PEER RESPONSE:
My client is a 13 year old named Ashley, Ashley suffers from an eating disorder. Ashley tends to binge eat and then makes herself throw up after binge eating a lot of food. In our sessions we discuss possible triggers to what causes Ashley to have this. parents believed Ashley is too hard on herself and compares herself to other girls her way too much, which is what triggered her to develop an eating disorder. Ashley has expressed to me that the real reason this all started was she began to feel overwhelmed when her parents would argue about their own issues and she felt like she was in the middle. The overwhelming anxiety caused her to throw up one day, after she felt that relief from throwing up, she just continued. What I noticed is that Ashley feels negative emotions towards herself so she lets it out on herself, with this it has also become a coping mechanism to any negative emotion in her life. It has become a way for Ashley to view relief and better about herself.
In our sessions we discuss what could possibly trigger and how we can be prepared to deal with it other than throwing up. Ashley has expressed that some internal thoughts she has before fasting include a lot of negative thoughts about herself. Such as ” shes so weak.” if she cannot fight the urges or voices in her head to not binge eat, which then leads her to feeling bad about herself even more. Other thoughts also include No one tends to understand her, when she feels like she wants to binge she feels like she can not speak to others around her about why or they wouldn’t understand why she feels this way and it has more to do than with how she looks or self confidence. She also feels like she is against the world, a feeling of emptiness. This has also caused her to create body dysmorphia that triggers her to throw up because she is seeing something else in the mirror.
The A-B-C contingency in this is
Activating behavior – overwhelming feelings and anxieties, parents arguing, test taking, body dysmorphia
Belief – that she is not good/strong enough to handle what is happening in her life right now
Consequence – she binges eats then throws up to feel a sense of relief, but is also punishing herself as well
Jennifer’s situation presents a complex challenge as she navigates the difficulties of maintaining sobriety amidst a series of setbacks. This essay explores the application of cognitive-behavior modification techniques to address Jennifer’s negative thought patterns and reinforce her commitment to sobriety.
The most suitable cognitive-behavior modification technique for Jennifer is Cognitive Restructuring, also known as Cognitive Reframing. This technique, rooted in cognitive-behavioral therapy principles, focuses on identifying and challenging negative thought patterns to promote positive thinking.
According to the textbook, “Cognitive-Behavioral Therapy: Basics and Beyond” by Judith S. Beck, cognitive restructuring involves recognizing and challenging irrational beliefs. In Jennifer’s case, her belief that “nothing good ever happens in her life” and her tendency to engage in negative self-talk contribute to her desire to break her sobriety. Videos on cognitive restructuring emphasize its effectiveness in breaking the cycle of negative thinking and promoting healthier perspectives.
Identification of Negative Thoughts: Start by helping Jennifer identify specific negative thoughts associated with her recent challenges. Encourage her to journal or note down these thoughts as they arise.
Reality Testing: Once negative thoughts are identified, guide Jennifer through a process of reality testing. Ask her to provide evidence for and against her negative beliefs. For instance, challenge the belief that “nothing good ever happens” by exploring positive aspects in her life, such as her successful academic pursuits and positive relationships.
Cognitive Reframing: Assist Jennifer in reframing her negative thoughts into more balanced and realistic perspectives. Encourage her to acknowledge that setbacks are a part of life but don’t define her worth. Help her replace extreme thoughts like “I’m a failure” with more balanced statements such as “I am facing challenges, but I have the strength to overcome them.”
Positive Affirmations: Introduce the practice of positive affirmations. Jennifer can create a list of affirmations that counteract her negative self-talk. Encourage her to repeat these affirmations regularly, especially during challenging times.
Utilizing Support System: Reinforce the importance of Jennifer’s support system, including her sponsor and friends in the 12-step program. Emphasize that reaching out during difficult times is a strength, not a weakness. Facilitate a conversation between Jennifer and her sponsor to discuss her current struggles.
Conclusion:
Cognitive restructuring is a powerful cognitive-behavior modification technique that can empower Jennifer to challenge and change her negative thought patterns. By implementing these steps, Jennifer can develop a more resilient mindset, reinforcing her commitment to sobriety despite life’s challenges. It is essential to continuously support her in practicing these techniques and remind her that positive change is possible through a shift in perspective.
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