Julie Blackman, LCSW

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There are other consequences of eating disorders that also need to be considered. It is essential that current relationships are mended and new, supportive relationships are forged.  Due to potential medical complications, the physical aspects of the eating disorder also require management.  Treatment recommendations may include:  individual, family or couples therapy as well as consultations with a physician, registered dietitian and psychiatrist.

Eating disorders, contrary to common belief, are more about managing stress, feelings and self-esteem than about food or weight.  It becomes “simpler” to shift focus from one’s feelings by re-directing that energy externally, towards the pursuit of managing food intake and body weight.   The eating disorder provides a false sense of control.   When internal experiences clash with outside expectations, one way to avoid the confusion and conflict is to utilize an eating disorder.

For example, imagine that you have been told all of your life that you are” too sensitive” and should be able to “shrug it off”.  The expectation, in those relationships, is that you always look “stable” and not make waves.  It implies that expressing emotion is somehow a bad thing, instead of a positive aspect of your personality and an effective way to communicate.   To disappoint those around you feels impossible.  Then the eating disorder enters your life and all of your focus goes to maintaining it.   The eating disorder provides the appearance of calm, which is really numbness as a result of physical exhaustion due to bingeing, purging or restricting.  These eating disorder behaviors cause you to become more isolated, irritable and anxious.   It does not resolve the issues, but actually exacerbates them.   The eating disorder produces more complications because the emotional, relational and physical consequences of an eating disorder are so dire.  The therapeutic relationship is an opportunity to identify the internal struggles underlying the eating disorder, and explore how these struggles impact relationships and livelihood, and to then help discover new, positive ways of coping with support.

Depression and Anxiety

Mood and anxiety disorders can be debilitating.  They drain motivation and energy while at the same time increasing fears about all aspects of your life.  Though experiencing depression is very different than battling anxiety, often the treatment approach is similar.  It is about identifying and understanding the triggers for the symptoms and learning new ways to manage those triggers when they surface.

Depression causes one to feel depleted of energy, motivation and self-assurance.  It affects sleep patterns and appetite; basic functions we need to survive.  If there seems to be a genetic or biological component to the depression, a consultation with a psychiatrist may be recommended.  To address the emotional component, it is important to discover the negative messages that you send to yourself because it colors your view of yourself, your relationships and the world.  Once you have a better understanding of what triggers your depression and causes it to snowball, you can work on new ways to manage those triggers and new positive experiences on which to build.  Because isolation is often an integral part of depression, the connection and support of the therapeutic experience can also help lift you out of the sadness.

The symptoms of anxiety can manifest in many ways including obsessive thoughts, compulsive actions, and an inability to concentrate and focus on daily responsibilities.  It interferes with relationships to the extent that the anxiety becomes all-consuming, preventing you from evaluating interactions objectively.  Oftentimes everything feels personal.  We would work together to understand the root of the fears and at the same time explore new ways to manage the anxiety such as behavior replacement and cognitive behavioral therapy.

Relationship Concerns and Divorce

When you are struggling in a relationship, it usually means that you have lost track of who you are and what you want from the relationship.  Your goals with your partner are no longer the same.  There are obstacles to being able to communicate your needs and negotiate them.  Together we would try to understand the evolution of the relationship as well as how you may have lost sight of what is important to you.

The process of contemplating and adapting to divorce puts you in crisis mode.  You feel like you are on an emotional roller coaster because you are grieving the loss of the relationship and at the same time trying to manage your present life while contemplating a future one.  Fears emerge about ability to handle what is at hand.  Support becomes paramount during these times.  The therapeutic relationship is a vehicle to working through the grief and confusion.  It helps you to organize your feelings and thoughts in a supportive environment because loneliness is inevitable, but it does not have to be all-encompassing.  This transitional time is an opportunity to re-discover what is important to you and what makes you special.  Most importantly, you do not have to go through it alone.

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