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It's time to say goodbye, or as we call it in therapy, "termination."
As a psychologist, this has been therapy fantasy camp. All psychologists are voyeurs. Under normal circumstances, when you do therapy, you see the world through the client's eyes. You construct images of their partners, homes, parents, friends on the basis of their descriptions, and you almost never get a chance to see the reality. For me to have conducted group therapy, and then after we were done to go back via television and see their husbands, families, and homes has been a sort of secret dream come true –- to see if my "construction" matched the reality. Thanks, Bravo! This is and will remain one of the most compelling clinical experiences of my career.
I was on the fence about whether I would be able to do clinical work of any depth under lights and with cameras rolling. Time limits meant you didn't see most of the therapy, which is where these clients did heavy lifting and sweating of a different sort. They learned about why they eat what they eat, when they eat, how they eat, and where they eat. They unearthed old demons, and learned about respecting others and themselves. They learned how to talk about their feelings instead of numbing them. They were called on their BS and made to take ownership. If they sustain these weight changes, it will be because they were willing to do it from the inside out.
Shay revealed that her struggles with weight were more complex than initially thought. There is a frequently held misassumption that ethnic minority women don't get eating disorders. That is patently wrong, and the rates of eating disorders in African American, Latina, and Asian American women are on the rise. Laxative abuse can be done secretly, and many who do it report that the feeling of "emptiness," the "flat stomach," and the sense of "clearing out" following laxative use is gratifying despite being dangerous. They erroneously believe they can eat what they want and then get rid of it. Shay showed us that the psychology of weight goes well beyond ab crunches and protein shakes. These are VERY difficult and complex issues. Her revelation was courageous, and it will take time for her to make these changes.
As we sign off, let's review what we learned about weight loss. It's about respecting your body with healthy food instead of punishing it with junk. It's about pushing your body to new limits, and then finding out you can push your life to new limits. It's about realizing that your history may tell you why you eat what you do, but it doesn't own you, and everyone has the capacity to make these changes. It's about realizing that food is not a substitute for love. It's about accepting yourself, and engaging in the process of weight loss authentically.
I am copying your third full paragraph and putting it on the cover of my diet journal. It will inspire me especially on those days I struggle.
Thank you for your blog and for participating in Thintervention. Your wisdom extends well beyond the seven castmates.
Dr Ramani--your clips were some of my favorite moments of the show. You're a great therapist and I wish we could have seen more. I understand how you can't really do full-on therapy on national TV--but what we did get to see was very moving and interesting and made me like all the characters more than I did before. Nice work.