Making the decision to meet with a therapist to discuss concerns related to disordered eating can be full of mixed emotions. On the one hand, it’s a monumental step towards positive change that can be literally life-saving… but on the other hand, that change comes with a perceived loss of control and uncertainty that can be especially anxiety inducing. Acknowledging the need for help or change can feel very different than actually being ready to take that first step, which is why it’s helpful to have an idea of what that first appointment might look and feel like so you can mentally prepare to move forward on the road to recovery.
Here at Emily Lombardo Counseling, I understand ambivalence and anxiety about therapy firsthand. In my personal history with an eating disorder, it took years to fully admit, even to myself, that my disorder was serious, deserved professional help, and that it was even possible for my life to improve in recovery without the eating disorder. Eating disorders are tricky because they masquerade as a life raft in an out of control, thin-obsessed society, even as they actively keep you stuck, make you sick, and drag you down.
If you are reading this and even considering therapy for the first time, I want you to know that I see the courage, determination, and belief in yourself that is required to set in motion the steps towards recovery. Due to my own firsthand experience, I understand the importance of starting with:
a strong, positive therapeutic relationship,
understanding your unique triggers and experiences, and
identifying a positive vision for your recovered future.
Therapy begins not with immediate loss of control or judgement, but rather with relationship-building, developing trust, and a shared vision worth pursuing that forms the foundation on which all work together will be built.
In our first appointment together, you will be welcomed into a calming, comfortable space that sends the message that you are there to be understood rather than judged, and accepted for your current readiness for change. The first session is all about getting to know each other, sharing information about practice policies, and making sure that we “pass the vibe check” in terms of a good personality fit. Personality fit is essential for therapy outcomes- I can be the smartest, coolest therapist in all of St. Louis, but if we don’t click, we won’t be able to do our best work because the relationship piece is such an important component of successful therapeutic work. Once we determine the vibes are right and start establishing trust and genuine positive regard, the therapy space starts to feel inviting and warm, rather than intimidating and prescriptive.
In addition to establishing a relationship, that initial appointment is an opportunity to start exploring your unique experiences, beliefs, and behaviors connecting to food and eating, and how those might have changed or evolved over time. I will likely ask questions to better understand, but never to judge, the role that food plays in how you think about yourself and your sense of safety and security in the world. Food is an integral part of our daily lives and is connected to so much more than what we see on the plate, so taking time to really understand your perspective and what influences your beliefs and attitudes around food and eating is essential to help inform the direction our work will take together. I will also ask questions about attitudes connected to body image, family systems, life goals, hobbies, other close relationships, and many other areas that shape who you are as a complete human who is more than an eating disorder diagnosis.
Lastly, I like to include a conversation about a positive vision of a recovered future in our first appointment together. Identifying ways that your life could improve in recovery shifts your focus from what you are fighting against to what you are building toward. This vision helps you separate from your disorder, reminding you of who you are and who you can be without the thoughts and behaviors that keep your world small. The process of pursuing genuine, lasting change can be uncomfortable and uncertain- a vision for a more fulfilling future reminds us WHY we are choosing to embrace short term discomfort for that long term freedom.
Eating disorders are great at convincing you that the help you need in therapy will be too frightening, too disruptive, and that you won’t be able to handle it in an effort to preserve the status quo. Booking your first therapy session is a gentle invitation to challenge the illusion that you need your eating disorder to feel genuine self assurance, confidence, and freedom. Starting therapy may require confronting some ambivalence or even anxiety, but when therapy begins with genuine relationship building, understanding rather than judgement, and a strong, positive vision for the future, it can fill those first steps towards recovery with more confidence and hope.