Reflection on First Consultations

I wrote in this blog a long time ago about the first step into eating disorder treatment and wanted to review some of the key points.

It typically takes years for people to reach out for help and can often take a few tries before committing to really get well. The result is that first appointments are critical to help someone start the road to health. 

Much has been written about how to engage someone with an eating disorder and for good reason. Experienced clinicians know how difficult it is to transform a consultation into steps towards recovery. 

Unlike most initial consultations, gathering all the facts is not the most critical part of the initial appointment. There will be time to sort through details and understand the facts. This first meeting must emphasize the reason for meeting. After years of illness, what has led to following through with getting help? Namely, what has changed to make this session possible?

It's often a difficult question to answer, but the purpose is to consider what might have begun transforming in that person to want to address a longstanding part of her life.

A marker of success of that first appointment is to help the person have enough perspective on her life to consider herself separate from the eating disorder for a moment and realize that recovery is deeply connected to that separation. 

Looking back at recent posts in this blog, I realize the existential component of recovery begins from the first appointment. Reflection on one's own value and purpose underlies the first session and emphasizes the most difficult part of treatment: finding meaning outside of the eating disorder. 

Stepping into treatment is a courageous act that needs to be matched by direction and courage from the clinician as well.

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