What To Do When Your Therapist Breaks Up With You

So I’ve known about this for weeks. 

Actually, our last session was December 12, right before the holidays. And honestly, it felt right. 

The past year with Jeremy has been incredible. Sometimes you find the right practitioner and things just are right. And let me take a few steps back from this to give you some context about what really happened. 

I was not dumped by my therapist in any literal sense. It was back in November or so when I had a phone call with him while in bed, as I was still recovering from the flu and had to cancel a second session in a row with him. The two incidents were not related at all, I wasn’t being punished but rather, he was leaving the practice altogether. This time last year, I would have probably jumped to a major conclusion as to why he felt the need to end our sessions and leave without offering to take me to his next practice. But, as treatment would teach me if the concern exists, then I need to face it head-on in conversation. As it turns out, he was taking a break from therapy as a whole, and needed to work on his own self-care, although a bit ironic, absolutely understandable. 

Here’s what I learned from ending things with a therapist. First off, he absolutely wasn’t going to let me off the hook from treatment. Our final 2-3 sessions were focused solely on my thoughts about the past year, and where I hope to go moving forward. He wasn’t going to tell me what I should do next, but he required me to think about what I wanted and/or needed. And to be honest, there was a very clear elephant in the room that we both knew I had to talk about (but I will circle back to that in a moment.) 

When reflecting on the past year with him, I realized that while I was sad to leave Jeremy, we had been smooth sailing for the past few months, despite a tumultuous summer of events for me. What I had to face in that moment was that while Jeremy was coming to a new shift in his own life, I too had to do the same. I had plateaued with him, and things were getting really easy breezy to talk about. While I can recognize that this is what will come from doing CBT work, I knew that I wasn’t at that place where I could walk out of therapy and never come back. And this is where I address the elephant. 

One of the three diagnoses’ I received from my psychiatrist this year was bulimia nervosa. While categorized as being in remission, I only get that classification because I am no longer self-harming myself in the process. But the reality is, it’s still an ever-present disorder I’m coping with daily. And not too well if I may be a bit critical. 

The past few months the only real treatment I have participated in regarding my eating disorder is the acceptance that I do have one, and one as serious as Bulimia, and being medicated for it. Prozac was chosen as the drug of choice for me, and a big part of that is that it’s one of the drugs that help treat binge eating. In practice, I know it works. And that’s a really hard reality to swallow (pun very much intended). 

The things I had to start to grapple with this year, is the idea that many of my memories from high school to young adulthood of girls nights in, may be tainted with my compulsion for food as a tool of manipulation. Many of my choices of favorite foods are based on this need to try and control how I feed. And for 10+ years I have been completely unaware of it. And that’s a grim reality to wrestle with. 

This is not to say my whole life is defined by a diagnosis, but I do have to break down a lot of what I think to be true. And the 20 pounds I gained over the course of this year says anything, it says that I have no idea how to feed myself in a healthy way. 

I know that I can’t participate in diet culture without it becoming an obsession. I know that even just negating one thing from my diet causes me to spiral (see a dairy omission turning into full on veganism). But on the same argument, I can’t just “eat what I want” without becoming fully dependent on fast food cravings and binge eating, and thus begins an even more dangerous cycle of self-loathing. 

So when Jeremy asked me “What do you want to work on in 2020?” I had to face the fact that it’s time to deal with this elephant. He responded with a small smile and a nod when I admit I need to face “the bulimia thing” as I had aptly put it. He had been gently pushing me to talk about it, and as I do, I had managed to weasel my way out of ever having a serious conversation as to what I was doing to manage this, other than medication. He admits that while he was equipped to begin the conversation, I need to find a therapist that is trained in this kind of treatment. I sigh as I know what has to be done. The final step of accepting that you have a problem is getting treatment for it. 

Where does this leave me? Well, for now, it means that I need a new therapist. Jeremy sent me a number of resources to find a new practitioner, which is beyond helpful. But I discovered a number of challenges even in the process of finding a therapist for EDs. 

If you aren’t in crisis, the resources available can be limited. You go to find treatment for EDs and often times the most prolific resources are inpatient and emergency services. Which for someone in my situation, it’s not that helpful. Additionally, I made this discovery: there isn’t a lot of people talking about how to eat healthy as a person with an ED. This was something I started thinking about a few months ago. 

When I initially got diagnosed with PCOS, I started looking into healthy eating programs, things that didn’t stink of toxic diet culture, tools that could help me try to get into better physical health. Myfitnesspal is a big trigger in my ED, so that wasn’t an option. I looked into the ever popular Noom app, which boasts of positive feedback to “change the conversation” but surprisingly, it doesn’t take into consideration if you have medical or psychological barriers. And I wasn’t the only one making that critique. Even just the way we talk about eating healthy, mentions of portion control and food substitutions don’t really consider how these methods are the basic tools of self-harm for a person with an ED.

It makes me wonder in this day and age of apps, and social media, why is it so hard to find connections about being healthy with an Eating Disorder? Why are we the ones that seem to not be thought about when we think about “eating right” or “getting in shape?” Maybe that’s the litmus test for toxic diet/ health culture, but somehow that answer seems lacking. I have so many friends who struggle with eating disorders, and yet we all seem to share a problem with trying to eat “healthy.” 

So this is my journey for 2020, to figure out how to eat, exercise to live with this eating disorder. And to share what I learn. Because people deserve to have access to this kind of information regardless of their ability to get a therapist or a nutritionist or get put on Prozac. There are so many people hurting from disordered eating who feel like they have no way out because no one wants to talk about it. And honestly, I don’t even want to talk about it, but now I’m frustrated and mad and if you know me well enough, that tends to trump any feelings of fear I have.