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Ellen Astrachan-Fletcher - The Dialectical Behavior Therapy Skills Workbook for Bulimia: Using DBT to Break the Cycle and Regain Control of Your Life

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Ellen Astrachan-Fletcher The Dialectical Behavior Therapy Skills Workbook for Bulimia: Using DBT to Break the Cycle and Regain Control of Your Life
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At the root of bulimia is a need to feel in control. While purging is a strategy for controlling weight, bingeing is an attempt to calm depression, stress, shame, and even boredom. The Dialectical Behavior Therapy Skills Workbook for Bulimia offers new and healthy ways to overcome the distressing feelings and negative body-image beliefs that keep you trapped in this cycle.

In this powerful program used by therapists, youll learn four key skill sets-mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness-and begin using them right away to manage bulimic urges. The book includes worksheets and exercises designed to help you take charge of your emotions and end your dependence on bulimia. Youll also learn how to stay motivated and committed to ending bulimia instead of reverting to old behaviors. Used together, the skills presented in this workbook will help you begin to cope with uncomfortable feelings in healthy ways, empower you to feel good about nourishing your body, and finally gain true control over your life.

This book has been awarded The Association for Behavioral and Cognitive Therapies Self-Help Seal of Merit an award bestowed on outstanding self-help books that are consistent with cognitive behavioral therapy (CBT) principles and that incorporate scientifically tested strategies for overcoming mental health difficulties. Used alone or in conjunction with therapy, our books offer powerful tools readers can use to jump-start changes in their lives.

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Ellen Astrachan-Fletcher, Ph.D.,is founder and director of the eating disorders clinic at the University of Illinois Medical Center, where she is also an associate professor. She has over ten years of clinical experience as a licensed clinical psychologist, specializing in eating disorders and womens mental health issues. She is a member of the American Psychological Association and the Academy for Eating Disorders.

Michael Maslar, Psy.D., is founder and director of the Mindfulness and Behavior Therapies Program at The Family Institute at Northwestern University. He is also an assistant professor at Northwestern University Medical School in Chicago, IL. Maslar has extensive training in dialectical behavior therapy (DBT) and is a member of the American Psychological Association and the Association for Behavioral and Cognitive Therapies.

This self-help workbook is an excellent tool to help alleviate bulimia nervosa symptoms. It is also a useful guide for the practitioner who is assisting the patient in his or her quest to overcome an eating disorder. I highly recommend this workbook to sufferers and mental health professionals alike.

Daniel le Grange, Ph.D., professor and director of the eating disorders program at the University of Chicago

DBT has taught me how to meditate more effectively throughout the day, regulate my emotions, and tolerate the most uncomfortable and painful of times. I never knew how to ride the rollercoaster of life without resorting to bingeing until DBT helped to change my behavior and my life. Because DBT centers on mindfulnessbeing in the present momentand having both acceptance of my condition as well as the willingness to change, I can now show up for my life without resorting to bingeing or other crutches. DBT has changed my life, and I have faith that it can change yours!

Sharon, client of coauthor Ellen Astrachan-Fletcher

At my first dialectical behavior therapy (DBT) skills training session, I found it easier to speak without using vowels than to speak without judgment. I was skeptical, but desperate to have a life without my eating disorder, and once desperation won the battle over skepticism, I was in. Once I was able to chip away at the judgment, I began to think it might be possible there was a way to deal with distress that didnt involve binge-purging. Before DBT, my emotions were something that required treatment. Happy, sad, angry, or glad, if I felt something, bulimia was right there to take me back to a state of numbness. Being able to radically and mindfully accept, without judgment, that I could actually experience an emotion and not have it end with a binge was a fascinating revelation. I still fight with bulimia, but I am armed with the tools of DBT and its now a battle I have a chance of winning.

Ilene, client of coauthor Ellen Astrachan-Fletcher

At first, I was very reluctant to join a DBT group, as I thought that I had control over my eating disorder. However, once I decided to participate in a group, I was hooked. For over two years, I have been involved in DBT. DBT has been a life-altering experience and my commitment has truly helped me to be present and create a life worth living.

Carissa, client of coauthor Ellen Astrachan-Fletcher

My commitment to DBT has brought me to an understanding of living in the moment. I now carry the benefits of instinctively knowing how to embrace life in an effective way. It is amazing how the exercises brought me to the awareness of just how little time I am now spending thinking obsessive thoughts about exercise and food!

Eileen, client of coauthor Ellen Astrachan-Fletcher

DBT has given me an appreciation for what I believed to be the most insignificant pieces in life: what is going on around me in the present moment. My eating disorder had taken away the familiarity of the simplest joys in life and had focused my attention to my body, exercise, and food. DBT had helped me refocus my attention to the present moment, rather than the past or future.

Annie, client of coauthor Ellen Astrachan-Fletcher

Publishers Note This publication is designed to provide accurate and - photo 1

Publishers Note

This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering psychological, financial, legal, or other professional services. If expert assistance or counseling is needed, the services of a competent professional should be sought.

Distributed in Canada by Raincoast Books

Copyright 2009 by Ellen Astrachan-Fletcher and Michael Maslar

New Harbinger Publications, Inc.

5674 Shattuck Avenue

Oakland, CA 94609

www.newharbinger.com

Portia Nelson, Autobiography in Five Short Chapters from Theres a Hole in My Sidewalk, copyright 1994, reprinted with permission from Beyond Words Publishing.

All Rights Reserved

Acquired by Catharine Sutker; Cover design by Amy Shoup; Text design by Tracy Carlson

Epub ISBN: 9781608822577

The Library of Congress has Cataloged the Print Edition as:

Astrachan-Fletcher, Ellen.

The dialectical behavior therapy skills workbook for bulimia : using DBT break the cycle and regain control of your life / Ellen Astrachan-Fletcher and Michael Maslar.

p. cm.

Includes bibliographical references.

ISBN-13: 978-1-57224-619-5 (pbk. : alk. paper)

ISBN-10: 1-57224-619-7 (pbk. : alk. paper)

1. Bulimia--Treatment--Popular works. 2. Dialectical behavior therapy--Popular works. 3. Bulimia--Patients--Life skills guides. I.

Maslar, Michael. II. Title.

RC552.B84A88 2009

616.8526306--dc22

2009014661

To all those in the world whose suffering prevents them from taking part joyously in two of the most simple pleasures, nourishing ones self and being present in ones life.

Chapter

Contents
Acknowledgments

Regrettably, the list of people who have helped to make this book possible is too long to include in full. However, we would like to acknowledge our spouses and children for kind support, encouragement, understanding, proofreading, patience, and all the rest. Wed also like to thank Marsha Linehan, Shari Manning, Kelly Koerner, Alan Fruzzetti, and all of the other brilliant clinicians and researchers who developed DBT for making this possible in the first place, and for having been such excellent teachers. Were grateful to our consultants on Morita therapy and attention, Mr. James Hill and Mr. Gregg Krech. We also want to thank our clients for having taught us enough to be helpful.

Introduction If you are reading this you may suspect that you or someone you - photo 2

Introduction

If you are reading this, you may suspect that you (or someone you care about) might have an eating disorder. Think about how the following questions may apply:

  • Do you ever feel out of control when eating?
  • Do you feel guilty, shameful, or sad about your eating habits?
  • Do you eat large amounts of food in a short period of time?
  • Do you feel the need to exercise, fast, take laxatives, vomit, or use any other behavior to get rid of the calories consumed?
  • Do you have trouble coping with strong feelings in general or feelings about your eating or body in particular?

If most of these questions fit you and your experience, you may have bulimia. The good news here is that help is available. It is now known that self-help by itself, or with some assistance, can aid you in overcoming an eating disorder. This book contains the essential information and skills to help you break the cycle of bulimia.

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