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On the last track, we discussed three concepts related to self-image distortion in bulimic clients. These three concepts related to self-image distortion in bulimic clients included: weight-obsessive thoughts; overestimating size; and unrealistic standards.
On this track, we will examine three binge trigger categories. These three binge trigger categories include: food and eating; body weight and shape; and negative emotions.
3 Binge Trigger Categories
Category #1 - Food and Eating
Likewise, feeling full after eating, or the satisfaction of having had a full meal, can trigger on onset of binging. Also, having fattening foods readily available can also trigger a binge. The client, extremely hungry at this point, craves calories, and the fattening foods provide a large source of these calories.
Stacey, age 19, began binging only occasionally. Every week or so, she would have a binging and purging episode. As the disorder progressed, Stacey noticed her episodes becoming more and more frequent. After a year, Stacey had developed a sort of pseudo-schedule.
Stacey stated, "The urge to binge usually begins around midday on a ‘normal’ day—that is a day on which I am trying not to eat. During the afternoon thoughts of food become more and more of a preoccupation; and eventually at around 4:00 pm my power of concentration will be sufficiently non-existent for thoughts about food to be totally overwhelming! So I leave my work and go to the store!"
Stacey’s triggers had become so regular that she could pinpoint them to a time of day. Think of your Stacey. What are his or her common triggers?
Category #2 - Body Weight and Shape
Shawna, age 21, obsessed about her fluctuating weight. During a binging session, Shawna could consume over 3,000 calories. She stated, "If I discover my weight has gone up, or I find that my clothes are too tight, or I look in the mirror and see that I am too fat, immediately I want to eat! I know this is silly when I really want so desperately to be thin, but I just feel as if I can’t cope any more and I might as well just give up and eat myself to death! Of course, I feel even worse after the binge!"
Clients like Shawna not only experience distress about their fluctuating weight resulting from binging, but also experience body image distortion. Although the bulimic client may be within a normal BMI, he or she may perceive a completely different self-image than others. While Shawna weighed 110, she still believed herself to be overweight and terribly fat. Think of your Shawna. How does his or her body image affect his or her binging?
Category #3 - Negative Emotions
Julia, age 24, was an emotional eater and purger. She stated, "Binges start when I’m tired or depressed, or just upset. I become tense and panicky and feel very empty! I try to block out the urge to eat but it just grows stronger and stronger! The only way I know to release these feelings is to binge. And binge-eating does numb the upset feelings. It blots out whatever it was that was upsetting me. The trouble is that it is replaced with feeling stuffed and guilty and drained!" Think of your Julia. What are his or her emotional triggers?
Cognitive Behavioral Therapy Technique: Trigger Talk
On this track, we discussed three binge trigger categories. These three binge trigger categories included: food and eating; body weight and shape; and negative emotions.
On the next track, we will examine three concepts of interpersonal relationships with regards to the binging and purging client. These three concepts of interpersonal relationships include: early childhood development; as a means to please; and secrecy.
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