Ask a Therapist: I'm scared to see a therapist for my eating disorder

Q: I started out with anorexia but now am bulimic/anorexic and have been this way for about 3 yrs now. I am on a binge/purge cycle and have purged everyday at least since November. One person knows about my ED and I am so scared to get help even though I know that I need it. I am fully aware of the dangers of bulimia. I am being treated for one of the symptoms of bulimia, which is passing out because of malnutrition. However, the doctors did not figure out that it is due to an ED. I'm 18 so I can get help without my family knowing which is a big deal for me because I can not let them know. They have a lot to deal with right now plus my mother does not really understand how to deal with things. Shes Bipolar and every once in a while has a Schizophrenic episode. I am scared of my father and stay away from him so I can't tell him either, my whole family dynamic is screwy. However, I am considering getting help for my ED. What should I expect if I do decide to go to a therapist? What kind of questions will they ask me. Thanks for your help.

A: First of all, I'm so glad that you are considering eating disorder treatment because the fact that you are passing out means that you are not only suffering from psychological problems but that you are in physical danger too. Please disclose your eating disorder to your physician so he or she can be a resource for you and can help you find a psychotherapist or eating disorder treatment center.While every therapist is different, I can give you a general idea of what to expect on your initial evaluation session. The initial session is an assessment where you'll sit down in the therapist's office and talk about what brings you to therapy; you'll get a feel for the therapist's style. This session will include filling out some paperwork - a mental health and family relationship history, rating scales or a brief checklist to establish a baseline to track your progress, and a release of information so your therapist can communicate and coordinate care with your physician and request your medical records, if needed. After gathering this information, the therapist will give you a diagnosis and make treatment recommendations. The recommendations may include outpatient psychotherapy, intensive outpatient psychotherapy, or inpatient treatment.As you seek a therapist, make sure you find one who specializes in treating eating disorders. A great resource to find a therapist is available PsychCentral.com's Find Help link. Another excellent resource is EDReferral.com and they have several eating disorder therapists listed in your state. It can be helpful to meet with a few different therapists so you can find one you feel most comfortable talking with and you feel most confidence in. Just like any other relationship, you'll click with some therapists over others. Consider your physical symptoms as warning signs telling you that you need to address this problem now. Please, don't wait to get help.Take good care of yourself!Julie Hanks, LCSW*This article originally appear in PsychCentral's Ask the Therapist column

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