Problem: What are: Accurate Diagnosis, Application of Theory with Potential Treatments?
Kay (She/Her) is a 31-year-old, white, partnered, female. Patient indicated she has a history of binge eating and purging. She said she wants to keep that "in check". She feels "stuffing and releasing" is "addictive". She engages in this behavior when she "goes through things" that she can't control. For instance, when she experienced a physical injury last year, she felt disordered eating was "out of control". She binged and purged in secret while injured. Patient described binging as: "stuffing myself as full as I can get, until I feel sick". Patient uses her fingers to purge. She indicated binge sessions last 30 minutes and purge sessions last "30 seconds to a minute". Frequency was explained as, "A couple times a month when things are out of control." On days she binges and purges, she engages in this behavior 1-2 times a day. Most recently, patient binged and purged the day before the intake. The previous time was two weeks ago. Therefore, she is assessed at mild severity. Clinician recommended patient schedule a physical and requested she have a full blood work-up. She explained her last physical and dental appointment was 6 months ago. She said the results were "nothing was out of ordinary". During last binge/purge episode, patient verbalized that she felt "judged", "trapped", and "lacked control" over food while on vacation. Therefore, when she returned home, she had a "sense of urgency" to finish work she was behind on. When she finished work she said that he emotions built up and she binged and purged. Consequently, patient felt "guilty", "disgusting", and "depleted". Initial steps of treatment will revolve around emotional regulation distress tolerance chain reaction analysis. Further will explore beliefs about food, intuitive eating. And ultimately clinician will assist patient and examining the route of beliefs about food, history of trauma, and decrease overall disordered behaviors.