Reader’s Question

I was under the care of a clinical psychologist for 13 months before we terminated in December. That therapist only did brief therapy, and we had a plan for 12 structured sessions that was eventually extended to 34. We dealt with issues ranging range from trauma and relational issues to intense mood swings with self-destructive behaviors, Schizoaffective Disorder, etc. I wish that help was forthcoming earlier on, but I live in a country where psychological help is considered taboo, and I did not get help until I came to university. I am thankful to have an excellent therapist in the midst of scarcity, and also for the privilege of having my therapy sessions sponsored by the university or I couldn’t possibly afford it.

Barely two months after completing my course of therapy, I am right back into it. Two months before we terminated the first time, I discovered that I also suffer from non-purging bulimia and was just about to start consuming laxatives. I later found out that my therapist had deduced this all the while, but she did not bring it up with me as because I didn’t seem concerned about it and it might have been too overwhelming for me to deal with an eating disorder in the midst of all the other issues. I’ve been having bulimia for the past 5 years, and as a psychology student myself, I know that it’s odd that I didn’t engage in purging behavior. Nevertheless, I have recently tried counting calories and attempted to induce vomiting.

The whole prospect of starting therapy all over again scares me. The idea of dealing with the abuse and neglect I suffered in childhood that led to all my problems terrifies me even more. I am well aware from my previous experience that true healing is going to be painful, though worthwhile. Plus, this is going to be another structured plan (as requested by my former therapist), and the idea of structure doesn’t sit too well with me. I don’t even want to think about the fact that choosing to stay on in therapy will mean that I will eventually have to do what I fear most — eat normal portions.

How can I mentally prepare myself for this new journey, and make sure that I gain the most out of it?

Our Clinical Psychologist’s Reply

From what you say, it could be argued that you are a candidate for longer-term therapy as opposed to structured short-term therapy. However, sometimes the structure and time-limited nature of therapy can be of benefit, especially if unconscious self-defeat, resistance, and stalling on taking remedial action is part of one’s personality. The most important thing to remember about therapy is that it is not the source of health but the vehicle to it. You have responsibility over your life, and even over all the mountains (past and present) you need to overcome to improve it. Sometimes knowing that you have only a set amount of time and a particular framework to operate within can be a blessing in disguise. And who you work with is often not as important as how faithfully you address and work through the issues. Healing, growing, and maturing all require change. And as hard as that might be, and as much as you might resist, you cannot expect a different outcome by doing things as you’ve always done. So, mentally prepare yourself for the change by making and keeping a commitment to do things differently.