Whats Wrong with Exercising Four Hours a Day: Connecting with Clients Who Hate Their Bodies

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Whats Wrong with Exercising Four Hours a Day?
Connecting with Clients Who Hate Their Bodies

• Angela Bardick
• B.F.A., B.Ed., M.Ed., Registered Psychologist
• Dr. Kerry Bernes
• B.Ed., M.Sc., Ph.D., ABPP (Clinical Psychology)
• The University of Lethbridge/Bernes Psychological
  Services
• Associate Professor/Registered Psychologist

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Overview

• Overview of the problem
• Weight and Body-Related Issues
• Motivating and Sustaining Factors
• Presenting Attitudes and Behaviors
• Therapeutic Relationship
• Targets of Intervention
• Creative and Individualized Treatment

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Overview of the problem

• Imagine discussions in
• Classrooms, hallways, or teacher lounges
• Also in
• Offices
• Restaurants
• Gyms
• Friends homes
• Your home

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You may hear talk about

• Bodies
• Food
• Exercise
• Weight loss and weight gain
• Admiration for athletic prowess and physical
  beauty
• Criticism for lack of physical prowess or
  physical beauty
• Wishful thinking
• Negative self-talk

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You may observe

• Children being picked last for teams
• People being teased for physical differences
• People being weighed and measured
• Curriculum subjects/presentations focusing on
  healthy habits
• People denying themselves food
• People exercising excessively

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What you wont notice

• Private, negative thoughts about weight, size,
  shape, and food
• Private behaviours
• throwing out lunches
• counting calories/fat grams
• Obsessive rumination about food/exercise
• use of diet/muscle enhancing supplements
• Binge/purge behaviours
• Individuals who isolate themselves yet appear to
  be actively engaged

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Increasing Awareness
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Negative Body Perceptions

• Body hatred is not a natural state of being!
  Babies are born with a natural fascination,
  adoration, and curiousity about their bodies.
  They eat when they are hungry, sleep when they
  are tired, and cry for attention when they need
  it. Somewhere along the journey from childhood to
  adulthood, we have lost our ability to enjoy and
  nurture the body that we have, instead believing
  we need to manipulate it into some unrealistic
  ideal.

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Motivating and Sustaining Factors

• Childhood issues
• Media
• Mental Health Concerns
• Personality Factors
• Stress
• Natural Body Processes

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Childhood Issues

• Messages from childhood
• Teasing
• Positive comments
• Criticism
• Social comparison
• Peer pressure
• Childhood trauma
• physical, sexual, or emotional abuse
• illness

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Media

• Messages from magazines, television, movies, etc.
  for women to be thin and men to be muscular
• Messages that infer you can change your life by
  changing your body

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Mental Health Concerns

• Depression
• Anxiety
• Difficulty dealing with emotions
• Mood disorders
• AD/HD
• Addictions

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Personality Factors

• Perfectionism
• Desire for control
• Conformity
• Appearance oriented
• Desire for approval
• Self-sufficiency
• Low self-esteem
• Impulsivity
• Histrionic traits
• Obsessive-Compulsive traits
• Narcissistic traits

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Stress

• Work stress
• Relationship stress
• Bereavement

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Natural Body Processes

• Hormones
• Adolescence
• Pregnancy
• Menopause
• Aging
• Physical Illness

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Weight Body-Related Issues

• Body Image concerns
• Eating Disorders
• Anorexia
• Bulimia
• Orthorexia
• Muscle Dysmorphia
• Sub-clinical eating disorders

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BRIDGE Graph
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Body Manipulation Triad

• Dieting
• Exercise
• Supplements/Steroids
• Surgical manipulation

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Presenting Attitudes and Behaviors

• Continuum ranging from mild to extreme
• Injuries
• Rigid obsession
• Isolation
• Insistence
• Denial of problem
• Resistance to change
• I need to do this.

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Why is this difficult to treat?

• Behaviours appear healthy and normal!
• Fear of being judged
• Lack of trust
• Likely to present with other issues
• Depression, anxiety, relationship issues, stress

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• Like our bodies,
• treatment is not one size fits all.

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Creative and Individualized Treatment

• Seeks to avoid stereotypes
• Is based on a thorough understanding of the
  person
• Facilitates insight
• Increases treatment fidelity
• Increases opportunities for change

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Comprehensive Assessment

• The presenting issue is not the real issue!
• Mental Health
• Depression
• Anxiety
• Any previous diagnoses?
• Physical Health
• Personality Factors
• Current stressors
• Childhood issues

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Patterns of Thinking

• Selective Abstraction
• Only thin women are beautiful.
• Overgeneralization
• I was thinner before I had a baby, therefore I
  must get back to my prepregnancy weight.
• Magnification
• If I cant fit into these jeans I wore in
  grade 12 I wont be able to stand it.
• Black and white thinking
• Only thin people are happy. I am not as thin as
  they are, therefore, I will never be happy.
• Personalization
• Two people laughed and whispered as I walked
  by. I know it was about how fat I look.
• Superstitious thinking
• If I eat sugar, it will automatically be
  converted to fat.
• Shoulds Musts

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Patterns of Being

• Behaviours
• Mirror gazing
• Exercise habits
• Eating habits
• Triggers
• Emotional concerns

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Therapeutic Relationship

• Empathic listening and understanding
• Attitude and orientation of knowledge
• Avoiding stereotypes
• Provide an atmosphere in which each person feels
  safe enough to reveal their story
• The development of a trusting therapeutic
  relationship will enhance the exploration of
  underlying issues and provide a basis for
  revealing creative and individual targets of
  intervention.

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Targets of Intervention
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• The reflection seen in the mirror is not a
  complete picture of who one is as a whole person.

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• When the target of intervention matches the core
  issue, the client
• Develops insights
• Feels heard
• Increases motivation for change

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Treatment recommendations

• Recommending that individuals stop a behavior
  that they believe to be helpful may be harmful
• Seek to redefine the behavior as health-enhancing
  
• Increase the individuals repertoire of other,
  more moderate and enjoyable, self-care strategies
• Seek to increase enjoyment!

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Creative and Individualized Treatment Goals

• Stems from exploration of motivating and
  sustaining factors
• Move towards a radical acceptance of the body and
  the self
• Focus on positive traits
• Move towards less healthy behaviours!

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Thank you!

• Should you desire a copy of this presentation,
  please contact
• abardick_at_shaw.ca
• kerry.bernes_at_uleth.ca