One of my core theoretical orientations in psychotherapy is the work of Carl Rogers. Rogers’ is known as the father of humanistic psychology, a philosophical orientation based on unconditional positive regard, where the helper shows complete acceptance and support for the human being, no matter what the person says or does. It is a client-centered approach that centers on an attitude of grace and values the person no matter their actions. Even if therapist does or does not agree with a client’s actions, they should accept the natural value of the person. The main factor in unconditional positive regard is the ability to be able to isolate behaviors from the person who commits them.
My personal experience with the medical treatment of obesity, I found that physicians did not use this approach. Often, harsh criticism of my weight made me feel isolated and helpless in the medical setting. I was not treated fairly, as a patient, but rather as a problem that needed to lose weight. For many years, I did not go to the doctor. During my lapband journey, I felt judged and the need to justify why the scale didn’t move. In retrospect, I know now that it had everything to do with the philosophical approach within the practice, and the attitudes of the professionally I had chosen to guide my journey. My current surgeon and primary care physicians’ approaches are completely different. It’s more personal because they understand and are willing to listen without blame. They trust me when I tell them what I eat and how I exercise and still, the scale is not moving. I don’t feel like I’m not being heard, but the only answer right now is consistent behavior management.
On a community level, I often see people judging others for the decision they make about their care. Whether this is derived from a belief that so-in-so isn’t doing such-in-such and their behaviors are leading to X-Y-Z, is not my business. So many people still think that the only way to “cure obesity” is with diet and exercise. It’s not THAT simple. It will never be some magic formula (or potion!) that we can drink to make us healthier (or skinnier, for those in it for vanity.) Believe it or not, many people want to lose weight for the sake of vanity and nothing else. They are quick to switch from diet plan to exercise routine to power potions as fast as the market can release it. They may even want to sell it to you so they can make their riches.
Do not be distracted by these people. They do not have your best interest in mind. Visually, they are looking for what’s wrong with you so they can prey on your weaknesses. They want to empower you to become better (by losing weight!) and they will quickly show you where to sign your check. Don’t do it. Look within. Process all the negative emotions and failed attempts, and realize that you are healthy when you live in the present moment, free of fear. Your self esteem is built on knowing who you are and accepting yourself today. All the negative beliefs you have held about yourself can be let go. You have the power to grow and nurture your intentions, with diligence and persistence. It shall conquer all things.
I write this as a counselor intern with eight years of experience under my belt in the field of therapy, and as a bariatric patient who is five years post op from Lapband this week, with one year two months post-op band removal and eight weeks post-op vertical sleeve gastroectomy revision—and it’s frustrating. I’ lost twenty-five pounds in the first month. My expectations were so much greater, so, yes, I have disappointment in with my current metabolic inefficiency. I’m disappointed because there has not been one day in the last two months where I exceeded 1500 calories in one day, and most, I did not exceed 1,000 calories. I exercise. I focus on getting protein in first. I am doing all the right things, and I am transparent about it. I keep my diary in MyFitnessPal open for others to view (just don’t tell me you read it because I don’t want to know you’re diet-stalking me.)
What I will tell you is this— you are only defeated when you check out of the process and stop doing everything all together. As long as you are still thinking about and processing what you have control of, your head is in the game. If you throw caution to the wind and just don’t care, eat whatever you want and lose accountability, you’d failed yourself. I have yet to fail myself. I still believe that I can lose the weight, and whatever this metabolic dysfunction currently is, I will pull through the other side. Yes, I am having blood work done again in a week, so checking for any hormonal or thyroid issues is on the agenda. Yes, I’m exercising my a$$ off. No, I’m not night eating, grazing or drinking sodas. I’m just metabolically stuck for a brief (going on 3 weeks) time. The obesity did not come on overnight (though, that year after the Lapband sure did feel like it at times) and it won’t come off overnight. I know this.
All I can do is continually accept compliments from family members and friends alike that I “look like I’ve lost” even though I haven’t. My sister encouraged me today to take measurements. I am. My mother reminded me to try on clothes I haven’t worn in 10 months. Everyone has a piece of advice for me. Guess what? I have nothing. All I have is unconditional positive regard for the process right now. Whatever is preventing me from losing will eventually pass, and the struggle will move on to something else. For now, I am going to NOT beat myself up over it, because what good is a therapist who beats herself up over little things she can’t control? This actualization of self brought to you by a very reflective, humble Bariatric Counselor.
The Six Behaviors that Encourage Self Actualization
1. Make choices that progress toward your goals
2. Be honest, humble and transparent in living your life
3. Position yourself to experience life by exposing yourself to new conditions
4. Give up defending your position, and develop the mental strength to resist anxiety
5. Focus on you and what it is you want to become
6. Selflessly concentrate on what you want and allow yourself to enjoy the process