CBT For Eating Disorders - Maximise Your Chances of Success

Before you start your CBT Counselling treatment programme there are a number of things you can do to maximise your chances of success. 1. Prioritising yourself and your recoveryr For CBT Counselling to enable you to overcome your eating disorder you need to be a keen and active participant in the process. This will take time and energy, therefore, as much as is possible you will need, for the period of time you are engaged in treatment, to prioritise both yourself and your recovery. This can be difficult, particularly if you have a low sense of self worth. The steps outlined below will help you to approaching the task in a pragmatic and determined way which will enable you to challenge any tendency to put your needs behind others. Step 1 – Anticipate and prepare for obstaclesr If you can anticipate the obstacles to change it gives you the opportunity to prepare solutions/coping strategies. Responding proactively rather than reactively to challenges means that you increase your chances of overcoming them as you give yourself time to choose the best solutions rather than having to make decisions quickly and under pressure. It also enables you to reflect realistically on the challenges of treatment reducing the chances of feeling overwhelmed them. Write two lists: 1. Obstacle to change table: these will be both psychological and emotional (e.g. anxiety about weight gain, lack of alte ative ways of coping with emotions) and practical (other commitments and demands on your time), so when completing the table think about both of these areas. 2. Solutions to obstacles: once you have identified your potential obstacles to change, identify possible ways of managing and minimises these challenges. Step 2 – Monitoring physical healthr An eating disorder effects both your physical and psychological health. Recovery therefore involves addressing both of these aspects. However, the risk to your physical health is more immediate and so must be managed and minimise before any other changes are initiated. Very simply, unless you are physically safe other changes become academic. Therefore, if you have not already done so please make an appointment to see your GP so that they can assess and monitor your physical health. Step 3 – Developing a support network Eating disorders can trigger a lot of guilt and shame and as a result you will find that you withdraw from others, hiding your true thoughts, feelings and behaviours. This is an understandable response in the absence of other ways of coping. However, although in the short term it can bring some respite from feelings of shame, in the longer term it will leave you feeling more overwhelmed, isolated and stuck. CBT Counselling offers you a different way of coping, but the journey to recovery is challenging, it is therefore important that you have as much support as possible. The shame surrounding your eating disorder and a sense of worthlessness may however make it hard to ask for support. So ask yourself the question, ‘if someone I cared about had this problem, would I want to support them?’. Those around you are likely to feel the same and although it might not feel as if you deserve the same as other, you do. If you do have someone close to you that knows about your eating disorder, or that you feel you could confide in, share the information from your treatment with them and think with them about how they can support you whilst you work towards recovery. Step 4 – Being appropriately assertive You may find that to compensate for feelings of shame, guilt and worthlessness you put your needs behind those of others. In the short term this may help you to tolerate negative feelings about yourself but in the longer term it means that your needs aren’t met leaving you feeling deprived, isolated and uncared for. Your feelings of shame may be so overwhelming that you are prepared to tolerate emotional, physical and/or sexual abuse. A key part of your recovery will be to get your needs met, this will feel both unfamiliar and uncomfortable because you are not used to focusing on what you need but on what others need. To make this shift first you must identify what you need. Then you must work out who can provide this. If you have a tendency to sacrifice yourself for others, you may have attracted people who do not have the capacity to meet your needs. If this is the case you will have to look outside of these relationships, possibly distancing yourself from them in order to move forward. Finally, you will need to communicate what you need. Being appropriately assertive is skill, and like all skills it will need to be practiced and given time to develop. CBT can help you to do this but as a first step you need place yourself in a more central position in your thoughts.