Question for vets more than 2 years out who are in counseling

Is there something specific related to maintaining your weight loss or new lifestyle that you have tried to discuss with your therapist that (s)he doesn't seem to "get" that you wish someone who understood WLS could explain to him/her...?

Lora

Hi Lora....

Its funny, I have not come back to the site in .... too long, I know.  However, I was sitting here wondering if I needed to find a therapist to help me navigate these waters.  I am failing.  I know it.  I feel it.  I have made a bad choice to put back on 10 pounds and as we all know... 10 goes to 20... to 30... and before know it....  we are right back at square one wondering WTH? 

Do you have some idea of a "interview" that I can ask potential therapists to get me to understand WHY I would choose to get back where I absoultely hated being and paid a high price emotionally and physically to overcome?  Did you find help in therapy?

Although my question originated from wondering if I have missed something (in my haste to complete the task at hand) that I really need to include in a proposal for a presentation to our all-state counselor conference in November (I am a licensed professional counselor), I *do* see a counselor myself (for PTSD) and have found that she has also been very helpful with assisting me in my efforts to understand some of my old emotional eating demons and to develop and maintain healthier eating habits and coping skills than I had pre-op.

I would start by looking for someone with training/experience in either eating disorders or addictions counseling (but, personally, would suggest avoiding someone who does PRIMARILY addictions counseling and little else).   You could ask about their general theoretical orientation (you probably want someone who at least mentions some type of "behavioral" therapy), but probably a more useful question would be to give them that one sentence synopsis and ask what type of GENERAL approach they would take to working with somneone like that.  Ask how they would approach 1) helping you answer the question (understand what is going on emotionally/psychologically) and 2) helping you change the direction you fear you are headed (make cognitive (thinking) and behavioral changes) before you gain any significant additional weight.  TAKE NOTES.  that way you can go back and review and think about the responses that you got from various people.  (I usually suggest talking to at least 2 people on the phone even if you think you "clicked" with the first one.)  If they answer the question in a way that makes sense to YOU and seems relevant to what you already know about yourself, the kinds of things you do and do not respond to, and what you already know deep down about some of the reasons you gained the weight originally (and where you might be going wrong), they are a potenital candidate.

Good for you for taking action NOW before things get out of hand.  I know sometimes it is hard to reach out for help (I speak from personal experience!), but I truly believe the quote in my signature...!

Lora

Hi Lora,

I guess the only thing that I would say is that my psychologist AND my psychiatrist both seem to push psych meds without regard to the weight gain possible with some of them. They think I'll feel better on different meds, and maybe I will. But if the side effect is weight gain, I know right now I'll lose my mind. The thought of regaining all of the weight isn't worth it.

I wish I could get BOTH of them to understand that and back off on pushing new meds. Not everything can be "fixed" pharmaceutically (sp?) anyway, can it? Gaining weight would probably set off a huge diversive psychotic episode and I don't want go that again.

Am I making any sense? PM me if you have any more questions or lmk if my post needs clarification. I know what I want to say but can't put it into the right words sometimes! =)

Yeah, I understand what you mean. IMO, meds cannot FIX anything... they can just make it easier to cope while you are WORKING ON fixing things!  I can definitely understand why taking a med that may cause weight gain would make things worse!

I had a psychiatrist prescribe Remeron for me (after I was assaulted, and neither Paxil nor Zoloft had helped at all).  When my PCP found out  -- after I had been on it a week (and was feeling like a zombie after the first dose, and literally stumbled around for an hour after waking up every morning) -- he had an absolute fit because it is notorious for significant weight gain (and I was already probably 275)!  WHY anyone would prescribe a drug like that for someone who is already SMO is beyond me, especially when there were still 4 or 5 other things we could have tried. 

Thanks for the feedback.

Lora

 Though not a vet, gonna add my  2 cents....

I would add to those seeking treatment, someone who has training in health psychology and ED/addictions may be a good fit, as it's important to know both the physiology & psychology of WLS. I've taken courses in obesity, ED, extra training in women's health..... The person I saw for my psych eval was an RN and PhD, so knew a thing or two.....

For something specific to therapists "getting" WLS, I don't know if it's entirely necessary for either extensive training or experiential knowledge for a therapist to really see where a client's needs are (though I feel it certainly helps!), I'd guess that if a client is interviewing the therapist for the first time, understanding that therapist's experience/knowledge set of change in general terms will be important. Struggle is a universal concept - I've not come across any therapist who didn't have at least personal experience with change and overcoming something powerful. Maybe it's comparing apples to oranges, but he/she should at least be able to empathize on that front....

 I'm not a vet, but I am curious reading this thread.  I am currently in counseling (PTSD etc) and adore my counselor.  I trust him and am not willing to start over somewhere else . He does his CE courses at the hospital where I am going to have the surgery and he has already requested information specific to WLS, but sometimes I wonder if this will put a wedge between our counseling "relationship" because it isnt' something he does regularly.

I cannot imagine it would "put a wedge" in the relationship.  If he does any counseling of cleints with weight issues, he at elast has a basic understanding of psychological and behavioral issues that contribute to obesity.... he -- like many/most therapists -- just (probably) does not have any training in the special psychological issues that can be associated with WLS clients (which is why I did a presentation on that topic 2 years ago at our state counseling conference and am hoping to do a follow-up presentation at this year's conference).

Lora

THanks for your reply.  I guess "wedge" was the wrong word, because I don't think there is really a risk of him "giving up on me"  (used to be a big fear ;) ).  I guess it is my perfectionism kicking in and I know already that there be some times that it is really frustrating for me to try to explain what I feel (since I don't "do" feeling words  :D  )

I'm not a vet either, but I had a bad day and ran to a baskin robbins for a fix. I was post op, so the fix I grabbed was sherbert (no fat, I dump on fat, but not sugar) and a kid's scoop, of which I could only finish half... But, my therapist said, "At least you didn't run to alcohol or something damaging like that..."

I really think there are some people out there that just don't understand that for me, as a formerly MO person, food is just like "alcohol or something damaging like that." I have considered switching just because she doesn't make the connection that me choosing to eat to make me feel emotionally better at the end of a very bad day is a very destructive move for me...

Huggles!!
~Sarah~