Interview with Lila Despotovich, Therapist

How did you become interested in working with clients with eating, weight and body issues?

As a woman therapist, what drew me to work in the field of eating disorders, weight and body image issues is their prevalence and ubiquity in today’s society, and particularly among women. I was becoming aware of a constant stream of images of impossible standards of beauty and of the messages by the media and the advertising industry that our bodies, and ourselves, are either too much or not enough, but never good enough. I felt that they often played upon our deeper insecurities and echoed our negative core beliefs about ourselves which we carried from our childhood. I could recall my own dissatisfaction with my own reflection in the mirror and ultimately my unhappiness about whom I was as a person, which lasted for many years. It saddened me that generations of women and young girls, but increasingly men too, were made to feel like this and some went to dangerous lengths in order to change and control their bodies.

Tell us more about how you personally approach working with clients

In my therapeutic work my intention is to create a safe space and a therapeutic relationship based on empathy and trust, within which clients can not just make sense of their difficulties and learn techniques for alleviating them, but also explore who they are beyond food, eating and their body image, find better ways of expressing themselves and being in the world and be heard when they are telling their story. Metaphorically speaking, I’m also there in the therapy room holding a mirror, with the aim that my client will begin to see themselves more realistically and more fully, with more acceptance and more compassion. I work as an integrative therapist and I use several approaches and techniques to suit the clients’ needs. These incorporate my psychodynamic and cognitive-behavioural therapy training, but I am also influenced in my work by mindfulness approaches and feminist writers and therapists.

How do you interpret and understand the way a client might use food as means of coping?

For many of my clients, food and control of their weight and size can become a way to control, manage or to cut off from their difficult feelings and unacceptable parts of themselves, to self-soothe or even to punish themselves. By the time the clients seek help, their difficulties often outweigh that initial purpose that the disordered eating was serving. Still, a change can be difficult. Every change involves a sense of loss – of the familiar, of the old ways of coping, of our old perceptions of ourselves. Being ‘stuck’ can also keep us away from the new and unfamiliar which can be scary for most of us. At times, we can all feel helpless and hopeless. Admitting that we have a problem and asking for help is a first and a courageous step in changing our behaviour and our relationship with food and our bodies. I think that being kind and patient with ourselves and taking consistent little steps is equally important. So is remembering that we are not alone with our difficulties. And that even at times when we are hopeless, our therapist can help keep our hope alive for us.