Webb Therapy Uncategorized Eating Disorders DSM-5

Eating Disorders DSM-5

Psychologists believe that the core issues of anorexia nervosa and bulimia nervosa are multifaceted, involving a combination of biological, psychological, and social factors. Here are some of the key issues:

Anorexia Nervosa

  1. Distorted Body Image: Individuals with anorexia often have a distorted perception of their body size and shape, seeing themselves as overweight even when they are underweight.
  2. Intense Fear of Gaining Weight: There is an overwhelming fear of gaining weight or becoming fat, which drives restrictive eating behaviors.
  3. Control Issues: Anorexia can be a way for individuals to exert control over their lives, especially if they feel powerless in other areas.
  4. Perfectionism: Many individuals with anorexia have perfectionistic tendencies, striving for an unattainable ideal of thinness.
  5. Emotional Regulation: Restricting food intake can be a way to manage or numb difficult emotions and stress.

Bulimia Nervosa

  1. Binge-Purge Cycle: Bulimia is characterized by cycles of binge eating followed by purging behaviors such as vomiting, excessive exercise, or misuse of laxatives.
  2. Body Dissatisfaction: Similar to anorexia, individuals with bulimia often have a negative body image and are preoccupied with their weight and shape.
  3. Impulsivity: Bulimia is often associated with impulsive behaviors and difficulties in regulating emotions.
  4. Shame and Guilt: After binge eating, individuals with bulimia often feel intense shame and guilt, which perpetuates the cycle of purging3.
  5. Co-occurring Mental Health Issues: Anxiety, depression, and other mental health disorders are commonly seen in individuals with bulimia.

Both disorders are complex and can have severe physical and psychological consequences. Treatment typically involves addressing these core issues through therapy, medical monitoring, nutritional counselling, and support groups.

Related Post

What does human development mean to you? How often are we thinking about our own development? Here is a start (“,)What does human development mean to you? How often are we thinking about our own development? Here is a start (“,)

Hello readers. I hope you are well. I imagine some of you are struggling and some of you are flourishing. Life consists of both. As humans, we relish pleasurable feelings and experiences and we tend to dislike uncomfortable emotions and experiences. I get it. I am just like you. We share this. I hope that provides some comfort.

What is human development?

Human development can be described as “systematic changes and continuities in the individual that occur between conception and death, or from “womb to tomb”” (Sigelman, De George, Cunial, & Rider, 2019, p. 3).

Human development involves the continuities (i.e., what remains consistent across time) and the systematic changes (i.e., patterns of change that are expected to come in order across time) that one experiences throughout the lifespan. Based on my education, there are three domains of continuity and change: 1. The physical and biological, 2. Cognitive (i.e., mind processes/thinking), and 3. Psychosocial and emotional. Let’s open these one at a time.

Physical development includes:

  • Physical and biological processes (e.g., genetic inheritance).
  • Growth of the body and its organs.
  • Functioning of physiological systems (e.g., brain).
  • Health and wellness.
  • Physical signs of ageing and changes in motor abilities.

Cognitive development includes:


Perception: the sensing of stimuli in our environment (internal and external), sending that information to the brain to be identified and interpreted in order to represent and understand our experience of the world and give it meaning. All perception involves signals that go through the nervous system.

Attention: the ability to actively (and often, involuntarily) process specific information in the environment while tuning out other details. Attention is a very interesting cognitive process because when we bring mindfulness to our thoughts we become open to the direction and attention of our mind. Remember this: where attention goes, energy flows.

Language: very broadly, Language is a communication system that involves using words (i.e., sounds arranged together) and systematic rules to organise those words into sentences and meaning, to transmit information from one individual to another. I was never very interested in language when I was studying at university however that has changed. We used language and concepts to talk to ourselves, about other people, and it is open to misinterpretation, error, and oftentimes language can be used as a means to hurt people or … bring us closer together.

Learning: very broadly defined as a relatively permanent change in behaviour, thinking, and understanding as a result of experience. Experience is everything from formal education to unique personal experience. We learn from each other, the world around us, books, movies, self-reflection and education etc. All of which are experiences.

Memory: Memory refers to the processes that are used to gather, organise, store, retain, and later retrieve information. I’m sure you’ve all seen a tv show or read a book about a person with Amnesia or Alzheimer’s disease. Imagine what your life would be like if you didn’t have the function of memory. I wouldn’t be able to type this very well, I don’t think. I wouldn’t remember my loved ones or what was dangerous in my environment. I know we all have unpleasant memories too and that may feel like a negative evolutionary by-product – however it is actually designed to protect us. Memory is finite – we actually forget a lot of stuff, or perhaps more accurately, we do not have the capacity to store and recall everything we experience.

Intelligence: I would like to reframe intelligence from what might be a common belief. Intelligence does not mean academically gifted as is considered valuable in Western society. I think Olympians and caregivers/parents have an intelligence that I do not because I haven’t learned their skills. Intelligence involves the ability to learn (i.e., sport, academics, the arts, swimming, survival, interpersonal skills), emotional knowledge, creativity, and adaptation to meet the demands of the environment effectively

Creativity: I consider creativity to be an evolutionary gift of our imagination, providing humans with the ability to generate and recognize ideas, consider alternatives, think of possibilities that may be useful in solving problems, communicating with others, and entertaining ourselves and others. Creativity can be stunted when we are struggling or caught in reactivity to external pressures or perceived stress.

Problem solving: is a process – yes, a cognitive one but also a behavioural process. It is the act of defining a problem; determining the cause of the problem; identifying, prioritizing, and selecting alternatives for a solution; and implementing a solution. Problem solving can be both creative or stress driven. I like to say whenever I am solving a problem I am also making a decision. A decision of mine is a choice. At university, our problem solving lessons were coincided with decision making which is why I think of it that way.

Psychosocial development involves:

Aspects of the self (i.e., your identity – which may change over time), and social and interpersonal interactions which include motives, emotions, personality traits, morality, social skills, and relationships, and roles played in the family and in the larger society. This is a huge area to be explored. I will endeavour to elaborate on our psychosocial development in later blogs.

In the late 1950’s, a German-American developmental psychologist named Erik Erikson created a theory for human psychosocial development across the lifespan. His theory suggests that human personality develops in a predetermined order through 8 stages of psychosocial development. See the table below:

Age or StageConflictExampleResolution or “virtue”Key Question to be answered
Infancy (0 to 18 months)Trust vs. MistrustBeing feed and cared for by caregiver.HopeIs my world safe? Will I be cared for?
Early Childhood (2 to 3 years)Autonomy (personal control) vs. Shame and DoubtToilet training and getting dressed.Will I would add self-efficacy here too.Can I do things for myself, or will I always rely on others?
Preschool (3 to 5 years)Initiative vs. GuiltInteracting with other children and asserting themselves in their environment e.g., during play.Purpose Taking initiative, leading others, asserting ideas produces a sense of purpose.Am I liked by others or do I experience disapproval by others?
School Age (6 to 11 years)Industry (competence) vs. InferiorityStarting formal education and participating in activities.CompetenceHow can I do well and be accepted by others?
Adolescence (12 to 18 years)Identity vs. Role Confusion (uncertainty of self and role in society)Developing social relationships with peers and sense of identity.Fidelity (loyalty) The ability to maintain loyalty to others based on accepting others despite differences.Who am I and where am I going in my life? What are my personal beliefs, values and goals?
Young Adult (19 to 40 years)Intimacy vs. IsolationDeveloping intimate relationships.LoveAm I loved and desired by another? Will I be loved long-term?
Mature Adult (40 to 65 years)Generativity vs. StagnationVocation and parenting, typically.Care Contributing to the world to demonstrate that you care.Will I provide something to this world of real value? E.g., children or valuable work, art, a legacy etc.
Maturity (65 year to death)Ego Identity vs. DespairReflection of your life. Feelings of satisfaction and wholeness.WisdomWas I productive with my life? Can I accept my life and have a sense of closure and completeness?

Problematic Thinking Styles (continued)Problematic Thinking Styles (continued)

Hello readers! A few of the cognitive styles below were mentioned in my last post. As humans, we have a tendency to forget things so a bit of revision can be useful.

Many people have cognitive processes that result in overall unhelpful thinking styles that they tend to apply globally across situations and which may result in emotional distress (such as depression or anxiety) or unhelpful behaviours (such as anger or avoidance). Some of the most problematic thinking styles are listed in the extract below.


Mental Filter: This thinking styles involves a “filtering in” and “filtering out” process – a sort of “tunnel vision”, focusing on only one part of a situation and ignoring the rest. Usually this means looking at the negative parts of a situation and forgetting the positive parts, and the whole picture is coloured by what may be a single negative detail.


Jumping to Conclusions: I’m sure you’ve heard people say on television, “Don’t jump to conclusions” or “The truth is we just don’t know yet”. We jump to conclusions when we assume that we know what someone else is thinking (mind reading) and when we make predictions about what is going to happen in the future (predictive thinking).


Personalisation: This involves blaming yourself for everything that goes wrong or could go wrong, even when you may only be partly responsible or not responsible at all. You might be taking 100% responsibility for the occurrence of external events.


Catastrophising: Catastrophising occurs when we “blow things out of proportion” and we view the situation as terrible, awful, dreadful, and horrible, even though the reality is that the problem itself is quite small. A helpful restructuring of this cognition is to ask yourself if the situation will still be awful, terrible, or dreadful in a month. There may be ongoing consequences or stress involved if you lose a job or a relationship ends, so validate the experience you are having but also take a look at the big picture. What’s the worst that could happen? Why is the worst so “bad”? And if you are being realistic about the issue, reach out for some help if you can.


Black & White Thinking: This thinking style involves seeing only one extreme or the other. You are either wrong or right, good or bad and so on. There are no in-betweens or shades of grey.


Should-ing and Must-ing: Sometimes by saying “I should…” or “I must…” you can put unreasonable demands or pressure on yourself and others. Although these statements are not always unhelpful (e.g. “I should not get drunk and drive home”), they can sometimes create unrealistic expectations.


Overgeneralisation: When we overgeneralise, we take one instance in the past or present, and impose it on all current or future situations. If we say “You always…” or “Everyone…”, or “I never…” then we are probably overgeneralising.


Labelling: We label ourselves and others when we make global statements based on behaviour in specific situations. We might use this label even though there are many more examples that aren’t consistent with that label.


Emotional Reasoning: This thinking style involves basing your view of situations or yourself on the way you are feeling. For example, the only evidence that something bad is going to happen is that you feel like something bad is going to happen. I live with anxiety and it can be debilitating at times. I use my “wiser thinking” or “rational thinking” to evaluate whether I am operating from an emotional mindset. You might ask yourself: “What’s the evidence?”, “Does the past necessarily predict the future?”, “Am I angry or fearful right now because that might be clouding my judgement?”. It can be helpful to talk to someone who isn’t caught in your emotional headspace, or perhaps wait for the emotion to subside to think about the situation again.


Magnification and Minimisation: In this thinking style, you magnify the positive attributes of other people and minimise your own positive attributes. It’s as though you’re explaining away your own positive characteristics.

(CCI, 2008)

Three rules for identifying abnormal child sexual behavioursThree rules for identifying abnormal child sexual behaviours

Retrieved and edited 06/12/2021 from “Voice of Experience: Three rules for identifying abnormal child sexual behaviors” by Gregory K. Moffatt, a veteran counsellor with more than 30 years experience. If you are a survivor of sexual trauma at any age, I encourage you not to read this article.

From the perspective of Moffatt’s professional experience, childhood sexual behaviours can be grouped into three categories: 1. normal behaviours, 2. behaviours that are not normal but not unusual, and 3. behaviours that are abnormal or statistically rare. For the purpose of this post, I will be replacing the word “normal” with “natural” and/or “common” moving forward.


Rule No. 1: Natural or common sexual behaviours in children are never forced. The exploration is mutual. While one child likely had the idea first, both children must participate freely. This doesn’t mean that two children might willingly agree to engage in abnormal sexual behaviours, however, therefore read the next to rules for clarification.


Rule No. 2: Natural or common sexual behaviours in children are never painful. Children who behave within cultural and developmental norms will stop what they are doing when they realise they have caused pain.


Rule No. 3: Natural or common sexual behaviour in children is never invasive. Natural childhood curiosity does not include inserting objects or one’s own body parts into the cavities of others — anus, vagina, mouth, etc.


I’m unsure why Moffatt didn’t make this a 4th rule – he did add that most of the time, this type of childhood behaviour occurs between children of similar age. It is highly unusual for a young child to sexually engage with a teen without violating one of the three rules above. That behaviour definitely calls for further investigation. And, certainly, any sexual interaction between an adult and a child is cause for mandated reporting.