In the world of psychotherapy, especially psychoanalytic psychotherapy, the body issues always present themselves with every patient, without exception, in one way or another.  Sometimes it is something that can be resolved in a few sessions never to be seen again.  Sometimes it is the bulk of the treatment.  Whichever way it goes, being embodied is no easy task.  And as April 01 was recently here, it makes fools of all of us.  Why?  Because the warmer weather calls for less clothing that we can all hide behind and as a result, our issues of food and weight become more visible to the world.

A gambling problem is not immediately obvious to a the naked eye, because one has to check credit card statements and other things to see if there is a problem.  Not so with a weight issue, it’s there for all to see.  And sadly, even with the warmer weather, some people seclude themselves even more because of the shame they feel about their bodies.

Given all this and the veritable forest that has been written about body and weight issues, here’s a few ideas that might help people before the bathing suits come out:

1.  Body issues plague men as well as women.  Perhaps not in the same volume, but not having the midsection of a Channing Tatum tortures more than a few young men.  Just getting men to admit this is a huge step.

2.  Get a good physical.  A doctor can tell you if thyroid or other issues are getting in the way.  One cannot fight nature with will power.

3.  Tell the doctor ALL the medication and chemical that you put in your body, prescribed and otherwise.  He/she will be able to tell you which ones might be working against you.  Again, one cannot fight against the forces of nature.

4.  Take a good look at your fridge.  Why?  Because, eventually all the stuff that’s in there you’ll eat.  Ask yourself, do I really want to do that?  Unlike other societies, Americans spend very little time thinking about what they are going to eat when and how.  Perhaps just a little more mindfulness might help you reach your goals (whatever they might be) if you become more conscious of the connection between your goals and your daily habits.

5.  Keep a daily food journal.  And don’t lie!  As shame inducing as this might sound, a dose of the truth might set you on a better path

6.  Think about how much you actually move in a day.  People often report they are far more active than they actually are.  When the personal trainer puts the pedometer (a device that measures steps taken in a day) on people, they are often shocked at how inactive they are, depending upon even the dog to get the paper in the morning, that is if they don’t just get it on their tablets.

7.  Don’t go it alone!  Studies show that goals are more successfully reached if one’s spouse or best friend joins in.  Who knows?  They might actually be grateful for you request for “support.”

8.  Start today with small things.  People often think that changes have to be big and dramatic.  In graduate school, one of my friends came back to school having lost 70 lbs.  When asked how he did it, he reported that he stopped using alcohol and did yoga everyday.  (I cannot promisee that you will have the same results.)  That was it.  Sometimes small changes can have big effects!!

9.  Ask for help.  Tell your friends, family and neighbors that you are going to try to make a change and it can become a communal effort.  You’ll be surprised at how much support you’ll receive from people you did not think could care!

10. This one is important!  No matter how big the slip up, the binge, the slacking off of exercise or whatever mistake you might make, do NOT use it as an excuse to say, “Screw it, it’s too hard.”  or “I’ll try again next year and I’ll just wear a t shirt at the beach.”  No way!  If you make a mistake, that’s ok.  Dust yourself off and start anew.  This is why we’re given a brand new day everyday.  This is where body stuff becomes soul stuff very quickly.  Why?  Because this is where we learn how to forgive ourselves and show ourselves compassion:  the compassion we’d probably show others.  So give yourself a break and get going!

(All this being said, please do not start/stop any diet/exercise regime without a doctor’s approval!!)

Perhaps one of the most important decisions that one can make when choosing a therapist, particularly an analytically oriented one, either for oneself or for one’s child, is whether or not that person is going to be a good “fit.”

Many therapists practice very “externally”, that is, they are going to support the defenses and habits that are in place.  The analytically oriented therapist in contrast, is going to try to get to the root of symptoms and replace them with actually healthy structures of personality.  This kind of work takes MUCH longer, is much more difficult and takes much more courage.  Not everyone is up to this challenge.

It has been my experience that analytic work does not only change the person engaged in it, but also can challenge the family of the person engaged in this work.  Oftentimes, the greatest resistance to the analysand changing is the individual’s family!  All too often, this comes in the form of devaluing or diminishing the work of the therapist or the person in therapy.  These comments, such as “You’re not all that bad.”  or “You don’t need therapy that often, do you?” although meant well, can be enormously damaging to the person in treatment.

Indeed, ironically, because the family undermines the work that means so much to person in treatment, the family can often find themselves distancing themselves from the person in therapy, not understanding why the work of therapy is ending up with their loved one more distant from them than ever.  Although this sounds obvious, very intelligent people can fall into this trap.  So here’s a few pointers for those of you who are contemplating treatment or are in analysis:

1.  Make sure the therapist can understand your family’s values.  This means that the therapist should be able to understand the family’s stated religious values and also the sub textual values:  those of socioeconomic class and expectations that come from such realities.

2.  Check out the therapist’s background:  Talk to people who have been through his/her process.  If the process sounds like something that you and your family can withstand, go for it.

3.  If the therapist’s process requires more trust than the family can muster; or the family must micromanage, find a therapist who is willing to do case-management.  If the treatment goals are being dictated by the family, then the therapist must be willing to trust this or have the courage to challenge the family when it’s needed.

4.  If the family is unsure about the treatment, get a second opinion.  Present both the identified patient and the process to another clinician and if everyone decides it’s time for a switch, then make it.  It might be time anyway.

5.  If, however, an attachment is important, then one might want to let the treatment process be.  Like surgery, it’s best not to have to move the patient midway through.

Like any process of human growth, like the Spiritual Exercises of St. Ignatius of Loyola for example, if they involve real change and growth, they will involve change and challenge for everyone involved.  It’s not child’s play and it’s best to have a clinician who has a few years of experience under his/her belt.  In this way, those gray hairs might be well earned and might be a sign of wisdom.  And at the end of the day, is not wisdom what we are all seeking?