How to access treatment without breaking the bank: Part II

(For Part I of this series, click here)

Even though I’ve had my eating disorder for nearly two decades, I really just started exploring the world of support groups five years ago, when I first moved to Los Angeles. Before that, I had a pretty negative view of anything that involved interacting with a bunch of people with eating disorders. Up until then, all of my “group” experiences were from structured inpatient, residential, or partial programs. You know, the kind of places I wrote about here. I think spending so much time in close quarters with other eating disordered individuals took it’s toll. Very disordered behavior and ways of thinking became “normal” and I lost out on many adolescent and young adult milestones. In the summer of 2011 I moved to LA and had every intention of not only never attending treatment again, but also never getting involved with anyone in the eating disorder “world” ever again. At the time I really thought it was the best thing for me, and I was excited to finally move on with my life.

Well, surprise! Of course my eating disorder followed me to LA, and “just moving on” was pretty impossible. I found a therapist pretty quickly, but I couldn’t afford to see her as often as was recommended. I was living a “double life” by trying to maintain the image of a high-functioning grad student while also dealing with a very intrusive eating disorder. This is when I started to look into groups. Luckily for me I was now living in one of the most support group-saturated areas of the country. I tried out a lot of groups, and not surprisingly had various degrees of success. Some groups were great, others were “meh,” and a few left me running for the hills.

It’s important to be realistic about what you hope to get out of a group. I’ve never heard of anyone recovering from an eating disorder after attending a once-a-week support group (darn!). Depending on where you are in your ED, a group may not even make a small dent in your symptoms. However, groups can still be of value to almost anyone who shows up, even just allowing you to feel connected and not alone for 60 minutes a week.

I tend to categorize groups into three categories– (1) member-led drop-in support groups, (2) therapist-led drop-in support groups, and (3) therapist-led closed groups or what is more commonly thought of as “group therapy.”

(1) Member-led drop-in groups– These are almost always free groups led by the members themselves. Alcoholics Anonymous is probably the most widely-known group of this kind. For EDs, there are several “Anonymous” 12-step variants, including Overeater’s Anonymous (OA), Anorexics & Bulimics Anonymous (ABA), and Eating Disorders Anonymous (EDA). OA is an interesting group; by the name you would assume it was strictly for overeaters or individuals who deal with what is now classified as binge-eating disorder. However, it has long claimed to welcome all eating disorders. Cool, right? I’ve never been to an OA meeting myself, but from trusted sources who have been I’ve heard this– yes, OA members are very welcoming of those who struggle with all EDs, and you’ll find people of all sizes and disorders in any given meeting. That said, I know many professionals who advise against individuals with anorexia or bulimia attending OA groups, due to the restrictive dietary philosophy of OA. The group was originally created for overeaters, so the focus is truly on “abstaining” not only from overeating, but any food or ingredient that may trigger bingeing, such as sugar or white flour. To a person with anorexia or bulimia who is not overweight, this philosophy can be quite triggering and harmful.

I have been to both ABA and EDA meetings. I was first exposed to the principles of ABA in 2007 when a treatment center distributed the ABA manual. To be honest, I was never very sold on the whole 12-step/higher power thing. I am not religious and I see many flaws in trying to apply the 12-step model to eating disorders. However, the groups themselves can sometimes be helpful even if you do not completely buy into the 12-steps. Like AA, ABA and EDA offer a variety of types of meetings ranging from meetings that focus solely on one individual “step” (not for me) to women’s only meetings or speaker meetings (more for me). My most positive experience with one of these was a couple years ago when I attended a weekly EDA meeting in Thousand Oaks. These groups were packed, and I almost got scared off by the crowd at first. I don’t think I ever said a single word during the whole six months I attended, nor was the content of the meetings ever that profound that I walked away with any amazing new insights. What I liked was the feeling of mutual understanding. I liked knowing that as dark and hopeless as things got for me throughout the week, I would at least feel understood and connected for an hour one night a week, even while sitting there saying nothing. Regardless of the meeting type though, be prepared to sit through several minutes of official meeting business as they read the lengthy list of rules, steps, and traditions. And at the end, be prepared to hold hands and say the serenity prayer. For real, just like in the movies. 😉

(2) Therapist-led drop-in groups– These are often free or low-fee “drop-in” groups led by a licensed mental health professional. You’ll often find these groups run by treatment centers. Sometimes they may only be open to alumni, but often they’ll be open to the public. Eating disorder organizations and nonprofits such as ANAD and NEDA may also run these groups. Just like member-led groups, these groups vary in quality and target audience. I attended a group run by a treatment facility in Woodland Hills and was not overly impressed. There were a couple loudmouth “regulars” who dominated the discussion and grated on my nerves. The therapist leading the group was not very good at steering the group back or ensuring everyone got a chance to speak. When I moved to Pasadena I attended the same treatment center’s group at the center’s more local facility. To my surprise, the groups at this location were completely different. There was a better therapist leading who was able to engage the entire group, and the overall atmosphere was much more welcoming and supportive.

(3) Therapist-led closed groups– These are less likely to be free, but are often offered at a “low fee.” Therapists may choose to hold groups with their existing clients who all share a similar issue, and/or they may welcome referrals. Oftentimes there will be a brief “intake” process where the therapist talks to potential group members to determine if they are an appropriate fit for the group.

My very best group experience was one of these groups. My dietitian referred me to a group run by a therapist she knew. I was hesitant at first because this was a very small group. When I joined there were only two other people besides the therapist. There would be no hiding here! Thankfully, It turned out to be a perfect fit. In this group I actually got to process things and interact on a very personal level with the two other group members and the therapist. We “clicked” right away and I always looked forward to Tuesday nights during that time period.

Walking into a group for the first time can be scary, especially if you’re new to the whole group thing. Whenever walking into a new group I tell myself that we’re all there for a common reason. We’re all at least a little insecure. If the group is a dud, you never have to go back. If it’s truly awful, you can just get up and leave. I still regret not just up and leaving after being told by one egotistical therapist “You don’t talk to each other in this group. All feedback comes from me.” um. . .

Some other things to consider when looking into groups:

  • Some groups tend to attract many “regulars” while others are less likely to have a consistent turnout. Very large 12-step groups, for example, can bring in a very different crowd from week to week. If you’re unimpressed one week, you could have a completely different experience the next week based on who shows up. Even for smaller groups that have more “regulars,” the census will still change over time, so it’s worth re-checking out groups you may have dismissed several months or years ago.
  • If you’re looking for a small, intimate group therapy experience and are currently seeing a therapist for individual therapy, you can always ask her/him if she/he would be willing to start a group. The plus here is that the therapist already knows you and should have a good idea of who you would mesh well with.
  • If you’re convinced there are absolutely no groups in your area, you may be surprised. I’ve found a lot of groups are not publicly advertised but can be discovered though talking to local treatment professionals. For eating disorder groups, I have to mention this website. Don’t be fooled by the outdated layout; it’s actually a great resource that is updated on a daily basis. You can search for all types of treatment by state/region.

Finally, if anyone from the Los Angeles area is looking for good groups, please don’t hesitate to contact me. I know of several that are going on in various areas of LA and can help you decide which would be the best fit for you. 🙂

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