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More PsychNotes: Stress and Coping

July 23, 2016       
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Using the Cognitive Diary for Eating Disorders
by Monica A. Frank, PhD

The Best Eating Disorder iPhone and Android Apps Healthline has selected Excel At Life's android app Cognitive Diary CBT Self-help as one of the best apps for eating disorders. Although the Cognitive Diary app is a general multipurpose app, it can be used for specific types of problems. The following provides some tips as to using it for eating disorders.

Although eating disorders are more complex and involve physiological processes as well, two psychological aspects of eating disorders can be managed:

1) Thought process. The type of thinking can vary with the type of eating disorder. However, typically the thoughts are inaccurate in some way. For instance, the thoughts may involve inadequacy, perfectionistic demands/expectations, and control. For anorexia, in particular, the thoughts include a focus on a distorted body image. In addition, the thoughts aren't always directly related to food or body image but irrational assumptions and demands of the self can be focused on any type of problem that is experienced so that other types of problems such as relationship issues can trigger the eating behavior.

2) Emotions. Often with eating disorders people avoid dealing more directly with their emotions whether those emotions are related to the eating problem or due to other issues in their life. By focusing either on the eating or controlling the eating, the person is able to avoid uncomfortable emotions. Stress is managed through this avoidance similar to how an alcoholic may drink to avoid problems. However, instead of resolving problems the disordered eating and avoidance typically adds another layer of stress.

How to use the Cognitive Diary app to help address thoughts and emotions:

1) Making a commitment. The first step is to commit to recording and evaluating your thoughts and emotions. You don't need to focus on changing the eating behavior but instead focus on changing your thoughts. What this does is prevents you from using the eating behavior to avoid emotions.

2) Recording emotions. The Cognitive Diary asks you to assess your emotional state—both what emotion you are feeling and the intensity of the emotion. Again, by doing so, you are not avoiding the emotion but instead understanding what you are feeling. This helps you to create a more mindful acceptance of your emotional state.

3) Evaluating thoughts. By recording your thoughts you can then examine them and determine how they might be inaccurate. Through this process you can develop a more accurate way of talking to yourself. It can help improve your self-concept and how you think of your relationship to others.

4) Repetition. The way that change occurs is through practice. By using the new thoughts you have developed repeatedly you can make these thoughts more automatic.

Read Cognitive Diary Training Example: Eating When Feeling Lonely

As you may see from this example, if a person continues to challenge the irrational thoughts, eventually other behaviors will develop to replace the eating behaviors. For instance, this person might begin to focus on inviting others to social activities rather than sitting home and brooding and eating.

Excel At Life also provides free audio downloads to help you with learning to change your thinking about eating.

Kindle Books by
Dr. Monica Frank



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