Relationship Problems: Couples and Family Therapy
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Disordered Eating and Eating Disorders
Food and body can be stressful and concerns about eating too much or too little and how you see yourself, judge yourself, or evaluate yourself in the eyes of others can become debilitating, preoccupying, and even dangerous to your health. Are you struggling to stop eating when you are full or even struggling to recognise if you are hungry or full? Maybe, you eat for the comfort it brings and experience cravings for food or eat mindlessly and too much. Perhaps, you’re checking yourself in mirrors and windows and focussing on parts of your body that you experience as “fat”, or “ugly”, or other words that diminish you in some way. Perhaps, you’re bingeing and throwing up afterwards, or over-exercising. Sometimes, you find yourself counting calories, focussing on what you eat, limiting what you eat, cutting out foods you consider “bad”. Maybe, you talk about body and health often, when you’re really talking about “skinny”, “thin”, or other ideas that seem to be aspirations rather than healthy attributes.
Disordered eating and eating disorders are fairly common in everyday life, and some eating- and body-related issues can be debilitating for people and for their families. The experience of “food crazy” can become overwhelming and perpetuate feelings of self-loathing and self-judgement that become a way of being in the world, often feeling like it will never end. Disordered eating has various forms of treatment depending on what the presentation is and can have successful outcomes for many people.
It is important to recognise that no-one has to remain captured in the endless loop of yoyo dieting, bingeing/purging, restriction, bingeing, over-eating, and comfort-eating. Psychologists and psychotherapists in this practice are focussed on addressing disordered eating with a view to treating specific aspects of the eating-related concerns and broader issues that might present alongside this. Depending on the severity and length of time of your eating-related concerns, various forms of treatment will be considered: family-based treatment (FBT), adolescent focused treatment (AFT), cognitive behaviour therapy for eating disorders (CBT-E), supportive psychotherapy (SP), Maudsley model of anorexia nervosa treatment for adults (MANTRA), mentalization-based treatment (MBT), referral for residential treatment. Group therapy will also run at various points of the year. Collaboration with a dietician and general practitioner/psychiatrist will also be considered, where appropriate, for general and optimal management of disordered eating. Please note: very low weight clients with anorexia nervosa are not able to be managed in this practice, as risk to life will be considered a reason for residential treatment.
Drugs, Alcohol, Sex/Pornography
Have substances, alcohol or sex and pornography become problematic for you? Maybe you binge on weekends, or maybe you use substances or alcohol every day. Perhaps you are already experiencing changes to your mood and increased anxiety. Maybe you use these things as ways to unwind, but other people are seeing an ongoing problem in your life. Sometimes, you miss work or cancel social arrangements in order to watch porn, or to drink, or to use substances; maybe, you hang out with people who do the same things that you do but avoid places and people where drinking or using substances would be frowned upon. Maybe, sex and /or pornography has started to disrupt your sexual arousal, your libido, your bank account, and even your relationship. Do you sometimes say things like “but everyone drinks a lot in New Zealand” or “it’s just what Kiwis do, it’s a drinking culture”? Or maybe edging and masturbation have become your dominant form of sexual activity, but sexual relationships have become impoverished and unsatisfying. Substance and alcohol abuse is a common problem encountered in society, as is the overuse of pornography or sex as a way of coping, but at the expense of many other aspects of life.
Treatment is available that does not involve rehabilitation and in-patient/residential treatment, depending on the severity of the substance/alcohol abuse/misuse. For sex and pornography, treatment in the community bodes well for future outcomes. It is important to recognise that no-one has to remain enslaved within the realm of harmful substance/alcohol use or within the grips of destructive desire. Psychologists and psychotherapists in this practice are focussed on addressing dual diagnosis, if present, where these issues occur alongside other mental health conditions. Depending on the severity and length of time of your abuse/misuse of substances or sexual behaviour, various forms of treatment will be considered: harm reduction therapy (HRT), motivational interviewing (MI), abstinence approaches and the Minnesota model (AMM), referral for residential treatment. Group therapy will also run at various points of the year. Please note: harmful sexual behaviour that involves children does place an obligation/duty on a therapist to disclose this behaviour to relevant bodies. This is non-discretionary and necessitated by law.
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