Table of Contents
Preface: read this bit first xi
Who is this book for? xi
What is this book about? xii
Final points before starting xii
Who are the authors of this book? xiii
Acknowledgements xiv
About the authors xv
Section 1 Getting started 1
First things first: staying physically safe and well enough to use the help provided in this book 1
1 Who is this book for? 3
"Do I have an eating disorder?" 3
"Does my eating problem really deserve any attention?" 5
"What can I do if I care for or live with someone with an eating disorder?" 7
"Why should I use self-help, rather than getting more formal help from a professional now?" 8
"So what do I do now?" 8
2 The key elements of cognitive behavioral therapy and the self-help approach 10
What is cognitive behavioral therapy (CBT)? 10
The key elements of CBT 10
Your journey through CBT: some landmarks 11
What is CBT self-help? 12
"I'm not sure that I'm ready to change": a quick word about motivation 14
3 How to use this book 15
Read it all 15
If you are a sufferer 15
If you are a carer 15
Whoever you are 16
Section 2 For the sufferer 17
4 Am I making a fuss about nothing? 19
Some important definitions 19
Myths to dispel 20
5 Motivating yourself to treat your eating disorder 23
Motivational states 23
The pros and cons of having an eating disorder 25
6 Is now the time to act? 29
Life circumstances 29
The balance between the pros and cons of your eating disorder 29
Accepting responsibility for change 30
7 Getting started with CBT 33
Becoming your own therapist 33
What to expect 34
Giving yourself the best chance of success 35
Summary 41
Section 3 The CBT self-help program 45
8 Start here: how to use this program 47
If you are a sufferer 48
If you are a carer 48
Practicalities 48
Anxiety and safety behaviors 49
Final tips on maximizing your chances of success 50
What do I need to get started? 51
The CBT plan for change 52
Building your own road map to recovery 56
9 The practical steps of CBT for your eating disorder 58
What if it is not working? Overcoming "therapy interfering behaviors" 59
Step 1 Developing and maintaining your motivation 59
Step 2 Developing a regular, balanced pattern of eating 60
Step 3 Challenging your thoughts and anxieties about weight 71
Step 4 Addressing negative thoughts and feelings about your body 83
Step 5 Addressing residual difficulties 91
Step 6 Maintaining the gains 92
Where to next in this book? 93
Section 4 For carers 95
10 Am I to blame for the eating problem? 97
Stop blaming yourself 97
Why didn't I notice before? 98
11 What can I do to support the sufferer? 99
Dealing with emotional distress 99
Should I feel so stressed and impotent? 99
How do I talk to the sufferer? 100
Dangers of collusion 100
What about the rest of the family? 101
What can I do if I am worried about the sufferer? 102
How to ask for help and who to ask? 102
Where can I get information? 102
Getting help for yourself 103
How can I keep the sufferer interested in change? 103
I am a friend of the sufferer: how can I help? 105
Sufferers with chronic disorders 106
Supporting the sufferer while they are following the self-help program outlined in this book 106
Section 5 Transitions into more formal help 109
Before you go any further 109
12 Thinking about getting more formal therapeutic help 111
What has stopped me seeking help before, and what might stop me now? 111
13 Starting the process of getting therapeutic help 114
Who should I talk to? 114
Preparing for your assessment 115
How do I involve my carers 116
What treatment will I be offered? 116
Coping with waiting 117
Attending your first session of CBT 118
14 What to look for in a good CBT practitioner 120
The therapeutic relationship 120
Accreditation/registration 121
Willingness to talk about method 121
Willingness to talk about the process of therapy 123
15 The role of carers in the transition to more formal help 124
What can I do to help my loved one get help? 124
So why is it so hard to help my loved one? 125
Section 6 Letting go of the eating disorder 127
16 The journey of recovery 129
Are there healthier alternatives to my eating disorder behaviors? 130
Who am I if I do not have my eating disorder? 131
What if I can't make all the changes now? 131
Can I stay "a bit anorexic/bulimic"? 132
What if the eating disorder comes back? 133
17 Relapse prevention 136
Forewarned is forearmed 136
Planning for the future - getting your life back 139
Review sessions 139
A word of warning: the risks of weight loss 140
Dealing with other issues 141
18 Have I done myself permanent damage? 142
Bone structure 142
Fertility 143
Will my eating disorder have had an impact on my children? 144
19 Carers need to move on too 145
Understanding the sufferer's perspective 145
Who is this new person? 145
What can I do if I think I see the eating disorder returning? 146
Who was to blame for the eating disorder? 146
Conclusion: eating normally again 147
For the sufferer 147
For the carer 147
Appendices 149
References and further reading 189
Index 191
