Hypothetical Case Study Dieting This Report Provides

Hypothetical Case Study Dieting

This report provides insight into a hypothetical case study regarding dieting. The case involves a patient from this point forward called; X. She tends to consider herself as an individual that has been a life long 'on again' then 'off again' dieter. She informs a counselor that she has shown minor success with dieting where she may have lost a few pounds however; she feels that dieting has lead to more failures than successes. "On occasion she has lost between two and three stone -- only to regain it again within a matter of months." It is not clear as of yet what her true cognitive motivation is. From the brief description there are more than a few possibilities such as there may be an undiagnosed mental disorder such as ADHD or OCD, she may be driven by an internal desire for perfection through weight control or she may have an undiagnosed eating disorder. Her current approach is that she is on a controlled eating plan but feels that she does not possess the self-control that is needed to maintain the this type of program. "If I give in and start nibbling or snacking I might as well say "it's all over for me" ... because I've always been that kind of a person: I am the "all or nothing" type. It only takes one bar of chocolate to send me spiraling out of control. The last time I gained much more than I lost ... And I am frightened the same thing might happen again." This case study therefore will attempt to assist X by providing insights into the Cognitive Continuum Theory and maladaptive automatic thought pattern and erroneous assumptions, attitudes and beliefs she is basing her lack of will power on.

Mankind has been exploring the implications of our evolutionary history in the domain of social and self conflict and we have discovered that we humans have a great many functions of subordinate and dominant hierarchical strategies that have basically evolved as our self survival and defense mechanisms. We live with many specific interactions among our behavioral, biological and neural traits which impact on the body's cognition or self-perception. Humans have therefore begun to use emotionally-based or somatic maladaptive strategies to help cope with perceived conflict, loss, or defeat. "Maladaptive behavior must be understood within the context of adaptive behavior, so we first need to describe adaptive behavior. Adaptive behavior is described in POMS DI 24515.056D.2 as the individual's progress in acquiring mental, academic, social, and personal skills as compared with unimpaired individuals of the same age. Adaptive functioning is age-related; i.e., adaptive behavior increases and becomes more complex as an individual grows older. It is defined by typical performance, not ability; e.g., a child may have the ability to dress himself/herself, but if the clothes must be laid out and it takes an hour to put them on, his or her personal functioning is compromised." (SSA Publication, 1998)

The medical community is now convinced that a majority of depressive disorders may be nothing more than the result of some maladaptive, voluntary or involuntary, defense strategy that usually is based on some insecure attachment. This implies that X may be working on a false assumption when she says she is an 'all or nothing' person. Thus, the first thing X needs to understand is that she is most likely basing her decision that her will power may not be sufficient to maintain her planned eating program is some type of cognitive defense strategy.

The Cognitive Continuum Theory is an adaptive theory of human judgment and it posits that the continuum of cognitive modes is anchored by a foundation of intuition and analysis. The use of some variant of the cognitive-behavioral therapy therefore may help in the treatment for X's kind of defense strategy. The process could enable her to develop more health-promoting ways of thinking and also help identify why this behavior pattern has been so prevalent in her life. In a sense, the cognitive continuum behavioral therapy could help her reevaluate her existing negative thought patterns and therefore establish a foundation for reconceptualizing her self-image and help manage new goals, angers, or conflicts causing her existing cognitive stress.

There are many approaches to studying the decision process. Assuming there are maladaptive behavior patterns may be dictating how X utilizes her decision making or cognitive strategies in different environments and situations. "There is no universally accepted definition of the term "maladaptive behavior." SSA does not define it, nor is it defined in the DSM-IV. The language used previously in 112.02 B.2.c.(2) was not a definition of maladaptive behavior but rather a measure of severity (i.e., ". . . behaviors destructive to self, others, animals, or property, requiring protective intervention."). (SSA Publication, 1998) With that being said, it is critical to eliminate any other possible causes of X's binge dieting. As demonstrated by the SSA Publication, there are some mental disorders that are often accompanied by maladaptive behavior patterns. These include: