I guess at this point I should come up with a pseudonymous letter for my new therapist, although sometimes I fear this blog is becoming alphabet soup. Let's call her M.
First of all, M. is a Clinical Social Worker and not a psychologist. I'm not sure why, there are two psychologists in the practice (which is not entirely devoted to EDs, does many women's issues, but EDs do seem to be its bread and butter. Yes, inappropriate metaphor, forgive me). I don't want to be a therapy snob, but I do kind of wish I was seeing a "real" psychologist instead. But I have nothing upon which to base this discrimination, so I'm just going to go with it. The main thing is that she specifically specializes in EDs.
In a nutshell, she's no H. She is younger (H. was 55, M. is 37), but not young enough to make me feel weird. But I thought she seemed too...flippant? I'm not sure how to discribe it. I felt like she acted too young and "hip" in some ways. Maybe she was just trying very hard to be casual to ease anxiety on the first visit.
Two things that irked me:
1) She asked what I am studying for my thesis, and didn't let me get past the first sentence before she just threw her hands up and cut me off with "Oh, I don't understand anything about science! [giggle giggle] I'm a humanities girl." And then carried on to something else. Damn, lady, way to be a good listener. Maybe I am overly sensitive because basically the two main things I have to define myself at the moment are my ED and my research (which I consider to be pretty enthralling, honestly, but if I didn't than I wouldn't be doing it), and I was more than a little annoyed when she just dismissed that.
2) When I told her I wasn't religious, but mentioned that I was raised Catholic, she immediately seemed to assume that Catholicism had traumatized the spirit right out of me, and didn't try to hide the fact that she finds Catholicism to be weird and sort of cruel. That irked me as well. No, I'm not Catholic anymore, but I do still retain respect for some aspects of the Church, and am still irked by anti-Catholic remarks from other Christians that don't understand it. My story of spirituality is an issue for another day, but suffice it to say that I don't like it when people make snap judgments and erroneous assumptions about what goes on in my head regarding faith.
3) She weighs me. H. never weighed me. She trusted me to be honest if she asked what my weight was, and I never lied to her. My eating will be distorted for two days leading up to an appointment if I know I'm going to be weighed. And I'm not at a critical weight right now, so I don't think it should be that important. I told her that, and she just said she won't weigh me every time. But if there is a possibility of it every week, it's just the same as if it were every week.
4) On the issue of weight, she emphasized that the numbers don't matter, she's not setting goals my numbers (then why must she put me on the scale???). She insisted that she wants to help me find balance, and said that "even if you only weighed XX" (XX = a weight that is very, very unhealthy for me, it's what I weighed when I first started seeing H), if you have a fulfilled, balanced life then that's ok. I was floored by this and didn't know how to respond. Even through my ED-tinted glasses I can see that being balanced and being XX are mutually exclusive. Maybe she forgot how tall I was and threw out an inappropriately low number for that reason, I don't know. This bothered me, because I sho as hell do not need any more reasons to balk at gaining/maintaining, I do enough of that second-guessing on my own.
Ok, those are my gripes. I am 100% aware that I may have over-reacted to some things, I was more than a little anxious that day. Remember, I have only met the woman once, and she did have many positive qualities. She was very upfront and didn't sugar-coat anything, which I appreciate. She was on top of medical issues, and made sure to ask about my heart, bones, etc. She was friendly, and did seem to have that demeanor in which she is caring but will give you a kick in the rear when necessary. I didn't hate her, besides the enumerated annoyances. I scheduled appointments for the month of September, and after that I'll re-evaluate and see if I think it looks like this will go anywhere. We didn't even get through all of the case history stuff last week, so it will be a session or two before I get a feel for how much she will push me on hard issues (and no, being pushed is not necessarily bad, I know I need it) and whether having a fresh therapeutic perspective will be a boost in overcoming some areas where I am currently stuck.
Ok, back to work. Being a grad student is rather all-consuming. But you know what? I love what I do. And realizing that my ED is sucking hours of worktime and concentration away from me every day may be something that helps me to get my feet out of the mud on changing some behaviors.
7 comments:
Hmmm, I'm not sure what I think of M so far! First of all, I wouldn't worry so much about the fact that she's not a psychologist. One of the best people I ever saw was a "counselor." She had no degree...in anything. Come to think of it, I don't know how she ran a business, but anyway... What's really important is your connection to M. It bothers me that she was dismissive of your thesis (I would call it dismissive), but then I wonder if she may have been nervous or something. She shouldn't be since she's a professional, but maybe. I do think it's inappropriate that she made assumptions about your religious background. I thought therapists were supposed to maintain some objectivity...no? As for weighing, I had one therapist who weighed me. I was very close to her and, honestly, I think the weighing is what drove us apart. She got too wrapped up in my weight issues and we couldn't focus on the stuff in my head. Weight IS important in recovery, but I think it's best for a nutritionist to do it (or, if you can handle it yourself, you can be trusted to report honestly). Her comment about it being ok if you weigh very little, but have a full life is bullshit to me. I've had a "full life" and been very sick before. In fact,the fullness of my life is what kept me in denial. So, that's horse poop. Maybe I'm getting too worked up. I tend to do this when I feel protective of people I care about. What I would do is talk to her about all of your feelings. What do you have to lose? If it's not a match, you can find someone else who is. It's like dating, I swear. I've gone through lots of therapists. I'm glad you're giving her a chance for this next month. It may have just been an odd, off session. On a happy note, I'm so glad you're so fulfilled with school. That's great!
Grrrr at M.
Same as Kim, I wouldn't worry about the fact she's not a psychologist, I am a social worker and have been in the same roles as psychs doing the same jobs, everyone has strengths and weaknesses really. At the moment my T is a social worker also and she kept me after 7 people last year (all who were psychologists) wouldn't!!! Soo... really its more about the skill and the person then the title.
Mind you in saying all that, I wouldn't blame you for not being sure right now! Goodness golly. I don't know how you didn't snap at her! I might've! Weighing can work in the right context but well, that would have to be an upfront component of treatment and whether you used that tx would depend on the client! I'm with you, I have to now be weighed by my D and I am NOT happy about it! Previously, I just TOLD what my weight was and like you, I was very honest and like you, if I know I'm gonna be weighed the restricting appears to be the name of the game just prior to appts!
She just... umm... humm... I don't want to tear her to shreds mostly out of respect for the fact that you're planning to go back and I wasn't there... but I tell you what there is a considerable portion of my being right now that wants to wrap you up and whizz you away from that place!!!
I'm with Kim, if you can talk to her about how you found the first session (i'd make a list cause it really sounds like she could make a person feel off centre) and see what happens. Also, if it doesn't work or she just dismisses you, unless you honestly there there is something she can offer you, I wouldn't continue to go to appts because she really could end up doing more damage then good IF things don't improve!
Shutting up now! :)
*hugs*
xoxo
whoa! I think what she said in regards to weigh was REALLy inappropriate! Oops i have to go i will comment more later..
I'm not too sure that M meant to be flippant about your thesis. Maybe she was just nervous and trying to get formalities out of the way. The weighing thing is a different story. M could be doing this just to have an accurate number, but she should also have a little faith in you. And I really don't like what she said about it being okay to weigh XX if you have a balanced life. It's complete nonsense. Don't let her words or her weighing cause you to restrict. In my opinion, M is not the therapist for you. I would consider looking for someone else right away.
Glad you went, but some of M.'s remarks do raise eyebrows. I would truly address your feelings at the next session. I think that's actually the best way to get an idea of how she will be. Will she be open to how you felt? Will she dismiss them as just over-sensitiveness, especially since it was the first session. After all, what you want is to be able to have an open, honest line of communication.
My general rule is three sessions, then I decide whether or not to stick with that therapist. Most therapists will tell you from the get go if you feel like you do not/are not clicking with them, that their feelings are not going to be hurt to move on. I'd say if they did after just a few sessions, then there are real problems there.
Hopefully, your next appt. will get better. Either that, or it will cement the fact that she will not be helpful for you.
Did she explain WHY she feels the need to weigh you at appointments? That may make things easier to swallow...or chew...okay, I'm cracking myself up here. But yes. I would feel concerned for the same reasons you mentioned. Like Tiptoe said, give her a few sessions and don't let her drive you to be any worse--remember that YOU are in control of your behaviors.
My most recent therapist said stupid things like this too--telling me that she thought girls "like me" who had "roundness in their face and body" were prettier than stick thin girls. She then expected me to agree with this statement. She also talked too much about her own issues. She was helpful in helping me realize that I was struggling because I was lonely and because of a marital issue and she helped me work through the latter, but suffice to say I'm not seeing her anymore because I didn't find that she had a clear direction for where she was taking me in therapy and I didn't want to be subjected to any more weeks of comments about my roundness and average weight. It's just triggering and unnecessary.
I think everybody already covered the credentials thing. I've seen PhD psychologists, psychologists with BAs who were ED IP unit case managers/therapists, social workers of various distinctions, an advanced psychiatric nurse practitioner, and a psychiatrist who also did therapy. As a grad student, maybe you like the validation of credentials more? But, really, the letters after the name made no difference in my therapy ... the best connection & most effective therapy happened with someone whose specialty was learning disabilities (which I definitely don't have). Some supposedly lofty folks have been jackasses and no help whatsoever.
I think it's wise to give yourself a few sessions. First, you'll have more time to adjust to your new setting, new people, a new practice and a new way of doing things (lots of therapists weight patients ... mine never did, b/c she didn't want me to associate avoidance w/coming to see her, so that work happened with the dietitian). Second, you'll have time to allow yourself to leave H behind ... M. can't and won't be H., but she can be something different for you that H. maybe wasn't, despite M's current seeming drawbacks. Third, I don't think Wilmington has a lot of options for specialized ED care ... there didn't used to be any clinicians doing that work (even as recently as around 2004 ... I have a friend there). So, some support would be better than no support. Lastly, I think if you get your initial concerns out of the way/aired, you can move on and start creating the relationship that will help carry you through this age/phase of your life ... which is very different from an incoming college freshman. As long as you keep the communication going, I think you'll find a way to make it work out fine ... take good care of yourself!
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