No one said it is going to be easy, but for some, it could be worth it.
While treatment was never my first choice either during my eating disorder, inpatient treatment and rehab can be beneficial for helping you put an abrupt halt to any “madness” or chains you’re having a difficult time breaking on your own.
Choosing a treatment center can feel like you’re choosing a college—so many options.
Whether you’re looking for a place to help you in a traditional recovery from anorexia, bulimia, exercise addiction or binge eating; or you are one of the 1 in 2 Americans seeking to get to the bottom of a chronic health issues—such as obesity or diabetes, the process of finding the “right fit” can take a life all its own.
Bring Google into the mix (Google searching reviews, menus or ‘the dirt’ on various places), and the Internet becomes a black hole—leaving you lost in cyberspace
What do you need
What questions should you ask?
How do you know how legit the place is, or if you’re wasting money?
Are they going to make you fat? (Often times a fear of mine when searching).
Unfortunately, many times these decisions (for treatment) come upon you with little time to decide “what to do”—your doctor is giving you an ultimatum, or in my case, my parents told me two days before, that I was going to get on a plane to go stay at a place in Arizona for a few months.
Abrupt (and often necessary) decisions must be made—out of the sake of your own health (and sometimes saving your life).
An important point here to realize is this: Eating disorders don’t mess. One moment, you can be walking and talking just fine, but keep up your habits and self-neglect long enough, and they can take your life.
In my years, I’ve lost a number of friends that I can count on both hands.
Anorexia, in particular, has the highest mortality of all mental illness, and that is not to discount the residual side effects that all eating disorders and unhealthy relationships with food and fitness inflict upon your body (see Body section).
That said, if inpatient treatment is your “final straw” or a higher level of care—something to get you away from your self-destructive habits is in the cards, here are some key factors to consider in choosing the bet treatment for you:
Do I REALLY Need It?
- Have you tried recovering on your own—to no avail? Only to stay stuck, day in and day out, wanting change, but not experiencing it?
- Is your eating disorder all-consuming—impacting your daily life (you’re constantly thinking about it, dreaming about it, walking on egg shells around it)?
- Are you ready for something different?
- Are you sick and tired of being sick and tired?
- Do others (therapists, family, friends) speak concern and love into your life—telling you they are worried for you, or about you?
- Do others NOT speak truth into your life—and you wonder why no one seems to be able to help you or care in your time of need?
- Are you experiencing un-health in your body? (poor vital signs, nutrient deficiencies, chest pains, low energy, etc.)
Treatment could be your ticket out of this mess. An intermission and turn-around in your eating disorder journey.
Treatment is not cheap—sometimes upwards of $1300-$1500/per day to cover costs for room, board and therapy fees. And it’s important to be aware that many insurance providers do not cover eating disorder treatment—at least to the full extent and time frame often recommended by providers.
Hence: It may seem easy to rule out treatment (inpatient) as an option if $1300 is not in your equation (unfortunately, this is a big reason why only 1 in 10 people get treatment for their eating disorder).
However, desperate times call for desperate measures, and just like investing in your education, or a house, or a car is a BIG decision—they are worth it, right?
Aren’t you worth it too?
Given you are at a place in your life—and your own battle—that you need a way out, a time in treatment could be the best investment of your life.
During my final stint in treatment, my parents did something they had never asked me to do before: They made me pay for my first month of treatment. With all my money in my savings, I forked over $30,000. Seriously.
It sucked. But guess what? I was more invested than I had ever before in my recovery journey—and when you put your money where your mouth or wants are, more of your heart follows.
What You Get Out of It
Most traditional inpatient centers involve: A whole lot of thinking and a whole lot of talking. Downtime for reflection and plenty of group therapies and 1-on-1 therapy sessions.
What do you want to get out of your time in treatment?
A few things that separated the final center that I spent my year-long stint in included:
- Individual therapy sessions five days per week (as opposed to 2-3 in many other settings)
- Intuitive and mindful eating work (rather than working off exchange based protocols or calorie counting, I began learning about intuitive eating from day one)
- Warm weather (Miami)
- Apartment living (The residential center was set up to operate more like “going to work”—during the days, we traveled about 10-minutes away to “the center” where we spent about 10-12 hours each day in treatment—groups, meals and therapy—but every night, we retreated back “home” to an apartment setting, where four girls lived in each unit with a recovery coach on duty)
- Outings (On the weekends, once we were at a healthier physical state, we’d go on one or two outings, such as movies, manicures and pottery painting)
- Big hearts (The staff had BIG hearts for helping girls in the throes of ED and always had a listening ear)
- A Transition/Recovery Program (A step-down program was offered to help girls transition out of inpatient treatment to a more ‘real-world’ experience, while still living in community and support)
- Computer and Phone Access (Having my computer on me was highly important. Some centers lock away electronics and phones—and for some folks, this helps them disconnect with the outside world. While we can all be a bit more disconnected, I valued having my computer and phone to stay connected to family and friends, as well as start my first-ever daily blog: A recovery journal that played a huge role in my own healing journey)
Some questions to ask staff on the phone during an intake may include:
- Therapy frequency
- Level of support—at various stages
- The food philosophy (intuitive eating, counting exchanges, etc.)
- Outings and activities (outside therapy)
- Setting (Sometimes a serene escape or a place removed from your own little world can be refreshing)
- Length of stay (most places have a minimum stay requirement—I stayed about 10 times longer than that requirement—and it was worth it)
- Ask about their WHY—Why do they do what they do? (If they can’t speak this with passion, gusto and hope…then you may want to look for somewhere else. You want a center who knows their way: To empower you towards freedom)
- ANYTHING else you want to know
Note: NO center is going to be perfect, AND chances are, it is going to be uncomfortable a lot of the time (hello, you’re challenging your inner beliefs and redefining new habits). But, if you keep your eyes on your bigger vision, then the time in treatment will be a breath of fresh air for your healing journey.
I cannot speak for every single treatment center out there in the world, but this is a topic I mention briefly in several entries and writings on the subject of finding a healthy relationship with food.
The food in my various inpatient treatment experiences was very heavily exposure-based treatment—meaning: food quality and nutrients were less of a concern, than challenging the lies and beliefs you I had around food.
Food was not a healing experience (in the sense a feeling of wellness in my body), but it was a healing experience in terms of making peace with the hundreds of food rules and body hate I created for myself over the years.
Looking back on the “madness” of eating Eggo waffles for breakfast and lunch one day (in the same day, yes), I still don’t always 100-percent understand the philosophies of exposure therapy, but I do see how, with my later insights gained around self-care and a genuinely healthy lifestyle, I can now laugh and look back on those times in treatment and say: “I lived to tell about it” and food is NO LONGER something I fear.
You know that saying, “You’ve got to go through fire to make steel?”
I went through A LOT of fire, and think all those Eggo Waffles, Egg McMuffins and California Pizza Kitchen pizzas turned my eating disorder mind into steel.
In short: The food in treatment is probably not going to be the most holistic of all foods, nor the philosophy that “food is medicine” for your body. Instead, “the ability to eat anything is medicine” and “freedom from food rules is medicine” seem to ring more true to my own treatment experiences, and all things considered, for a short time in the scheme of your life, “eating whatever” can teach you A LOT of things (about yourself, how you treat yourself and the fact that you are NOT defined by what you eat).
Couple this awareness, with an awareness that eating an 80/20 balanced diet—outside of the walls of treatment, based upon foods your body recognizes as real food and fuel for life—will get you further than ED ever could.
Most centers can provide you with a sample of their daily schedule of a day in the life of treatment—but these calendar blocks of groups, meals, therapy and occasional outings mean very little until you’re actually there experiencing it.
“Fun” is not a word I would use to describe treatment.
More like: “Out of body experience.”
In that: You can totally be going through the motions of participating in some cool groups, connecting with a therapist around some deep issues (you’ve been neeeeeeding to talk about) and even trying some new things (like getting crafty in Art Therapy or awakening your inner actress in Psychodrama), but regardless of the activity or therapy of the moment, the treatment experience will probably feel like an out of body experience—for at least a little while—because…your ED is not there.
Or, rather: ED is not invited.
Prior to entering treatment, your days, your mindset, your schedule revolved around ED—the highs of a binge or purge, the next sweat session, the euphoria of a growling stomach at night.
Once you entered treatment however, all of that changed.
ED may still be very present in the mind…but treatment forces you to not act out in your body.
Often times, I felt like a prisoner in my own skin—wanting so badly to restrict or workout, but not being able to.
This is essentially why most people will tell you: “Treatment sucks.”
It sucks because ED is unhappy. However, if change is uncomfortable (and treatment certainly is uncomfortable), the opportunity for change is great.
FIND THE RIGHT SUPPORT TEAM
Outside of treatment, there is strength in numbers.
Whether you’re thinking about working with a life coach, a nutritionist, a personal trainer, a mentor, a business coach, a strength & conditioning coach, a counselor and beyond—here are a few things to consider adding to your ‘initial interview’ process for picking the best individual for your own team…
- Know your why. First things first—know why you are seeking guidance, and support. What do you really need help with? You need to be able to express this on the front end of the professional-client relationship so the person can partner with you in your The more specific, the better. (ex. Why a functional medicine doctor? In order to address the underlying roots of disease. Why a fitness coach? To increase your lifts by at least 5-10 lbs. in the next 3 months. Why a counselor? To hold you accountable to your recovery, etc.)
- What’s worked well in the past? Think back to a time in your life where you succeeded at a goal or experienced success in a particular area of your life. Think about the coaches, healthcare providers and people who have made an impact in your life (coach=counselor, teacher, athletic coach, instructor, etc.)—what about working with these individuals was effective for you? What was their style lie? Was it being given an exact plan to follow, like a checklist? Someone who had a no BS approach and wasn’t afraid to “tell it like it is”? A provider who let you determine your own path? Awareness of how you’ve best worked in the past can help pave way for knowing what you need today.
- What do you love about your teachers? We’ve all had a teacher or two who we’ll never forget. My 10th grade English teacher, Mr. Covert comes to mind. More than just checking off a list for us 15-year-olds to learn all about Edgar Allen Poe, Hemmingway or The Great Gatsby, he brought the stories and authors to life in a number of unique ways, and earnestly tried to teach us lessons far beyond text on a page (life lessons). In other words: He cared and integrated creativity into his lessons. And I will never forget my 5th grade teacher Miss Harrison. The effort she put into trying to make learning fun did not go unnoticed—games, movies, creative assignments and speeches. She invested time, thought and, once more, creativity into the learning experience. I know I connect with “teachers” who are thoughtful and bring something to the table—nuggets of information, fun, creativity. They are genuinely invested in me, the individual—not just another client or session to fill.
- What do you need? (A Doc? Teacher? Coach? Counselor? Guide? Trainer?) If you want to learn more, find a teacher. If you want to be better, find a coach. If you want to dig deeper and reflect more, find a counselor. If you want to grow as an individual, find a mentor. If you want to be told ‘what to do’, find a trainer. If you want a sense of direction, find a guide. While all of these roles can bleed into one another, know what primary style you are looking for in whatever type of provider you need and in what areas (mindset, health, life, spiritual, relationship, financial, etc.). *You may have more than one provider on your team.
- Knowledge & Experience. It’s about a combination of the two. You can hire the most book-smart individual in the world, but if they don’t have the hands-on experience to back all that knowledge, there’s a lot of talk and not a ton of action. The same can be said about experience. Experience is a great teacher, however, if the individual is just using their own experience (and projecting what worked for them onto you), you will only get so far. For instance, say you hire a nutritionist to help you improve your relationship with food based upon her personal knowledge in the nutrition field—she’s got a degree. However, she doesn’t specialize in working with those in recovery from eating disorders, and sometimes it seems like she just doesn’t get why eating butter on your veggies is really challenging for you or why you may lie on your food logs. Without the experience of working with individuals in your situation, or experience with the mindsets you battle yourself, you may find yourself not getting anywhere with her. This is not always the case, but often times knowledge and experience are a powerful combination for a healthcare professional you click with.
- Money, money, money. Hiring a team is no light investment. And it’s a wise investment when you feel totally connected with your teammates. Have a general idea of your budget, but realize, when you find that ‘just right’ individual, sometimes it’s totally worth it to invest (in yourself). If their knowledge, experience, care, concern and process is going to help you learn, grow and “get there” (wherever “there” is), the providers are invaluable.
Have a good idea of these questions and concepts on the front end, and it will make finding the ‘right fit’—whatever type of teammates you choose—ten times easier!