How can a therapist help with eating and body image issues?

If you’re wondering “how can a therapist help with eating and body image issues”, you’ve come to the right place.  Lucy, our resident integrative psychotherapist has answered your most common questions on this topic.

What is a therapist?

A “therapist” is usually used as a general term for someone who helps individuals who are experiencing emotional and psychological difficulties to explore their issues and make changes in order to feel better. It is also often used as a short-hand for a psychotherapist or counsellor (essentially the same thing but with a slightly different training). A psychotherapist (or counsellor) specifically recognises the lasting impact of the past and is focused on looking at what has happened to you, rather than what is “wrong” with you and how that might be impacting the present.

Some types of therapists include:

• A person-centred therapist has humanistic training and holds the view that everyone is an “expert” in their own lives and has the capacity for growth and change. The counsellor provides a safe space for this exploration by offering empathy, congruence and unconditional positive regard.
• A psychodynamic therapist focuses on how the unconscious and past experiences shape current behaviour. They might help you to talk about childhood relationships with your parents and other significant people and consider the impact of these. A psychodynamic therapist might be more directive and/or interpretive than a person-centred one.
• A cognitive-behavioural therapist usually focuses more on the present and uses specific practical techniques to identify intrusive negative thoughts and beliefs and seeks to challenge and change these into ones that are more helpful and less harmful.
• An integrative therapist is one who uses techniques and theories from different modalities to tailor an individual approach for the client.

Some therapists use creative methods (music, movement, art), some bring in ideas from philosophy or neuroscience and some use mindfulness and/or meditation. Whatever their background or training, the aim of any psychotherapist or counsellor is to build a trusting and non-judgemental relationship that helps to develop understanding, acceptance and self-compassion and improve your psychological wellbeing.

What kind of therapist can help with food and body image difficulties?

Any therapist can potentially help with food and body image difficulties but it might be helpful to look for one who specialises in disordered eating, eating disorders and/or intuitive eating. Often these issues will have started in childhood and so a person-centred, psychodynamic or integrative therapist is often the most appropriate and will help you to consider:

• What were/are your parents’/carers’/siblings’ relationships with food/body like?
• What messages were you given about food (implicitly and explicitly) growing up? – What messages were you given about your body (implicitly and explicitly) growing up?
• What societal/ cultural messages were/are there about food/bodies/movement?
• Which significant events from childhood might have impacted how you felt about food/ your body?
• How and why might food be a coping mechanism for psychological or emotional issues?

They would then help you to consider the impact of these on your current distress, in order to understand disordered thoughts and behaviours, process and challenge the shame you might feel about these and move to a place of healing through acceptance and self-compassion. This often leads to a more neutral or even positive relationship with your body and a peaceful relationship with food, allowing you to live a fuller and happier life. A cognitive-behavioural therapist focuses more on current beliefs that you have about food/body and explores what evidence there is to support these and offers alternative perspectives. This is useful too and an integrative therapist will often lean on these techniques combined with an exploration of the past. This is often the most effective approach.

Can a psychotherapist diagnose an eating disorder?

A therapist cannot diagnose a mental health issue: this is done by a psychiatrist (either after a referral from your GP or privately). You can talk to a therapist about any diagnosis and this is often helpful so that they can consider whether they feel their approach is appropriate, how best to work with you and to help you understand them better. You do not have to have a mental health diagnosis to work with a therapist.

Will a psychotherapist talk about medication?

You can talk to a therapist about medication (and a therapist might ask if you are taking any) but it is not for a therapist to tell you whether you should be on medication for your mental health. Again, this is something to discuss with your GP and/or a psychiatrist. A psychiatrist is a doctor who specialises in mental health. A therapist cannot prescribe as they are not a doctor and should not direct you in any way about medication.

Will a psychotherapist help with dietary advice?

A therapist will focus on your relationship with food rather than on what you eat. A dietitian or nutritional therapist has expert knowledge about nutrition and should be sought for advice on this. You can talk to a therapist about food but a therapist should not give you a meal plan or advise you on what to eat. It can be helpful to see both a dietitian and a psychotherapist/counsellor when healing from eating and body issues.

How long does it take to work with a therapist?

This depends on you and on the type of therapist. Cognitive-behavioural therapy is usually short-term (often six to ten weeks). Other types of therapy are usually longer-term. Issues with food and body are usually enduring, originating in childhood, and therefore an extended period of weekly sessions is often required to work through them.

So what next?

If you would like to know whether therapy could be right for you, you can get in touch via our form, and book a free discovery call with our psychotherapist Lucy ([email protected]). Here you can discuss your challenges and see whether this type of support is right for you. Support can be provided alongside support from your Dietitian, or independently.