The Role of Therapy in Healing from Eating Disorders: What to Expect from Your First Session

Seeking therapy for an eating disorder is a powerful step toward healing, but it can also feel intimidating, especially if it’s your first time in a therapist’s office. Therapy for eating disorders provides a safe space where individuals can explore their struggles with food, body image, and underlying emotional issues that contribute to their condition. In this article, we’ll walk through the basics of eating disorder therapy and what to expect from your first session.

Understanding the Need for Therapy in Eating Disorder Recovery

Eating disorders, including anorexia, bulimia, and binge eating disorder, are complex mental health conditions that impact both the mind and body. These disorders often stem from deep-rooted issues like low self-esteem, trauma, anxiety, or depression. Therapy is essential in treating eating disorders because it addresses these core issues while helping to build a healthier relationship with food and self-image.

Different types of therapy are used to treat eating disorders, such as Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and family-based therapy. These approaches vary in structure and techniques, but they share a common goal: to help individuals gain control over their thoughts and behaviors surrounding food and body image.

Preparing for Your First Therapy Session

Walking into your first therapy session can feel overwhelming, especially if you’re unsure about what to expect. Knowing a bit about the process beforehand can help ease any anxiety you might have.

Here’s how to prepare for your first session:

• Bring any necessary documents or referrals: If you’ve been referred by a doctor, bringing relevant medical history or notes can help your therapist better understand your needs.

• Think about your goals: While your goals may evolve over time, coming into therapy with a few initial goals can give both you and your therapist a sense of direction.

• Try to relax and keep an open mind: Therapy is a place of non-judgment, and your therapist’s role is to help, not to criticize or evaluate.

Your therapist will guide the session, so there’s no need to have everything figured out. Simply showing up and being open to the process is an important first step.

What Happens During the First Therapy Session?

The first session in eating disorder therapy often serves as an introduction for both the therapist and the client. This session is sometimes called an intake or assessment session, where the therapist gathers information to get a sense of your unique situation. Here’s what you can generally expect:

1. Getting to Know Each Other

• The therapist will ask questions to learn more about you, your background, and your history with food and body image.

• You may be asked about previous treatments, if any, and how your eating disorder symptoms affect your daily life.

• This is also an opportunity for you to ask the therapist about their experience, approach, and expectations. It’s important to feel comfortable and confident with your therapist, as building a trusting relationship is key to effective therapy.

Discussing Symptoms and Challenges

• Your therapist will ask questions to understand the specific symptoms you experience, such as restricting food, bingeing, purging, or over-exercising.

• Be prepared to discuss any challenges you face, such as body image concerns, mood swings, or obsessive thoughts about food. It’s normal to feel uncomfortable or hesitant, but remember that sharing openly helps your therapist develop a treatment plan tailored to your needs.

Exploring Triggers and Underlying Emotions

• The therapist may ask about any situations, feelings, or past experiences that trigger your eating disorder behaviors. This could include stress, trauma, relationship issues, or societal pressures.

• Exploring these triggers can be uncomfortable, but understanding the underlying causes of your eating disorder is crucial in building a foundation for recovery.

Setting Initial Goals for Therapy

• You and your therapist will work together to set initial goals, which might include developing healthier coping strategies, improving self-esteem, or reducing disordered behaviors.

• Your goals may change over time, and that’s okay. The aim is to have a starting point that you can build upon throughout your therapy journey.

Types of Therapy for Eating Disorders

Several types of therapy are commonly used in treating eating disorders, each offering different tools and approaches. Here are some of the most common ones you may encounter:

1. Cognitive Behavioral Therapy (CBT)

• CBT is one of the most widely used treatments for eating disorders. It focuses on identifying and changing negative thought patterns that lead to unhealthy behaviors.

• Through CBT, you’ll learn to recognize harmful beliefs about food, body image, and self-worth, replacing them with more positive, realistic ones.

Dialectical Behavior Therapy (DBT)

• Originally developed for borderline personality disorder, DBT has also proven effective for eating disorders, particularly for those struggling with emotional regulation.

• DBT teaches skills in four main areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These skills can help manage urges to engage in disordered eating behaviors.

Family-Based Therapy (FBT)

• FBT is often used for adolescents with eating disorders, involving the family in the recovery process.

• Family members learn how to support the person in recovery, creating a healthier home environment and improving communication.

Interpersonal Therapy (IPT)

• IPT focuses on improving interpersonal relationships, which can impact self-esteem and coping mechanisms.

• By working through relationship issues, IPT aims to reduce eating disorder symptoms linked to feelings of isolation, rejection, or unresolved emotional needs.

How Therapy Supports Recovery

Therapy is a process that takes time and commitment, but it provides invaluable support throughout recovery. Here’s how therapy aids the healing journey:

1. Building Healthy Coping Mechanisms

• Therapy teaches practical skills to replace disordered behaviors with healthier coping strategies, such as journaling, deep breathing, or grounding exercises.

Reframing Negative Thoughts

• With the guidance of a therapist, you’ll learn to challenge and reframe negative beliefs about yourself and your body. This helps reduce the mental hold of the eating disorder over time.

Improving Emotional Awareness and Regulation

• Therapy provides tools to recognize and manage emotions without resorting to disordered behaviors. Understanding emotional triggers and how to handle them is crucial in recovery.

Developing a Positive Self-Image

• Many people with eating disorders struggle with low self-esteem. Therapy fosters self-acceptance and self-compassion, allowing you to view yourself more positively.

Addressing Concerns and Fears About Therapy

It’s normal to have fears or reservations about starting therapy. Here are a few common concerns and how to handle them:

1. Fear of Judgment

• Therapists are trained professionals who are there to support, not judge. They create a non-judgmental space where you can be open about your experiences.

Worry About Reliving Painful Memories

• Sharing difficult memories can be part of the healing process, but you control how much you share. Therapists will never push you to reveal more than you’re ready for.

Uncertainty About Change

• Change can be scary, but therapy progresses at your pace. Your therapist will guide you gently, celebrating small victories and respecting your comfort level.

Moving Forward with Hope

Starting therapy is a courageous decision, and every session brings you one step closer to recovery. Therapy provides tools to navigate the complex emotions and challenges associated with eating disorders, offering hope and support through the healing journey.

Recovery is not a straight path, and there may be ups and downs. Remember, each step—no matter how small—is a step toward a healthier relationship with yourself. With the help of a skilled therapist, you can replace disordered behaviors with positive coping skills and find strength, resilience, and renewed self-worth along the way.