LACK of Pre-op Education
I am pre-op and I have been inundated with pre-op education about what to eat, what to watch for re: post surgical complications, what to do with excess skin, but all that my surgeon or insurance company has required of me emotionally is a psych eval. My insurance company requires a 6 month supervised diet/exercise program supposedly to "increase my chances of sticking to the post-op diet." I believe it is for other reasons, but that is another story. The reason why most of us are obese is not for physiological reasons (at least not usually exclusively), but for other reasons such as eating disorders, depression, self-image issues and a variety of emotional and mental issues. We are not told to look inside or work our hearts and minds in this process and as a result those core issues are still there, but just more exposed, like an open wound after wls. Yes, it is our responsibility, but it is also the responsibility of our medical providers to guide us in areas where we have come for help. As someone who has worked on her weight and other issues with a therapist on and off for years I am fortunate to have someone to work with me through these issues. I would not begin counseling with him at this point because he doesn't have experience with these issues, but he has colleagues who will work with him behind the scenes and I am comfortable with him. I went to several therapists before finding one I liked. Most of them felt distant and soem seemed to talk down on me. Whenever recommending a therapist to anyone for any reason I have always given the following advice: 1. Interview them - ask them if they have had experience with your particular issue (in our case, obesity and post-wls issues). If no, then tell them you would be more comfortable working with someone who has experience in that area and ask for a referral. If yes, ask them how much experience they have and specifically what kind of issues have they seen after WLS. 2. Prepare for Your Consultation. Go to a 1st consulation and write out a one page story of everything in your life that has brought you to WLS or whatever issue you are seeking help with. The first appointment is usually the most difficult. In getting a new therapist up to speed you usually go through all of the bad stuff in your life and you do it in an hour. You then walk away having done nothing but putting it on the table. Most people are so depressed after a first visit that they want to dive into a giant cheesecake while doing drugs and consuming a toxic amount of alcohol before jumping off of a bridge. Many people never go back to therapy after 1 or 2 visits for that very reason. It is much easier to hand over that one page then start talking about details. 3. Assess then Move On. After the first meeting assess whether you liked the therapist, whether you felt comfortable with him/her, whether you had respect for his/her opinions and whether you liked his or her approach. It is often very difficult to tell what you think after the first visit since they are even miserable after meeting with the greatest therapist in the world. If you have a feeling that you are talked down to, that he/she just doesn't get it or it doesn't feel right for any reason then find another one. If you think you can work well with that person then promise yourself you will go to at least 4-6 sessions before reevaluating. Therapy does nothing if you don't go. It is essential that you feel comfortable with a therapist for therapy to work. Most therapists are book smart. Most therapists will have some patients who rave about him/her, but the bottom line is if you do not trust and respect him/her for any reason it will be a miserable and ineffective experience. Having said that, once you find a good therapist stick with it. You get to the point where you almost look forward to going and you feel like you have accomplished something by going. Better yet, many issues will be headed off before they can fully rear their ugly heads if you are working with a therapist BEFORE you are in crisis. It is never too late to start. For those of you who are having problems, get help now. There is no reason why you have to struggle through them yourselves. Jennifer p.s. as an aside, when looking for a therapist most of us would do best with someone who is a behaviorist. I have personal biases against analysts who walk you back through your childhood and make you relive it. I think it is harmful except in a few cases. That is just my opinion and many will disagree with that one.
Blessings, Jill
WLS 5/31/07. Maintaining a weight loss of 141 pounds and feeling amazing!