By Myra Cooper
This guide is written for pros operating with humans soreness with bulimia nervosa and for victims themselves. It presents a framework for figuring out what keeps the illness and why it has built. furthermore, there's a step by step programme to assist restoration. The authors draw on advancements in cognitive concept and on innovation and cognitive th erapy therapy ideas. They specialise in the hyperlink among considering and behavior, and provides assistance on studying the best way to establish and alter unfavorable suggestions, underlying assumptions and middle self ideals. real info is gifted along a programme of labor sheets, self-assessment questionnaries and case examples from the authors' specialist event.
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Additional resources for Bulimia Nervosa: A Cognitive Therapy Programme for Clients
52 BULIMIA NERVOSA face With repeated vomiting the glands around the mouth that produce saliva, par ticularly the parotid gland, may swell gradually. The swelling is painless but the face may take on a round, chubby appearance. This is reversible and will gradually diminish as eating habits improve. throat Inducing vomiting may result in injuries to the back of the throat, which can then get infected. Recurrent sore throats, blistering (as well as mouth ulcers) and hoarseness are common in those who induce vomiting.
Osteoporosis, or loss of bone density, puts people at risk of stress fractures in later life. It is particularly likely to be a problem in those who have reached a very low weight, whose periods have stopped for a long while because of their eating problem, or who have a history of anorexia nervosa. Dieting (see below) in itself can also affect bone density if the diet chosen is deficient in calcium (this is particularly important before age 30 or so), and may contribute to osteoporosis. effects on fertility and pregnancy Dieting and weight loss can impair fertility, although the effects are generally reversible.
After doing this you will have an idea of whether you need to prepare a detailed plan to deal with any problems that may result (advice on this 62 BULIMIA NERVOSA follows later). The following exercise will help you with this. 2 to complete it and follow the steps outlined below. 2 Examining specific (personal and sensitive) fears What you predict will happen: How likely is it that this will happen (0–100%)? Evidence for: Evidence against: Outcome: How likely do you think it is now that this will happen (0–100%)?