Talking therapies

When people are diagnosed with an eating disorder they are often offered some type of counselling or therapy. These ‘talking therapies’ are offered to help people overcome emotional difficulties and change unhelpful patterns of thought and behaviour. Here we use the term “talking therapies” to cover a range of different therapies which could include:

  • Cognitive Behavioural Therapy
  • Psychotherapy
  • Generic counselling
  • Dialectical Behavioural Therapy
  • Family Therapy
  • Group therapy
  • Art therapy
Young people we spoke with had most commonly received Cognitive Behavioural Therapy (CBT) but all of these treatments could be helpful for people with eating disorders. These treatments are available on the NHS (usually with a waiting list) but some people we spoke with paid for private treatment. Therapies each have a different way of working and where some may help with a particular person or problem, another therapy might not be successful. If one type of therapy does not help a person, they might find it useful to try another type of therapy. Talking therapies can be combined with other forms of support or treatment: for example seeing a dietician (to help with a meal plan and nutritional wellbeing) or occupational therapist (practical help with daily activities) and being prescribed medication for anxiety or depression.

Finding the right therapist

“I remember thinking, ‘Therapy! That’s what American people do. We don’t have therapy in the UK.’” -Eva

People were often quite ill when they started therapy, and often felt that they didn’t want to “lose” their eating disorder. Jasmin worried that a therapist would try to “make me fat”. Some people had had talking therapy before, for anxiety or depression so had an idea what to expect.

People wanted a knowledgeable therapist who they “clicked” with, could trust and who took them seriously. Some people felt their therapist didn’t “understand” them, didn’t have enough specialist knowledge or kept forgetting things that they previously discussed. Sometimes people just didn’t get on with their therapist and found them false, “irritating” or “patronising”. When talking therapy was successful, people formed supportive long-lasting relationships with their therapist. Rob explained that for him the therapeutic relationship was more beneficial than the therapy itself.

Benefits of talking therapies

As part of their illness, people had developed deeply held unrealistic patterns of thought and behaviour. Talking therapy could help “identify”, “challenge”, “rationalise” and “break” these patterns – something many people found helpful.

Eva explains how Cognitive Behavioural Therapy helped her see that her thoughts about eating and…

Age at interview 17

Gender Female

Age at diagnosis 14

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In CBT they asked me things like is there anything that’s upset you, and I’d say yeah and then explain it. And they’d be like, Why did it upset you? What And then you’d sort of break the thought down like, say you think, Oh I can’t wear those jeans today, I look really fat And then they’d be like, What like you’d break it down into like thoughts of why you think you look fat. And you’d be like, Oh because I ate such and such yesterday Or, I just do And then you’d realise, I just d isn’t really, you know like a valid explanation for it. And you’d think well why, because I’m exactly the same weight as I was yesterday, I can’t possibly have gained a stone in a day, sort of thing, and you think, Oh maybe I am being irrational And it helped in that way to see it laid out like in three parts. Like the thought before, thought afterwards and sort of the rationale behind it. That did help seeing like logical, illogical conclusion sort of thing. It did help doing that.

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Writing down what she ate and the associated negative thoughts and feelings, helped Jasmin become…

Age at interview 19

Gender Female

Age at diagnosis 17

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We started to look at sort of the binging side of things, like what causes a binge, like the psychological side of it and then the physiological side of it, and how to kind of become more or a lot more aware of why I was doing, why I was acting the way I was acting. Like he, I had to fill out what I was eating every day and then fill out what I was thinking and feeling at the times so that we could kind of see what the eating disorder thoughts were, because before I think those thoughts had, had been there and they were so strong they were just, they were, they had kind of taken over, whereas then we started to kind of separate that, there was my thoughts and then there was the eating disordered thoughts. And then the aim was to kind of challenge those thoughts and look at why they were wrong to think that way.

What do you mean by your thoughts and the eating disorder thoughts? That’s quite interesting the way that you just put it.

I think deep down I knew what was right and what was wrong I knew it was right to eat a certain way, but then there would be those eating disorder thoughts trying to tell me that that was wrong. I guess, like thoughts, like the fact of eating something bad I’m suddenly going to put on weight, I knew that wasn’t true but that’s what, that kind of, those eating, eating disorder thoughts were saying to me and I’d give in to them and think, okay if that’s true then I need to purge because otherwise I’m going to suddenly put on weight.

Any thoughts about, you know, if I, there’s that whole thing of, sort of, if I was losing weight then I felt like I was achieving something so it made me feel better about myself and it made me feel like I was a better person and yet I knew that wasn’t true, but that was kind of the, what the eating disorder thoughts were saying. That if I was putting on weight then I was lazy and I was fat, and worthless and that sort of thing. So we would kind of do that and then look at the advantages and the disadvantages of thinking those things, and then have a challenge for that, what I should really be thinking, so one thought was that I should be weighing myself every day, disadvantages of that being that it would affect my mood for the day, it would affect what I ate throughout the day, it would be whether I decided to eat or not eat.

Positives being if it did go down I felt better about myself and I might actually want to eat, but then we looked at, like an alternative which is the fact that weight fluctuates naturally every day so weighing myself every day isn’t a good way of measuring whether I was actually losing weight or not and that I was better off just doing it once a week if I was going to.
Strapline’ Writing down everything she ate and the associated negative thoughts and feelings, helped Jasmin to become more aware of why she was behaving in certain ways and find alternative perspectives.

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Elizabeth said that, over the years, she had developed “funny rules” about food and eating and CBT helped her to realise how irrational they were. The therapeutic process in itself could “free up head space” and simply offer a space to express emotions. People gradually realised that anorexic or bulimic behaviour was so time-consuming and the so damaging to their state of mind, that they could prevent people from achieving their goals in life such as having friendships, having a job or a family.

Therapy was a turning point for Elizabeth. It helped her revalue her life and realise that she…

Age at interview 20

Gender Female

Age at diagnosis 12

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I started to see a specialist cognitive behavioural therapist who kind of worked through a lot of those issues with me and who I still see now about realising that actually there are other values in life apart from the anorexia that, that shouldn’t be one of your values in life. That there are other things to live for and that actually staying anorexic will have massive disadvantages for the rest of your life, like job prospects, friendship prospects, the time it takes. The sheer time involved in being anorexic is a lot.

And so it really sort of made me perk up and think, Wait. I need to, if I’m gonna live as a, if I’m gonna live a successful life what do I want out of my life? And I can’t have the life I want if I stay anorexic And so that has really kind of been a turning point.

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Charlotte compares the methods of Cognitive Behavioural Therapy and Dialectical Behavioural…

Age at interview 22

Gender Female

Age at diagnosis 16

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I’ve tried bits of CBT, I’ve never been on an official programme but when for example I’ve been in hospital or when I’ve been with the Crisis team, they’ve kind of done bits of CBT with me. I guess DBT is more intense, it comprises of both group and individual therapy and it lasts a lot longer than CBT, it also covers things in more detail, and I think they chose that because it was, the kind of the behaviours and the symptoms that I was showing just kind of best fitted the DBT rather than the CBT.

There’s, I think a major difference is that they emphasise, the emphasis in DBT is also a balance between change and acceptance, whereas sometimes the CBT and they’re kind of the professionals that kind of going on at you to keep changing and adapting, it can be quite invalidating to how you’re feeling, whereas with the DBT it’s kind of accepting that this is the way things are at the moment, but that things can also change.

And what’s your experience with DBT? How do you feel it works for you?

I think it really helped me when I was doing it, when I was on the course of therapy. When I finished and I went to university that was quite a lot of changes that were happening in my life and it made it a lot harder to keep using the skills and things that I had learnt, but certainly whilst I was in therapy, and also for a short time afterwards it did kind of reduce certain harmful behaviours cos you have to keep a diary card, a weekly diary card of your emotions and kind of certain behaviours. And those did kind of reduce and the emotions became more balanced. Yeah.

And I managed to achieve things that, you know even the simple things like sending back your coffee if it’s not what you ordered for, I would never had the kind of the guts to do that before but DBT kind of gave me the ability to be able to ask for things like that.

Is that to do with confidence do you think?

Yeah. it’s also, kind of they teach you how to ask for things and the way to go about asking for things, and it kind of gave me, I kind of thought, well I’ll try this once and see how it goes, so it’s kind of like a little experiment and then when I did it and things didn’t turn out awfully and it wasn’t a disaster, it kind of gave me the confidence to do that again.

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Young people had often felt frustrated that other eating disorder treatments had been focused on their weight and not on the other issues. Talking therapy often worked on the basic issues of self-worth, perfectionism and control and people found this focus useful. Felicity said that it was thanks to therapy that she became much more “psychologically healthy person”. For Nikki, therapy was “the most helpful thing” towards recovery and helped her become more reflective and outward looking. However, Elene wanted to understand more about the deeper causes of her eating disorder which she didn’t feel CBT addressed. Roberto had a few therapy sessions but said they weren’t “sufficient” on their own and he would’ve needed other forms of support alongside.

Some had not seen a therapist face-face but had instead read books or done CBT exercises online. Although online exercises weren’t tailored to individual needs, they were readily accessible whenever people wanted.

The limits of talking therapies

People felt that talking therapies worked best when people were motivated and open to it. When people had been very ill, particularly underweight, they found they couldn’t accept that their thought patterns might be irrational and illogical.

When Elene was entrenched in her eating disorder, her therapist couldn’t change her belief that…

Age at interview 20

Gender Female

Age at diagnosis 15

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I was first seeing him around maybe April, I can remember having a conversation with him in July, where he was like, This isn’t going to work Because I was convinced that like breakfast, if you had breakfast you would be fat and he was like trying to convince me otherwise.

I’m not sure like how effective I think the whole cognitive behaviour therapy thing is because like I said, like I think it’s it makes you, when you’re really, really entrenched in like screwed up thinking and, like with the whole breakfast example like I just didn’t think that no matter what he said to me I was like, No, no. Like breakfast I will get fat. Like these people have no idea These really scathing thoughts like running through my mind. What does he know Like What is that shirt he’s wearing [Laughs].

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Emily said her bulimia had become so deep-rooted that she found it hard to describe her feelings or explain the reasons for her behaviour. CBT could be “hard work”, draining and time consuming; therapy could last for several months or even years. It could be difficult to find the time to keep thought diaries – on the worst days people felt they were continually noting down negative thoughts which could feel like “a chore”. The sessions were often in the daytime and missing school could be hard for those who wanted to do well in school.

Lauren found Cognitive Behavioural Therapy hard work. Attending appointments and writing down…

Age at interview 23

Gender Female

Age at diagnosis 20

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Once I’d sort of identified what the triggers were it meant that I could really tackle what, what issues I was facing and that just came through a lot of talking but parallel to that was the kind of food side of things. So I had to start writing a food diary of everything I was eating and the ideal was that I would try and add a portion every two weeks.

And that could just, it starts with really simple things like just changing from skimmed milk to semi-skimmed milk or like a low fat yoghurt to, to a full fat yoghurt and trying to make the changes kind of small and manageable. I had to choose the changes. So it was always me making the decision, What do you want to start with And it was starting with foods that I still saw as safe but just trying to get me to eat more.

And alongside that I had to write down all my negative thoughts I was having. So whenever I was faced with a situation that I thought was difficult or I was getting those negative thoughts coming in, it might have been eating the food, it might have been at a social situation, and then write down the negative thought and then write down what evidence there was for that. So for example, if I was going out for dinner and I put, I don’t want to go out because I think I’m going to get fat. The food’s unhealthy Those, those kind of things I would look at the evidence and say, Well, actually, I’ve never been fat in my life. I’ve been out before and I’ve never put on weight and it’srdquo; So then replacing that with a kind of balanced thought and thinking, Right. it’s okay to go out once in a while and I need food cos I’m underweight So those kinds of things, it’s just rationalising the thoughts and getting my thoughts back in rather than the anorexic.

But that was a lot harder at the start. I found it really difficult to do and I didn’t think it was going to work because I found it such a chore and just having to sit and write down and all the negative thoughts I was having, there were so many in a day. So I was constantly writing and just doing the portion as well. Because I was at university I sometimes wouldn’t do it, and knowing that I was going to get weighed every two weeks I would feel guilty if I knew I’d lost weight or I was giving put on weight. You know, if I put on if I went on the scaled and I’d put on the weight I’d be a little bit happy but I’d also feel this enormous guilt but, at the same time, if I’d lost weight I would feel really bad cos I would think, Well, I tried and it didn’t happen

And at the start, I, it went downhill. It was kind of the first couple of months to the April, which was my twenty first birthday, which was when I was at my worst so actually, my weight did drop even with treatment before it could come back up again. I always found it really difficult and just such a chore and I didn’t want to go to my appointments. I didn’t like all the talking and just, I guess I just wanted to give up a bit or I just found it too much hard work and I didn’t want to do the hard work and it really wasn’t until the kind of May that I kind of had a turning point and started, things started changing for me.

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If the person wasn’t motivated or ready to get help, they might feel “pressure to open up” or pretend “to go along with it”, like Georgia described.

Georgia felt that the counselling service at Child and Adolescent Mental Health Service was aimed…

Age at interview 18

Gender Female

Age at diagnosis 15

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And what was that [in Adult Mental Health Services] counselling like? Compared to your previous experiences?

It was better but I didn’t, still didn’t really, I think it was kind of aimed at adults rather than 18 year olds. And it felt like if I was like 30 or 40 I would have got something out of it, but half the time I didn’t understand what they were talking about. So it was kind of, kind of felt like CAMHS was aimed too young and Adult Services was too old and I’d never really got to either of them at the right age.

I was just gonna ask that. Was it sort of something for young people that you wanted or would have needed, not for children and not for sort of you know older adults…?

Yeah. it’s kind of like there’s a gap between like I don’t know 14 and 25-ish, but there’s not really anything there for, you’re just kind of stuck into things that don’t really work.

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Some felt that talking therapies weren’t helpful and would have preferred help with practical issues, such as going to the supermarket or eating out in public.

Family therapy

Family can play an important part in treating eating disorders, especially when people are very young and still living at home. People’s experiences of family therapy varied. For some it didn’t work at all; they described the sessions as awkward and confrontational or felt that involving family was irrelevant because they saw the eating disorder as “their problem”. Katie said the family therapy sessions were unsuccessful and “turned into slanging matches”. Sessions could be very emotional and upsetting; Francesca said sometimes she and her family “would all sit and cry”. Some people never wanted to tell their parents about their eating disorder, let alone be involved in therapy.

For others, it could be an essential step in recovery.

Family therapy was a difficult but hugely helpful experience for Francesca and her parents. They…

Age at interview 21

Gender Female

Age at diagnosis 16

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[Family therapy was] very, very difficult. Actually really straining and upsetting, but all of us involved but it was really quite important for me like. My Mum especially refused to do it for quite a while in the first few months, and like they tried to do it the first time I went to the Clinic and she absolutely refused, she was just like, No way, it’s nothing to do with me. And I don’t quite know how we managed to eventually convince her to do it; it took a lot of me and my Dad, like Please come. Like I think she was scared that she was going to be accused of being to blame for everything, and that wasn’t really what it was about. But obviously quite a lot of my issues with my eating disorder had been about family life. Again not that they were to blame, but just certain things had made me the way I was and have certain feelings and they really needed to be discussed and I, I was too scared to do it outside of therapy. I didn’t want to hurt her feelings you know, not at all, I love my parents to pieces and they’ve given me so much. You know they really are great but it, some things needed to be said.

From them to me, you know, to me and me to them as well. We had a really good family therapist that we went to, and she helped and encouraged us to have the conversations we needed to have you know, and make sure that there was no blaming going in those contexts, you know, we just needed to be open and say, you know, that I needed my independence a lot, which my parents didn’t give me. I didn’t want to say that to them and also they needed to let me go a bit, cos they were holding on too much to me and we just were kind of able to have these frank, open discussions but, as I said, it really was very, very upsetting like, you know, we’d sit there at some sessions and we’d all cry [laughs]. I’d just be like, Oh I can’t believe [laughs] this has happened.

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Family therapy can involve one or both parents, as well as siblings, depending on their ages and the family situation. Sarah-May’s family took part in multi-family sessions that involved different families. Sometimes one parent could be reluctant to take part:  Hannah Z’s dad wasn’t keen to come along but when he did, she really “respected” him for it. At first, Francesca’s mum was reluctant to join family therapy. Francesca thought her mum was worried about being blamed but the experience turned out to be very different.

People considered the biggest benefit of family therapy to be the support and insight it offered their parents. Young people had often received help for themselves already and felt fairly well supported and informed but felt their parents had lacked understanding and tools. Francesca also had therapy with her boyfriend, who became an important person in her recovery.

Group therapy

Many of those people who had been treated as an inpatient in hospital attended different types of group therapies in the unit. These included art and drama therapy and workshops on creative writing, yoga, meditation and self-esteem. Different groups offered structure and meaningful activity to hospital days. The groups also helped people to develop coping “tools” to draw on during difficult times and help prevent them from relapsing.

Zoe learnt yoga through mindfulness-based therapy. It helped her to not [be] doing anything.

Age at interview 23

Gender Female

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I now do regular yoga so that’s still a part of it and but it’s just another way just to have a bit of sort of time where you’re just, you’re not doing anything for any reason. it’s just like an hour of kind of, I don’t know, being in the moment or whatever. You know, not actually doing anything so it’s good for me and I think that has come through that sort of mindfulness path where I first experienced a bit of yoga and that sort of therapy, yeah.

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Although Francesca hated art therapy and her art work being psychoanalysed in art therapy, it…

Age at interview 21

Gender Female

Age at diagnosis 16

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I went to art therapy and absolutely refused to do art. I was like, I’m not going in, I can’t do it, I hate art and like [laughs] I was crying and screaming the room down and they made me go in and I hated it, but I learnt from that issue that I have such a great fear of doing things that I’m not good at, you know, I was able to work on, you know, what my fear is and why I’m not able to do things I don’t know and you know, that, from just from that session they set me a lot of tasks and I now, I set works upon just doing simple things that I’d never done before and simple stuff I felt that I was, wasn’t good at and it was really breaking down all the different barriers. So I just, I don’t think there was one thing, I think it was everything put together in that way.

What is art therapy like?

Absolutely awful [laughs]. I hate it; I would never ever want to go again. It was, I don’t know if it’s different everywhere you go but for us, we kind of had an art teacher kind of thing that would set you a task. He’d just be like, OK this is the theme like say some place would have, like he’d show us an Egyptian picture for example and he’d be like so I want you to look at it and think about it, and just draw something which your emotions are telling you to draw. I still to this day, don’t get the point of it; I don’t agree with it, I just, I don’t understand it at all. One day, just to annoy him, I just decided to draw a smiley face with nothing else. I just thought, Well fine, if you’re going to make me do this, this is what I’m going to do I got so frustrated cos then he tried to psycho-analyse it [laughs] so you know, I’d draw this smiley face cos I was really angry and I was just trying to get everyone to leave me alone and [laughs] things like this and I just, I don’t agree with it, but it obviously works for some people, some people find it therapeutic, for me it just made me even more angry, which I didn’t think I was actually and it showed me that I obviously did have anger issues as well that I needed to let out. But as I said I was able to learn something from it and I focused on that instead of [laughs] what he psychoanalysed me to say.

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People felt that group therapy wasn’t always suitable. If the group members were all at different stages of their illness/recovery, this could have a negative impact others.

Eva didn’t find group therapy helpful. She felt that people fed off each other’s negative…

Age at interview 17

Gender Female

Age at diagnosis 14

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I didn’t find group therapy as helpful really because everybody’s at different stages of recovery so some people wouldn’t really want to get better and they’d be a bit negative in group, and then it’d, I’m one of those people that if somebody else is in need I’ll always feel like I need to help them, and so I started to feel like, I stopped focussing on myself really which is what you need to do when you’re in hospital. You need to focus on getting yourself better, but I started to think about how can I help such and such to get better, and so in that way I didn’t really find the group therapy as helpful.

If you forget about yourself there?

Mm. And sometimes it would remind me of bad thoughts that I’d been ignoring and sort of re-iterate them to me so.

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Groups were seen as most beneficial when they were between “like minded” people who were at a similar stage of recovery. (For more see ‘Inpatient treatment in hospital).

Counselling at school, college or university

People could access more informal counselling at school or university or with their GPs. This type of counselling was quickly and regularly accessible, with short waiting times and information about other services. However this counselling was often less specialist. Emily felt that school counselling was not appropriate for “in-built chronic eating disorder”. People felt it was more useful to tackle other problems that could be linked to the eating disorder, such as bullying, relationship problems or exam stress.

Francesca had weekly mentoring sessions through the University’s disability office. They worked…

Age at interview 21

Gender Female

Age at diagnosis 16

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What does the weekly mentor mean, how does that work?

it’s part of the disability scheme and they allocate it based on your need and, obviously when I had my first assessment, I was quite needy, safe to say. So I actually get allocated an hour and a half each week to go to the mentor and it’s kind of up to me and her what we do, like I work with her. Any anxieties or problems that I’ve got I work through, like she lets me if I have a presentation to do, like I can go there and practice my presentation, she helps me work out the timetable for the week so that I can make sure I get all my work in at certain times, and she also sort of, actually really encouraged me over the last year to make sure I have social time and time for myself which I think, what else do we do? If I have any problems, she’s just there to listen.

So, which is nice to know that there’s someone impartial that I can go to. But yeah it’s really just up to me whatever else I needed. If I need any help, she will contact other people for me, on my behalf, and help me do that, like when I had issues. This year I had to find accommodation again without friends, but she helped me do that and she helped speak to people on websites and all of that so, it’s just really whatever you need.

So it’s very pro-active and very involved?

Yeah, really. If there’s time to that I just, she can see that I’m, I don’t want to be there she’ll kind of just be like, OK, is there something I can help you with? What’s up And sometimes I’ve, I just, I just don’t need anything that week and she’s just like, OK well, we’ll leave it at that, you’ve got my email And if I ever do go upset or have any issues, she’ll email me during the week before our next meeting just to check up on me. But she’s nice so I do always know that she’s there. That’s very helpful.

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No counselling

We also spoke to people who had never had any formal therapy or counselling, as they had not engaged with services or had never been offered it. Maria, despite a stay in hospital, refused to take part in talking therapies. She says she managed to recover through her own resources.

Maria didn’t have any counselling. She is better now but has always wondered whether she would’ve…

Age at interview 18

Gender Female

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I kind of always wondered if I had had therapy and counselling what, what would I have uncovered? Would it, I’m not, I never know whether to be, you’d think someone like me would have had mountains of therapy. But I haven’t. And so you think I was very interested about it. I think is it really, should I be sceptical, is it a load of nonsense? And do I always thought I know my own mind better than they do. But I wonder. But I think it might just be because I’ve not been able to talk to someone about it, I’ve just had to think about it a lot. And now that, since, when I was ill that was just a waste of time. But now that I’ve been better and I can see things logically, and also I’ve, you do, you do your own sort of research because that’s another thing that’s quite important to me now and in a way I kind of wish I didn’t, but I do think about kind of eating disorder things quite a lot. And I wish that I didn’t.

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Sam has never had counselling but has seen ‘a life coach’. He said it felt like a more productive approach:

“[life coaching helps] to make actions and evaluate as you go. And that kind of works for me I think. Rather than just talking about it ‘cos I think that sits with me”.

Some people who hadn’t found help from the standard therapies had turned to ‘complementary’ therapies, such as hypnotherapy. Katherine found that hypnotherapy helped her gain the will to deal with her unhealthy behaviours.

Hypnotherapy helped Katherine develop skills she didn’t gain from CBT. She describes what…

Age at interview 19

Gender Female

Age at diagnosis 11

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And eventually I went to hypnotherapy and I think actually that was probably one of the main things that helped, possibly because it didn’t give me an opportunity to think whether the treatment they were giving me at the clinic was very much like, it depended on me actually taking the first step and doing what they were telling me to do. And I just, it just didn’t have any effect on me. I just didn’t want to do it and I wouldn’t do it. Whereas kind of perhaps with the hypnotherapy, I just sort of kind of by that stage wanted to be a bit better but needed something that wasn’t really me necessarily telling me to do something. I didn’t, I didn’t really understand. I can remember the sessions, I was completely lucid. But they kind of gave, gave me the skills the cognitive behavioural therapy was meant to give, but that for some reason I just didn’t get when I went to, went to the clinic.

So what happened in the hypnotherapy sessions?

It was it was like friend of the family or someone who had set up her own, she’d gone private having done it with the NHS I think, and she had her own practice in her and so it was like a very nice kind of like room and you just went in. And she spoke to me for a couple of sessions about the condition, trying to understand it so that she knew exactly where she was approaching it from.

And then in, when I ultimately went in for like the first hypnotherapy session, it was, I sat down in a chair, and then was told to kind of, I closed my eyes, and then it was more like we continued the conversation really, so there wasn’t any element of kind of like, Now you’re going under, one, two, three, and, but then that kind of like sort of, in a slightly more sophisticated way sort of came in a little bit later on, and you know I was completely aware of my surroundings the whole time. It was basically just like kind of really deep state of relaxation, just kind of sitting there, completely aware of what was going on, not quite asleep but under still like hearing, I can’t remember what her name was, hearing the woman talking to me. And responding. I was able, I was talking back to her and she was just asking me about like, oh God what was she asking? Kind of asking about things from like my childhood and things. And then I think asking me questions about the eating disorder as well, and the condition, and trying to understand it as well. So I was in a state where I was giving her completely honest answers, and yeah without kind of being able to double foot her.

And do you remember that you were sort of fully you know in full capacity to stop it should you have wanted to?

Yeah, no. She was always very much kind of, I understood completely from the very, from the word go how the sessions would be run, and how much I would be in control because that was one of the reasons I was so hesitant about it at first because I was like This is complete, this is nonsense like there is no way that I’m going for hypnotherapy sessions. This is absolute rubbish.

And kind of having met her and having like looked at the work that she’d done in the past, and having done a bit of research on her and realising that it was actually quite like a reputable thing, and she said from the word go, you know, Look this is what will happen when you come in here. You’ll be in complete control. If you tell me to stop then I’ll stop. You’re able to wake up if you want to at any stage. So it wasn’t a concern of me after I’d met her for a few times yeah.

And how many times did you see her?

I think maybe five or six. It must have been less than ten because they weren’t cheap sessions. But certainly we went for about a good five or so.

And what do you feel that the benefit of it was for you?

I think I just had more confidence to kind of, I was more not necessarily enthused is the right word, but just more willing to kind of approach the, not necessarily the treatment that was being given to me, but on my own terms to kind of improve rather than, whereas beforehand I was just on this sort of flat level of, I am not going to improve, I am not going to take any steps to try and improve my condition or get better. The hypnotherapy kind of sort of rationalised I think a bit for me, and sort of helped me realise that you know the behaviour and the lifestyle that I was living was not healthy, it wasn’t fair, and I just sort of approached it more, with more clarity.

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Staying in hospital

When someone with an eating disorder is severely underweight, seriously unwell or refusing treatment they are sometimes advised to stay in hospital. Most will be...