| Challenging |
| Make a point of recognizing your victories. Celebrate your victories, share them with others. Rejoice in them. Be aware of the old messages and tapes. Question and argue these old tapes, don't listen to them, and certainly don't believe them. Ask yourself what you really want out of life. Is it the life consumed by an eating disorder? What does life free from A/B look like to you. What prevents you from achieving this when A/B is around? What about a happier, freer life, that is more productive and fulfilling? When you feel like making comparisons to other people, stop yourself it can only end in heartache and dissatisfaction. Ask people who you trust for reality checks and feedback. Don't be afraid to reach to others for help and support. Begin to challenge the story you have of yourself. Rewrite a truer version. Acknowledge your strengths and skills, don't short change yourself. BE GOOD TO YOURSELF - YOU DESERVE IT. Honour yourself - celebrate that you are an individual and you do not want to be. Part of an unhealthy culture which identifies people's worth by external factors. You are not the problem, A/B has made you a tool of the problem - the physical manifestation of a complex unhealthy world around you. Learn to take ownership of your own issues. Everyone has issues, but the ones you need to acknowledge are your own. Sort out which are your issues and which are other people's. Love yourself unconditionally. Label the messages of anorexia as being anorexia. Challenge your thinking. Is that anorexia talking? When you can hear the anorexia talking and forcing you to do something. Go against that voice and acknowledge that as a VICTORY. Say it out loud - VICTORY I WIN! Fight it out loud - tell it to shut up It's a roller coaster ride to recovery/discovery, a little blip doesn't mean the end. Avoid black and white thinking about recovery. Remember when you feel down that "This too shall pass". Record all your victories, no matter how small they seem, because they all add up. Look at your victory book regularly and take pride - you did this, all of these are your victories. Goals of Therapy • Decrease or stop B-P • Decrease depression • Increase self-esteem • Increase assertiveness • Improve body image • Learn new ways of dealing with emotional and social factors that have led to symptoms Behavioral Interventions • Aversion therapy The individual may switch to other forms of self-abuse Cognitive Behavioral Techniques • Challenge attitudes & beliefs that are thought to mediate the disturbed behavior • Intercept the B-P episode and teach cognitive strategies of “self-control” • Modify abnormal attitudes toward food, weight, perfection Myths to Be Challenged • Once I break my diet… • Fats are bad • I have to be thin to be beautiful • I’ll love me when I weigh… • I have to be thin to be healthy • I have no willpower, so I’ll never be thin Transactional Analysis • Discuss B-P in terms of injunctions – Don’t fail – Don’t succeed – Don’t need – Don’t talk about family – Don’t be you; don’t be – Don’t trust • Life positions – I’m okay, you’re okay vs. – I’m not okay, you’re okay Group Therapy • Same goals as for individual therapy • More cost effective than individual therapy • More effective than for anorexia nervosa • Need co-leaders Psychopharmacological Intervention • Antidepressants • Anticonvulsants Eating Behaviors Leading to Bulimia Nervosa • Good food / bad food labels • Restrictive diets • Yo-yo dieting • Using food for non-food reasons • Skipping meals Diet Therapy • Eat at regular times, up to 6 times/day • Follow an exchange diet • Increase carbohydrates, if restricted • Eliminate good food/bad food labels • Become “friends” with binge foods – list trigger foods, worst to least – eat a less troublesome food from a controlled source with a significant other – same food from controlled source, alone – same food, uncontrolled source with another – same food, uncontrolled source, alone – continue process with other foods on list • Become familiar with nutrient dense foods Determine triggering events and find substitutes |
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