The 20th century has been called ‘the century of psychiatry’, and in many ways one could read that as ‘the century of psychotherapy’. A hundred years ago, at the onset of World War I, psychotherapy had touched the lives of only a tiny number of people, and most of the population had simply never heard of it. Since then it has reached into almost every aspect of our lives—how we treat the mentally ill, how we understand our relationships, our appreciation of art and artists, and even how we manage our schools, prisons, and workplaces.
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Ashley- Intern Extraordinaire
It is estimated that 1-3% of young adult women and one tenth that number of men suffer from the eating disorder bulimia nervosa, which involves binge eating followed by purging and feelings of guilt and shame. The goal of treatment is to unearth the factors that trigger such a disorder. The Treatments That Work series offers effective ways to combat various medical issues, and in Overcoming Your Eating Disorder: Workbook, by Robin F. Apple and W. Stewart Agras, patients are presented with ways to conquer bulimia nervosa and binge-eating disorders. The following excerpt talks about keeping a Daily Food Record, a method that allows patients to connect what they eat with how they feel.
Common Concerns About Keeping Records
Despite the value and usefulness of keeping food records, it is not uncommon to be somewhat hesitant about self-monitoring.
Perhaps you have used food records previously and were unsuccessful. Even if prior attempts to record your eating were ineffective, we encourage you to give record keeping another chance! We expect that you will find food records helpful when used as part of this treatment…
Maybe you think that closer examination of your eating problems will only make matters worse. You may feel that you already spend too much time thinking about eating anyway. But there are many reasons for becoming even more vigilant about your eating, particularly when your goal is to improve it. As explained, the process of keeping track of your eating, and also the product of record keeping (a long-term food diary) can bring substantial benefits. When you monitor your own eating behavior, you become more ware of the context in which your eating problems occur, particularly the thoughts, feelings, and situations that place you at “high risk” for binge eating and purging. By noting the association between these types of factors and the occurrence of binge-eating episodes, you will be better able to identify and anticipate these difficult, triggering situations and to work out strategies for avoiding or responding differently to them. Retrospectively, you will be able to learn from past problems and successes with your eating by reviewing the contexts in which these types of eating episodes tended to occur and the coping strategies you attempted to implement. Noting long-term patterns will help you view your eating problems as more predictable and controllable…
The Importance of Timely Recording
Many individuals with bulimia or binge-eating disorder often acknowledge having a poor memory for the details of their binge episodes. They commonly describe “spacing out” while eating; even those who remain “aware” tend to reconstruct their eating patterns in a manner that reflects a global, overly negative, and black-and-white thinking style (e.g., overestimating the amount of food consumed, exaggerating its effect on their body weight and shape, viewing any departure from rigid rules about what should and should not be eaten as gross violations, and interpreting a small overindulgence as having “ruined” the whole day). For these reasons, we recommend that the most effective strategy for recording food intake is to do so at the time of or as soon as possible after eating. The advantages to this are considerable. First, the information obtained is most accurate and least vulnerable to distortion or poor memory. Second, the food record, when used in this fashion, can serve as a tool for planning meals and snacks in advance. When used in this way, the Daily Food Record can actually prevent or reduce the extent of overeating and purging by fostering a sense of commitment to sticking with a regular eating pattern and healthy food selections. Third, looking back over your records can help correct the types of perceptual distortions just described (e.g., the sense that you overate or “blew it,” without actual data to support that feeling or impression). Reviewing your food record daily may help you stay focused on the positive, reminding you that you are still on track, even when you are ready to give up. Likewise, an accumulation of food records over time will provide data about your rate of progress and level of improvement during the course of treatment.
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