Eating Disorders are typically concerned with weight, body size, and shape coupled with a fear of gaining weight or becoming fat. Eating Disorders typically include symptoms of being preoccupied with food, counting calories, fear of weight gain, binging, purging, starving oneself, or overexercise. Many people will eat food in secret, isolate from others, and become obsessed with negative thinking patterns around low self-esteem and body dissatisfaction.

Diagnosed eating disorders include:

Anorexia Nervosa.

Bulimia Nervosa.

Binge Eating Disorder.

Avoidant Restrict Food Intake Disorder.

Other Specified Feeding and Eating Syndrome.

The philosophy behind Uniquely Human Psychology is that perfectionism is unachievable. Therefore, the main aim of assessment and therapy is to alleviate the person’s distress and symptoms and highlight body diversity and behaviour change to attain desired health outcomes.

The therapeutic approaches provided at Uniquely Human Psychology are all evidence-based.

Cognitive Behaviour Therapy – Enhanced (CBT-E)

This intervention is suitable for older adolescents (15-19) and adults with Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder (BED), Avoidant Restrict Food Intake Disorder (ARFID), Other Specified Feeding and Eating Syndrome (OSFED). When this therapy is applied – therapist’s will try to help individuals change both their eating disorder mindset and unhelpful behaviours.The core theme of CBT-E is based on the understanding that there are common patterns that exist for all types of eating disorders and it is these patterns that continue to maintain an individual’s eating disorder cycle. When necessary, therapy may initially aim to renourish a person through nutrition.

Cognitive Behaviour Therapy (CBT) and Exposure Therapy for Eating Disorders

This approach is suitable for the treatment of food phobias and ARFID (Avoidant Restrictive Food Intake Disorder). Anxiety and fears exists with food phobias and ARFID. Avoidance of particular foods may contribute to weight loss or failure to appropriately gain weight and nutritional deficiencies. Psychosocial problems that effect friendships and overall wellbeing for individuals with food phobias and ARFID can lead to withdrawal and depression. When necessary, therapy may initially aim to renourish a person through nutrition.

Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)

This treatment is suitable for older adolescents (15 -19) and adults with Anorexia Nervosa.

MANTRA aims to address the cognitive, emotional, relational and biological factors which tend to maintain Anorexia Nervosa by working out what keeps an individual trapped in their anorexia, and gradually helping them to find more adaptive ways of coping. As each treatment is individually tailored – this can include: developing motivation to change and recover; improving food intake and nutrition; addressing interpersonal difficulties; developing more helpful styles of thinking; learning new ways of managing emotions; and developing a sense of identity that is separate to Anorexia Nervosa.

Family Based Treatment for Adolescents with an Eating Disorder (FBT)

This approach is suitable for children and adolescents (up to the age of 17 and 11 months) with eating disorders such as anorexia nervosa and bulimia nervosa. The Criteria for this program at Uniquely Human Psychology includes:

1) The individual receives a diagnosis of anorexia nervosa or bulimia nervosa and is medically stable for outpatient treatment.

2) Recent onset illness (within the first year). **If the illness onset is over 12 months then a modified CBT-E approach will be utilised.

3) The individual is living in the family home AND parents are willing to attend all treatment sessions

4) Parents are willing to take charge of renourishing the individual in the first phase of treatment. This approach is developmentally driven because the eating disorder interferes with normal development and therefore limits their ability to make appropriate decisions regarding food and eating. Therefore family involvement is essential to treatment outcome.

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Individuals fearful of foods usually fear foods due to fear of the food itself, or because of an associated situational fear (like vomiting) but not concerned with weight.

Eating Disorders or Food Phobias: Complexities

Eating disorders and food phobias are different in nature and typically are different in treatment modalities. Both can involve having foods that are avoided and restrictive food intake.

Individuals who have food phobias will generally have more symptoms that are anxiety based, and the fear centers around having to eat, cook, or be close to specific foods.

Symptoms can include dizziness, excessive sweating, nausea, feeling like you cannot breathe, heart rate increase and shaking, all similar to panic disorder symptoms.

Individuals with an eating disorder such as Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder (BED), Avoidant Restrict Food Intake Disorder (ARFID), Other Specified Feeding and Eating Syndrome (OSFED) and Food Phobias – can have nutritional and physical consequences. A person can become malnourished, and lack essential vitamins and nutrients due to starvation. Weak and brittle bones can also occur for individuals with and eating disorder and food phobias and when prolonged starvation occurs – anemia, low blood pressure, hair loss, kidney failure and other medical conditions are common.

Not all food phobias are the same within each individual. Some may be fearful of eating perishable foods, other individuals may have trouble with texture and taste of foods or smells. This can initiate nausea or a sensation of gagging if trying foods that fall into this category. Another food phobia can also be a fear of cooking for others, that the food may be over or under-cooked. It can also include fear of cutting yourself or burning oneself in the process of cooking.

Young children may also have a fear of trying new foods and this may never disappear and continue through adulthood.

Types of Food Phobias

Food phobias will typically involve a food aversion. This is important because it may trigger a feeling of revulsion around food rather than anxiety. Aversions can be very strong and last lifelong.

Another type of phobia is the fear of an inability to swallow or fear of choking. It has been linked to extreme sensitivity with the gag reflex. The anxiety is maintained with the thought that they will choke and so the food is avoided which releases a ‘feel good’ thought and emotion, giving the phobia more power.

Similarities and Differences

Eating Disorders and Food Phobias hare common characteristics of anxiety based thoughts and symptoms. Food phobia and eating disorders evoke avoidance of certain foods due to fear. Both can have starvation and malnutrition effects with long-term medical complications.

Differences vary in how the individual views themselves and food. Those with eating disorders see themselves as ‘fat’ or needing to lose weight. Often the weight loss is never sufficient, and the person is unhappy with the way they look and are perceived. Individuals will frequently engage in compensating behaviors in an attempt to alter body shape and size and weight.

With food phobia, individuals are fearful of certain foods due to a fear response. Some individuals may fear vomiting or textures and the smell of foods. Typically there was a precipitating event, for example, eating fast food in the car as a child and then throwing up. The individual then comes to associate all fast foods, or foods with a vague connection to throwing up – and will refuse to eat them.

There is no concern with weight, body shape, or self-esteem with those that have food phobias. Typically the individual will want to be able to gain weight and eat similarly to their social group.

Treatment Approach

Cognitive Behaviour Therapy (CBT) and Exposure Therapy for Eating Disorders

Exposure work is essential. Being able to work up slowly from least fear-provoking to most fear-provoking is part of the process.This approach is suitable for the treatment of food phobias and ARFID (Avoidant Restrictive Food Intake Disorder). Anxiety and fears exists with food phobias and ARFID. Avoidance of particular foods may contribute to weight loss or failure to appropriately gain weight and nutritional deficiencies. Psychosocial problems that effect friendships and overall wellbeing for individuals with food phobias and ARFID can lead to withdrawal and depression. When necessary, therapy may initially aim to renourish a person through nutrition.

Individuals work with a therapist at Uniquely Human Psychology to be able to tolerate anxiety at various fear hierarchies to be able to learn distress tolerance and coping skill mastery. This enables individuals to be able to practice in and out of the therapeutic setting. Steps are typically progressive and logged. The phases are used to raise anxiety at each level and to learn what physical, emotional, and mental symptoms occur as well best practices to manage it, so the individual feels that they can stay in control. Steps become more relaxed as they are worked through, and anxiety may not be 100% reduced from level to level. It is encouraged to practicing daily food phobia exposures and keeping a written log of the process and challenges.

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Meet Kuma, the Bordoodle

Kuma is a cross between a Border Collie and a Poodle and has been bred to be companion and therapy dog.

What Does the Research Show

Research shows that Pet Therapy has the following benefits:

Decrease stress
Decrease difficult or unwanted emotions like anger, anxiety, and depression
Increase self-esteem
Increase social interactions, decrease loneliness
Lower blood pressure and heart rate levels, lower blood pressure increases following stress-inducing tasks and quicker post-stressful-task recovery times
Build feelings of empowerment
Increase positive social interaction skills
Boost therapy attendance
Allows for new opportunities to regulate effect
Allows for attachment healing
Helps tolerate distress (e.g., increased mindfulness, distraction from distressing thoughts or emotions, self-soothing by petting the animal)
Increase in self-awareness

While the effect of pets on eating disorder (ED) treatment has not been studied widely, research is emerging suggesting dog-assisted therapy is correlated with improvements in self-esteem, confidence, and control.

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Body image is both the mental picture you have of your own body and how you see yourself when you look in a mirror. Self-esteem is how you value and respect yourself as a person. Self-esteem affects how you take care of yourself, emotionally, and physically.

How do the two concepts relate

Body image and self-esteem directly influence one another. When you have healthy body image, you feel comfortable about your body and know how to care for it.

When someone doesn’t like their body, they may not feel good about themselves or take care of themselves. This can mean not eating or sleeping enough, staying away from friends and family, or turning down chances to do things they would otherwise enjoy.

How do I know if I have a healthy Body Image and Self Esteem

You see and think of yourself as a whole person, not a collection of specific body parts.
You accept and celebrate the uniqueness of your natural body shape and size.
You understand that a person’s physical appearance says very little about their character and value as a person.
You feel comfortable and confident in your body, and avoid worrying about food, weight, and counting calories.

How do I know if I have a negative Body Image and Self Esteem

You focus on your body’s weight and perceived flaws.
You feel uncomfortable and self-conscious about your body.
You’re convinced you would be happier or ‘better’ if you were thin/thinner/small/smaller.
You believe that only other people are attractive.
You exercise to lose weight or to ‘make up’ for calories that you’ve eaten.

Therapeutic Approach at Uniquely Human Psychology

Cognitive Behaviour Therapy (CBT)

A different emotional outcome can be created by interrupting a pattern of thinking and behaving. Cognitive Behavioural Therapy (CBT) uses thought-challenging (also known as cognitive restructuring) to challenge negative thinking patterns that contribute to destructive thoughts by replacing them with more positive, productive ways of thinking.

Steps Involved at Uniquely Human Psychology

1. Identify Negative Thoughts
With negative body image, physical appearance is given importance related to self-worth. Individuals may believe that a particular physical attribute defines them or casts them in such a negative way that they they may believe they are worthless. Recognising these inaccurate perceptions is difficult once they take hold. At Uniquely Human Psychology – we can help you to identify irrational and destructive thoughts.

2. Challenge Negative Thoughts
The next step in thought challenging involves evaluating negative thoughts and then challenging them. This requires evaluating the evidence that supports the negative pattern of thinking. For example, individuals may believe a particular physical attribute will make them unpopular or disliked. Strategies to challenge this idea include weighing the pros and cons of holding on to this belief and assessing the realistic probability that this belief is true.

3. Replace Negative Thoughts With Positive Thoughts
Once the negative thoughts have been identified and evaluated for truthfulness, it is time to replace them with positive, productive thoughts that create a favourable outcome. At Uniquely Human Psychology this will involve practice and dedication – but has been demonstrated to be extremely effective in breaking the cycle of negative thinking.

Cognitive Behaviour Therapy (CBT) for Body Esteem and Self-Esteem at Uniquely Human Psychology – aims to be as objective and realistic as possible in interpreting situations that tend to trigger automated, negative thought patterns. By becoming more aware of the power of your automated thoughts, the ability to interrupt them can be developed and engaged.

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An individual with orthorexia is fixated with the quality, rather than quantity, of their food to an excessive degree. Orthorexia can start with ‘healthy’ or ‘clean’ eating, then progress to the elimination of entire food groups such as dairy or grains, and then to the avoidance of foods such as those with artificial additives, foods treated with pesticides, or particular ingredients (e.g. fat, sugar or salt).

Typically orthorexic behaviours and attitudes are common amongst people with eating disorders such as Anorexia Nervosa, Bulimia Nervosa or Binge Eating Disorder.

Symptoms of Orthorexia Nervosa

The symptoms of orthorexia go beyond a simple interest in healthy eating. A person with orthorexia may experience:
Strong anxiety about their food choices, particularly around their diet not meeting their personal high standards of ‘purity’
Heightened self-esteem when eating foods that are ‘healthy’
Mood swings, anxiety and depression
Feelings of satisfaction and happiness from clean, healthy, pure eating
Feelings of guilt when consuming foods that are not considered healthy and pure
Excessive time spent thinking about food and the consumption of food
Regular advanced meal planning, feelings of guilt and displeasure when meals are not planned in advance
Avoidance of eating food away from home or not prepared in your home kitchen, because you will not be able to comply easily with your healthy eating plan
Creating distance between friends and family who do not share the same beliefs you have about food

The Extent of the Issue

When compulsive behaviors and mental preoccupations with healthy eating start to impair an individuals quality of life, you may end up suffering from severe weight loss, and malnutrition. Typically, Orthorexia Nervosa may cause problems in an individuals social, academic, or work life. Individuals may typically also suffer from negative self-worth, negative body image, and become obsessively dependent on their healthy eating lifestyle to the point of social isolation.

Treatment Options

There is no official treatment designed specifically for someone suffering from orthorexia however Uniquely Human Psychology will treat the condition similarly to Anorexia Nervosa or Obsessive-Compulsive Disorder (OCD) . Exposure and Response Prevention (ERP), which has been found to be the most effective treatment option. ERP is a form of cognitive behavioral therapy (CBT). This method of exposure therapy gradually exposes an individual to the obsession to allow the person to cope with the anxiety in a healthier way. ERP can support an individual in changing their obsessive thought patterns about food and at the same time, treat any co-existing mental health conditions, such as depression, panic disorders, and stress and anxiety disorders.

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At Uniquely Human Psychology, we provide relationship therapy to Consensual Nonmonogamy and Monogamy Couples. We also provide an alternative to the Family Court System through Collaborative Professionals WA.

Relationship Therapy at Uniquely Human Psychology will involve the following:

Gottman Method and The Sound Relationship House Theory

This foundational theory of The Gottman Institute gives couples the tools they need to have a healthy secure relationship. In his New York Times bestselling book “The Seven Principles for Making Marriage Work,” Dr. John Gottman introduced the concept that a foundationally secure partnership is like a house. It has weight-bearing walls and levels that each person builds upon to create a sturdy bond. He called this structure the Sound Relationship House, and for more than 20 years, it’s given countless relationships the tools they need to have happy and content relationships.

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Assisting cosmetic practitioners identify psychological risk and improve patient satisfaction by offering in-depth patient consultations and assessments either face-to-face or via telehealth to determine readiness for cosmetic treatment, or to support patients in their decision-making.

At Uniquely Human Psychology, we assist in preparing the patient for their surgery or cosmetic procedure, or providing psychological support post surgery.

What Will It Involve

Cosmetic Readiness Assessments are conducted by psychologist, Raquel Cain, who has an understanding of both the benefits and challenges of cosmetic procedures. She has seen how cosmetic procedures can greatly enhance a patient’s psychological wellbeing and confidence, when a patient is motivated for the right reasons and in the best physical and emotional position to undertake a procedure.

We want to work together with you, to achieve your goals, whether that is through cosmetic treatment or other means to enhance your self-esteem, body image and wellbeing.

Our hope is that patients who do undergo cosmetic procedures after our assessments do so feeling more prepared, equipped with coping strategies and ultimately achieve better outcomes and more satisfaction with the results.

Following this assessment, and in accordance to the APS Psychological evaluation of patients undergoing cosmetic procedures, we will send a brief letter back to the referrer with our feedback from the session. We will determine whether the patient is:

1) Low risk – indicating that the patient demonstrates reasonable expectations and motivations for the cosmetic procedure. Patients identified as low risk would include recommendations such as: the patients appears ready to go ahead with cosmetic treatment without any further input, unless requested by the patient or practitioner.

2) Moderate risk – indicating that we have identified some risk factors during the assessment, such as unrealistic expectations or inappropriate motivations, or mental health issues which appear to be currently unmanaged. Patients identified as Moderate risk might receive a report indicating recommendations that further therapy sessions are indicated before or after the cosmetic procedure to help prepare the patient to develop coping strategies that will help them achieve a more positive treatment outcomes.

3) High risk – indicating that we have identified some significant risk factors during the assessment, which are unmanaged. In these cases, a recommendation against cosmetic treatment, until the mental health concerns are more stable, would be indicative. We would be happy to provide or make recommendations for psychological support to assist in managing these concerns. We would then be happy to re-assess the patient at a later stage for the cosmetic procedure.

How do I refer a patient?

If you would like to refer a patient directly to Uniquely Human Psychology, please send us an email to raquel@uniquelyhumanpsychology.com.au.  Please provide some brief information about the reason for referral, and what cosmetic surgery or procedure has been requested. Please provide your patient’s contact details, with their consent. Uniquely Human Psychology have developed a referral template for Cosmetic Practitioners that can be used as a guide.

Download here for:
Referral Template for Cosmetic Practitioners

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Many people share something in common. They’re preoccupied with their looks and see flaws in their appearance that others don’t see. This may seem like nothing more than a bit of vanity. After all, most people are conscientious about how they look, and many are dissatisfied with some aspect of their appearance. But those who suffer from Body Dysmorphic Disorder (BDD) or Body Dysmorphia are stuck in an all-consuming obsession that can significantly disrupt their lives.

What is Body Dysmorphic Disorder (BDD)/Body Dysmorphia

Body Dysmorphic Disorder (BDD) is a distinct mental health disorder characterised by intense obsession over some aspect of appearance. This obsession causes significant distress and interferes with daily life, including social events, family, and work.

Those who suffer from BDD fit the following criteria:
Consumed with thoughts about their appearance
Socially isolated
Likely to engage in dangerous behaviours, such as self-starvation or other disordered eating habits

Often, those who suffer from BDD search endlessly for a physical solution for something that is a disorder of the mind

What are the Co-occurring Conditions

Depression
Eating Disorders such as Anorexia Nervosa, Bulima Nervosa, Binge Eating Disorder, Avoidant Restrict Food Intake Disorder (ARFID), and Other Specified Feeding and Eating Syndrome (OSFED)
Obsessive-Compulsive Disorder (OCD)
Panic and Anxiety Disorders
Post Traumatic Stress Disorder (PTSD)
Sleep Distrubances/Sleep Disorders
Substance Use

The Emotions that Enable a Disorted Body Image

A disorted body image involves a negative pattern of thinking that is highly critiquing. These constant internal critisisms create feelings of guilt, shame, and embarassment. Instead, they become convinced that their deeply held assumptions and beliefs about themselves are accurate, reasonable and rational.

Therapeutic Approach at Uniquely Human Psychology

Cognitive Behaviour Therapy (CBT) and Exposure Therapy for Body Dysmorphic Disorder (BDD)/Body Dysmorphia

This therapy approach at Uniquely Human Psychology is a form of psychotherapy that focuses on changing patterns of thinking or behaviour to change an emotion. This problem solving technique teaches skills to overcome negative and destructive thinking patterns. The idea is that it’s not the event that creates our emotions – it’s how we interpret the event or the meaning that we give it. It emphasises the critical role that thoughts (cognitive) and actions (behavioural) play in creating and maintaining belief systems.

In Body Dysmorphic Disorder, this may manifest in the following ways:
Cognitive factors: negative body image, overly critical of weight and shape, and negative self-evaluation
Behavioural factors: restricting food, binge eating, purging, body checking, and avoiding

Cognitive behavioural therapy for BDD at Uniquely Human Psychology will help to identify which factors are playing a role in maintaining a negative body image and then work to address each one by teaching the skills in order to allow healing to occur

The Cognitive Component of CBT for BDD

The cognitive part of CBT works off these assumptions:
Thoughts dictate emotions and behaviours.
Body Dysmorphic Disorder involves flawed, inaccurate, and irrational thoughts.
Changes in thinking lead to changes in emotions and behaviours.
Cognitive behavioral therapy helps individuals by identifying and changing those thoughts that are not accurate to create a different outcome.

The Behavioural Component of CBT for BDD

The behavioural part of CBT works off these assumptions:
Behaviour determines emotions and thoughts.
Body Dysmorphic Disorder (BDD) involves counterproductive behaviour
Changes in dysfunctional behaviour lead to positive changes in emotions and thoughts

Cognitive Behaviour Therapy (CBT) helps individuals overcome difficulties by identifying and changing those behaviours that contribute to forming and maintaining destructive thoughts and emotions

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Offered as an additional, non traditional method of therapy for Binge Eating Disorder (BED).

Ever since Binge Eating Disorder was added to the official list of eating disorders in the DSM-V (the diagnostic manual for mental health disorders), the need for binge eating disorder treatment has become obvious.  BED is the most common form of eating disorder, but treatment is still in its relative infancy as compared to treatment for other eating disorders like anorexia nervosa or bulimia nervosa. At Uniquely Human Psychology – we may offer you a non-traditional methodology that is complimentary to the evidence-based treatment methods.

What is Imagined

Uniquely Human Psychology can make greater strides in treatment than a one-size-fits-all treatment program.

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Perfectionism, Anxiety, Panic, Depression and Mood, Burn-out and Stress, Worry, are but a few health conditions that Uniquely Human Psycholoyg will treat either as a co-morbidity or as a separate condition

Treatment Modalities at Uniquely Human Psychology

Cognitive Behaviour Therapy (CBT)
Acceptance and Commitment Therapy (ACT)
Cognitive Behaviour Therapy – Enhanced (CBT-E)
Cognitive Behaviour Therapy (CBT) and Exposure Therapy for Body Dysmorphic Disorder (BDD)/Body Dysmorphia
Cognitive Behaviour Therapy (CBT) and Exposure Therapy for Eating Disorders
Cognitive Behaviour Therapy (CBT) and Exposure Therapy for Phobias
Exposure and Response Prevention (ERP)
Family Based Therapy for Adolescents (FBT)
Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)
Relationship Therapy

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