Therapist AMA
Hello! My name is Hannah Caradonna. I'm a therapist on 7 Cups. I'm happy to answer any questions about eating disorders, body image, self esteem or anything else related to the topic. :)
Edited in Thread Guidelines 10.16.23 by KristenHR
This thread's guidelines for participation per @DanielleGonzalesPsyD
- Members agree to support one another by speaking from experience vs advice giving
- Members agree not to discuss weight (vitals, BMI, ideal body weight, weight gain, weight loss, anything related to a metric and measures body composition, size, etc)
- Members agree not to discuss meal plan metrics (Kcals, plate exchanges, safe foods, fear foods, food aversions, etc)
- Members agree not to discuss specific medical procedures related to Eating or Body Image (discussion of tubes, invasive nutrient interventions, etc)
- Members agree not to discuss exercise habits in detail, this may be a behavior others are actively working on reducing or not engaging with. You may refer to any joyful movement you are doing that you find helpful with your recovery
- Members agree not to discuss specific related ED behaviors/urges but are welcome to share emotions that surround those urges/bx. For example instead of saying "I had a difficult night and engaged in [insert ED behavior]". We ask that members just simply say "behavior" and leave it general
- Lastly, even if the intention around body image/composition compliments come from "good place" we ask that members not make comments about each other's bodies and find values, characteristics, qualities to compliment on another on!
@HannahCaradonnnaMSW
1. Often in recovery, people have loved ones who want to help but aren't sure how and those struggling with the ED can't always articulate what they might need - what would you tell them to tell their supporters?
2. Going to therapy the first time can be really daunting to think about. What can someone expect from a first appointment?
3. One common struggle for people with EDs who aren't underweight is being believed - by friends, by family, and even by medical professionals. How can someone struggling help the people in their life to understand the seriousness of the disorder?
@Anomalia
Hi Anomalia. Thank you for the interesting questions.
1. First of all, asking for help can be the hardest part of the whole process and I think it is important to acknowledge that it isnt easy to get to that point. You could pick a person in your life that is easiest to approach – it could be a friend or a family member or a teacher – and start with that person. Or, find a therapist. There are no simple answers of what to say to your supporters but something like I dont know what I need right now but I appreciate having you in my life is totally good enough. You are already dealing with the eating disorder itself, you dont need to worry about what to tell your supporters.
2. Good question! I cant speak for all therapists but I can tell you that in my first appointments, I ask questions about the problems bringing them in for therapy and gather some information about their life history. And we start to come up with a goal for working together. And in terms of process, I try to create a warm and secure environment so that it feels safe to share.
I highly recommend the podcast The Mental Illness Happy Hour. The host has a website with lots of useful information and surveys about all sorts of things including Your First Day in Therapy. You can read literally thousands of peoples responses. Just go to https://mentalpod.com/surveys and look for First Day in Therapy. You can take the survey or just browse the results.
3. As the person struggling with an ED, Im not sure it is your job to help other people understand. It is more important that you yourself understand the seriousness of the disorder and find different people that can offer you support. For example, you can get support through the 7 Cups ED Subcommunity and you can find in-person support groups in your hometown. If you have a medical professional not take you seriously, you may need to find a different medical professional. You can also get in touch with a therapist who is more likely to be understanding and then they can help advocate for you in the medical system.
@HannahCaradonnnaMSW - Great answers - thank you! And thanks for the podcast recommendation - I bet that's a helpful one for a lot of people :)
@Anomalia
No problem. :)
@HannahCaradonnnaMSW ...
Hi, I'd like to say thank you, Hannah, for doing this. I don't really have a question right now - my brain is in a totally other space. But I wanted to write something so I'd be 'subscribed' to your thread. ~ Platy
@cyanPlatypus6370
Great! Let me know if you want to chime in.
Hi there! Thank you for taking the time to answer these.
I have a question for you too, one that comes from a lot of members I've spoken with among other things.
I think oftentimes anotexia is portrayed as looking a certain way, usually, a very thin woman. What are your thoughts about it looking different ways and how society react to it, how professional react to it etc, and how it doesn't seem to be taken as seriously? If someone is not deathly ill, does that make their eating disorder less valid or less of an issue? Is there a certain point that makes it "bad enough?" For example in one of my favorite slam poems by Blythe Baird she says, "If you develop and eating disorder when you are already thin you go to the hospital. If you develop an eating disorder when you are not thin, you are a success story."
I hope that makes sense!
Again thank you so much
@SmileYoureWorthIt
Hi! Thank you for the question. Yes, I totally understand what you are talking about. And I think part of what you are addressing is how our culture values women looking a particular way. We love the weight loss shows like "The Biggest Loser" with contestants competing to lose the most weight.
But the weight itself is not really the root of the problem for anorexia. The problem is the never-ending belief that life will be better with a little more weight loss and the intense fear of gaining any weight. It is the twisting together of internal insecurities with external *perceived* looks.
It frustrates me to hear that people are having the experience of a health care professional not taking someone seriously who comes in with an ED. And it can be quite serious regardless of how thin they are because anorexia involves starving yourself and anyone no matter the shape or size will have serious negative health effects - both physical effects and mental health effects.
@HannahCaradonnnaMSW
Thank you so very much for your reply! I think you are certainly right... we objectify bodies and glorify and sensationalize weight loss. It seems you cannot go ten minutes without hearing about the latest and greatest way to lose weight fast or the new diet pill.
I think you're right, the root isn't the weight.. it is the things behind it, and until we get past the underlying issues we can never truly overcome.
I admire you and as a hopeful future clinical social worker, look to people like you as an inspiration and guidance.
Love and light to you- thank you <3
I really don't know what to ask. I guess, How do you get over the fear to be able to talk about having and ED when all the people around think I am fine. I lost some weight but it's fine.
hiya Hannah! I was wondering if you could give any insight on what to do if you have an eating disorder but you aren't technically underweight? How can you make people take you seriously and make them realize you have a problem? Often times I get congratulated on my weight loss by my friends and family, they don't see it as a bad thing and I don't really know how to make them realize that it's not healthy and I often times just accept the compliment instead of addressing the issue I guess. Should I not accept their compliments and confront them about what's really going on with me? Sorry if this is confusing haha I'm a bit all over the place today
@Mooninthesky @IamOHhh
I think you guys both had similar questions so I thought we could talk about them at the same time. The root of the question you are both asking is about asking for help and feeling like the people close to you don't realize you have a problem. In terms of getting over the fear of telling others, I don't think you need to tell all the people in your life what is going on with you. Similar to any health issue you have going on, you may choose whomever you want to share about it. My suggestion is to pick just a few people at the most who you feel are approachable and let them know you are struggling. Depending on the person, you may just ignore a "wow, you look great with that weight loss" type comment.
Some people just won't understand what you are going through. And nor do they have to. We can't all relate to each other all of the time even when it is someone we care deeply about. And, similar to being in recovery from an addiction, if you have people in your life that don't understand what you are struggling with, you may have to surround yourself by a community that will support you better instead. Find places online (like 7 Cups) or in person (therapist, support group for recovery) and let those voices be the influencal and more powerful voices that impact you.
@HannahCaradonnnaMSW Thank you for your reply.
I've noticed around the community that eating disorders see to be more diagnosed with folks with things like borderline personality disorder(or really any personality disorder) and trauma come up a lot too. Is there any specific reason why there is a correlation between the two?
@TheAsh
I'm no expert like she is, but I did want to throw my two cents in!
Oftentimes an eating disorder is a negative way of coping with something else, an underlying issue. For example, it gives us a sense of control when everything seems out of control. I say sense, because the reality is our ED is in control and just tricks us. It can be similar to self harm in this way, and it's also part of the reason an ED is difficult to treat. Until we address the underlying issues, it doesn't go away. That's where people so often are misinformed. For many with an ED (I would hazard to say most,) it isn't about the weight. <3 I may be off base, but I hope that makes sense
@SmileYoureWorthIt
Yes, absolutely. EDs are about the underlying issue rather than weight itself. Or the relationship to food rather than the food itself.
@TheAsh
Good question and good observation! Yes, there is correlation. One of the main aspects of Borderline PD is an inability to regulate feelings and self-soothe and so there is a tendency to for those with BPD to rely on self-harming behaviours for regulation (I consider eating disorders to be a type of self-harm along with some addiction behaviors). But, that isn't to say that everyone who has BPD has an eating disorder nor that everyone with an eating disorder has BPD but there is some overlap for sure. And people with BPD often do have a trauma history.
How do I know if I actually have an ED or it's all just in my head?
@braveWriter9149 ... Like the one above says, I'm not an expert either but ....
EDs are in your head. Not like "oh it's all in your head" or "snap out of it" (said with sarcasm) but meaning that EDs are a mental illness and while weight, numbers, calories, etc can become involved - that is really not the deeper issue.
Okay, now deferring to Hannah (steps down) ... I hope maybe that helped, Writer. Have a good Saturday! ~ Platy
@cyanPlatypus6370
I like your answer. Agreed.
@HannahCaradonnnaMSW ......... Awwwwwh :) ((Platy feels good)) Thanks, Hannah! ~ Platy
@braveWriter9149
You can look at the diagnostic criteria for an eating disorder and see if you fit the criteria. But it sounds to me like you are wondering if the thoughts you are having are problematic. I don't know quite what you are struggling with in your head but if you find that you are feeling bothered by your thoughts, it's worth it to talk to a therapist. I am biased about this though ;)
@HannahCaradonnnaMSW
Hello Hannah, I'm Alijah and I'm 17. I think I have a binge eating disorder but I will get diagnosed soon. If I may I want to list my symptoms to see if this is for sure
-Weight gain
-Lack of movement and exercise
-Lack of water and dehydration
-Headaches and constant body pain
-Big portions of meals and overeating (even when feeling full)
-Guilt and feeling depressed after eating
-Thoughts and urges to purge
-Lack of self esteem and fear of being shamed
thats all I can think of at the moment, please tell me what you think as soon as possible
thank you 😊
@EbonyandAli
ps. I also forgot to add multiple trips to bathroom proballu due to lack of water. This has been bothering me the most, ty
@EbonyandAli
I'm really sorry to hear about your struggles with food. I can't really offer a diagnosis in this forum but what I can say is that I really support your idea to go get some help. It sounds like it would be a good idea to work on your relationship to food. Let me know how it goes :)
@HannahCaradonnnaMSW
hi, I don't know if you're still answering questions but thought it was worth a shot.
I was just wondering if there was a way to tell if you're relapsing/ a way to catch a relapse. I've been in recovery for a few months now and due to physical complications I can't continue to eat the way I'd been managing to. As my thoughts hadn't returned as bad as they were I'd still class myself as in recovery. But I am starting to get comments off friends who think my disorder is back and I am unsure how to tell if it is returning and if I need to inform my doctors
@Deeniesway
Thanks for the question and I am happy to keep answering questions in this thread :)
It's pretty common for the thinking and behaviours to return when you go through new stressors in life. I've had clients come in for counselling a decade after they recovered from an eating disorder becuase they have started noticing similar thoughts or behaviors. So, I would say that if you find yourself nearing that territory again then you absolutely want to contact your doctor again - not because you are in terrible shape right now - but because you want to pull yourself back before you get any deeper into it. If you have a therapist you can work on what has been coming up for you that is feeling somewhat triggering of the behaviors and thoughts again.
@HannahCaradonnnaMSW Thanks for the response! I have a therapist but it's not for my ED and they're away this month which is why I thought I'd ask here so I knew whether to tell them when they returned. I don't actually have the thoughts as much just the behaviours but I know I am already trying to hide them. But I think that's more because I'm scared I'll have to stop therapy. Thanks though. I shall try to bring it up in September
@Deeniesway
Your therapist can still help you with this even if the therapy isn't specifically for the ED. Our struggles are all connected.
I just saw that you continued answering this thread so I thought I could ask my question here too!
So my question was, why do I keep looking for triggering stuff, why am I looking more or less consciously for this kind of material? For instance, I watched To The Bone movie (and I didn't like the story, even not taking the ED stuff into account), which was triggering and I wasn't in the best place at the time, but I felt like I had to, I felt attracted to it...
Oh, and I have another question! Nothing related to the first one, but what should I do to help myself if I feel like there's an event that could put me in a bad or weird place, which event I think might potentially be a trigger? I don't have regular sessions with my therapist by the way, I'm just at the start of this process and there are a few weeks left before next appointment.
@brightLight35
Thanks for asking these questionisms <3
I did the same with to the bone
@brightLight35
Yes, it looks like we are reviving the AMA, lol.
Why do you keep looking for triggering stuff? Good question. If I was your therapist I would be using that question as the starting point for a full therapy session. In other words, there is no one answer. What I would say about it is that often times the disordered eating becomes a distraction from the central issue as well as a coping strategy.
If you haven't started therapy yet, it is fine to try to avoid situations that are triggering. I like to have clients try to confront those situations and work on being aware of feelings that come up as they participate in the triggering situation. And then gradually you learn to recognize the trigger as it is happening and experience the feelings in real time and come up with a soothing strategy that isn't ED related and that matches the triggering situation. But I wouldn't try that without working with a therapist. :)