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When Psychotherapy Does Not Help

Question:

Hi Dr. Allan Schwartz, I’ve been diagnosed with Anorexia about 5 years ago. After that I followed all instructions given by my therapist, including taking Fluoxitine. For nearly 2 years nothing had improved and I stopped because I had to relocate. My situation hasn’t been too good. I’m very sick of myself not being able to quit all this ritual eating and thinking. I can’t concentrate on my work, I can’t read and I can’t even stay focused when I go to the movies. My head just keeps working on food and calories all the time. Now I weigh about 75 pounds I am 5 feet 2 but rather healthy. I tried to find self-help guides and have been reading on some materials except that I can’t bring myself to do it. I really feel helpless and hopeless and just want my old me back but I don’t know how…

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Answer:

It is crucially important that you fully understand that at 5’2" tall and a weight of 75 pounds You Are Not Healthy. In fact, you are dangerously underweight. I am willing to make an educated guess that you no longer have a menstrual cycle and that you are at risk of dying of starvation. I am sorry because I take no satisfaction is saying this but, at this point, I believe that you should be in the hospital where you can be helped to reach a safer weight. You should call your family, inform them and go to the hospital. You cannot concentrate and feel this way because your body is telling you that you are depressed and that you are starving.

Denial is a powerful part of Anorexia. That is why you state that you are 75 pounds but healthy. It is always amazing but I have worked with women who look skeletal (as I am sure you do) and who look in the mirror and see themselves as fat. You Must understand that you are now in an Emergency Situation. Please, go and get help immediately. You can go to the Emergency Room of your local Hospital and let them know that you have Anorexia and are scared. They will help you. But, just to repeat, call your family and have them come and help you with this. Also, have a friend help you with going to the ER.

You are correct when you say that your therapy did not work. The reason it did not work is that you were in individual psychotherapy. While there is nothing wrong with individual psychotherapy with other kinds of emotional problems, it is inadequate with Anorexia. Anorexia requires a Licensed Nutritionist who specializes in treating anorexia. The nutritionist meets with the you and helps you forulate daily meal plans and keep written track of them. In fact, the nutritionist is as important if not more important then the therapist. There also needs to be a psychiatrist to help regulate medications, a Medical Doctor who checks on medical health and the therapist should be doing Cognitive Behavioral Therapy. Some people recommend group therapy with other group members who have anorexia. Yes, the treatment of and recovery from Anorexia requires a lot of time and work. The reason is that patients are resistant to improvement and no one therapist can do the job.

Please, go to the hospital and get help Now.

Good luck to you.

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