Appetite Awareness Workbook

W. Craighead Linda

Informations

• Publié par: New Harbinger Publications
• Date de parution: 01 janvier 0001
• Nombre de lectures: 0
• EAN13: 9781608822966
• Langue: English

Extrait

Publisher’s 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 © 2006 by Linda Craighead
New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
Cover design by Amy Shoup; Cover image: John Dowland /PhotoAlto /Getty Images; Acquired by Spencer Smith; Edited by Spencer Smith; Text design by Tracy Carlson
All Rights Reserved
epub ISBN: 9781608822966
Library of Congress cataloged the print edition as:
Craighead, Linda W.
The appetite awareness workbook : how to listen to your body and overcome binging, overeating, and obsession with food / Linda W. Craighead.
p. cm.
Includes bibliographical references.
ISBN 1-57224-398-8
1. Compulsive eating—Popular works. 2. Appetite disorders—Popular works. I. Title.
RC552.C65C69 2005
616.85’26—dc22
2005029562
New Harbinger Publications’ Web site address: www.newharbinger.com
Contents
Acknowledgments
Introduction
Chapter 1: Today’s Food and Weight Dilemma
Chapter 2: The Appetite Awareness Training Solution
Chapter 3: Disordered Eating or Eating Disorder?
Chapter 4: Discover Your Stomach Signals
Chapter 5: Take Back Your Power
Chapter 6: Reduce Binges to Mere Overeating
Chapter 7: Effective Emotional Eating
Chapter 8: Food Awareness Training
Chapter 9: Self-Coaching for Life
Chapter 10: Leaving the Maze of Disordered Eating
Appendix A: The Purging Trap
Appendix B: The Fear of Weight Gain Trap
Appendix C: The Weight Loss Window
References
Acknowledgments
I would like to acknowledge my first mentors whose personal enthusiasm and dedication to understanding problems with eating and weight set me on the path I have followed, which has culminated in this book: Dr. Martin Katahn and Dr. Albert Stunkard. I would also like to express my appreciation to two of my colleagues who have served as my models for clinically relevant research, and whose work has strongly influenced my thinking about mindfulness and the role of internal cues: Dr. Marsha Linehan and Dr. David Barlow. Dr. James Blumenthal, Dr. Kelly Brownell, and Dr. Charles Nermeroff have provided invaluable professional as well as personal support for my work over many years. The National Institute of Mental Health has provided funding for several studies on Appetite Awareness Training (AAT). Most importantly, I want to acknowledge the many contributions that my students, former students, and colleagues have made. They have contributed in so many ways that I cannot specify them all, but their ideas and their feedback made AAT what it is today: Dr. Heather Allen, Dr. Carolyn Aibel, Dr. Kathy Elder, Dr. Stacy Dicker Hartman, Dr. Heather Niemeier, Dr. Meredith Pung, Dr. Nancy Zucker, Dr. Debra Safer, Dr. Alisha Shanks, Dr. Malia Sperry, Dr. Heather Nations, Dr. Elizabeth Olsen, Dr. Lara LaCaille, and current students Arnika Buckner, Diana Hill, and Lucy Trenary Smith. Thanks for your enthusiastic and unwavering support, which has allowed me to get the message of AAT out to all of you reading this book. Thanks to all of their clients and mine. Your willingness to try out new ideas and to give us feedback about how these strategies worked for you was an essential part of the process of refining AAT so it would be more understandable and more effective for others. A special thank you for the young woman who wrote the essay included in this book.
I would like to thank my children for showing me firsthand how babies learn to eat, and how soon and how strongly the food environment starts to influence the biological appetite regulation system we are born with. My husband, Ed, has been my strongest support both personally and professionally. He has always believed in me even more than I was able to believe in myself and has pushed me to achieve my own goals. I thank all my family for encouraging me to work on this book even when it took away some of their time with me.
Introduction
Appetite awareness training (AAT) emerged from my years of research and clinical work helping people figure out how to feel better about the way that they eat and how they look. As I look back on my very first effort (I was a college senior leading a group for college women who wanted to lose weight for my honors project in psychology), I realize how radically I have changed the way I think about eating and weight. As I worked with (mostly) women, I came to the conclusion that the fundamental basis for the way I learned to treat disordered eating left much to be desired. The basis for cognitive and behavioral interventions for eating problems is to have the client self-monitor in a way that requires her to write down everything she eats each day. The purpose of this self-monitoring is to draw your attention to how you are eating so that you (with the help of your therapist) can figure out what is not working for you and can develop a way to eat that works better. There is nothing inherently problematic about self-monitoring. It is in fact the most powerful tool that anyone can use to change their own behavior. However, I came to believe that recording what one ate put way too much emphasis on the kind of food eaten and not enough emphasis on a person’s eating decisions, which were, ultimately, what had to change.
Most clients who came to see me had already tried food monitoring in one form or another. Recording your food intake is regularly touted in current diet magazine articles as the most effective way to limit what you eat. Clients who were overweight and might have benefited from paying attention to the differential calorie content of different foods were often the most turned off by my request that they monitor their food intake; some refused to do it at all. Some loved food records but became too dependent on this external source of control; they gained weight whenever they weren’t monitoring very carefully. For my clients who were not objectively overweight, the food part of the monitoring often seemed irrelevant or it increased their distress and compulsivity around eating.
In the process of experimenting with alternative ways to help my clients pay more attention to what seemed important, I developed the intervention I call appetite awareness training . My clients’ responses have been overwhelmingly positive. Almost all of them report that they are more willing to do appetite monitoring and that it focuses more on what seems important to them. I have trained many other professional therapists to use this technique, and they have reported similar positive results. Therapists often tell me how much better they feel about asking their clients to monitor appetite rather than food.
To provide scientific support for AAT, my research team reported several initial studies (Allen and Craighead 1999; Craighead and Allen 1995). Our current work suggests that treatment for eating problems that is based on the principles of AAT is at least as effective as any other treatment that has been evaluated at this time, and is preferred by many of those we have treated. Craighead et al. 2002 evaluated AAT-based individual treatment for women diagnosed with binge eating disorder and found that over 80 percent had stopped binge eating by the end of treatment. None of these women reported that they would have preferred to monitor food only. A few indicated they were only willing to monitor appetite, because they had very negative reactions to monitoring food, but most indicated they were willing to include some limited food monitoring with the appetite monitoring the strategy you will see described in chapter 8 and appendix C in this workbook. A subsequent study (Elder et al. 2002) evaluated group treatment for college women with binge-eating problems and found a similar, very positive response to this model of treatment and type of self-monitoring.
Most recently, we have evaluated an AAT-based twelve-session individual treatment for women diagnosed with bulimia (Dicker and Craighead 2003; 2004). In this study, clients were not allowed to monitor food, only appetite. Since none of these women were significantly overweight (most were quite normal weight), we did not believe food monitoring was necessary and we wanted to test the effect of appetite monitoring by itself. Most of these women (80 percent) fully recovered; they had completely stopped bingeing and purging as assessed one year following the end of treatment. A few, all of whom were substantially improved, had been particularly severe at the beginning of treatment (purging at least once a day) and needed longer or more intensive intervention. All but one of the participants had tried some form of food monitoring in the past, and almost all reported they did not like doing it or did not find it helpful. All who had ever tried food monitoring reported that they found the appetite monitoring more helpful than their past experiences with food monitoring, and they highly recommended AAT treatment for other women having problems with binge eating. Currently, my colleagues James Blumenthal, Ph.D., and Frank Keefe, Ph.D., are evaluating appetite monitoring at Duke University as a component of comprehensive weight management programs for individuals with significant medical concerns.
I encourage you to give AAT a chance to help you with your eating concerns. I realize this approach will feel quite different from many of the strategies you have already tried or are currently using, but I believe that you will find this approach a better alternative. Give it a try. You are obviously not happy with the strategies you are currently using. One of my clients who recovered described her r