Saturday, July 23, 2011

The Team

I have mentioned some random appointments, but I don't think I've really talked much about my treatment team on here yet. I see a therapist and a dietician every week, am pretty happy with both, I guess, though I don't really have any basis for comparison.

I had mixed feelings about my therapist, W, at first.  I had never been in therapy before this past January, so I didn't really know what to expect.  I discovered early on that the whole therapy thing made me really uncomfortable.  It is definitely NOT in my nature to vent (or talk at all) to strangers, and it sort of eluded me that the whole point of this therapy thing was to be honest and forthcoming so that she could understand my mindset and therefore actually help me.  So I spent the first several sessions being polite and shy and not exactly seeing the point of it all.

It took me a while to realize that the question "How are you?" is different coming from a therapist than it is from someone in the grocery store.  Your therapist doesn't want to hear: "Good! Great! Weather sucks, doesn't it? How are you?" Your therapist is asking how you really are. She is looking for the answer you can't give anyone else because it would be weird and awkward to say to a neighbor in passing that you actually feel shitty because you think might have measured your cereal wrong that morning.

Once I realized that therapy doesn't exactly work if you aren't honest, my sessions with W became much more productive.  I'm still not totally comfortable baring my soul in therapy, but I'm coming around.  One big issue I still have is that W usually has to bring things up before I will talk about them - meaning that if something is bothering me, I won't mention it explicitly and W has to be a detective and figure it out.  Yes, I realize this is completely inefficient and wastes time and my parents' money. I KNOW.

I am also bad about mentioning anything that was bothering me earlier in the week but no longer seems relevant.  For example, if I spent Monday-Thursday intensely hating life/my body/the world and bursting into tears every ten minutes and skipping snacks because I felt fat, I probably wouldn't mention it at my appointment the following Saturday because now it all seems stupid and I don't want W to think I'm a nutcase.  Yes, I really do worry about this.

I warmed up to my dietician, B, a lot quicker.  Personality-wise, she's a little more easy-going and friendly than W.  I also just found it much easier to talk about food and calories than about feelings. At first, I thought regular appointments with a dietician would be pointless because weight gain is, after all, not exactly rocket science.  I can add up calories like it's my job, so I didn't really get why I had to see B weekly.

Actually, B is awesome and does much much more than hand me a meal plan and send me on my way.  She definitely takes the time to talk through my thought processes about food and exercise, and sets me up with a plan that is both healthy and comfortable for me.  When I freak out about my weight, she is good at talking me down and helping me keep things in perspective a bit.  The downside to seeing B is that she weighs me, and I get extremely anxious for a few of days leading up to it.  Not going to lie, my eating the day before an appointment is always less than optimal.  Not horrendous, but definitely not what it should be.

W and B don't really communicate about me (as far as I know), but they often have overlapping ideas - eating in restaurants, eating more variety, cutting exercise, to name a few.  In general, B offers a lot of practical ideas and assignments whereas W tends to be more vague and cerebral.  I used to think B was much more helpful to me on a day-to-day basis - mostly because I HAD to eat every day but I didn't necessarily have to mull over the inner workings of my brain.  Lately, though, I am finding my sessions with W to be really useful and her advice has been sticking with me all week after I see her.  I don't know if this is a result of my brain being better-nourished and more receptive to therapy or if I am just learning how to be a better therapy patient (probably a combination of the two),

Anyway...I've been thinking about this a lot lately because when I go back to school in about a month (!!!) I will probably have phone sessions with W but not with B.  I'm not sure how I feel about this...I really like W, but she doesn't challenge me in the same concrete ways (e.g. bring a different kind of sandwich for lunch every day or try a new restaurant). And even though I hate it, getting weighed by B  and going over my food/exercise plan in person every week has been really important in terms of keeping me accountable, and I don't entirely trust myself to keep it up on my own.  I will probably still get weighed periodically somewhere, but I really like and trust B and I hate the idea of starting over with someone else.

So, therapy tomorrow. Goals are to tell W about: 1) losing weight a few weeks in a row; 2) not sleeping well; and 3) my worries about school.


  1. Does B know any dieticians in your school area who could be helpful?

  2. I think my main ED doc I guess it's a question of whether I want to start over with a new team, continue via phone with W and/or B, or do some combination of the two, which seems like it could get tricky.