Hi Jen,

I'm in a bit of an ED pickle myself right now, having regressed in certain behaviours that have been non-issues for a little while.

I understand where you are coming from - not wanting your T to lose patience with you. I worried about the same thing. My T is actually not an ED specialist, so T sent me to a Registered Dietitian who IS an ED specialist. Things went really well for a while, until my RD went on leave for four months, and then I REALLY worried about becoming too much for T!

Needless to say, the more I held in, the less I shared with T, the worse my behaviors got, and the more challenging they were to manage and hide. I encourage you to to tell your T your struggles He will likely not lose patience with you, and unless you are completely honest with him, he won't be able to help you either. It's excruciatingly hard to share ED struggles, or at least it was for me, so I had to resort to writing on more than one occasion, and handing my T a letter to read. It was the only way I could communicate at all about my ED, and still is one of my fallbacks for when I get tongue tied.

One more thing - from experience, I can say that I'm pretty sure it's not you being stubborn about all this - it's your ED. My experience with this aspect of the ED - the part where I didn't want to share certain info for fear of being too difficult - is that it's my ED getting scared so to speak. I make progress, I grow, I no longer need to rely on ED behaviors, so of course my ED voice gets louder, kinda like a cat hanging on to the edge of the furniture for dear life and leaving claw marks as it slides down. That's what ED does - it convinces you that things are fine, or that you're doing well enough, or that talking about ED stuff would be a bother. But it's a lie. The only way out of an ED is through, and the only way to journey through is to talk about it.

It's not easy, but it's doable, and you're worth it!

I'm struggling right now with ED behaviors myself. Honestly, they've not been this severe since high school. (1980s)

My T doesn't know anything about my ED behavior at all. It wasn't an issue when I started with him in November. I'd had it under control for years... I'm struggling with how to bring the issue up, especially since it's increased so dramatically since March. I'm so afraid he'll be angry and say "why did you wait so long to tell me?"

I like your idea of writing a letter, R2G. Maybe I could do that. Of course then I'd need to get up the nerve to give it to him.

(((Jen12))) I can totally understand where you're coming from. I want my T's approval so much and would want to die if he thought less of me. And I think what R2G is saying is spot-on, it's not necessarily your stubbornness, but more the ED itself that is rearing its head and trying to establish control over you. IMHO the harder you struggle to contain it, the louder it's voice is.

Good luck and hugs to all fighting the ED battle.

Just adding my voice to say, "Yes, me, too." I had an ED in High School, in and out ever since. But since starting therapy, it's worse. I think it's calmed a bit in the last month, but I don't discuss with anyone. Not T, not spouse. I know (at least I think I know) that it's a control mechanism, in use more now because all of my stuff is being brought up in therapy.

I'm wishing everyone love and luck.

Yes, my experience is and has been very similar to yours everyone. I had a problem in high school, but it wasn't recognized as a problem at all.

So I talked to my therapist again yesterday. I told him that I was afraid that if I remained stubborn or stuck in this then he would get frustrated and want to drop me. He said, "You're afraid I might fire you?" And I agreed.

What I was NOT expecting was what he said next. He said, "Yes, I might fire you. But it wouldn't be because I lost patience with you. It would unethical to lose patience with you and act on it." He went on to say that if he fired me because we were stuck it would be because it was what was best for me at that time. He told me that this ED is like a relationship and that if I wasn't willing to work on it then he would want to take a break and then be available when I DID want to work on it.

The thing is (among other things) is that this has only recently become an issue and a focus, if not THE focus, of our sessions. Several months ago when I was self-harming (for the first time since high school -- long story) the self-harm wasn't much of an issue. Now the same motivators help me to restrict my intake. And now that's a problem. I've been checked out by a doctor and all my levels and EKG and everything are fine. I'm not underweight -- in fact, I'm still a bit overweight. But now this has become THE focus of therapy (and I brought it up and wanted to focus on it some -- I take responsibility for that), but it's such a big deal to him that he would actually fire me if I was stuck in it.

I don't get it. If I were in physical danger I guess I would understand better. But it's the same mental gymnastics I've done all my life -- just this time the "topic" is eating and weight loss.

I don't know. I'm still processing. Thank you for listening and letting me ramble. I'm all ears if you guys have anything to add that can help me make sense of this process.

I like how your T handled the concept of "firing" you. My T said something similar - if my ED takes over, and I need alternative support that T can't provide, yes, we would stop working together for a time. When things were better situated, then we would start working together again. When T explained it that way, it made me feel a lot better, knowing I couldn't lose T because of ED.

The important thing to remember is that you can be deathly ill with an ED, but everything shows up fine on the standard tests - EKG, weight, basic CBC panel. It's the tests that doctors that aren't specially trained to work with EDs that are important. For example, my dietitian is an ED specialist, so she tells my doctor exactly what tests to run when I see her for my monthly check-up. My weight returned to "normal" within six months of beginning treatment, however, it does fluctuate, sometimes dropping to the low end of "normal" which was always my argument that I'm "healthy and fine" but that is far from the truth. It's the mental gymnastics, as you put it, the mental battle, that keeps me in EDs grips. It is a DAILY struggle still. Yes, I'm making progress and my body is getting physically healthier, but the mental piece is the big thing that must be diligently addressed.

And yes, for a while (like months upon months) it was the sole focus of therapy. Sometimes I brought it up, sometimes T did, and the quick "hows the ed going" would take up the whole appointment. Thankfully, I have an awesome treatment team (therapist, dietitian specializing in EDs, psychiatrist, primary care doctor) that communicates frequently, which is the best way to deal with EDs. If you don't have a dietitian, I strongly encourage you to find one who specializes in EDs. It sounds as if your T is not an ED specialist, so that's why its even more important to find a dietitian that is. My T is not an ED specialist either, which is why I was sent to this particular dietitian.

Something I learned recently - until the mental piece is cleared up, it is a matter of replacing unhealthy ED behaviors with other - including self harming. I know that I'm not supposed to restrict anymore. I've also agreed not to partake in a few of my previous self-harming choices. Instead, those behaviors were replaced with others. So now my team is working on helping me find safe and healthy alternative activities to engage in instead. It's a long, spiral road we're on, but recovery is quite worth it!

Good luck, and keep in touch if you'd like to "talk!"

R2G, thank you so much for your response. I honestly didn't know that there are things that could be wrong and that doctors will often not know what to look for. I AM meeting with an ED dietitian next week and I've already signed the agreement for my T and her to exchange information and treatment plans.

I think the crux of the issue with T is that I need to ask him, yes or no, if therapy is a safe place to talk about the ED stuff. He wasn't saying that he would "fire" me for a time while I went elsewhere to get help -- I specifically asked him that. I said, "I don't want this to be one of those situations where the therapist tells the client that he thinks someone else would be a better fit," and he said, "I don't think that's going to happen." So it's not that he feels I might be better served by different therapy. He was acknowledging that if we got stuck in therapy then he could foresee taking a break until I was ready to "give up (your) relationship with your eating issues."