… but, is there such a thing as “touch-up” treatment?

In the spirit of my remission and relapse post, I’d like to emphasize the many shades of gray between the two extremes.  You don’t wake up one morning to have fallen off the recovery cliff overnight (though it seems like that for some people).  You can be doing “great,” or “overall good, but not quite as great as I could be,” or “eh, have been better,” or “having a tough time,” or “really struggling.”  Often I think you are conscious of when you are starting to slip.

Additionally, I think that there are a lot of people who never reach a state where they are symptom-free.  They still struggle with disordered thoughts, some food rituals or food fears, occasional purging, bad body image, guilty over not exercising, etc. (not all of the above — that would be significant.  but a couple of the above).

Individuals in both of these cases are looking for “touch-up” treatment (as a friend of mine calls it).  You’re not looking to go back to following a meal plan and to counting everything that you eat… or to spending 12 hours a week in an IOP program talking about stuff that you worked through five years ago.  But is a 50-minute session with a therapist every week really going to really normalize your eating, or finally get you past that fear of gaining weight, or get your worsening anxiety and depression under control?

… or, does it take going back to meal plans, exchanges, ED groups, journaling, and all of that to reach your treatment goals?  You’re working on the stubborn issues that weren’t resolved even back in the day when you did have intensive treatment… would an outpatient therapist be able to help push you past them now?

… and if “touch-up” treatment isn’t possible… is that why so many people get worse before they get better?  Because they need more intensive treatment to make any progress?

I hope not.  I am really rooting for “touch-up” therapy.

Just something to think about.