/
WE ARE BOUND TO OUR BODIES WE ARE BOUND TO OUR BODIES

WE ARE BOUND TO OUR BODIES - PowerPoint Presentation

lindy-dunigan
lindy-dunigan . @lindy-dunigan
Follow
402 views
Uploaded On 2016-09-13

WE ARE BOUND TO OUR BODIES - PPT Presentation

BUT WE ARE NOT BOUND TO BE UNHAPPY WITH OUR BODIES Thomas Cash TERMINOLOGY The concept of body image is complex and multifaceted extreme shape concern Farrell et al 2005 It refers to an individuals view of their body size shape weight and appearance total body or specifi ID: 465418

image body eating amp body image amp eating 2004 nervosa disorders shape step treatment cash fairburn journal checking cognitive

Share:

Link:

Embed:

Download Presentation from below link

Download Presentation The PPT/PDF document "WE ARE BOUND TO OUR BODIES" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.


Presentation Transcript

Slide1

WE ARE BOUND TO OUR BODIES

BUT

WE ARE NOT BOUND TO BE

UNHAPPY WITH OUR BODIES

Thomas CashSlide2
Slide3
Slide4

TERMINOLOGY

The concept of body image is complex and multi-faceted

‘extreme shape concern’ (Farrell

et al

2005)Slide5

It refers to an individual’s view of their body size, shape, weight and appearance (total body or specific parts)Slide6

BODY IMAGE AND EATING DISORDERS

Importance recognised by incorporation into DSM-IV

Negative body image:

is a pre-cursor for eating disorders in at risk populations (Killen

et al.

1994)

is the main factor in the psychopathology of eating disorders (Gleaves & Eberenz 1993)Slide7

Historically little emphasis has been placed on body image in therapy

Successful treatment may not bring body image satisfaction

The level of body image distress at the end of treatment for Bulimia Nervosa predicts relapse (Freeman

et al

. 1985; Fairburn

et al

. 1993)

The risk of relapse may be enhanced because of inadequate provision of treatment for extreme shape concern within eating disorder treatment (Farrell

et al

. 2005)Slide8

COMPONENTS

Perceptual distortion

Body dissatisfaction

Behaviours

Cognitions Slide9

PERCEPTUAL DISTORTION

An imagined bodily defect or exaggeration of features in which a discrepancy occurs between actual and perceived sizeSlide10

It was recognised as a feature of:

Anorexia Nervosa by Hilda Bruch (1962)

Bulimia Nervosa by Stice (2004)

Size is frequently over-estimated

Fairburn

et al.

(1999) a combination of behaviours e.g. body checking and selective attention to body parts

The internalization of a thin ideal (Stice 2004)

Body dissatisfaction and the internalization of a thin ideal (Mussap et al. 2008)Slide11

Perceptual distortion may result from psychosocial stimuli:

Low mood

Hunger

Eating high calorie foods

Farrell, Shafran & Fairburn (2003) indicate that distortion varies depending on the measurement technique.

It is unclear what is within the normal range of attitudes towards the body (Probst et al. 2008)Slide12

BODY DISSATISFACTION

Features include discomfort and complaint about appearance; whole body or discrete areas frequently described as fatSlide13

Thighs, buttocks, stomach and breasts

Muscular physiqueSlide14

Increasing dissatisfaction can predict the onset and elevation in bulimic pathology (Stice 2004)

Attention to disliked parts can lead to pre-occupation (Freeman

et al

. 1999) and maintain the problemSlide15

Dissatisfaction has been ascribed to cultural/societal views and personality

Western media encourages thinnessSlide16

BEHAVIOURS

These include

avoidance

of situations (fear of attention, self consciousness)

of seeing oneself in the mirror

problem areas may hidden by clothing or postureSlide17

BEHAVIOURS

Body checking

Grooming

Looking in the mirror at perceived defects

Pinching and measuring specific areas

Comparison with media figuresSlide18

Frequent weighingSlide19

Body dissatisfaction can be maintained by checking behaviours

When emotions aroused by checking are extreme, checking may be avoided to prevent discomfort

Engagement in avoidance or checking depends on several factors including mood, weight and eating changes (Safran

et al.

2004)Slide20

COGNITIONS

Cognitive biases include selective memory and extreme drive for thinness

Obsessionality and fear of fatness

Pre-occupation with appearance is distressing and time consuming

Intrusive thoughts even if recognised as abnormal or untrue can cause difficulty in functioningSlide21

Thought- shape fusion is a cognitive distortion associated with eating disorders (Safran & Robinson 2004)

Three components:

Likelihood:

thinking about food makes it likely that the individual has gained weight even though this is illogical

Moral

: thinking about eating forbidden foods is morally equal to eating them

Feeling

: thoughts about food increases the feeling of fatness

Thought-shape fusion may help to maintain the disorderSlide22

Distorted psychological perceptions can occur as cognitions of apparent delusional intensity in direct response to appearance

Slide23

Body image is closely linked to self-esteemSlide24

THE APPLICATION OF CBT TO BODY IMAGE DISORDERS

CBT is widely acknowledged as a leading treatment for Bulimia Nervosa and Binge Eating Disorder (NICE 2004)

Group CBT has been proposed as the most favourable way to address body image in eating disorder treatment (Cash & Strachan 2004; Reas & Grilo 2004)Slide25

Improvements in body image, self-esteem, depression & social anxiety were reported by Strachan & Cash (2002), however, improvements in eating pathology were ‘weaker’Slide26

CBT BODY IMAGE GROUP

Use of the Body Image Workbook (Cash 1997) can improve body image

CBT group package was designed using components from Cash’s workbookSlide27

Castle Craig HospitalSlide28

GROUPS

6 sessions

once a week

Topics

Personal assessment of the problems, relaxation/distress tolerance

Origins of body disparagement: historical and current

Triggers to body disparagement, NATs, corrective thinking

Practical exercises including rituals and mirror work

Review and repeat questionnaires

Plan for on-going actionSlide29

Group treatment aimed at normalising body shape concern in people suffering from an eating disorderSlide30

CASH’S STEPS

Body Image Workbook p9

Step 1

Discover your own body image and set your goals for change

Step 2

Understand the causes of your discontent

Step 3

Get comfortable with your body through body-and-mind relaxation and body image desensitization

Step 4

Discover your appearance assumptions and challenge their control over your body imageSlide31

Step 5

Change your faulty Private Body Talk with corrective thinking

Step 6

Defeat your self-defeating behaviour by facing what you avoid and by eliminating your appearance preoccupied rituals

Step 7

Treat your body right with affirming and enhancing activities

Step 8

Continue to improve and prevent relapse by preparing today for tomorrowSlide32

SESSION ONE

Questionnaires

Relaxation/distress tolerance

HomeworkSlide33

SESSION TWO

Body image profile constructed from questionnaires

Historical and cultural perspectives

Body image diary, ABCs

Helpsheet for changeSlide34

SESSION THREE

Appearance assumptions

Triggers to negative body image

Negative automatic body image thoughts

Mirror desensitization introducedSlide35

SESSION FOUR

Self-defeating behaviours, checking and avoidance

Thinking errors

Mirror desensitizationSlide36

SESSION FIVE

Perceptions

Mirror desensitizationSlide37

SESSION SIX

My proudest moments

Letter to my body

Relapse prevention

Questionnaires & evaluationsSlide38

All areas indicated an improvement.

At follow up improvements remained but were less marked.

With extra mirror work and behavioural tasks improvements have been greaterSlide39

‘I determined how I perceived my body and that had a huge impact on the way I thought about myself. I could choose to see bad things or I could choose to see good things’

‘I would love this friend regardless of what they looked like. If my body were an estranged friend why shouldn’t I love that….I gave it such a hard time’Slide40

REFERENCES

Bruch, H. (1962). Perceptual and conceptual disturbances in anorexia nervosa.

Psychosomatic Medicine

, 24, 187-194.

Cash, T.F. (1997).

The body image workbook: an 8-step program for learning to like

your looks.

Oakland, CA. Harbinger Fairburn, C.G., Peveler, R.C., Jones, R., Hope, R.A. & Doll, H.A. (1993). Predictors of 12-month outcome in bulimia nervosa and the influence of attitudes to shape and weight.

Journal of Consulting and Clinical Psychology

, 61, 696-698.

Cash, T.F., & Strachan, M.D. (2004). Cognitive behavioral approaches to changing body image. In T.F Cash, & T. Pruzinsky

(Eds.),

Body Image a handbook of theory, research and clinical practice

(pp. 478-486)

.

New York. Guilford.

Fairburn, C.G., Shafran, R., & Cooper, Z. (1999). A cognitive behavioural theory for anorexia nervosa.

Behaviour Research and Therapy

, 37, 1-13.Slide41

Farrell, C., Shafran, R., & Fairburn, C.G. (2003). Body size estimation: testing a new mirror based assessment method.

International Journal of Eating Disorders

, 34, 162-171.

Farrell, C, Shafran, R., Lee, M., & Fairburn, C.G. (2005a). Testing a brief cognitive-behavioural intervention to improve extreme shape concern: A case series.

Behavioural and

Cognitive Psychotherapy

33, (2) 189-200.

Freeman, C., Beach, B., Davis, R., & Solyom, L. (1985). The prediction of relapse in bulimia nervosa.

Journal of Psychiatric Research

, 19, 349-353.

Gleaves, D.H., & Eberenz, K. (1993). The psychopathology of anorexia nervosa: a factor analytic investigation.

Journal of Psychopathology and Behavioural Assessment

, 15, 141-152.

Killen, J.D., Taylor, C.B., Hayward, C., Wilson, D.M., Haydel, K.F., Hammer, L.D., Simmonds, B., Robinson, T.N., Litt, I., Varady, A., & Kramer, H. (1994). Pursuit of thinness and onset of eating disorder symptoms in a community sample of adolescent girls: A three-year prospective analysis.

International Journal of Eating Disorders

, 13, 227-238.Slide42

National Institute for Clinical Excellence (2004).

Eating disorders: core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders.

Nice Clinical Guideline No 9. London: National Institute for Clinical Excellence. Available from: http://

www.nice.org.uk

Reas D.L., & Grilo, C.M. (2004). Cognitive behavioural assessment of body image disturbances.

Journal of Psychiatric Practice

10 (5), 314-322.

Shafran, R., Fairburn, C.G., Robinson, P., & Lask, B. (2004). Body checking and its avoidance in eating disorders.

International Journal of Eating Disorders

, 35, 93-101.

Shafran, R., & Robinson, P. (2004). Thought-shape fusion in eating disorders.

British Journal of Clinical Psychology

, 43, 399-408.

Stice, E. (2004). Body image and bulimia nervosa. In T.F Cash, & T. Pruzinsky

(Eds.),

Body Image a handbook of theory, research and clinical practice

(pp. 304-311)

.

New York. Guilford.