Sharing therapists

I’ve been in all different levels of treatment with numerous professionals and various treatment centers, and overall I’d have to say that both group and individual therapy are important (and beneficial) in recovery.  With group, there are several people who you can bounce ideas off of, get advice from, relate to, and rely on for support.  I feel like most of the real therapy work happens in individual, though, where you can focus on your specific issues, goals, etc.  I really do think it helps to have both individual and group components to your treatment plan, though.

This said… something that has always thrown me off is having my individual therapist as my group therapist.  This has happened to me a couple of times, in residential, IOP, outpatient, etc.  It changes the dynamic for me for a couple of reasons:

1. Every time I said something to the group I though, “has she heard this already?  did I tell her this before?”
2. I read (too much) into the things that she said
3. If I were having a bad day, she usually noticed
4. I wondered if there would be repercussions to the things I said (for example, I didn’t want to mention something in passing and have to spend the next two individual sessions processing it).
5. I worried that I’d treat group like an individual session and spend too much of the total time focusing on my own issues

These aren’t all bad things.  It’s good that my therapist would recognize that I was having a crappy day, since I likely wouldn’t have brought it up and the therapists who didn’t know me as well probably didn’t know anything was not right.  She also probably pushed me a little harder, since we did have a relationship and she could do that comfortably.  So, for the most part, it was good for me to have some groups with my individual therapists.

With all of this said, where things start to get a little messier is when other people in the group also share the same individual therapist.  I’ve been in some programs where everyone had the same primary therapist and others where there were a handful of individual therapists that also ran groups.  Both situations add that extra variable to the equation – sharing a therapist with another person in your group.

The therapeutic relationship is so unique that sometimes I think it can be challenging to “share” your therapist with someone else that you know.  I’m not concerned about the confidentiality as much as the dynamics of the relationship.  As the patient, you only have one therapist.  When you have a good relationship, it feels special.  You feel like you have this connection that maybe other patients don’t have.  It makes sense – every week you are confiding in this person, trusting him/her to guide you and to give you some insight.  This relationship and person mean something to you.  He/she is a part of your life.

Being in a group with your therapist and another one of her patients is a reminder that you’re not the only patient.  You know this logically, but the reminder can be kinda tough.  Sometimes it’s rough to see her concerned and focusing on someone else.  It can feel invalidating.  It can feel like a competition between you and the other patient.  It can be hurtful if you feel like you’re being ignored or that your interaction with the therapist is different.  It really adds a dozen additional variables into the therapeutic relationship equation.

There are a lot of things that make eating disorder groups tough.  Girls get competitive over eating, weight, exercise, etc – even if you don’t allow talk about numbers.  You have to be careful who you put in a group together, and even having one or two pretty anti-recovery people can change the whole atmosphere.   Sharing a therapist with several of the girls almost adds another thing to compete over.  Even if you refuse to participate in the competition to get the most attention or require the most concern (really, these competitions exist!), it can be hurtful to to feel neglected or uncared about.  I don’t think this is a topic that is often addressed in groups… but I think that sharing a therapist with other girls, and all being in the same group together led by your primary therapist, can be a little tricky…

Five of the most underrated coping skills

…according to Grey Thinking, at least.  I’ve seen so many coping skills lists full of bubble baths, deep breathing, positive affirmations, etc, and really am just bored with them.  Someone needs to come up with some creative and new alternative coping mechanisms!  I might as well start.  Here’s a list of some of my favorite / most-helpful coping skills, that I’ve never seen (or very rarely seen) on any “learning to cope” list.

Five of the most underrated coping skills:

1. card stores
2. bulletin boards
3. kudos charts
4. crafting
5. dvds

I have a lot to say about each one of these, so I’m going to break them up into different posts.  However, I’d love to hear you feedback and any alternative or underrated coping skills that you might use.

The fat tax

The growing obesity epidemic is nothing new, and I’ve written about government-imposed food restrictions in elementary schools before, but I’m pretty disappointed that the government would charge non-dieting, overweight Americans: State’s Obesity Risk: Lose Weight or Lose Insurance

To summarize this article in a couple of lines:

Alabama is giving its employees roughly a year to start getting in shape or state employees will be charged $25 a month for insurance that would otherwise be free.

Some states offer benefits for healthy living, but Alabama is the first state to punish those not trying to slim down.

How many studies need to be published to show that dieting is not the answer?  And why is the government not taking medical conditions and eating disorder into consideration?  Are we giving the general population the necessary tools to improve overall health?  How exactly does Alabama suggest that these individuals go about losing the proposed weight?

We already live in a society that encourages negative body image and an unattainable physical ideal (note: I do not blame society for eating disorders.  still, it doesn’t help).  How awful is it to not only be receiving the “you are too heavy” message from the media, but from the government as well?  Maybe you are already struggling with weight, food issues, emotional eating, medical problems — who knows… and now you are going to be punished by paying an additional fee for weighing too much?  How shameful.

Shame doesn’t solve anything (and certainly won’t help the obesity epidemic).  Shame will lead to more emotional eating (you have to compensate for those awful feelings!), which will just dig people deeper into that hole.  I’m not saying I know how to fix things… but I’m pretty sure that this is not the correct direction.