A conversation with the therapist...
Susan Maria Leach: “I am proud to introduce Beverley N. Mucciardi, an exceptional therapist who happens to be local to our office in South Florida. She will be helping us to move closer to our goal of both a healthy physical and emotional well being. “
Beverley N. Mucciardi: “Thank you for allowing me to participate in your mission to provide a variety of services and support for bariatric patients. I welcome this opportunity to be of service to this very special group of people.”
Susan Maria Leach:"When I got involved in the personal lives of bariatric patients after having my own bariatric procedure nearly eight years ago, I didn’t know I would be opening a Pandora’s Box. I thought that by providing post ops with a solid path to follow to a healthy goal weight - once the weight was gone they would be able to move on to a wonderful life. What I discovered was that for many, morbid obesity was a result of underlying issues, rather than the cause."
Beverley N. Mucciardr: “Your metaphor of a Pandora's Box when it comes to the lives of pre- and post-operative bariatric patients is so accurate! One of the reasons I love my work is the immense privilege it is to accompany so many amazing people on the journey to claim and become more of their potential selves. That journey usually involves dealing with the Pandora's Box that each of us carries through life. Sorting through the issues to find the treasure is sometimes scary but always challenging, fascinating and, in the end, immensely rewarding”
Susan Maria Leach: “I am now of firm belief that bariatric surgery would have much higher long term success rates if surgeons would embrace psychological counseling as an integral part of the process rather than just a formality for insurance approval.”
Beverley N. Mucciardi: “I completely agree with you that bariatric surgery would have much higher long term success rates if most patients participated in high quality psychotherapy both pre- and post-operatively. The rather cursory psychological screening that I have seen my Florida clients receive is not geared to help the patient gain insight into the psychological/emotional factors that may have contributed to and/or resulted from their morbid obesity.
There does not seem to be much appreciation in the medical community for the immense challenge to self image and relationships that result from rapid weight loss nor of the underlying issues of which obesity is often the symptom, not the cause. Most people with obesity fantasize that when they finally lose weight their personal issues will be resolved. To the contrary, personal issues are often exacerbated, as I'm quite certain you've witnessed.
The factors that cause the person to self-soothe with food are still present post operatively. Most people have no alternative skills to manage their stress or to cope with the disappointment that while the body has changed, most of the same old feelings, challenges and self judgments are still operating.”
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Perspective
Since I was an obese child and have lived my life in a body that has expanded and contracted markedly multiple times, I have a strong personal and professional interest in the psychological and emotional factors in obesity. Overweight folks tend to blame the problems and dissatisfactions in their lives on their weight. Although we now know there may be many factors that contribute to being overweight, I believe in most cases, obesity is a symptom, not the cause, of deeper inner problems. Those problems often include some form of conscious or subconscious low self esteem and the self-judgments and self-criticisms that go along with it.
Various fears and/or the need for protection are often part of the picture. The person may have been the target of hurts, slights, criticisms, physical or sexual abuse or victimized in some way. When the coping mechanism to deal with these issues is food and weight gain results, failure at attempts to control or lose weight become part of a vicious cycle that increases feeling of worthlessness and self disgust which leads to more compulsive eating.
People who interrupt this cycle by choosing bariatric surgery take what I see as a heroic step to change their lives. But since many have no understanding of the underlying dynamics of their emotional lives and the impact of subconscious beliefs, self judgments and self criticisms, they often find themselves in a much improved body but are shocked and profoundly disappointed with their life because the underlying problems have not been addressed.
People cope with this painful disappointment and disillusionment in a variety of ways. We humans are endlessly creative! Some find ways to work through to a new and satisfying life. Some can find no other way to cope except the familiar use of food and so become part of the "failure" statistics. Some develop other coping mechanisms that may become as self destructive or more so than the obesity; people turn to alcohol or other drugs, compulsive shopping, compulsive sexuality, etc. and sink further into a pattern of self disgust. What a tragedy that is!
Just as the bariatric patient needs to be reeducated about how to nourish and maintain their body with new patterns of eating, supplementation and exercise, many need assistance in identifying and clearing out dysfunctional mental and emotional patterns and replacing them with more skillful ways of living.
Background
I went to college and graduate school as an adult during the years my children were growing up. My Bachelor of Arts is in Psychology and my Master's Degree is in Clinical Social Work from the University of Maryland at Baltimore (1989). I have an ACSW as well as an MSW and am trained in Ericsonian Hypnosis. My internships were served at a Hospice in Washington, DC and in a private Community Mental Health group in suburban Maryland that offered individual, marital and group psychotherapy. I was offered a part-time position there after graduation and have been in practice since that time. I work with adults, couples and senior citizens in a general practice.
My particular interests are in the impact and opportunity of life change periods (i.e. marriage, divorce, birth, death, geographical moves, job change, rapid weight loss or gain, severe illness, etc.) and the body/mind/emotion connection in physical disorders.
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