Book Notes Perils of Weight Loss: Stage Four Stuff

by | Mar 1, 2013 | 3 comments

The previous posting briefly laid out the six stages that many of my clients progress through during EMDR therapy. The EMDR process has a rapid and multi-level effect on the client, both during the treatment and out in the world. The person changes in many ways. It is a comprehensive transformation, and it is permanent. For example, a person may complete a great portion of the EMDR work related to, for example, childhood physical abuse. As we resolve the impact of this history, there are changes that happen to the client internally, and changes related to how they begin to perceive and engage the world externally. It can feel uncomfortable for them and sometimes for those around them.

There is a bit of truth to the cliché “ignorance is bliss.” EMDR is a psychological laser beam to your truth and it is not always pretty or easy.

I can’t get very specific here; hence the reason for the book, but one important thing to remember is that these stages are very clear and distinct.

Here is a brief story about one of my clients that should demonstrate the sometimes dramatic movement from one stage to another. We’ll take it from stage four. You will see that from most people’s perspective, she should be finished with her therapy. She has everything she ever wanted. The old self is dismantled. We are out of stage three and now when we think the work is done chaos sets in. We are not finished with the work. We are just getting started.

This young woman identified herself as the “fat girl.” She was single in her late 20’s, a project manager at an IT firm. She described her family as “perfect.” She had a handsome brother who was of course the star quarterback. Her mother was attractive, petite, and wore a size one or something. She described her father as tall with salt and pepper hair, well-groomed of course, with well tanned skin. He was a Florida executive and he looked it. Then there was my client, the little “fat girl”, probably a miscalculation in the conception department.

“I’m the mistake,” she said.
“If you look at our family pictures and ask yourself…who doesn’t belong?”
“Well, it is obvious; it’s me.”
To her, she was the little “fat girl” in front of all the perfect people, the one who was dropped off in the wrong family at the wrong time. A cosmic mistake.

When I first saw her, she was not fat. She was thin, tall, blonde, and depressed. She recently lost over 80 pounds. All she ever wanted was to be skinny and look like she belonged in her family–to be “good enough.” There it was, her dream had come true. She lost the weight, and now she wants to die and she does not know why.

She said, “This is another dirty trick God is playing on me.”
“How can this be?”
“I’m skinny and I am supposed to be happy now.”

I’ve seen this many times before, but each case is different and it can be a bit of a mystery to figure out. Stage four is when everything a client has come to therapy for is accomplished and then trouble sets in. Usually the client doesn’t know why and often neither do I. That is the beauty of EMDR, like I said; it is a laser beam to the truth. The answer is always inside the clients head, not mine. EMDR is a wonderful and effective way that sets the stage for unlocking the mystery. Believe me, I am not clever enough to figure this out on my own.

We set the EMDR session up and started. Things moved rather uneventfully for a time and then she said, “I’m feeling afraid.” I said, “Okay, go with that.” (Which sounds lame I know, but it’s what we are trained to do, to stay out of the way.)

Then she began to weep, tears really pouring down her face. I waited until the tears subsided and then I stopped. She turned to me and softly said, “I don’t know who the good people are anymore; because only good people talk to fat girls.”
She continued, “Now, everyone talks to me and I am terrified.”

There it is. One sentence, “I don’t know who the good people are anymore.”

Now we know why she’s depressed and now we can get to work. Her depression lifted that day, but there was a lot of work to do. Now that she understood, she wasn’t depressed any longer, but she was anxious and very uneasy for awhile. This was all manageable because she knew why.

There you have it – a perfect example of stage four moving to five with a very real danger of returning to stage one. There is a danger of putting the weight back on and going back to the old way because it is safer. It’s safer because it’s the land she knew and could manage. Being the “fat girl” who didn’t belong was easy for her, she had been doing it her whole life.

Her truth, like everyone else’s, lies ahead, not behind. Navigating through these treacherous waters and this exciting new terrain is the work we finished. It was a movement through stages five and six that in the end was about accepting herself—at any weight.

She discovered that there was a wonderful and healthy world out there for her. It wasn’t about “fitting” into someone else’s world as much as it was about creating her own world and accepting herself. She discovered a healthy place somewhere between the land of the “fat girl” and the land of the “perfect family” that was all her own.


  1. Rebecca M.

    That’s really interesting. I know the feeling of “everything is fine so why am I miserable?” I think it’s great that you can help people figure that out in a single session with EMDR.

    • Andrew Dobo

      Rebecca, thanks for the kind comment. Of course it doesn’t always work in one session. Sometimes it takes a while to figure these things out. Dr. D

  2. Melissa

    I have one EMDR session specifically that the pain and sadness lifted immediately home session… after 3-4 weeks of straight crying when I experienced a traumatic event. I know it is different with everyone… but so thankful for this experience. Because of my own healing I am attending Tampa training in June !


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