I mentioned that I had some homework from my therapist which I have diligently been progressing since my last appointment. Although not really. In fact, I think I was supposed to add to the table we started – however, you can see from the image below, that my black ink (post-appointment) contributions are somewhat limited. (In all honestly I’ve discovered an inability to write ‘small’. My teensy writing looked big and unwieldy compared to that of my therapist, so my minimal contribution is really about the aesthetics! Yes, truly and ruly!)
However, I have been taking the time to think about our discussion to properly process it all; the crux of which was the development of an Integrated Case Formulation Grid (which I think is essentially my Case Plan). As you’d be aware, having committed it to heart, my last post detailed my diagnosis… which has allowed us to jointly develop a plan to move forward.
Cognitive factors
- I’m a black/white and all/nothing thinker – I label everything (including myself and my behaviour, food etc) as good/bad etc
- I think in terms of ‘deserving a treat’
- I define myself by my weight loss success (or otherwise)
- It defines me and I don’t know who I’d be if I didn’t have an eating disorder / weight issues
- I put myself down to match my self-image and binge-eating behaviour; and give myself permission to fail
- But… I am self-aware and want to change
What I must do: change my language (no good/bad); be mindful; redefine myself exclusive of my weight
Behavioural factors
- I binge-eat when stressed, bored, angry, alone, anxious etc
- Binging has become a habit, dieting has become a lifestyle
- I find pleasure in eking out my binges and this reinforces the excitement of eating and binging episodes
- I’m either ‘dieting’ or ‘eating badly’, there is no in-between
- I cope with life by sedating myself with food and wine, which fills the ‘empty hole’
- But… I’ve lost weight before and know what I should be doing
What I must do: change my behaviour; eat regular meals; limit my alcohol intake; find new coping strategies
Systemic factors
- I live alone and spend significant amounts of time alone so no one is around to ‘monitor/question’ my behaviour
- I’m not in a relationship and believe my weight is a barrier to a relationship
- I believe I’m a failure because I can’t lose weight or lose weight quickly
- I won’t try if I think I can’t excel or succeed and, in those cases, am prone to apathy and procrastination
- But… I have access to resources and assistance
What I must do: develop realistic goals; attain a more balanced life; identify non weight-related goals
Psychodynamic factors
- I was / am a ‘parent pleaser’ and a ‘people pleaser’
- I’ve tried to define myself through achievements and seeking attention from others
- I have a fear of failure and if I’m not succeeding, I am failing
- I am a secretive eater who comforts themself with food
- But… I’m more aware of my feelings of insecurity and lack of confidence
What I must do: define myself less through others’ perception; and ummm….(*NB. I’m struggling for answers to this one!*)
Biological factors
- I don’t sleep well and am prone to having a busy mind once I go to bed in the evening, which leaves me tired
- I deal with stress and tiredness by eating to excess
- Drinking too much diet coke makes me hungrier (my stomach constantly grumbles)
- I comfort myself with food
- But… I’m getting fitter and healthier (feel less flabby) giving me more respect for my body
What I must do: continue to exercise; be mindful; keep a worry log if things are keeping me awake; quit drinking (or limit) diet coke.
So there you have it. The roadmap to a new and improved me. Or something.
I’m supposed to have started working on my ‘treatments’. And I am trying. Please pick me up if you see me using negative language about myself / my behaviour / food etcetera here, or on Facebook or Twitter. I’ll try and use words like ‘healthy’ for food, instead of good and bad (or good and evil, which I’m more prone to use).
I’ve started my food log which I think is supposed to help normalise my eating habits and times, but I have to confess, I’m finding it hard and it’s throwing up (although not in a vomiting way) some challenges. But that’s a whole other post.
I’m not sure how to resolve some of these issues, but I’m sure that will come with more treatment and discussion. (And more work.) As my therapist said, after 30 years of letting my Mad Monkey Mind run free, it’s pretty reasonable to expect it will take a while to tame – if possible at all!
I did leave a couple of things we discussed OUT of the summary above, because… well, a gal needs SOME privacy. (Believe it or not!) But, I suspect that others can identify with a lot of the issues above.
Is that the case? Can you see your behaviour or thinking there?
Have you had any success with treating or responding to these issues?
March 22, 2012
I almost wrote an entire blog post here. And realized it needs to go on my blog.
Essential, when I give myself hope, the weight comes off. When I lose hope, the weight does not come off. So how can I find the hope again?
March 22, 2012
Oh god Deb, you’re asking the wrong person cos I’m definitely not there yet! Look forward to reading your post!
March 22, 2012
Yes, I can see myself in many, but not all. Some that jump out at me are: all or nothing thinking, the habit part, no in-between to dieting or eating badly (which clearly ties to the all or nothing thinking!). I also think about how you say you define yourself with this whole thing and while I would not say that about myself, I can say that it has certainly become a focus of my life in the past couple of years and I worry that part of that is because of blogging and reading blogs because, well, that means a lot of time spent on this particular aspect of my life. I have high hopes that my new job will help with this, giving me something else to focus on:)
I’m impressed with your list – the honesty, introspection, detail. Hopefully your therapist can help you further define your goals and the things you can specifically do to change the behaviors that you want to change.
March 22, 2012
Thanks Karen… interesting that you should worry about the blogging perpetuating a focus on dieting etc as the therapist actually talked to me about that – suggesting my blog needed to become more positive and perhaps broader in its outlook!
Deb
March 22, 2012
Wow – this is amazing work. Thinking about your attitude is such a big step – and while making a long list of all the things that throw a wrench into your happiness is intimidating, the answers to each section are very similar – exercise, eat healthy food, drop the diet coke, etc. Of course, reframing your thinking about how you define yourself is a big issue, but once you are taking care of your body, it will be easier to take care of your weight-centered view. When you eat well and have good energy, you want to do more stuff. Soon you’ll thinking about how amazing you are at fake-Zumba, and not what you look like in the class : )
March 22, 2012
True! One of the things I had to complete were some of the ‘strengths’ I have in the biological sphere – I struggled cos well, it’s not nearly as exciting as childhood issues (psychodynamic) or the behavioural or cognitive stuff… but I realised that PHYSICALLY, because I am a bit fitter and because I have lost weight I do feel better about myself already. If I read old posts (which I did recently) I’m reminded of how my stomach always felt huge and ‘in the way’ and how I struggled to breathe sometimes. That alone was depressing enough to keep me binge-eating.
Deb
March 22, 2012
Hi Deb! Keep that in mind that this is my 2 cents on the subject. I personally do not see you as an all-or-nothing person. Why? Because you are not as extreme as you feel. You do have quite a bit of moderation and balance, though you might not feel it. Why do you feel you are “all or nothing”? It could be for other reasons, that maybe you are hesitant to try certain things or something like that. Just guesses here, but the “all-or-nothing” feeling disguises other types of feelings. I often find the reason I do something is not really about the superficial reason I initially think, which is why logical rational thoughts are often better than gut instinct.
I have a husband, 4 kids, and a dog. Besides working with my clients at work, on my downtime, I am still constantly concerned about many other people’s problems. <<Those are my best days because my own issues are put in their rightful priority level then. Perhaps, you should start an evening hobby/class or volunteer so that other people's problems can put your own stuff in good perspective. Or… maybe I have no idea what I'm talking about. 😀 You're the only person who knows why you do what you do.
🙂 Marion
March 22, 2012
Hi Marion and I really don’t mind your 2 cents as sometimes it’s handy having an objective outsider’s point of view and I’ve certainly appreciated MANY of the comments I’ve received on my blog posts and many have got me thinking even more.
I guess the all-or-nothing thing feels like a mindset issue. I know what I SHOULD be saying and I can write about it ‘At least I’m trying’ / ‘I need to focus less on xxx’ but mentally I don’t believe it.
I remember as I grew up, my father used to say ‘It doesn’t matter if you win or lose, as long as you try your hardest,’ but he SO didn’t believe that and was an ultra competitive person himself. I suspect I’m a bit like that – deliver the right messages but my thinking is a bit screwy. That’s the thing that worries me the most – that I’ve got to overcome such thought patterns. It’s one thing (as the therapist suggested) being less negative about myself, my behaviour, food etc… when I talk or write about it, but it’s another thing to actually change the thought that immediately pops into my head. *Sigh*
(Guess that’s why I’m seeing a professional!)
March 22, 2012
Squee! Can you send me my own WALI form? 🙂
I can relate to many things in the above list, especially if I substitute bingeing/dieting with something else (not revealed here). I know I’m prone to all or nothing thinking.
I can especially relate to your list of systemic factors: I’m 43, live alone and haven’t been in a relationship for a long time. I know my life is kind of lopsided at the moment and I have too much time to think about my “issues”.
Like Marion said, maybe it would be a good idea to get a new hobby, espceically now that you’ll have that 4-day work week! I think I should do that too…
March 22, 2012
I agree with you and Marion on the hobby Satu – I sort of thought that blogging might do the trick (I started doing a bit of creative writing a few years ago)…
And I SO know what you mean about the overthinking. Have you heard of that book, ‘Eating, Drinking and Overthinking’? I bought it years ago and wonder if I shouldn’t pull it out again! I think that’s one of the worst things about too much time alone – I’m prone to overanalyse EVERYTHING!!!
PS. If you did want to do the WALI, you can download it. And the form in today’s blog was a different one, but I have the reference info on the form itself!
Deb
March 22, 2012
Holy cow I swear we are identical twins (many years apart, mind you)!
I never thought of myself that way but I either diet religiously or eat everything not tied down.
FANTASTIC post, Deb!
March 22, 2012
Thanks Maureen. I wondered if a few people could relate to some of those issues (though I wouldn’t have shared them if I thought they were TOO strange!!!).
Deb
March 22, 2012
It’s kind of fascinating, when you manage to step outside yourself and observe what you’re doing and begin to figure out the why. I can relate to a number of the factors you’ve recognised, because I had those same issues (and still battle with a couple…). It should give you hope that I’ve banished or at least diminished 90% of them now.
B.E.D. is frighteningly common. I suspect that the number of undiagnosed cases is massive and that most of those people have no idea they’re afflicted with an eating disorder. You’re way ahead of them.
I have confidence in your ability to overcome this thing. I hope you do too.
March 22, 2012
Kerryn, that DOES give me hope (that you’ve banished some of those factors!).
Thanks for the positive vibes… (Hope one day I’m the one giving the encouragement to another frustrated BEDer!)
Deb
March 23, 2012
yes…the homework…writing small in tiny boxes….my assignments were different then this but all the same….when I first started …I often would say to myself that it was easier NOT doing the homework because it would in fact lead to a binge..but…it does change….
and it keeps changing and it is a slow growth to learn to be patient…mindful…and destroying the power of the old myths…
xoxo
March 23, 2012
Thanks Jules. Mindfulness – and in a good way (not in an over-thinking / obsessing way) – is one of my biggest challenges I think!
March 23, 2012
Ooooo…all those boxes and check lists scare me…but that’s just me. Fact is, I can relate to all the factors you mention in all areas. And the good news is that if I made progress you can too 🙂 I am very much a work in progress and for that I am grateful. I don’t even care if I am ever “cured” as long as I make progress 🙂
One thing I know that helps with all-or-nothing (also know as either-or) is to start using “both-and” statements…to start looking at how more than one thing can be true. I can both enjoy wine and not drink too much of it. I can both exercise and get enough rest. And so on….
In the end, and you said this yourself, you are AWARE…awareness and introspection and writing it out and so on REALLY does help.
March 23, 2012
Karen, you’re right. Writing about this stuff really does help me. I think I’m pretty articulate in person, but it’s still easier to write than speak – I can think more about what I want to say.
I definitely need to start using the ‘and’ statement – and let a bit of grey (gray) into my world!
PS. It gives me hope that people like you (and Kerryn who commented previously) have overcome some of these same issues – to the extent that they no longer impact on your life in the same way.
Deb