Expert: Matthew Cook - 4/11/2010

Question
Dear Matthew,

I'm really struggling with self-esteem issues at the moment and was wondering if you had any advice. I'm a 27 year old woman and about 5 years ago I suffered a bout of anorexia and the self-harming thoughts are returning. I have become obsessed with 'celebrity' measurements (believe me, I know how completely ridiculous this is - I mean, I'm 27 for God's sake, not 15...) and I cannot help but compare myself to them - my hips are 38 inches and all the measurements I read about show the women to have 33 - 35 inch hips, with 36 being hailed as 'curvy' - what does that make me? An elephant? I have a healthy bmi of 20 (it was 16 at one point) but I hate my huge body and have started dieting again in order to reduce my size. So stupid I know, but I feel so self-conscious about my size. Please do you have any advice for breaking this thought process and trying not to care about such ridiculous things? I am terrified of going too far again and getting ill but I don't know how to stop feeling so upset about my size.
Alexa

Answer
Hi Alexa –

You are dealing with one of the recurring issues with eating disorders – and that is the maintenance of your recovery. Well done for seeking some help now that you have identified the first signs of things slipping back into old ways again.

You say that you have self-harm thoughts returning, and have started dieting again even though your BMI is only 20. I do think it would be helpful if you contacted your doctor or therapist to explain your situation, and ask for some help with this.

There are lots of ways to try to stop such automatic negative thoughts – different ways suit different people, and it would be useful to discuss these issues with a counsellor/therapist who could help you find your own way to cope, identify other ways you can build your sense of self worth and self esteem and feel in control of your life.

For example, one client I knew ‘externalised’ such thoughts by hearing them as the separate voice of her eating disorder, and even imagined it as a devilish imp on her shoulder that she would tell to ‘get lost’ and even knock it off her shoulder! She would then change what she was doing and concentrate on something else instead.

Another client, as well as throwing out all her fashion magazines and set of scales) used the old H.A.L.T technique which can be adapted for all sorts of situations. Whenever she noticed she was thinking ‘fat’ thoughts, she visualised in huge letters HALT! (and heard it shouted in her mind). If you don’t know, it stands for: Am I Hungry? Angry? Lonely? Tired?
The point is, it would take her mind away from thoughts about her body shape and make her think about what was really going on with her emotionally at that moment. She would then do something more caring for herself that was more relevant to her emotional needs.

You have identified self esteem problems in your own case. And this seems tied up with your body image. Its a cliché that eating disorders are fulfilling some purpose for us, and that we need to be able to develop more positive ways to fulfil whatever that need is. Over time, you will hopefully develop your own positive sense of self worth – through developing your interests and talents, finding something that absorbs your attention, nurtures your spirit and helps you grow with a sense of purpose.

And for lots of self caring ways (such as developing your own ‘coping bank’) to help work on your body image and self esteem, have a look around an excellent website called Something Fishy – start with this thread:

http://www.something-fishy.org/reach/bodyimage.php

and another:

http://www.something-fishy.org/reach/toolbox.php

And regarding helping you to stay on track with your recovery, another website helps you find your own eating disorder ‘mentor’. A mentor is someone who has ‘been there and done that’ and maintained their own recovery for some time, and now wants to help others do the same. Its called ‘Mentor Connect’ and you can find it at:
http://www.key-to-life.com/mcoverview/

Hope that all helps


Matt C