How to screen a therapist?

February 1, 2008 5:40 PM

FatFilter: Help a morbidly obese woman find a compatible psychologist or therapist.

I'm a 30-year-old woman who has weighed upwards of 400 pounds since I was in high school. I have attempted and failed nearly every diet and "way of eating" that's come around, from the healthy to the just plain ridiculous.

I think I would benefit greatly from working with a psychologist to deal with some of the issues that cause me to overeat. The problem is that I would like to look at the obesity as a symptom of the psychological issues - depression, low self-esteem, and a touch of OCD - rather than those issues as a symptom of the obesity. I have tried to work with therapists in the past that focused on dieting and losing weight as a means to combat the depression and raise my self-esteem. However, dieting for me always plunges my self-esteem even lower - I can't love and appreciate the body I'm in while I'm trying to change it, and whenever I'd stop losing, I'd feel even worse about myself than when I started.

I really don't know how to properly screen a therapist to find one that will be helpful for me. What are some possible questions I can ask to try to find a good match? Can I do this over the phone, or do I have to schedule office visits with as many as it takes to find the right one?
Thanks for your help. Throwaway email: [e-mail]

posted by anonymous to health & fitness (7 answers total)

If your employer has an Employee Assistance Program, that would be a good place to start--they were very helpful when I wanted to find a new therapist and it was much less stressful than the previous time I sought a mental health practitioner: hours spent leaving messages on voice mail while trying not to cry, waiting for anyone to call me back as I worked my way down the list of approved doctors. That'll drive you crazy even if you start out totally balanced.

Even if you click with someone over the phone, you should feel free to meet up with as many doctors as it takes to find someone you click with. There is nothing more fucked up than sitting in a room for an hour with someone that you know just doesn't get it. It doesn't necessarily mean they're not good at what they do, just that differing communication styles can be hard to get around when the whole point is bald communication.
posted by padraigin at 5:59 PM on February 1, 2008

If you are in the Bay Area, or even if not, you might contact the authors of Fat! So for a referral. ">Sondra Solovay or Marilyn Wann.
posted by ClaudiaCenter at 6:29 PM on February 1, 2008

Garr. [e-mail].
posted by ClaudiaCenter at 6:31 PM on February 1, 2008

Posssible questions:
What is your experience with eating disorders, especially obesity?
How do you usually work with obese clients?
(i know that's not what you want to work on but it gives you some idea of their
orientation and prejudices about weight.)
I have a whole bunch of other issues. If I told you that I had no interest in losing weight right now, despite my obesity, how would you handle that?"

Your previous therapy has taught you something about what doesn't work for you. A good therapist should ask about past experience, what worked and what didn't as part of the first meeting. If not, you should be clear what your priorities are and why. Any good therapist should respect your priorities and your self-knowledge and be willing to help you be happier and more comfortable as yourself before you add the pressure of a diet. In fact, if they didn't respect your perspective once you told them, I would walk out and find someone better.

ps: at least in California, most licensed therapists are psychologists, marriage & family therapists (who also do individual work) or clinical social workers. If you need medication, you might want a psychiatrist involved (the last thing you want is an anti-depressant that makes you gain weight).
posted by metahawk at 6:42 PM on February 1, 2008

Here is a list of fat-friendly health professionals. Best of luck to you.
posted by sugarfish at 7:27 PM on February 1, 2008

Ms. Anon: You are spot on in addressing the issues of why you eat to satisfy an emptiness. Many folks don't realize that at all, or ever. You have a vision of yourself looking differently, but it's after you work on your issues, such as OCD, prefectionism or abuse, losing weight is just a bonus perk. Perhaps if you re-frame your challenge as curing your emotional baggage instead of losing fat, the universe will right itself and all will fall into place.

The change will be subtle, but will happen eventually and you will find it gets easier once you've identified the particulars and begin to stress less about what you look like on the outside to what your true, pure self is on the inside. Nothing will change until you face the demons.

Have you sought OA? If nothing else it could be a springboard to other recommendations. Ask around to other people , Craigslist perhaps or your own bariatric physician. Network until you find something comfortable.

You're taking the right steps, please keep in touch to let uys know how you are doing. I'm not sure if this helped but it can't hurt.
posted by ~Sushma~ at 9:05 PM on February 1, 2008

Near Palo Alto? Deb Burgard might be who you're looking for.
posted by umbú at 7:06 AM on February 2, 2008