Q & A with Jocelyn Langholz Psychotherapist, Memorial Medical Center Behavioral Health Outpatient Services

Josalyn Langholz

Josalyn Langholz

What does a psychotherapist do?

Therapists at Behavioral Health deal with a wide range of issues, working with individuals of all ages, as well as couples, and families. I have been providing outpatient therapy to children and adolescents at MMC since 2001. In recent years, my clientele has been increasingly comprised of adolescent girls and young women. I frequently deal with issues of depression, mood management, anxiety, trauma, and self-harming behaviors. Disordered eating is often associated with these issues, leading to my interest in obtaining specialized training in the treatment of eating disorders

I currently offer assessment and outpatient treatment of eating disorders for individuals of all ages. This service is designed to provide therapy for individuals with eating disorders who are medically stable and adequately motivated to safely benefit from outpatient therapeutic intervention. For those who are not medically stable or unable to respond to therapy on an outpatient basis, referral to inpatient eating disorder programs can be made.

What can a patient expect during an initial visit?

An intake appointment is scheduled after referral, which can come from an individual, parent, or physician. Patients who are referred for possible eating disorders are asked to complete two forms, one gathering general history and a second with questions about foods, eating habits, dieting, and exercise. During the intake session, we talk about current concerns and gather a psychosocial history. We talk about overall life experience – childhood history, current family, work and education, social relationships, activities, health, and possible traumas. This history provides an opportunity to begin to identify links between experience and current eating issues. Questions related to eating issues will also be explored. During this initial contact, education and consideration of possible goals and treatment direction begins. At the end of the appointment, a patient will have initial recommendations, new information, and, if appropriate a follow-up appointment to continue therapy.

What is the largest misconception you think patients have about eating disorders?

People often believe that eating disorders are all about food and body issues. While weight loss, unusual eating and exercise patterns are often the obvious symptoms, an eating disorder is rarely just about the food. Eating disorders are very dangerous and can lead to long-term health issues and even death. Simply treating the physical aspect of eating disorders is not enough.

The onset of an eating disorder is most often triggered by an experience of feeling out of control. This often occurs at the time of major life transition, such as leaving home, a break-up, family disruption, health challenges, loss, abuse or other trauma. To avoid the intolerable sense of being out of control, the person finds something they can control through distorted eating habits. At first, it feels good. However, these false feelings of control mask the real issues. They push the sufferer into further commitment to self-destructive eating and body control patterns until a full-fledged eating disorder such as anorexia or bulimia emerges.

Treatment of eating disorders is multi-disciplinary in nature, including health monitoring by a primary physician, nutrition education and planning, family support, and mental health therapy. Medication is also often a component of eating disorder treatment. Therapy focuses on thoughts, emotions, and behaviors obviously related to food, as well as the underlying issues that contribute to the investment in disordered eating as a coping mechanism. I see my role as therapist as well as case coordinator to ensure that medical and nutritional services are available and utilized in the course of treatment.

What’s the one piece of advice you’d give patients to improve their overall health?

I frequently find myself reminding patients to find balance in daily life. Eating well, getting enough rest, and exercising regularly improve emotional health as well as the obvious benefits to physical health. Balance means having a healthy relationship with yourself and with others. Balance also means dealing with stresses and challenges as they arise, getting help when you need it. These wellness habits are also key components to recovery from eating disorders as well as other emotional behavioral issues. The good news is we all have these resources inside of us and simply need to learn to trust and use them.

If folks wanted additional health information about eating disorders, what are some available resources?
The NEDA website, http:// nationaleatingdisorders.org, has extensive information focused on prevention and treatment for individuals, families, and educators.

Life Without Ed, by Jenni Schaefer (2004)
Intuitive Eating, Evelyn Tribole and Elyse Resch (2003)
Surviving an Eating Disorder: Strategies for Families and Friends, by Michele Siegel, Judith Brisman, and Margot Weinshet (2009)