For mood adjustment and weight reduction, Britain’s National Obesity Observatory recommends Behavioral Activation, which basically encourages patients to become more active, because withdrawal from life increases depression. The idea is, anyone who just stays home will miss out on “opportunities to be positively reinforced through pleasant experiences, social activity, or experiences of mastery.”
The usual course of treatment is 20-24 sessions. A briefer version (8-15 sessions) called BATD is also available, which helps the patient identify values that will help them decide which outside activities to engage in.
Rational Emotive Behavioral Therapy (REBT) belongs to the general category of cognitive-behavioral therapy. Developed by Dr. Albert Ellis, REBT is “based on the concept that emotions and behaviors result from cognitive processes.” In other words, with appropriate coaching, a person can learn how to think differently, which will in turn modify feelings and behavior.
Part of the work is to uncover subconscious core beliefs which may be erroneous. This is how Wayne Froggatt capsulizes the Ellis idea:
In this framework “A” represents an actual event or experience, and the person’s “inferences” or interpretations as to what is happening. “B” represents the “evaluative” beliefs that follow from these inferences. “C” represents the emotions and behaviors that follow from those evaluative beliefs.
REBT has been found useful in treating a wide range of problems, including eating disorders, addictions, and impulse control disorders. It is effective for couples therapy and family therapy, which many experts acknowledge as the most productive approach with obese children. It encourages self-observation and self-knowledge, and one big advantage is that it is active rather than passive.
REBT is something that people do themselves, rather than something that is “done to them.” It is very different from Freudian and other approaches for this important reason:
An individual’s past is seen as relevant in that this is where much irrational thinking originates; but because uncovering the past is not usually helpful in changing how a person reacts in the present, REBT therapists do not engage in very much ‘archaeological’ exploration.
A client who wants to change a dysfunctional tendency is asked to deliberately behave in the opposite way, even if they are not “feeling it.” For instance, try acting like someone who loves to exercise. After a while, the person might find that they actually do love to exercise. Some call this the “fake it ’til you make it” method, and many people do find that it helps them to internalize the enthusiasm they initially only pretended to have.
Another valuable technique is to postpone gratification. One method is to wait five minutes before giving to a craving, then wait another five minutes, and so on. Often the craving will pass, or life events will intervene and remove the opportunity to act on it.
Delayed gratification is incorporated into Dr. Pretlow’s W8Loss2Go smartphone application. The person can spend a little time contemplating the visual “white noise” generator, which is calming, and helps settle that uneasy feeling of needing something to eat. The app also features the “Distractions Jar” that contains a number of ideas, either self-generated or suggested by friends, about things to do until the urge to snack goes away.
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Source: “Treatment: Behavioral Activation for Depression,” div12.org, 2015
Source: “A Brief Introduction to Rational Emotive Behavior Therapy,” Rational.org, February 2005
Image by W8Loss2Go