Many of the clients who come to see me are young, in their 20s and 30s, wanting hypnotherapy to improve their self confidence and self esteem. They come with a range of issues from managing relationships, trauma, fears, phobias and more.
One of my clients, Mary, stands out for me. A young, attractive, yet painfully thin young woman asking for help with her eating disorder. “I binge eat and then throw up. I do it all the time and I want to stop.” Her eyes are full of tears and she sits so far back in the armchair in my clinic like she doesn’t really want to be seen. During the session she relaxes a little. I begin to understand how the condition has her in a vice like grip; food is of little interest, she’s always on alert for the nearest toilet, constantly checking for tissues and to make sure breath spray is always handy. Her daily routine is completely dominated by her cycles of eating and throwing up. She no longer cares what other people think of her as, quite frankly, she didn’t really care much for herself either.
She opens up about her childhood and her loneliness. The pattern of binge eating, vomiting and her punishing exercise regime had begun long ago as she struggled for the attention she craved for so many years. “It’s so hard to love my body,” she said during one of our sessions, “so I have booked a boob job. I think it will help me, don’t you?” She looked at me with big, blue eyes searching for agreement and the reassurance that I couldn’t give her. As a therapist I know that plastic surgery is not necessarily the answer to her issues and sadly, more than likely, only exacerbate things further.
NHS research suggests that 1.25 million people are effected by eating disorders, such as anorexia nervosa or bulimia nervosa, in the UK. Many of these sufferers have concerns about their body shape, size and weight and some, like Mary, may also have body dysmorphia so they have concerns about body image as well. Sufferers focus on their outward appearance and may fixate on certain parts of their body such as skin, nose, hair, hips, thighs, waist and, in the case of men, muscular build. They also tend to over-evaluate their body and weight and can demonstrate obsessive behaviours such as picking at perceived flaws on their skin to make it “smooth”, excessive body checking, or avoidance in the mirror or other reflective surface, excessive weighing and measuring. These behaviours can distort perception and the seriousness of body size and weight.
Its important to note that not all body dysmorphia sufferers will have eating disorders and, of course, the same is true the other way. Eating disorders and negative body image are complex issues and tend to be associated with low self worth. The exact causes of eating disorders and body dysmorphia are unclear but its likely to be one or a combination of factors such as a genetic predisposition in families, a chemical imbalance in the brain, trauma or negative experiences in childhood such as abuse or bullying.
Recovery from an eating disorder and body dysmorphia can be supported by cognitive behavioural therapy (CBT). It tends to follows a similar pattern – regaining weight through behavioural change and then psychological recovery – each plan customised for the sufferer. In severe cases, anti-depressants may also be prescribed to be used alongside treatment. CBT is effective because it focuses on the negative thoughts, feelings and behaviours that underlie the eating disorder and negative body image, recognising the triggers in order to break the patterns and retrain your brain. It helps sufferers to appreciate their own internal qualities and talents and uses a number of self-esteem strategies, such as: journaling, creating lists and reflections to highlight the causes and consequences. Facing the fear becomes easier as the emotions and anxiety subsides.
Research suggests that only around two-thirds of sufferers will improve or make a full recovery. Loving our bodies maybe too big a step but we must appreciate and accept our bodies for what they are. It will take time and effort, and, like Mary, you may need professional help from a therapist. Mary’s road to recovery is long and bumpy but at least she’s taken those first important steps.
Here are some of the typical strategies used in CBT. You may want to try some these interventions yourself:
Confide in someone you trust – talking is the often the first step towards recovery and it can be a relief to share your issues with someone who will be supportive and non judgemental. Explain what you are going through, your feelings and your physical symptoms and what you need from them. This person can support you on your journey to wellness.
Journaling – this is a daily exercise to appreciate the good things about yourself and your body. Writing something positive every day shifts your attention from negative comments about yourself. Things like “today I had a good hair day”, “I like how this top looks on me” are all positive statements to shift your negative thinking and achieve a more balanced perspective. It maybe hard at first but with persistence it gets easier.
Stop body checking – its easier said than done but reduce the amount of body checking in the mirror, weighing or measuring yourself. Ask your support person to challenge you. It may cause anxiety at first but the idea is to cut back on the number of times you body check with an aim to gradually stop.
Challenge avoidance – this can be complete covering up of the body and wearing inappropriate clothes for the situation. The challenge is gradually increasing the level of exposure and your support person should help you.
Buy clothes that fit – buy some items of well fitting underwear that make you feel good, more confident and reduce the anxiety and negative self talk when you are getting dressed. Aim to feel good about all the clothes you wear.
Realign attitudes and behaviours – many eating disorder programmes work on the principle of cognitive dissonance and encourage sufferers to reject the cultural pressure towards weight and the body perfect and reset our attitudes and behaviours towards it. Write letters to yourself, friends, organisations explaining why being thin or the body perfect ideal bothers you so much and what they need to do to change. Try writing a blog and use social media to find messages that support body acceptance and follow sites that encourage body positivity and role models.
Change your negative self talk – overcoming negative self talk and thoughts is essential in recovery. Notice how they effect your mood or behaviour and challenge them. Take a few days to notice your thoughts about your weight and body and the challenge negative and unhelpful ones by turning them around. For example, if you think you’ll never get better, well how do you know? Will you really never get better? Replace these unhelpful thoughts with “It may take time but everyday I will get better” and “I can do it”.
Give it time – remember recovery is a process and there will be ups and downs along the way. It will take time and you may relapse several times before you successfully overcome the negative behaviour that underlies your issues.
Good luck. Let me know how you get on. Best wishes always x
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