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.
- 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
- 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
- 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
- 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!*)
- 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?