There are lots of things I wish I'd developed and written down. This is but one of them. It is not that new, it is not that revolutionary. It is a useful clinical tool which I have used a few times this week and patients have found it powerful. It comes from the wonderful Dr Russ Harris and his colleagues Jo Ciarrchi and Anne Bailey. They describe the choice point exercise.
When you are living in contact with the present moment you become aware that life is full of choice points. These are the points where we have to decide on what our behaviours are going to be. For this meal am I going to eat anything, will I stick to the meal plan or cut back, will I binge or exercise are just a few examples. The choice point can be used to understand the elements that go into making that choice.
First, what are the difficult thoughts, feelings and bodily sensations that show up when faced with a difficult situation. Lets say it is lunchtime. What thoughts might show up "I'm so fat, do I really need this (NO!), people will think I am disgusting for eating in front of them, what is a safer option .... this is all too hard" and the thousands of other thoughts that fly by in a difficult time. These thoughts come with feelings - fear anxiety, panic, anger, sadness. Physical sensations may also show up - hunger, sweating, thoughts racing, heart pounding. Do any of these feel familiar to you?
On the other side is a space to write down the values you want to live by and the skills and strengths you can use. Values are the way you want to live your life. What is really important to you. It might be health, it might be relationships or being more independent. Think of the life you want if you did not have an eating problem. It is also important to remember all the skills you may have learned in your therapy. How might you deal with the uncomfortable thoughts, feelings and sensations that are arising around a meal. You might know of defusion or cognitive challenging or wise mind to deal with thoughts. You might have learned some distress tolerance skills (slow your breathing down) and emotion regulation skills (name your feelings, find them in your body, make space for them, notice them change and come and go). You may have learnt radical acceptance and willingness.
That gets you in to the choice point. In order to decide what behaviours to use the exercise reminds you to look at not what your mind is throwing at you but what behaviours would move you towards the life you want. What helps you move towards the direction you want to go. Is it bingeing. Is it restricting, is it using the skills to move you forward.
I like the exercise because it helps us keep what we want in life at the forefront of our decisions. It helps us remember that it is not what our heads tells us that is important (our minds rarely help us move forward) but the behaviour that we choose does move us forward. It also is a god chance to remind ourselves of the skills we can use to help us manage the moments that lead into the choice point.
Thanks to the developers of the choice points for their work, and their decision to share it with the wider therapy community. I hope you might find it useful.
When you are living in contact with the present moment you become aware that life is full of choice points. These are the points where we have to decide on what our behaviours are going to be. For this meal am I going to eat anything, will I stick to the meal plan or cut back, will I binge or exercise are just a few examples. The choice point can be used to understand the elements that go into making that choice.
First, what are the difficult thoughts, feelings and bodily sensations that show up when faced with a difficult situation. Lets say it is lunchtime. What thoughts might show up "I'm so fat, do I really need this (NO!), people will think I am disgusting for eating in front of them, what is a safer option .... this is all too hard" and the thousands of other thoughts that fly by in a difficult time. These thoughts come with feelings - fear anxiety, panic, anger, sadness. Physical sensations may also show up - hunger, sweating, thoughts racing, heart pounding. Do any of these feel familiar to you?
On the other side is a space to write down the values you want to live by and the skills and strengths you can use. Values are the way you want to live your life. What is really important to you. It might be health, it might be relationships or being more independent. Think of the life you want if you did not have an eating problem. It is also important to remember all the skills you may have learned in your therapy. How might you deal with the uncomfortable thoughts, feelings and sensations that are arising around a meal. You might know of defusion or cognitive challenging or wise mind to deal with thoughts. You might have learned some distress tolerance skills (slow your breathing down) and emotion regulation skills (name your feelings, find them in your body, make space for them, notice them change and come and go). You may have learnt radical acceptance and willingness.
That gets you in to the choice point. In order to decide what behaviours to use the exercise reminds you to look at not what your mind is throwing at you but what behaviours would move you towards the life you want. What helps you move towards the direction you want to go. Is it bingeing. Is it restricting, is it using the skills to move you forward.
I like the exercise because it helps us keep what we want in life at the forefront of our decisions. It helps us remember that it is not what our heads tells us that is important (our minds rarely help us move forward) but the behaviour that we choose does move us forward. It also is a god chance to remind ourselves of the skills we can use to help us manage the moments that lead into the choice point.
Thanks to the developers of the choice points for their work, and their decision to share it with the wider therapy community. I hope you might find it useful.
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