Working with Sufferers of Bulimia, part II

As mentioned in Working with Sufferers of Bulimia, part I the need for counsellors who work with sufferers of Anorexia, Bulimia, to enhance their understanding of these disorders in order to improve the quality of the therapy they provide is becoming more and more apparent as each new piece of research emerges. Furthermore, “Delineated treatment specifically tailored to the needs of each disorder” (Quinlan, 2013) as required for the treatment of eating disorders may be best accomplished by a full understanding of the differences in characteristics of these disorders.

Though there is no such thing as a typical patient or client, commonalities do emerge between sufferers of bulimia. It is often found that women who are engaged with the binge purge cycle, have been engaged with weight loss or have concerned with their weight and or a fear of being fat since their early teens (Beaumont, George and Smart, 1976). Additionally, further commonalities in personality traits have emerged among bulimic sufferers. Research into the personality traits of bulimic sufferers has show that they will often display more impulsive behaviours than those with Anorexia, (Garfinkel, Moldofsky and Gerner, 1980). These findings are confirmed by research carried out that showed a higher that average impulsivity often expressed by substance abuse (Pyle, Mitchell and Eckert 1981). In marked contrast to this, those sufferers of Anorexia are often “markedly obsessional, socially withdrawn” ( Bruch 1973). The rigid control of the anorexia patient is at variance with the more outgoing and extroverted style of behaviour of the bulimic patients. Bulimic patients however may alter their naturally outgoing social style as the binge purge cycle takes over their time and efforts, and they may become withdrawn and isolated. Add to this the on-going shame associated with bulimia and the sheer volume of time many bulimics give to their binge purge cycles and even though they may actually crave interaction, friendships and social encounters, they may find they withdraw and retreat into the comfort and familiarity of their food obsession rather than actively seek out and engage with others.

Once again given the propensity for sufferers of bulimia to maintain a fairly even weight, then identifying their eating disorder can be very difficult among their friends and family and so this eventual withdrawal can seem all the more difficult to explain and leave residual feelings of hurt or anger by those who cannot understand her behaviour.

Coping with Child Sexual Abuse in Adult relationships. Part II

In the psychotherapeutic treatment of adult survivors of Child Sexual Abuse (CSA) therapists are often mistaken in treating the survivor in isolation and fail to include in their therapy, the role of the partner in their couple relationship. This is to limit and detract from the therapy on offer as “If, as we can all agree, healing takes place in moments of secure attachment (Solomon, 2003) then the opportunity provided for healing within the current couple relationship is a vital and dynamic opportunity that ought not be overlooked” (Quinlan, 2013).

In my practice at Midwest Counselling I too have found it common that adult survivors of CSA seek out and replicate the trauma of their abuse (Briere & Scott, 2006). Attachment theory, (Bowlby, 1988) may account for why in some cases the “normal” attachment processes formed in early childhood are replaced in adulthood by this re-enactment of disruptive relationships, and may even lead to re-enactment of traumatisation (Allen, 2001). Because of unresolved issues arising as a result of the CSA, such as fractured impressions of how adult sexual relationships are supposed to work, or errant self-images as a result of childhood programming, then often the adult generalised view is fractured and errant. For instance they may view all physical contact as frightening, painful or abusive, or that all men/women are inherently dangerous. It follows then that these views shadow them into their adult couple relationships.

Subsequently then in treating adult survivors of CSA, the circularity of systemic family therapy may also be helpful. As mentioned in Coping with Child Sexual Abuse in Adult relationships, Part I, in couple relationships, it is commonly found that the partner of the survivor of CSA is bringing with them their own problems of equal measure. Therefore, as the therapy investigates the paradigm that exists between the couple, a pattern of co-dependant coping strategies may emerge. This iterates the importance of treating the client in a holistic way, and of looking at more than just the trauma of the CSA but also at the extended influence this is having on their couple relationships. So too, the benefit to couples counselling is massive, it can help raise a number of questions that could facilitate to a great extent the investigation into the nature of the couple relationship that exists that is been brought to couple therapy for “fixing”.

Given the aforementioned propensity for adult survivors of CSA to seek out and form relationships that emulate patterns and elements of the original abuse, then the benefit of including the partner in therapy is inherent. By engaging with both partners the therapist can work on limiting the re-enactments and re-traumatisation of the client. Furthermore and equally as importantly by soliciting the participation of the clients partner, the therapist can encourage and facilitate the growth of understanding and respect, and the identification of mutually beneficial goals that may ultimately lead to a constructive and nourishing adult relationship.

January Blues???

It’s dark, cold and a very long way to pay day.

Is it any wonder that the third Monday in January has been awarded the dubious honour of being called Blue Monday – the most depressing day in the year?

The resolution to begin a lifestyle overhaul got postponed till all the Quality Street were finished, the exercise regime is impossible in the dark and wet… and sure you can’t quit smoking when it’s this gloomy out?? Hardly inspiring stuff, is it?

Putting a little balance back into our lives is really what these resolutions are about and are a big help in finding a bit of peace for 2013.

Take 10 mins and look at your life in terms of 8 different categories and try to (honestly) give each one a rating out of 10 – if you’re falling below 5 in any of the areas it may be time to take a look at it and see what can be done.

  • Health
  • Money
  • Social life
  • Partner/relationship
  • Work/career
  • Friends/family
  • Home
  • Personal growth/spirituality (religion, interests, hobbies,)

Set yourself reasonable and attainable goals and as always feel free to fail and start again.

Best of Luck and Happy New Year!

If you feel you many benefit from talking to someone,

please feel free to call me on 087 709 74 77 or

email me in confidence at midwestcounselling@gmail.com.

What is Depression?

What is Depression?

There is a difference between depression with a little‘d’ – which we all get – and depression with a big ‘D’. Depression with a little ‘d’ is a natural response to having a bad day or hearing sad news. Depression with a big ‘D’ is when your whole energy and concentration is down and you are struggling to focus. It is a mental health condition which affects a person’s thinking, energy, feelings and behaviour. It’s not just having a bad day!

Symptoms of Depression

Depression has eight main symptoms. If you experience five or more of these symptoms, lasting for a period of two weeks or more, you should speak to a GP or mental health professional. The symptoms of depression are:

• Feeling sad, anxious or bored

• Low energy, feeling tired or fatigued

• Under-sleeping or over-sleeping,waking frequently during the night

• Poor concentration, thinking slowed down

• Loss of interest in hobbies, family or social life

• Low self-esteem and feelings of guilt

• Aches and pains with no physical basis, e.g. chest, head or tummy pain  associated with anxiety or stress

• Loss of interest in living, thinking about death, suicidal thoughts

What causes it?

Depression has a number of possible causes. For some people, it happens because of a traumatic life event such as bereavement, relationship breakdown, financial difficulties or bullying. In other situations, the person may have an inherent tendency towards depression, and such genetic factors can be key in the case of bipolar disorder. This mood disorder involves not just periods of depression, but also periods of elation, where the person’s mood is significantly higher than normal. During these periods, a person may have excessive energy with little need for sleep, may have grandiose ideas and may engage in risk-taking behaviour.

What should I do if I think I am depressed?

The most important thing to do is to speak to a doctor or mental health professional in order to get a correct diagnosis. There are a number of treatments for depression, depending on the cause and severity of symptoms and a professional is best placed to decide which, if any, treatment is most appropriate. Accessing reliable information is also vital.

 Taken from Aware.ie 15th July 2012

Suicide Warning Signs

Article taken from

Suicide Ireland 13th July 2012

 Warning Signs

Information to help you spot the warning signs of depression and suicidal behaviour. We can all make a difference.

What are the warning signs?

These are some of the classic signs that someone you know may be in need of some help. Please watch for the following symptoms…

Talking About Dying

  • any mention of dying, disappearing, jumping, shooting oneself, or other types of self harm.

Recent Loss

 

  • through death, divorce, separation, broken relationship, loss of job, money, status, self-confidence, self-esteem, loss of religious faith, loss of interest in friends, sex, hobbies, activities previously enjoyed

Change in Personality

  • Sad, withdrawn, irritable, anxious, tired, indecisive, apathetic
  • Change in Behaviour
  • Can’t concentrate on school, work, routine tasks
  • Change in Sleep Patterns
  • Insomnia, often with early waking or oversleeping, nightmares
  • Change in Eating Habits
  • Loss of appetite and weight, or overeating
  • Diminished Sexual Interest
  • Impotence, menstrual abnormalities (often missed periods)
  • Fear of losing control
  • Harming self or others
  • Low self-esteem
  • Feeling worthless, shame, overwhelming guilt, self-hatred, “everyone would be better off without me”

Report from RTE News on Suicide stats in Ireland 2011

Reported on RTE News 11th July 2010

 525 suicides, representing 11.4 per 100,000 of the population, were registered in 2011.

The vast majority of those who took their own lives were men.

The figures are contained in the Central Statistics Office Vital Statistics for 2011, which look at the numbers of births, deaths and marriages registered in that year.

The 2011 figures saw a rise in male suicides, which accounted for 84% of all suicide deaths.

Responding to the figures, the Irish Association of Suicidology said international research shows that for every 1% increase in unemployment there is a 0.78% increase in the rate of suicide.

It said that given the impact the economic downturn had had, especially on young males, it was not surprising that men were so at risk to suicide.

However, the association said that there is always help available to anyone suffering emotional distress or feeling suicidal, including through the samaritans or their family GP.

490 suicides were registered in Ireland in 2010.

Dan Neville TD, President of the Irish Association of Suicidology, said he was “extremely concerned” by the increase in the number of deaths by suicide.

Mr Neville said the figures were not a surprise because there was anecdotal evidence of an increase. He said the true figure was closer to 600 when “undetermined” deaths were taken into account.

He said the figure reflected the neglect of suicide prevention for decades, and the economic recession, which impacts on the levels of depression, anxiety and despair.

Mr Neville said that he has been assured that €35m allocated to the development of mental health services was safe from cutbacks.

He said in the past, the HSE did hive off money allocated to mental health for other services, and there must be vigilance that this doesn’t happen again.

He called for the urgent appointments of a Director of Mental Health Services, and a new director of the National Suicide Prevention Office.

“They are key positions that there should be no delay in the appointment of,” he said.

“Particularly the Director of Mental Health Services. This is a new position, promised by the government, by Dr Reilly. But it’s something we have been looking at for years.”