Eating is so pleasurable, so satisfying, that when presented with the options to stop—typically a diet or meal plan—they scoff and they should.
Dieting is a temporary solution that offers little emotional or pleasurable reward or, most importantly, long term relief of the relational issues in which eating problems are rooted. While well balanced nutrition is essential, first we need to create an environment where food challenges are free from emotional triggers.
The most time consuming and challenging part of working with emotional eating is motivating the client to make the changes and get the help she is seeking. And yet, it is also the most important part.
To be effective we must engage and believe, truly believe on a deeply personal level, in the client’s ability to change even though the resistance both therapist and client experience is quite challenging.
Believing in the client’s good nature, seeing in her what she cannot, within a relationship grounded in the challenge of resistance, not in spite of it, is the best place to start.
Trusting that you are there is what makes long term recovery possible.
It is no wonder that battle and fighting metaphors are common in the area of eating disorder and emotional eating treatment. It almost makes sense to engage in an “other” focused metaphor; ‘slay the enemy,’ although we know that the battle is within one’s self. The first challenge to working with resistance is: to reframe it in love, patience and kindness.
Acknowledge the fear that fuels it and reassure her that ‘we’ will get through it together.
To fulfill the emotional need the client is seeking we need to listen, understand and give voice to the unspoken message resistance is communicating. The role of resistance, in this case, is the reality that the client does not know what she is feeling, so how could she communicate the despair of not knowing? The goal is to increase awareness in an emotionally experiential way through meaningful language.
Our task as healers is to mediate the experience in a way that translates behavior into an emotionally rich language that both makes sense and makes available the emotional awareness and labeling of feeling, so that the client can identify her emotional states and understand herself better.
Helping the client to grow her emotional vocabulary is an essential part of the process. When you are able to guide the process in this way, resistance begins to look a lot less like, ‘I don’t want do it,’ and more like, ‘I didn’t know how to describe what I felt and I was stymied in giving myself or you a response.’ Now we have something to work with!
Beginning to verbalize feelings, wading through the subtle nuances of feelings and giving voice to the client’s experience (with the therapist as guide) is hard work.
When She is Difficult to Reach
It often seems like the entrenchment is set in cement–locked tight, with no room for growth, let alone decreasing symptoms. Learning this new way of being with one’s self is learning a new language from the inside out. It takes much time and patience. What looks like resistance, may in fact be acquiring a new skill and developing a new relationship with one’s self.
Supporting the small changes and celebrating them while keeping the larger goal in focus is an important aspect of progress in treatment.
I recently had a conversation with a psychiatrist where we talked about change happening at the pace of millimeter by millimeter. It is slow and that is good. The long view of treatment and learning to not abandon oneself is worth the time and effort. From my clinician’s standpoint, it is also more satisfying when the client is making long term, transformational changes by integrating knowledge and awareness in a steadily consistent manner.
Relationship health is often measured by the autonomy to be oneself–to be separate and connected at the same time. The relationship with emotional and disordered eating is authoritarian because of the client’s deficit in her ability to access the emotional language. Rules and orders are organizing in the beginning, but in the long term become tyrannical.
When the client develops her emotional vocabulary and skills to identify her feelings, she now has a choice about what to do with them. She can use food to mediate difficult to experience feelings or she can address the feelings themselves and create a new feedback loop that does not include food.
My experience is that when given the choice, it becomes much more difficult to go back to emotional or disordered eating once a richer emotional life is beginning. The pull toward food is lessened and conversation progresses beyond symptom management to engagement with the treatment plan, essentially stepping into the fullness of life.
An ebb and flow of learning, adjustment and integration begins to be established and life becomes exciting.
Long-term change is motivated by, and graced with, patience, kindness and the awareness of what is possible, millimeter by millimeter.
Emotional eating photo available from Shutterstock