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Cindy’s Anxiety

Cindy has been having some anxiety about the future. She successfully lost 43 pounds and has been maintaining that loss for over 8 months, but she still has negative thoughts and images that pop into her head from time to time. The most common one is that she sees her future self standing in front of the mirror, trying to zipper her jeans, and realizing that they have become too tight. She experiences a sickening realization that none of her clothes fit anymore. Her heart sinks as she steps on the scale and sees how much weight she has regained.

I discussed with Cindy the fact that this visual in her head of trying to zip her jeans is making things so much harder for her! I helped Cindy replace that visual with a much more realistic one. In this picture, her future self steps on the scale and notices that it has gained 3 or 4 pounds. But instead of experiencing that sickening feeling in her stomach, she immediately becomes problem-solving oriented. Cindy breaks out her diet notebook and her Beck Diet Solution book, reads her advantages of losing weight list, reads back to the times when she was doing inflexible eating, and sets up an eating plan for that very day. Because she has already firmly mastered the skill of following a plan inflexibly, it is not difficult for Cindy to put herself back in that mindset, especially because reading her advantages list has concretely reminded her why it’s worth it to do this. Within a week or two, Cindy already sees the scale going back down. This is completely realistic, and helped put Cindy’s mind at ease.

Sue: Part 7, Fear of Losing Control

Sue is still afraid that if she eats something wrong, she’ll lose control and not be able to get back in control. We had the following discussion:

Sue: I’m just afraid that one false step will be the beginning of the end.

Dr. Beck: How many times in the past few months have you taken a false step?

Sue: A fair number, I guess.

Dr. Beck: And how many times did you start on the path of serious weight gain?

Sue: Never.

Dr. Beck: And why is that?

Sue: Well, it’s because I’m learning to see something as an isolated mistake. I’m learning how to get back on track right away. I’m still motivating myself by reading my list of reasons to lose weight. And other stuff.

Dr. Beck: That’s exactly right. It’s because you now know exactly what to do when you stray, and you know how to get yourself to do it.

Sue and I agreed that she needed to keep track of all the instances in which making one mistake did NOT lead to her losing control. We also agreed that this month, Sue would reread The Beck Diet Solution. She plans to take notes in the margins about what she can do if there ever does come a time when she starts to gain weight back.

This exercise will serve as a good reminder for Sue that all the skills she needs to stay on track are there in black and white, for her whole life. I think this will also provide her with a good measure of relief.