“Give me therapy. I'm a walking travesty, But I'm smiling at everything.” – All Time Low

Months and months ago, on my way out of Dr. DiBenedetto’s office after making the decision to remove my lap band and have gastric sleeve surgery, I was handed the list of requirements I would need to fulfill before surgery would even be scheduled.  Call their nutritionist and have as many appointments as it takes for her to clear me.  Call their therapist and have as many appointments as it takes for her to clear me.  Make an appointment with my primary care doctor and have as many appointments as it takes for him to clear me.  Tests.  Appointments.  Results.  Adjust vitamins, deal with abnormal test results.  Re-test.  Another appointment.  Another test.  Another x-ray.  Support group meetings.  A lot of time away from work.  A lot of explaining to my boss and my boss’ boss.

This would be my life for more than a year.

I was nervous about the therapist.  I knew she was not going to clear me, and I didn’t think she should.   I mean, why would the gastric sleeve work for me long term when the lap band had not…what about me has changed in the last 10 years?  How would this time be different?  Sure, I could have the surgery and lose the weight and be happy for a few years just like I did with the lap band, but what was going to stop me from re-gaining weight again if I didn’t learn how to deal with food, life, people, myself.  And I definitely did not want that to happen again.  I caught a glimpse once of how fantastic my life could be and I want that.  Forever, until I die.

 Dr. D had made it pretty clear to me that if he took me on as a revision patient, I needed to be committed to changing ‘cos he was not going to ruin his record of excellence for me if I was not willing to work for success.  Tough love.  My favourite kind.

I was “willing to work for success”…but I had no idea how.  I didn’t know what or how to change.  And I am impatient…..I wanted to change NOW.  Snap my fingers and have it happen.

But I knew this was not something that happens overnight.  It’s something that requires moment-by-moment effort - chipping away at habits, addiction, and thoughts and replacing them with all new ones.  This is a major project.  The most important project I will ever have.  If I have any hope for long term happiness and fulfillment, I HAD to change, do the work, follow through with it and be patient.

But I was truly worried the therapist would not clear me “until I had changed” and so the long process of getting to my sleeve surgery would take even longer.  I worried they wouldn’t get how huge this is for me, and I’d be left on my own to find my way and I’d get lost like I always do and then this would be my life forever.  Still, I was not going to go in there and schmooze my way into clearance like I knew I could if I wanted to.  At this point, I was again at rock bottom and frankly, I was gagging on how badly I wanted to change.  So lying would not be the thing to do.

The therapist saw me, and as expected, she refused to clear me.  She very quickly started to explain her reasoning in a really sympathetic, patient voice and told me this does not mean I won’t be approved for surgery at a later time.  She looked at me like she expected me to be disappointed and upset and angry.   I told her she could stop explaining - I was not surprised and this is the right call….so what happens now? Tell me what I need to do.  She assigned me to another therapist who is trained to work with bariatric patients. 

But the in meantime, she told me to embrace what I already knew:  that this would not happen overnight.  I would not wake up one day and be “cured”.  I am reversing two decades of bad habits and damage to my body and it’s going to be hard and emotional and painful and I am going to want to give up. No one can do this work for me or force me to do it…. how and when it happens is up to me.  Instead of being overwhelmed by that, I start by putting one foot in front of the other.  I won’t see how far I’ve gone until I have taken many steps and made some progress.  I need to turn to my support people for guidance but they are only there to support me, not do it for me.

If you read my previous posts, you know that I had tried therapy before and had not found it, well…therapeutic.    But I decided to keep a very open mind and remember that this is a totally different time, a different situation, a different problem.    In our first session, Jessica, my therapist, referred me to a psychiatrist to rule out any chemical imbalances or undiagnosed mental health issues. 

I told the psychiatrist – a wonderful, South African woman I kept imaging having coffee with - I had battled depression on and off for years.  I was very clear I did not want to take drugs – I have tried many different types of anti-depressants already and honestly have never felt any different on any of them.  None of them had any effect on me – positive or negative – and it was just not a cycle I wanted to start again.  You start one med, you wait 3 months to see if anything happens, then you’ve gotta wean off it before you start another. 

The psychiatrist’s opinion was that I suffered from situational depression, not clinical depression so medication would not be useful anyway.  Phew.  Common sense prevails.

So, back to Jessica.  She was reassured by the psychiatrist’s report and we dug in.  We spent the first few sessions just talking about my history, my family, who I am, how I see myself, how I see others, what’s important to me, how I relate to the people in my life, what major life decisions I had made, what did I want out of life, what did I do to cope with stress, my history with my weight…..that kind of thing. 

I remember when talking about the rape being adamant that it had in no way affected me and I was completely over it since it happened 20 years ago.  It was just an unfortunate, insignificant thing that happened to me once.  And I meant it.  I honestly did feel that way.  I completely believed it.  I think I mistakenly thought that since I can enjoy sex, and be alone in the dark, go out at night by myself or that I don’t have flashbacks, that it didn’t affect me.  It’s a testament to the work we have done together that I can see things differently now and recognize how devastating that, and the events surrounding it, really was to me and be willing to admit that and talk about it.  It changed who I am as a person completely.  Changed how I felt about myself, changed how I felt about everyone in my life, changed what I looked for in a romantic partner, and changed how willing I was to open myself to anyone.  There’s no shame in that.  There’s only acceptance and moving forward.

About the third session in, I asked Jessica when she thought she might be able to clear me for surgery.  She said she was glad I brought it up because she sensed some tension between us because of this.  I wanted clearance, she could give it but she didn't want to give it to me and not have me do the work.  I told her I respected that and that I did want to do the work, but I also did not want to hold up the process of booking surgery.  Having weight loss surgery is not a straightforward process.  One step leads to the next.   Without the clearance letter, the process grinds to a halt.  I told her that even if I wasn't having surgery, I want to do this work.  I saw the value in it and thought it would save my life, that I was in it for as long as it takes.  But I don't want to wait forever to have surgery.  She gave me my clearance letter that day and I promised her I would come back.

And so I went back.  Over the year, we have talked a lot about Mindfulness, a practice inherited from Buddhist tradition.  Very basically, mindfulness is about being present in the moment and completely aware of what is happening in the moment.  Mindfulness can defeat delusion, and so it is considered powerful and takes constant practice to master it.  My homework was to read several books – two of which were specifically about mindfulness and eating - and start practicing being mindful in all different situations.  This is important for taking responsibility.  It’s also important to help eliminate overeating by paying attention to how, what, why and when I eat.  Finally, it’s important for helping me feel connected to my body. 

Another important piece to our time together involved exploring my emotions and the thoughts behind a feeling.  She taught me to stop and examine how it is I’m really feeling when I start to suddenly feel overwhelmed by any strong feeling at all.  Realizing that if I am angry (or happy or sad or irritated or anything at all), why I’m angry and finding an appropriate outlet for that other than self-destruction. 

We also talked a lot about what it means to me to be a feminist.  I felt like a fraud calling myself that because I was assaulted and raped, because my weight was so out of control, because I was making decisions from a place of weakness instead of strength, because I was so opposed to the idea of marriage and yet here I was, married.  But I still used that word to describe myself because it made me feel like I had a wall protecting me.  I had no idea who I was anymore, but I was sure I was a feminist.  It was the only strong thing about me…that word.  So if that is important to me, and is really a piece of my identity, then I need to define for myself what I am really saying and live it, not just say it.

I’ve been seeing Jessica twice a month for over a year.  In December she decided I was progressing so well that we only need to see each other once a month now.  How she has helped me, well there’s no easy answer.  It’s an ongoing process.  She didn’t “fix” me but she has provided me with insight, skills and strength that I can call on at any time and, my life has changed for the better because of her.  Because of her, I’m shedding this fake skin I’ve been wearing for 20 years and I am feeling more alive, more like myself than I have all this time and now I just cannot stop smiling.  Sometimes my time with her is truly profound, other times it is just simply revealing.  I have left her office with happy tears rolling down my face more than once. 

The work I do with her in session, and on my own as a result of our sessions, is one of the tools I need to beat obesity for good and allow the gastric sleeve to do its job.  It’s the silver bullet.  This emotional/psychological work I am doing is the piece that was missing with my lap band surgery.     I’m sure I will always struggle with my weight.  But now I feel capable of handling that and any other challenge life throws at me.  Bring it!

Random things:

·        I love insightful quotes

·        This is my fave Johnny Cash quote:  “I wore black because I liked it. I still do, and wearing it still means something to me. It's still my symbol of rebellion -- against a stagnant status quo, against our hypocritical houses of God, against people whose minds are closed to others' ideas.”

·        I feel most like myself when I wear black

·        I desperately want black hair.  I think women with black hair are  gorgeous.  I can’t pull it off.  I’ve tried three times and I just always look old.  The last time I had black hair, someone asked if I was Sam’s mother.  Ouch.

·        I absolutely detest black licorice.