From my 10+ years’ experience of working with clients struggling with food, weight, binge eating disorder or bulimia, I have become very used to people not showing up. Not showing up for free consultations that they have booked with me to find out about the Eating Freely Program. Not showing up for appointments. Not showing up for my group. And it’s not that I am not a good therapist (!), it is because of a lack of commitment to changing – because that change means either letting go of something that is really important to them, or acknowledging something they have never really admitted to themselves, never mind to anyone else.
Take the 8 Week Group Program I used to run for example. I would always try to have 10 or even 12 people signed up for the program, so that we had at least 6 people each week, right through to the end. If 12 people have signed up, I can guarantee that two will not even make the first meeting. One or two more will almost definitely drop out in the first two weeks, and possibly another will leave half way through.
You might be thinking “well, maybe her group wasn’t very good”, but that’s not it. The format and content of all our programs is excellent – practical and non-judgemental, welcoming and gentle but also direct, and it follows a tried and tested path through four pillars of support that absolutely re-frame every aspect of a disordered or dysfunctional relationship with food, and weight, which I know work from my thousands of client hours – individually and in group – and I have the testimonials to prove it.
I remember when I was putting several groups together in 2017, and one young woman who had been struggling with binge eating disorder for over five years who was thinking about joining the group texted me to say “I’m still on the fence”, which is the most honest any client has ever been about committing to change, and another client in one of the groups who said on week 1 – “I’m here, but I’m not ready to join in yet”. This client had bulimia, which can really take hold of clients and form part of their identity – and that is difficult to let go of when you really do not know what you are going to replace it with.
In “Fat is a Family Affair” (141-42), Judi Hollis says:
However clients often, at the point of starting to work through recovery, despite white-knuckle resolve, end up holding on to the following false beliefs:
- I want to believe that it’s just a weight problem.
- I refuse to pay attention to my eating for the rest of my life.
- I promise, when I get thin, I’ll never gain it back”.
A few good days just before going to the first counselling or group session can suddenly cancel out years of struggling for clients. “Oh look, I haven’t binged once in the past five days, Obviously I can handle this myself, I’m going to cancel my appointment and just keep this up”.
I would ask how many periods of 5 days, or a week, or two weeks have you had within the five, or ten, or fifteen years of battling against binge-eating, emotional eating, swinging between dieting and overeating or bulimia?
Fear is also a huge part of committing to change. Who will I be without this? I have no idea who I am without this identity, even if I’m the only one who actually knows about it.
Clients come to therapy for all sorts of reasons, and they come because they have decided that enough is enough, they can no longer tolerate living the way they have been, and something needs to change. So they are rejecting their old ways of being in the world. Clients with either Binge Eating Disorder or Bulimia have anther threat to cope with too – how will I cope with tough stuff if I can’t binge any more? What will replace food as my comfort blanket? Clients very rarely have a clear vision of the alternative, and that makes it very difficult to commit to the process of change, because there is no clear vision of Who I Will Be after it.
I tell clients who have no vision of the alternative and are very fearful of the unknown version of them without their eating distress, that there is a choice, to stay where they are, which is not a good experience, but it is safe, a comfort zone. At the risk of offending some readers, there is a saying here in Ireland – “shite is warm”! Sometimes it feels ‘safer’ to stay in the shite! But you can also risk moving through a different type of uncomfortable experience, that is the journey through therapy and nutritional rehabilitation, in the solid promise that life is better on the other side. More control, more understanding of who you are and what you need, better communication with others, and the volume turned way way down, if not off, on the internal negative, critical voice that all my clients carry around with them.
Can you commit to change? Can you commit to looking at your discomfort with the underlying emotions, or the past events that triggered ‘self-soothing’ through eating, or how good or bad at Assertiveness, Boundaries or Communication you are (the ABC of relationships!). Can you put your hand on your heart and say “I know this is not about my weight, that is not the real problem, so a diet will never be the true solution”. Can you do that? And if you could, what difference would it make to you? Your family? Your friends? Your own day to day life?
You can choose to stay in the uncomfortable, safe place – but remember – shite is warm….