Even if you don’t say those words out loud, I can see them in your eyes.  That is one of the biggest fears, if not THE biggest fear of those who come to see me for help with an eating disorder.  I recognize that look because I saw it in the mirror right before I went to every counseling session.  That thought went through my head when I went to see my dietician.  I just knew there was a conspiracy to make me fat.  That’s all anyone wanted, I was sure of it. 

            Never mind the fact that you are probably losing hair, you get winded walking up the stairs, your skin is dry and flakey, your brain feels like it’s in a fog most of the time, you get chest pains sometimes, and you can’t eat even when you want to.  Never mind that you are miserable both physically and emotionally.  The worst thing you can imagine is going to counseling or treatment and becoming fat.  It sounds crazy to people on the outside, but I get it.  Even if the rest of the world falls apart, at least you are thin.  Even if I couldn’t do whatever it was I thought was important at the time, it didn’t matter because at least I could be thin. 

So what is the answer?

            The answer to the question is NO, I am not going to make you fat.  I have no interest in making you fat.  Truthfully, I prefer to leave your weight up to your doctor and your dietician.  I don’t want to fight that battle with you.  Except for the fact that I want you to be healthy enough to do all the things you want to do and more, your weight is really none of my business.  I am far more concerned about your emotional well-being than I am your weight.  I know that sounds hard to believe because everyone makes such a big deal about your weight, right?  After all, if people weren’t on your back about your weight, you probably wouldn’t even be thinking about going to counseling, right?

            I don’t fully believe that.  If being thin felt that great, if it fixed all your problems, then you would not be reading this.  My guess is your world has become so small that all you think about is food and weight, and that it is hard to imagine a life without those thoughts consuming you.  I bet there are times when you cry because you want to eat dinner with friends but you have to turn them down because you just can’t do it.  I bet there are times when your joints ache when you get out of bed and you feel like you are 90 years old.  I bet you feel like shit much of the time, but you have convinced yourself that’s normal, that everyone feels that way.

            Living with an eating disorder is miserable.  And to be quite honest, recovery feels miserable in the beginning as well.  Anyone who tells you otherwise has not been there.  Even though I have no interest in making you fat, and your weight is not my business, helping you deal with the discomfort of getting healthy is my business.  It will take time before getting healthy feels good.  But you CAN handle it.  It will be uncomfortable, and sometimes painful.  But you CAN handle it.  Living with an eating disorder is difficult – you handled that.  I know you have it in you to handle recovery.  You might as well give it a shot – you can always return to your eating disorder if this recovery thing doesn’t work out. 

If I’m not gwoman with shirt flying in wind in fieldoing to make you fat, then what does happen in counseling?

            Great question.  Every therapist is different, so I can’t speak for how other people do it.  And every client is different so I can’t even say for sure what counseling will be like for you.  What I do know is that at some point the eating disorder behaviors served a purpose; they made sense.  I am in no rush to get rid of those behaviors until we figure out how they served you.  I really want to understand what your life is like, what you feel, what you think, what is it like to be in your shoes.  From there, we can decide together the best plan. I won’t take control away from you.  You get to be part of the process.  In fact, I expect that you are the expert in your life, not me, so it would be silly for me to tell you how to live your life.

            There will be times when you hate me – that seems to be part of the process for most everyone I have worked with.  That’s ok.  I hated my therapist too.  And I kept going back.  And I got better.  And, guess what, she didn’t make me fat!  I understand the terror you feel when you talk about food, or try and do something different with your food.  Sometimes it actually feels like you will die if you have to eat one more bite.  I don’t mean that symbolically, I mean it literally feels like you will die.  I know how intense those feelings are and I will walk through all of them with you.  I am not afraid to go anywhere we need to go.  I won’t give up on you no matter what.

            I think the best way to describe what therapy will be like is to say that it will be completely unique to you.  It will be a creative, collaborative process between the two of us.  Even if something has worked for hundreds of other people, if it doesn’t work for you we will throw it out and try something else.  It will be hard, it will be uncomfortable, it will be inspiring, it will be funny and tearful, and it will be worth it.  It’s ok to be afraid and come anyway.  As much as you don’t want to hear it, this can kill you, and I refuse to let that happen if I can help it.