating any strength training in our program, because you know that's normally what's recommended? Did I know that a calorie deficit causes people to binge eat?

I tried to remain calm and answer her questions, but I basically shut down at that point. She apologized to me post-questioning, saying she felt she had been inappropriate, but I honestly felt like the damage had already been done. I expressed to her that I had already felt nervous bringing this up with her because of my past history. I told her I understood her concern, but we had discussed my issues of overeating junk food and how they had very little to do with "a restrictive diet" and way more to do with how it had been one of the few coping mechanisms I had for a large portion of my life. I told her I had been to a dietician before who had educated me on my diet and my BMR and how I always OF COURSE eat more when I have a particularly active day... about how I WAS on a calorie deficit because I was trying to lose weight, but how I also had been tracking my weight loss (about half a pound a week) and was aware that I was not "losing weight too fast." I also expressed about how I didn't feel like I had very much support because most people I interact with on a daily basis treat "diet" and "weight loss" as bad words unless you very specifically caveat every little thing you say, and now I'm having to do the same thing in therapy and it's exhausting.

So basically... I'm at a loss. I feel like what little trust we built in therapy over the past SIX-ISH MONTHS has been damaged. My fears, however irrational they were from the beginning, have now been inadvertently proven correct. And now I don't really know how to move forward with this. I did like my therapist prior to this. I still like my therapist for everything except anything having to do with my weight struggles. But man... it is something I struggle with so intensely I do not know if I can separate it from everything else. If anyone has any advice or has been through something like this before... I would super appreciate some positive posts. What an overwhelming last couple of days it has been.

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