Monday 20 April 2020

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How I do bulimia psychotherapy: ICAT-BN 
approach

When a person spends money on psychotherapy, he wants to understand what will be done to him and how. What approach will they “apply” to it? I use 2 options:
  • Cognitive-behavioral psychotherapy for bulimia as well as some elements from  ICAT-BN and ACT.
  • Or the CBT-T protocol Cognitive Behavioral Psychotherapy Ten

The choice between them is simple: if the client has an RPP plus BMI of about 18 or more, then it will be (2) CBT-T If another option,then(1)CBT .About CBT-T for eating disorders can be read separately Concerning the main protocol of CBT, eating disorders also have nothing to say briefly - too much to print 


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The meaning of this psychotherapy is to help the client understand what is happening to him and why, how it turns out that RPP occupies a large place in life. And also learn how to solve problems not with the help of glitches and breakdowns, but with the help of other, more suitable methods. How to work with this protocol, I studied at continuing education courses at Moscow State University , which I am very pleased with. Well and finally ICAT-BN remained, I will tell below. I note that recently I use this method very rarely. So if you come in 2019 and later, most likely I will work 

What is ICAT-BN?
ICAT-BN stands for Integrative Cognitive-Affective Therapy for Bulimia Nervosa, or in Russian, integrative cognitive-affective therapy for bulimia nervosa.

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What to expect from ICAT-BN
Of course, no magic pill exists - I never get tired of repeating it. ICAT-BN, like any other psychotherapy, is work, work and work again. Moreover, this is such a job that is not easy and does not work right away. It causes a lot of emotions, and not only positive ones

You need to clearly understand that you will not succeed in sitting on two chairs : to save the way you eat now (your eating habits and rules), and to remove bulimia.

In the vast majority of cases, bulimia is provoked by special dietary rules . Later, after several years of torment with bulimia, it may be that the attacks are in no way connected with nutrition, but this is rather the exception.

Therefore, we will discuss your nutrition, and we will make changes to it to make it more healthy and suitable for your psyche and body.
I am not a nutritionist and do not recommend any diets. But I - and you too - clearly see when you skipped lunch, deliberately limited calories or excluded carbohydrates from the diet (for example).
In the process of therapy, we study together what is happening to you. Key psychotherapeutic effects (interventions) that can be expected from ICAT-BN:

๐Ÿ‘‰ You learn to understand what emotions you are experiencing and why. You learn to deal with them in a different way , without the help of food and bulimia.
๐Ÿ‘‰ You learn additional skills that help you overcome impulsive urges (“go and snatch”), especially when you experience negative emotions. In other words, you learn to reduce the likelihood of an attack in difficult situations.
๐Ÿ‘‰ You learn to change your diet so that it does not provoke bulimia.
๐Ÿ‘‰ You find what exactly in your life is the source of negative emotions or the reason for the lack of positive emotions (and, as a result, bulimic behavior), and learn to change this source.
How does a typical session go
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Of course, they are different - at the beginning of therapy one thing, in the middle - another. We always start by studying the diary of nutrition and eating behavior for a week. ICAT-BN uses a special diary, not usual for cognitive-behavioral therapy. In it, cases of overeating and vomiting are additionally noted. Each such case becomes the number one priority for discussion.

We find a connection between this case and what happened within a few minutes or hours before the attack. We discuss the feelings that arose in that situation during the attack, now at the time of discussion. We find out exactly what was affected: self-esteem or attitudes, whether there was excessive criticism of oneself or it was not clear how to calm down. Learning to solve these problems without the overeating / cleaning cycle. We determine the homework for the next week, everything, 50 minutes passed.

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