Behavioral Therapist???

I am sitting here thinking to myself that I probably will need to work with a behavioral therapist after (or before) my surgery... I'm not saying that I am crazy or anything; but, how does one reach almost 300 pounds at least three times in their life? There has to be some kind of inner voice that causes me to wreck myself, right? What is your thinking?

I know many families celebrate with food.... and people comfort with food.... and friends gather and fellowship over food... but what is it that makes some people "ok" with food and others not? I know genetics has something to do with it; however, I really want to defeat this life long battle. What do you think?!?

Personally I think 6 mos of therapy is far mor important than the silly 6 mo. diets some people have to do. The mental part is far more difficult than the physical part and very few people take care of that part of the journey. So go for it, you will be fa better off for the effort!

I agree Hislady.

I think it will be important for me to work through some stuff...

I am biased professionally, but I think that almost everyone who is MO or SMO should HAVE to participate in counseling for at least a w months starting soon before, and then continuing for several months after, surgery.

People who are simply "obese" and have WLS often gain their weight for reasons that are not psychological in nature, but almost everyone who is morbidly obese or super morbidly obese has psychological and behavioral issues that contribute to the obesity.  (The incidence of childhood sexual abuse, adult rape, or trauma of some other kind is significantly higher in women who are obese than in the general populatio .) 

Surgery doesn't magically fix those issues and -- after a respite for a few months post-op when we have no appetite, etc. -- many people find that the old "demons" start to reappear.  People who don't deal with the emotional/psychological demons, and who don't address their old maladaptive eating behaviors, are less likely to lose as much weight as they would like and/or to maintain their weight loss.

I do pre-op WLS psych evals part time and work with WLS clients, some of whom a pre-op, but most of whom are post-op and are struggling with the issues that were at the heart of their overeating.

I am certainly not saying that everyone needs counseling to be successful with their WLS, but many do.  Most people have areas of their lives that a short period of counseling can assist with, even if they are not food related.  It think it is one of those things where "if you think you might need it, you probably do" applies. Or at least that if you think it could help, it probably will...

Lora

Well, I wasn't physically abused... But always been made to feel that I wasn't as good as I could be due to my weight. I look at old photos and wonder where the horribly obese kids is that I seem to remember being. I was put on a diet waaaaaaay before I should have been. And always been made to feel as if I were imperfect or less than worthy. So, yeah... I probably need some therapy. LOL!

Yeah, a lot of WLS folks look back at photographs of themselves as kids or young adults and remember feeling horribly overweight or feeling like they were enormous because of the way they were treated and then they are surprised to see that they were not really as fat was they thought (or as others thought). 

The damage that those negative messages can do, though -- the messages that we aren't quite good enough because we aren't thin enough -- can continue to play in the back of our minds for many years and hold us back in many ways.

I think therapy is a VERY important part of this process and I encourage every one to find a therapist that they click with to, at the least, check in with from time to time throughout.  I see my therapist once a week and she helps me to look at things from a direction that I don't always manage on my own.  

Thanks Gwen... That's probably what I'll do too!!!

I have spent the last year and a half in therapy and have had lots of therapy in the past. I have had group therapy. The difference this therapy has made is that it is at a center that deals with eating disorders and the therapist is trained in Dialectical Behavioral Therapy. It builds of Cognative Behavioral Therapy. It has been great having someone trained in food issues and thats all they do. I think all my years in counseling has been part of the journey but it has truly been the last year and half that has been the most transformative. Here is a link explaining what DBT is.

http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Mental_Illness/About_Treatments_and_Supports/Dialectical_Behavior_Therapy_(DBT).htm

I completely agree that the psychological counseling and aftercare program is SO much more important than the 6 month diet requirement for insurance. They really have it ass backwards. Really. And if you are self pay, you don't have to do anything. Crazy.

So yes, go to therapy. Even if you can't find a DBT therapist go to a CBT therapist. It will be the best decision you ever made besides making the decision for surgery.