unsplash-logoFlemming Fuchs

non diet

5 Reasons Why We Need More Group Therapy

When I decided that I was going to try to set up a therapy group on my own and run it from my home, I received a few raised eyebrows from my colleagues. There appears to be a general consensus among therapists that groups are difficult to recruit for and take a lot of energy to manage.

During my training I did a placement at a private eating disorder clinic and I needed to get some group experience. The clinic approved my idea for an 8 week overeating support group and, despite high visibility and paid for marketing platforms, there was very little interest. The group ended up with three participants but I absolutely loved that little group. The way they supported and challenged one another felt like a privilege to be a part of. I came away each week feeling energised by the work and really looked forward to the next one. This was my first taste of running a group and I loved it!

Today I run therapy groups for binge eating from my home. I did my own marketing and this time the interest was there. I had always suspected there was a demand for it and through trying various different means, I managed to spread the word and the people came.

group therapy binge eating

Group therapy is something else. I would go as far as saying that I think group therapy is often more effective than one to one, at least when it comes to a shared problem, such as compulsive eating.

The power of groups cannot be overestimated in my opinion and here are some of the reasons why I believe we need more therapists willing to set up groups.

1.     “Money doesn’t bring happiness but it does bring options.” Anthony Bright

Let’s get really practical for a moment. Group therapy is so much more affordable than one-to-one therapy. Group therapy can be an opportunity for someone to access therapy who might ordinarily be unable to due to limited means. With many therapeutic services having their funding cut, group therapy is a way of getting more help to more people.

2.     “Shame dies when stories are told in safe places.” - Anonymous

In every session, at some point, someone will share a story or difficulty they are having and be met with a “me too” response. It’s so common to feel guilty and ashamed about the things we are struggling with. There is often a compassion for others that isn’t always extended to ourselves, so when we hear someone talking about their experience and it’s a similar thing we see in ourselves, it can be like looking into a mirror but the self-judgment subsides. This starts to change the way we feel about our problems, which makes it easier to make changes. No-one changes from a place of shame.

3.     “The transference phenomenon is an inevitable feature.” – Carl Jung

Groups offer so many opportunities to work through old relational hurts. What are the members projecting onto each other? With individual work, there is only the therapist as a transferential object. This could mean that a male therapist might never evoke transferential feelings about mother so that stuff doesn’t get worked through. We are born into family groups, so our sense of our place in the group is a powerful way to gain self-awareness and challenge self-beliefs or even identity.

4.     “Knowledge is of no value unless you put it into practice.” – Anton Chekhov

The group provides an opportunity to practice something new. If the struggle is conflict avoidance, the group can provide the opportunity to practice managing conflict in a contained environment. If the client finds it hard to ask for what she needs, she could start by asking for something from the group.

5.     “There is an indefinable mysterious power that pervades everything.” – Gandhi

There’s just something else that happens in a group, something I struggle to find the words for. When people gather with a shared intention, things shift and morph and create something new. Each group has it’s own identity and shared personality. Is it love? We don’t talk about love much in therapy but I have seen moments of deep connection in groups. People care for one another and sometimes that means challenging someone and dealing with difficult feelings that arise towards each other. I welcome the difficult situations because they are the biggest opportunity for growth.

 Fear and uncertainty often prevent clients from considering group therapy as an option. If group therapy becomes more popular, the idea will seem less daunting and people might be more willing to give it a go.

 This includes therapists too. Yes, I appreciate it’s not for everyone but I know a few counsellors who like the idea but don’t know where to start. Next week I’ll be posting my “Top Tips For Getting a Therapy Group Up and Running.” If it’s something you’ve thought about doing, hopefully it will give you a some ideas about how to make your group a reality.

Podcast Interview

I had a lot of fun recording a podcast episode for Better Mental Health this week. In the episode I talk about body image - the trouble with comparing yourself to others and the influence of social media.

You can find the episode at https://podcasts.apple.com/gb/podcast/better-mental-health

I also share a bit about my own story with binge eating, which isn’t something I have done a lot of online. I do think we connect through sharing our stories. I see this a lot in the binge eating therapy groups I run. When we know we aren’t the only one facing this challenge, we feel less alone. When we feel compassion for someone else’s story that’s similar to our own, we can find a bit of compassion for ourselves.

Struggling with compulsive eating and bingeing is nothing to be ashamed of. It’s confusing and scary and it can be hard to find your way out on your own. There are many places to get support, professional or otherwise, you don’t have to face this alone.

Episode 11 - Sarah Dosanjh on Body Image

Episode 11 - Sarah Dosanjh on Body Image

Why dieting isn’t the answer to overeating

I am pretty vocal about being anti-diet. Diets do not work for the majority of people. Our behaviour is driven by how we are thinking and feeling. Going on a diet usually involves trying to create a behaviour change without making any other changes. Diets will insist that you just have to be disciplined enough and if you don’t manage to stick to the diet, you must be lacking in willpower.

As Kelly McGonigal writes in her book Willpower! You only need willpower if there is a conflict of will. Diets create a conflict and no-one can thrive while living in a conflicted state. There are three things that could happen when you go on a diet.

i can't stop eating binge eating weight loss

You might lose weight and be a “success” story.

Firstly, you might lose weight and keep it off. This is very much the exception not the rule but it does happen in a tiny percentage of cases. When it does happen, these people have created a shift in identity. They develop a new attitude to how they eat and move their bodies and that attitude is integrated into their personality. Usually these are people who didn’t have a great deal of emotion around their eating or body image to begin with. They are not people who have tried dozens of diets and have had the experience of feeling like a failure around food. Because the emotions are not particularly heightened, they are not working with the same resistance that so many of us are. Not fair? Perhaps, but we can’t change our emotional history with food. We need to accept where we’re starting from.

The rebound effect of diets.

Secondly, you may stick to the diet for hours, days, weeks or months - maybe you even hit you goal weight but at some point most people will throw off the shackles and resume eating, usually more than before and usually with a sense of feeling out of control until you find yourself back at your starting weight or higher. How distressed you are by this experience will predict how disordered you could start to become around food the next time you try and exert control over your eating.

Dieting triggers eating disorders.

And lastly, you restrict and maintain your restriction through tolerating the conflict of wanting to eat but not allowing yourself to. This one can be dangerous because it’s the feeding ground of eating disorders. In anorexia tight restriction is maintained but at enormous cost. Obsession, fear, anxiety, isolation and deteriorating health all follow this type of restriction and once you’re gripped by it, it’s incredibly difficult to fully recover. Perhaps you manage to restrict but with periods of bingeing, well this is a slippery slope into binge eating disorder and once you start making “amends” for bingeing (purging, exercise, laxatives, fasting) you slide into bulimia territory.

How do I stop overeating?

You may be thinking this all sounds a bit hopeless. What are you supposed to do if dieting isn’t the answer? I think we need think about what we can learn about the first group. They changed their identity around how they were with food. Their conflict and emotionality around food isn’t as high. In order to change how we eat, we first need to reduce our own conflict and emotionality around food. I know you want to jump straight into making the changes. Of course you do, this has become so incredibly important to you but the challenge may be to make it LESS important. This is why ditching the diet mentality is crucial. It’s not just about not dieting but about shifting the mentality. This is the mentality that you carry around day-to-day and it influences every single food choice you make and turning food decisions into a minefield.

This is how so many people get stuck, the desperation to lose weight through controlling what you eat is what will keep you feeling out of control. Like a spiders web, the more you struggle, the more stuck you become. We need to end the war to find peace and then rebuild from the debris. This means surrender, not destroying ourselves through trying to win against our appetite for it is a fierce and non-compromising opponent.

 

A Rant About Calories

When oh when will we stop with the demonisation of calories? Products on the shelves loudly and proudly proclaim - “Only X number of calories per portion!”, “Low in calories!” or my biggest pet peeve – “Guilt free!” (implication – low in calories).

Since where are we supposed to feel guilty about needing to eat food and for that food to contain calories?! Gah! Calories are energy and energy is necessary for, well, just about everything!

People fear consuming too many calories and in today’s environment of easy-access, high energy food I recognise that this might be a legitimate fear for some but worrying about getting your calorific levels ‘right’ may simply create a lot of internal chatter that makes it difficult to really know what your body wants at this moment in time.

You have probably been there - standing in Pret or Tesco, comparing sandwiches and pre-packed salads and trying to find the fewest calories to trick your body into thinking this is enough for your lunch. Your body is smarter than you are when it comes to calorie usage.

Also, we don’t absorb all the calories we eat, did you know that? Yep, some of those calories pass right through you and there is no way of knowing how many you absorb. Did you know that if two people consume a 100kcal banana, one could absorb 95 calories and the other 85 calories? FROM EATING THE SAME THING!

You don’t know with your thinking mind how many calories you need and the body’s caloric requirements change from day to day based on numerous factors from activity levels to the weather to how many calories you consumed the previous day.

So please, let’s start appreciating those humble calories, the building blocks of our body, the unsung heroes of our life.