While supervising other therapists, I often see a focus in their work on addressing a behaviour change in their clients.
Have you asked yourself the following questions and tried these strategies as the answer?
| Questions | Strategy |
|---|---|
| How do I encourage my client to be ok with restoring their weight? | Wearing more comfortable clothes to manage weight restoration |
| How do I help me clients to reduce body checking behaviours? | Made a goal to reduce the percentage of time body checking |
| What strategies can I use to help my clients stop weighing their food? | Encourage clients to get rid of food/ weight scales |
| What apart from urge surfing can I do to reduce binge eating episodes? | Develop emotion regulation skills to manage binge eating episodes |
What is wrong with these strategies you may ask?
Nothing! They are important and very useful. However, they are focused on behaviour change without considering what might be driving these behaviours in the first place. They are also focused on reframing and rationalizing beliefs about weight.
For example:
Client: I have gained weight and feel fat and disgusting
Clinician: Remember, you are underweight so gaining weight does not mean you are fat. For your age and height, you need to be gaining weight. You could try wearing more relaxed clothing and not having scales in the house”
What if before we moved to changing the behaviour, we leaned in and were CURIOUS about the factors behind the behaviour.
It might look like this:
Client: I have gained weight and I feel fat and disgusting
Clinician: Let’s say for a moment that this was true, that you had gained weight. What would be the hardest and worst thing about that?
Client: People would notice and would look at me
Clinician: And if we go with that, what would be the hardest thing about them looking at you?
Client: Then they would judge me negatively
Clinician: And what would that mean, if they judged you negatively?
Client: Then they would not be my friend/ partner, etc anymore
Clinician: And if they were not your friend anymore, what would that say or reflect about you as a person?
Client: That I am not good enough. That I am not lovable.
Being curious about what schema or emotional learnings the person has about themselves and the world rather than using a strategy to change it straight away, gives us clues into what will keep maintaining this behaviour once the behavioural strategy is not available.
Knowing the core belief and emotions behind the eating symptom helps us support our clients to heal from and address the main driver of the behaviours. But we can’t do this if we jump to change too quickly before we are curious.
So next time you notice yourself jump to a change strategy, be curious about that and see what it feels like for you and your client to run the fear or belief out till the end and see what you land on!
If you would like to explore these ideas further, click here to register for my upcoming Body Image Reimagined Workshop, or click here to reach out to explore options for supervision.
