Dr Christopher Freeman - The Complete Guide to Overcoming Eating Disorders, Perfectionism and Low Self-Esteem

Dr Chris Freeman is one of the UKs leading authorities on Anorexia Nervosa. He is based at his Eating Disorders Clinic at the Cullen Centre, The Royal Edinburgh Hospital in Scotland.

Peter J. Cooper is Professor of Psychopathology at the University of Reading, and Honorary NHS consultant in Clinical Psychology.

Roz Shafran has worked at Oxford on the treatment of eating disorders using CBT. She currently works as the Charlie Waller Chair in CBT at the University of Reading. She is the author of Cognitive Behavioural Processes across Psychological Disorders: A Transdiagnostic Approach to Research and Treatment (Oxford University Press).

Dr Sarah Egan is Director of the Clinical Psychology program at Curtin University in Perth, Australia and is also the Australian representative of the World Congress of Behavioural and Cognitive Therapies committee. She continues to work as a clinical psychologist in private practice.

Professor Tracey Wade teaches at the School of Psychology at Flinders University in Adelaide, Australia. She is also Course Director of the universitys Clinical Postgraduate training programs and has worked as a clinician treating eating disorders for the past 20 years.

Dr Melanie Fennell is the author of Overcoming Low Self-Esteem and Overcoming Low Self-Esteem Self-Help Course. She currently works as the Director of an advanced cognitive therapy course, which is a collaborative venture between the Oxford Cognitive Therapy Centre (OCTC) and Oxford University. One of the first clinician researchers to introduce cognitive therapy to the UK, she was a founder member of the OCTC, an internationally recognized centre of excellence in cognitive therapy and training. As a member of research teams in the Oxford University Department of Psychiatry, Melanie contributed to the development and evaluation of cognitive treatment for a range of emotional problems. A recognized expert on low self-esteem with an interest in depression, she has run many workshops and presented research papers at major international conferences.

Constance Barter was diagnosed with the eating disorder anorexia nervosa at the age of fourteen. Hospitalised as an in-patient at a specialist eating disorders unit for seven months, Mealtimes and Milestones is her diary of this time. She is now completely recovered and works as a Young Ambassador for BEAT, the leading UK charity for people with eating disorders.

Chris Freeman, Peter J. Cooper, Roz Shafran, Sarah Egan, Tracey Wade, Melanie Fennell and Constance Barter

Constable & Robinson Ltd.

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Overcoming Anorexia Nervosa first published in the UK by Robinson, an imprint of Constable & Robinson Ltd., 2002

Revised edition published in 2009

Copyright Chris Freeman 2002, 2009

Overcoming Bulimia Nervosa and Binge-Eating first published in the UK by Robinson Publishing Ltd., 1993 Revised edition published by Robinson, an imprint of Constable and Robinson Ltd., 2009

Copyright Peter J. Cooper 1993, 2009

Overcoming Perfectionism first published in the UK by Robinson, an imprint of Constable & Robinson Ltd., 2010

Copyright Roz Shafran, Sarah Egan and Tracey Wade, 2010

Overcoming Low Self-Esteem first published in the UK by Robinson Publishing Ltd., 1999 Revised edition published by Robinson, an imprint of Constable & Robinson Ltd., 2009

Copyright Melanie J. V. Fennell 1999, 2009

Mealtimes and Milestones first published in the UK by Robinson, an imprint of Constable & Robinson Ltd., 2010

Copyright Constance Barter, 2010

This ebook published in the UK by Robinson,

an imprint of Constable & Robinson Ltd., 2013

Copyright Chris Freeman, Peter J. Cooper, Roz Shafran, Sarah Egan, Tracey Wade, Melanie J. V. Fennell and Constance Barter, 2013

The right of the authors to be identified as the author of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988

All rights reserved. This book is sold subject to the condition that it shall not, by way of trade or otherwise, be lent, resold, hired out or otherwise circulated in any form of binding or cover other than that in which it is published and without a similar condition including this condition being imposed on the subsequent purchaser.

A copy of the British Library Cataloguing in
Publication Data is available from the British Library

ISBN: 978-1-47210-737-4 (ebook)

Important Note

This book is not intended as a substitute for medical advice or treatment.

Any person with a condition requiring medical attention should consult a qualified medical practitioner or suitable therapist.

Cover design copyright Constable & Robinson

A self-help guide using
Cognitive Behavioral Techniques

CHRIS FREEMAN

ROBINSON
London

To Aleck, my father,
the wisest man I have known

To all current and past staff at the Cullen Centre for Eating Disorders, Edinburgh, who are, and have been, a great clinical team to work with, and who have discussed and practised many of the ideas in this book. Particular thanks to Charlotte Nevison and Patricia Graham, who as psychology trainees did much of the spade work.

Over the past two or three decades, there has been something of a revolution in the field of psychological treatment. Freud and his followers had a major impact on the way in which psychological therapy was conceptualized, and psychoanalysis and psychodynamic psychotherapy dominated the field for the first half of this century. So, long-term treatments were offered which were designed to uncover the childhood roots of personal problems offered, that is, to those who could afford it. There was some attempt by a few health service practitioners with a public conscience to modify this form of treatment (by, for example, offering short-term treatment or group therapy) but the demand for help was so great that it had little impact. Also, whilst numerous case histories can be found of people who are convinced that psychotherapy did help them, practitioners of this form of therapy showed remarkably little interest in demonstrating that what they were offering their patients was, in fact, helpful.

As a reaction to the exclusivity of the psychodynamic therapies and the slender evidence of their usefulness, in the 1950s and 1960s a set of therapeutic techniques was developed, collectively termed behavior therapy. These techniques shared two basic features. First, they aimed to remove symptoms (such as anxiety) by dealing with those symptoms themselves, rather than their deep-seated underlying historical causes (traditionally the focus of psychoanalysis, the approach developed by Sigmund Freud and his associates). Second, they were scientifically based, in the sense that they used techniques derived from what laboratory psychologists were finding out about the mechanisms of learning, and they put these techniques to scientific test. The area where behavior therapy initially proved to be of most value was in the treatment of anxiety disorders, especially specific phobias (such as extreme fear of animals or heights) and agoraphobia, both notoriously difficult to treat using conventional psychotherapies.