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Do I have an eating disorder? I’m not really sure if i do or not. My dad always thought i did in middle school because i dont put my lips to my fork when i eat i use my teeth to “rake” the food off instead and i always thought that was crazy. At the time i was about five foot six and weighed about 130 wich i thought was a bit much until i saw myself in a full length mirror. now im a senior in highschool and im five foot seven and as of this morning im 144.3 lbs. I worked my way up to 167 last year and tried to get down to 140 for prom. I diddnt succeed and i ended up eating so much i gained 10 of the 20 lbs i lost and then over summer after i got diagnose with celiacs disease i diddnt eat very much, there would be days i just skipped food all together. everyday at the pool more and more guys would look and I felt more confident. when i went to my doctor for my celiacs doctor about a month ago, she said that my weight concerned her. apparently 140 is the lowest my body can be without being unhelthy and i weighed in at 142. I still didnt feel it was enough and about 2 weeks ago i discovered that if i take my adhd medicine everyother day not only can i slack off when i really want to but i get sick and then im not hungry. I went down to 140.2 for about 4 days and i felt like a fat kid. In gym I couldnt run as fast as normal and i was out of breath in no time, when we got back i looked in the mirror and saw how gross i looked. my boyfriend thinks im self destructive in ways other that not eating because he sees me eating apples and rice bars alot and thinks its the only healthy thing i do for my body since i stopped cutting.But he dosnt understand either way and dosnt seem to notice either way so i figure hes happy about thedirection of my figure. I couldnt get my meds to make me sick anymore last week so i stopped taking them and i just ate everything with sugar or chocolate or fat and went up to 147 and it freaked me out. Christmas eve i took my meds without thinking and like usual when i take hem i diddnt eat. a few hours later i got really sick but due to a childhood surgery im unable to vomit so i just dryheave and it hurts but im used to it. I diddnt eat untill christmas morning(yesterday) and i ate all day long. then thismorning i did my usual. I got in my yogapants and a bra and ran down to weigh myself. unhappy with being almost 5 lbs above goal i got off and looked in the mirror again. poking and pulling and shaking i decided that i need to get back down but mom handed me a bowl of oatmeal that im currently avoiding and thinking about flushing even tho im starving so i think ill take my meds again tomorrow so ill be at my goal before mybirthday on the 29th and then ill beable to decide if i need to loose more or not. i realise this cant benormal. making myself sick to avoid food instead of making myself purge it and actually eating so is it really an eating dissorder if i take vitamins to get my minerals and then skip a day here and there for food but i never actually purge it?if so how do i fix myself, im too scared to tell my councellor because she thinks ive made so much progress wih everything else i dont want to dissapoint her and shed probably want me to tell mom who would make me eat at the table again so she knows im eating… I want to be in the fashion and art world and food just makes me fat… not fashionable nor artistic but disgusting and lathargic and even with crunches and dieting i cant seem to look the way i want … i also feel that im unhelthy weight already because the chart for weight is based off hight and im prety sur my chest is probably about 15 or 20 lbs of my weight wich means id be at unhelthy weight already wouldnt it? I just stil dont like the way i lok tho please help me figure this out

Yes, you have an eating disorder. It doesn’t matter what you call it. You are obsessed with your weight and what you are and are not eating and you are treating yourself horribly. Starving yourself (even for a day), giving yourself the dry heaves, and misusing your medications is not the way to get in control. Eating sensibly and doing a reasonable exercise routine is. You might also be pleasantly surprised by how things change if you take the diagnosis of celiac disease seriously. Going on a gluten-free diet is challenging but many people who have celiac feel much, much better when they drop wheat from their diet. See a nutritionist if you need some hints for how to go about it. You just might be able to substitute a healthy management of a gluten-free diet for your unhealthy approach to eating.

If you want to be in the art and fashion world, focus on making art and designs. Professionals in the industry are far more interested in the quality of your work than the size you wear.

Please show your counselor your letter. She can’t help you unless she knows the honest truth about what you are up to. Please don’t worry about “disappointing” her. Professionals do know that progress is often a matter of two steps forward and one step back. It’s part of the process. And by all means, let your mother help you. Your overconcern with your weight is threatening your health and your future.

I wish you well.
Dr. Marie

I am 24 years old and I have been seeing the same shrink on and off for ten years. A month ago, I admitted to him that I was sexually attracted to him. He admitted that he was sexually attracted to me too, and that he likes me, but he has very clear boundaries, and given our history, a sexual relationship just wouldn’t “sit well” with him. Before admitting my feelings, he had told me he thought I was attractive. The first time was when I was 15, and the other times were more recent. I am a psychology major, so I understand the concept of transference and countertransference. I understand that it would be extremely unethical for him to act out or sexual attraction, but I still feel rejected, unwanted, and increasingly depressed.

About a year ago, he told me that the only way I would be happy is if I cheated on my boyfriend. I did, and that’s when my feelings for my therapist got so severe. I would even have dreams that I was having an affair with my therapist instead of the person I was actually having an affair with. Since then, I have cheated on my boyfriend with over 8 people. Many of which, I would never normally have sex with. Afterwards I feel shameful, disgusted, guilty, and depressed. I feel like I have lost my dignity, and forgotten what my boundaries are. I think all I really ever wanted was my therapist. I think these feelings are damaging, and perhaps causing me to have a problem with sexual compulsion.

I told him that I didn’t want to be his patient anymore, and he told me that he enjoyed being my therapist, he said he likes talking about sex with me, and he wants me to continue being his patient. He even said that this was somewhat selfish of him. Every time I see him I get really depressed and want to binge on either alcohol or sex afterward. I feel like our therapeutic relationship is toxic for me. Its really hard for me to stop seeing him, because I want him as a part of my life, but he is my therapist and these relationships are not permanent. Should I just never go back? Should I take a break? See someone else? Are my feelings really damaging me? Is he already being unethical?

There’s always the possibility that you’re misinterpreting things. I’m only getting one side of the story. But let’s assume that you are absolutely accurate in your letter.

In that case, there are a number of red flags that this relationship has moved from being therapeutic to exploitive. My first concern is that you’ve been seeing a therapist for 10 years, since you were only 14. At the very least, it suggests that your therapy isn’t working. Therapy is supposed to be, as you said, a temporary support and learning process. Of even more concern is that you seem to be feeling worse, not better, as a result of your interactions with your therapist.

Then there are the issues around sex: I can’t imagine a therapist suggesting that someone cheat. Reconsider a relationship? Yes. Cheat? No. The term says it all. Cheating is dishonest and usually only leads to feelings of shame, guilt, and regret. Most worrisome of all is that your therapist has told you many times that he finds you attractive and has said that he “likes” to talk about sex with you. You are right that it’s not at all unusual for a patient to have a crush on her therapist but that should become a topic to work through with the therapist maintaining clear and consistent boundaries. And counter-transference is what therapists deal with in their own supervision, not with the patient. Your therapist should have immediately understood he needs supervision when he found himself saying that he wanted you to continue as his patient for his own selfish reasons.

In an ideal situation, you would be able to talk with your therapist about your feelings as a way to figure out your part in relationships and tp practice handling conflict. But that assumes that the therapist is trustworthy and able to do only what is in your best interests. It’s not about what does or doesn’t “sit well.” It’s a matter of professional ethics.

In a situation like you describe, I worry that to share your dreams and feelings with your therapist would lead to more confusing conversations that make you feel guilty for wanting to leave. If that is the case, it may be more reasonable for you to interview a few therapists and find someone new to talk to. The very first issue you will need to deal with is your experience with your former therapist and how it is likely to impact your trust in your new one. Your new therapist may also be able to help you decide whether your longtime therapist’s behavior should be reported to the licensing board.

I’m truly sorry that you are coming away from a decade of treatment feeling depressed and confused. As with physicians, our job as therapists is to first do no harm and then to do our very best to do good. It grieves me to hear of situations where a therapist loses his or her own bearings in such a way that the patient gets hurt. I encourage you to take charge of your life and to find the supports you need to get comfort and to heal.

I wish you well.
Dr. Marie

Wich

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