Earlier this summer I wrote about the summer months as an opportunity to catch up with former patients who are back in the area, dropping in for "wellness checks". Now that fall is around the corner most of my patients are beginning a transition back to school, with all of the stresses and opportunities this change brings. Since many eating disorder sufferers are prone to anxiety and risk-avoidant, they often experience significant anticipatory anxiety as they wonder: will I like my new teacher? Can I handle the work load? Will I have any friends? What if I don't keep my perfect 4.0 record? Will I make the cross country team? How different is high school from elementary school? How can I keep up in marching band when I missed band camp? And many, if not most, of these fears, can be translated into food, fat, and body phobias. Therefore some of the important work of therapy at this time involves decoding the fat fears and translating the underlying fears into words. As we all know, fears translated and expressed become much less powerful; and then the focus can turn toward problem solving skills.
It's also true that school can present some real obstacles. Often we've had to be creative with a client's meal plan when she has to leave for school by 7 a.m. and has been assigned to "first lunch" at 10:50. Frequently teachers prohibit eating during classes which calls for some advocacy to allow time for snacks. And although we work very hard to teach our clients not to value themselves based solely on their appearance, an ill-timed comment from a peer can undo a great deal of progress in this area.
On the other hand, a return to school can be of positive benefit for some of my patients. Sometimes there is comfort in the return to the routine that summer cannot always provide. Other times the incentive of returning to participation on the fall sports team can provide motivation to gain and maintain weight. For some college-aged individuals coming back to campus represents a return to their most supportive environment.
I'm certain all of you who work in the field are aware of the potential benefits and pitfalls of the return to school season. Please write and share your thoughts. Until next time, Gail