Volunteering. Doing voluntary work can give you a sense of satisfaction and help you meet new people.
Striving to improve your overall fitness. Regular exercise increases your endorphin levels and has a real ‘feel good' factor.
Joining or starting a film or book group. Watching films and reading books are great solo past times but getting together with others once a month to discuss your opinions can be even better.
Pursuing further study or training courses. Taking on new learning and skills can be very rewarding and absorbing. You may also further your career in the process. Studying also offers another great chance to meet new people.
Trying to meet that special someone. Loads of reputable online dating sites and singles functions exist out there. Give it a whirl and see what happens.
Think hard about your interests. We all have things that really float our boat - classic cars, art, architecture, sport, animals, outdoor pursuits, history, crafts or carpentry. The possibilities are truly endless. Find out what pushes your personal interest buttons and make time to indulge yourself.
Sobriety or ‘clean living' isn't a life sentence of boredom and deprivation. It's quite the opposite if you choose to make it so.
Cleaning house
Stop the rot by scourging your living space of all addiction-related stuff. You don't need reminders around the place when cravings descend. Throw out the ashtrays, needles, alcohol and old betting slips. Clean your home to reflect your new resolution to live life cleanly and positively.
A clean and tidy home can also help your mood remain stable. Part of looking after your physical and mental health is looking after your living environment. Even if you're not naturally tidy, make an extra effort to treat your home with the respect and attention you deserve to give yourself.
Taking up supportive socialising
When you first stop using your DOC you may need to reassess your existing friendships. Some people may turn out to be simply ‘using mates' and have little else to offer you. You may need to be ruthless and sever ties with certain people.
The people in your life who've been worried about your addictive behaviour or stopped seeing you because of it, may well be the people you need most right now. Try re-engaging with them and let them know about your newfound abstinence so they can offer you much-needed support.
Addiction thrives on secrecy and recovery needs the public gaze. Tell appropriate people about your problem (and your plans to overcome it) in order to ‘up the ante' and erode feelings of shame. Also bear in mind that people can't offer you support if they aren't aware that you may need it.
Planning to Prevent Relapse
If you follow the advice offered in the previous sections of this chapter, then you're well on your way to avoiding relapse. However, we also want to alert you to the following points that can slyly provoke relapse:
Making seemingly irrelevant decisions. ‘I'll just walk home via the pub to save the extra time of avoiding it because I'm running late' or ‘I'll just pop into the casino to see my mate whose number I've lost' or ‘Maybe I'll stay in this weekend as all my housemates are away and I can work in peace and quiet' or ‘I've got a headache so I'll just take the one codeine tablet'. These kinds of thoughts and decisions may appear fairly innocent but they're not! Addiction is a slippery customer and it can lead you into thinking you're making a safe and sound decision when really you're setting yourself up to fall off the wagon. Beware of seemingly irrelevant decisions that are actually wolves in sheep's clothing. Double check your real motivation behind every decision you make in early recovery.
Finding the novelty wears off. In the beginning everyone is so pleased and impressed by your abstinence. Maybe they make special allowances for you and check in on you regularly to tell you how well you're doing. Then one day you realise that your ‘sobriety' is now being taken for granted. People are no longer especially interested in your recovery from addiction and actually neither are you. This situation's normal; it's what should happen. Once you're far enough away from your addiction people forget about it to a large extent; you're just you again. Rejoice in that rather than feeling neglected and hard done by. You don't need the constant pats on the back anymore. You're recovered, so enjoy.
Experiencing false bravado. So you think you've been clean long enough that you can handle a little social drinking, drug use, moderate gambling or porn surfing. The fact that you have that thought and desire means you probably can't safely chance moderate use. Don't risk it. You've been okay without your DOC for this long - why put all your hard work at such risk?
Feeling everyone else can do it, so why can't I? Because you have a history of addiction, and that's that. Yes, those fortunate addiction-free individuals can drink or have a smoke when they choose. You, however, have to be very careful indeed. This situation's not unfair or unjust - it's just the way it is for you.
Make a list of all the seemingly irrelevant decisions and addiction resurgence ideas you think you may fall prey to in future. Then challenge them with healthy, helpful and accurate recovery-reinforcing attitudes.
Chapter 11: Beating Body Image Blues
In This Chapter
Living happily with your looks
Making healthy improvements
Appreciating your whole self
There's more to life than being really, really ridiculously good looking and I'm going to find out what it is.
Derek Zoolander (played by Ben Stiller in Zoolander)
Taking care of your physical health and appearance is both normal and natural. Looking after yourself through regular exercise, good eating and personal grooming is part and parcel of good mental health. However, many people place too much importance on being physically attractive. Looks can become an over-riding preoccupation and lead you into emotional disturbance and/or low self-esteem.
There's no denying that physical attractiveness has an impact on others. First impressions are often based on how you look in combination with how you behave. Psychologists define the term ‘body image' as your internalised sense of what you look like. In many cases, the ideas people hold about their appearance are roughly accurate; in others, they can be quite divorced from reality.
In this chapter we touch on some of the more severe and debilitating types of body image disorder, help you to determine if you've got one and offer suggestions for treatment. The bulk of this chapter, however, deals with more commonly encountered body image problems. New ways of thinking about your physical self are introduced and strategies for building a better body image are explained.
First, let's define what we mean by ‘healthy' and ‘unhealthy' body image. Someone with a healthy body image may not necessarily love the way they look or even be above average in looks. Having a healthy body image is less about how attractive you are and more about accepting your looks as they stand. A healthy body image allows you to enjoy your life fully, whatever you look like, and be able to make the most of what nature gave you. People with unhealthy body images tend to desire looking radically different and imagine that they'd be far happier if only they were better looking.
You're certainly not the only person in the world who worries about physical appearance. Even people who are generally considered to be very attractive often are beset with body image problems. It just goes to show that your happiness with your appearance isn't inexorably linked to your objective attractiveness.
Making Friends with the Mirror
‘Mirror, mirror on the wall, who's the fattest, ugliest, plainest, gawkiest, most freakish of them all?' (Delete as appropriate.) Does this refrain ring a familiar bell with you? Is your relationship with the mirror fraught with anxiety and horror? If so, join the club - it's a big one. Dissatisfaction with personal appearance is rife in the western world (and increasingly beyond). The severity of body image problems can vary from mild and irritating to severe and debilitating. At the mild end of the scale, you may just grumble about your looks but still be able to live an e
njoyable life. If your body image problem is more extreme, however, it may lead to depression, poor self-esteem, social withdrawal and complicated disorders like body dysmorphic disorder (BDD), anorexia and/or bulimia.
BDD is a disorder that involves extreme preoccupation with one or more physical features. The features the BDD sufferer regards as unacceptable and abnormal are usually not that noticeable to other people. BDD sufferers often have compulsive behaviours such as masking physical areas of concern (through clothing and make-up) and checking in the mirror continually to ensure the perceived defect is still concealed (or hasn't worsened in some way). Both women and men can suffer from BDD.
Anorexia nervosa is an eating disorder characterised by severe fear of fatness, or indeed of being a normal healthy weight, coupled with intense efforts to lose weight. In the majority of cases, the sufferer believes she or he looks normal even though other people (including doctors and therapists) insist that they're underweight. Anorexia affects men and women alike, despite the misconception that it's a female illness. Typically, sufferers will have elaborate rules and rituals about food that enable them to restrict calorie intake. Efforts to lose weight include severe restriction of food intake, excessive use of laxatives, over-exercising and vomiting after eating.
Bulimia nervosa is another eating disorder but most sufferers are within a normal weight range. The disorder is characterised by periods of dieting punctuated by ‘binges'. Typically, an individual will consume over the recommended daily intake of calories in one binge-eating episode. Following a binge, the sufferer purges either through self-induced vomiting, use of laxatives or both. Like anorexia, bulimia is also often considered a ‘women only' problem; in reality, however, many boys and men develop bulimia too.
The following sections provide some questions to help you figure out whether body image is a problem for you.
Do I have a serious body image problem?
Do you think that you have a particular physical feature that's abnormal, defective or ugly? This feature may be anywhere on your body. Remember that your perception of this feature is what counts here, even if others disagree with you about it. Consider your responses to these questions:
1. Has a close friend, family member or health professional told you that your concerns about your feature are groundless and there's nothing noticeably different or wrong about the way you look?
2. Do you continue to be distressed about and preoccupied with your feature despite assurance from friends, family members and doctors?
3. If you add up all the time you think about, worry about or check your feature of concern in one day, does it amount to one hour (or more)?
4. Do your specific worries about your physical feature prevent you from socialising or stop you from forming intimate relationships?
If you answer ‘yes' to any four out of the five questions listed above, you may have some degree of BDD. Disorder-specific CBT treatment can help you. A professional psychiatric assessment may also be useful; discuss the issue with your GP and ask for a referral. Even if you think your problems are at the mild end of the spectrum, we advise you to err on the side of caution and get a medical opinion anyway.
Do I have an eating disorder?
Extreme concerns about body image can result in eating disorders such as anorexia or bulimia. Answer these questions to ascertain your feelings in relation to food, weight gain or loss, and your self-image:
1. Are you very fearful of gaining weight, staying at the same weight or of others thinking that you're fat?
2. Do you try to strictly monitor how much you eat (portion size), what you eat (food groups) or calories consumed each day?
3. Do you become very distressed (depressed or agitated) if you eat more than you planned or consume a ‘forbidden' food?
4. Despite having lost weight, do you feel dissatisfied with your size and convinced that you must lose more?
5. Do you try to hide the fact that you're trying to lose weight from friends and family because they've expressed concern that you're underweight?
6. Do you induce vomiting, drink lots of water or diet soft drinks to fill yourself up, use laxatives or exercise compulsively in order to lose more weight?
7. Are you preoccupied by food and your size? Do you find that they're almost always on your mind? (You may also have dreams about food and eating.)
8. Despite your best efforts, do you sometimes lose control and binge? A binge may be eating foods you typically avoid or larger portions than you normally allow yourself (you may feel intense guilt and regret afterward).
9. Do you have certain rituals about eating such as: chewing a certain number of times, cutting up food into small pieces, consuming less than others you're eating with, eating at specific times or wanting to eat in private?
10. Do you weigh yourself once a day or more? Check the prominence of your hip, joint and shoulder bones daily? Test out your size in relation to certain articles of clothing?
If you answer ‘yes' to five or more of the above questions you may be either suffering from an eating disorder or be at risk of developing one. Talk to your GP and ask to be referred to a psychiatrist for an assessment. Medical units dedicated to treating eating disorders exist and many CBT therapists will have specialist knowledge of this problem.
If your perception of how you look is preventing you from going to work or school, socialising and generally pursuing your goals (see Chapter 8 for more about goals), don't hesitate to seek professional help. Conditions like BDD and eating disorders tend to worsen over time if untreated. We strongly advise that you get treatment as soon as possible. Chapter 21 provides lots of advice and information about getting professional help to deal with your problems.
Many people make a full recovery from the body image disorders we discuss in this chapter. Doing so involves a lot of determination and work - but it can be done. Be optimistic and stubbornly stick to a recognised and effective form of treatment (see Chapter 21 for pointers on where to seek help).
Considering hypothetical cases
You may not have found the questions in the sections relevant to you but still recognise that your relationship with your physical self is less than ideal. Many of us have bouts of self-loathing regarding our appearance; they may pass reasonably quickly or be indicative of more chronic dissatisfaction.
Have a gander at the following hypothetical examples:
Jake is tall and slim. He got teased a lot during his school years and was called ‘stretch' and ‘bean pole'. Jake remains very self-conscious about his height and build. He constantly compares himself to his friends at the gym who are more compact, muscular and stocky. Jake has developed a habit of scrutinising himself when he gets undressed in front of the mirror. Generally, he's pretty uncomplimentary about what he sees: ‘What puny little shoulders I have! My stomach muscles are non-existent. Why do I even bother working out? It clearly has no real effect'
Jake's habitual harsh self-criticism in front of the mirror isn't doing his overall self-esteem or body image a lot of favours. But he's been doing so for so long that he doesn't realise how damaging this criticism actually is.
Savannah hates her face; she thinks that her nose is too prominent and that her eyes are too far apart. She takes no notice of her glossy hair and even teeth. In fact, she's so dissatisfied with her facial appearance that looking in the mirror is painful. Since adolescence Savannah has avoided mirrors, spending as little time witnessing her own reflection as possible. She quickly does her hair and applies a modest amount of make-up each morning, then avoids looking in the mirror for the rest of the day.
Savannah considers reflective surfaces to be her enemies. She completely discounts her best features and focuses instead on those she dislikes.
One of the key differences between people with a healthy body image and those with an unhealthy one is what they choose to focus on when they look at their reflection. People with poor body image typically home in on areas of dissatisfaction to th
e exclusion of other aspects of their looks. Those with a healthy body image are more likely to pay specific attention to areas and features that they consider to be their best points.
Cognitive Behavioural Therapy For Dummies Page 17