Today’s blog is about change.
Whilst reading “Fat is a Family Affair” (Judi Hollis) yesterday, I was struck by my experience of setting up my latest therapy group for eating distress (which started last night), and Judi’s concept of change in relation to Food Obsession (her conceptualisation of eating distress).
From experience in setting up my group, I know I need to recruit a minimum of 10-12 people in order to have a group of 5-6 left by the end of the eight weeks. I see all potential members for a pre-group meeting, ensure they are medically safe enough to do the group (in the case of anorexia particularly), give members a chance to ask all their questions and allay their anxiety, and take a deposit to confirm their place.
If 10 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 isn’t very good”, but that’s not it. The format and content of my group IS good, and it follows a tried and tested path through three main areas of eating distress which I have learned through hundreds of client hours works for clients – individually and in the group – works for clients, and they appreciate it and find it helpful.
This whole dynamic around the formation and maintenance of the group was clarified for me yesterday, when one client, 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 the group last night who said “I’m here, but I’m not ready to join in yet”.
In “Fat is a Family Affair” (141-42), Judi Hollis says:
“The old line goes, “there’s good news, and there’s bad news”. So first the bad news. Every food-obsessed person (sic) must face the fact that they are suffering from a lifelong illness, an illness that requires extreme measures to overcome. Now, the good news. Just because it is difficult does’t make it impossible. As soon as you accept that recovery is difficult – once you understand the disease and the necessity for dramatic change – recovery is no longer so difficult”…
However clients often, at the point of starting to work through recovery:
“despite..white-knuckle resolve, end (sic) up holding on to the following false beliefs:
1. I want to believe that it’s just a weight problem.
2. I refuse to pay attention to my eating for the rest of my life.
3. 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 bulimia or binge-eating?
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. But what will replace that? 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. That’s not very motivating, is 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’s safe. Or risk moving through another type of uncomfortable experience, that is the journey through therapy, 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? Lasting, Life Changing Change? Or are you still struggling with the acceptance of the reality, and the seriousness of the situation you are in? To bring about lasting, effective change, we must first accept the severity of the problem, and commit to working hard in order to overcome it. Are you ready to do that yet?