ABSTRACT
This case study outlines specific aspects of the consultancy with a 24-year-old client, ‘Sarah’, who had struggled since puberty with overeating and had always found it difficult to stick to diets and exercise programmes. At the start of our work together she weighed 203lb, which was overweight for her 5’8” frame, and across the six-month, ten session consultancy she lost 20lb. This was achieved through a combination of improved dietary control and increased physical activity, mostly fitness classes. Both discomfort disturbance and ego disturbance issues relating to eating and exercising underpinned Sarah’s difficulties in reaching and maintaining a healthy weight. This case study focuses specifically on some of the ego disturbance issues which were causing Sarah emotional distress (chiefly anxiety and unhealthy jealousy) in exercise settings, and were consequently a cause of exercise avoidance. These issues were not exclusive to the fitness environment, and had also been affecting her life and relationships. Disputation, which included the use of humour, rational emotive imagery, and behavioral assignments, was utilized to help Sarah learn how to make herself less distressed when thinking about or engaging in exercise, and to develop a more effective rational philosophy about her own fallibilities. This case study highlights a highly individualized approach to identifying and removing barriers to being more active.
