What is the theory behind the worksheet?

This exercise relies on the core beliefs approach proposed by James & Barton (2004), which assumes that behavior is influenced by implicit negative schemas about ourselves.

How will this worksheet help

This worksheet will help you identify the most important cravings of yours and how to develop behaviors that help you manage them.

How to use the worksheet

The exercise Responding to Triggers is used to bring awareness to the cravings, urges, thoughts and feelings that arise when faced with the desired food item while also making a distinction between problem-solving in the external world versus the futility of the control agenda with internal experiences. 

This exercise is used in groups. Make sure to provide each group member with paper and pens so they can record their thoughts, feelings, and cravings during the activity.

First, bring the desired food and put it into a bowl. Now go around the room with the desired food and let each group member see and smell it. Ask group members what thoughts, feelings and cravings they experience with the food item in front of them and tell them to note them down on paper. Ask them to share some examples and as they do so, label the examples as thoughts, emotions, or cravings so the clients can understand the distinctions between them. 

Then use the following script to explore different ways of relating to cravings, ultimately using the metaphor of wave to help participants consider the possibility of just experiencing cravings as they rise and fall without acting on them: 

Triggers and cravings worksheet (pdf)

• One way to avoid external triggers is to 
• literally throw them away. (Throw the ice cream into a trash can.) Where’s the ice cream now? It’s no longer in front of you; it’s melting with a bunch of trash. We’ve effectively gotten rid of the trigger.
• What about the thoughts, feelings, and cravings? Can you just throw them away? Have you tried to do this in the past? (Solicit examples, with the goal being to get participants in contact with a control agenda— with trying to change or control their feelings or make them go away.) And in your outside life, what have you tried for dealing with these thoughts and feelings? What do you feel like you should do or should be able to do with them? How have you tried to deal with them when they show up? (Elicit a discussion of the limitations of control when applied to internal experiences.) What if it were the case that we can’t simply throw these experiences away when we don’t want them? Could we try something different with these internal experiences?
• Now I’d like you to try something else. Take a moment to get present with any urges you may have when looking at that carton of ice cream or any other food you typically crave. Imagine picking it up, putting it in your mouth, and beginning to eat it. Try to taste the food as it enters your body.
• Notice what thoughts are going through your mind and the emotions and physical sensations that arise, and breathe. What physical sensations are you experiencing in your body? If you feel overwhelmed by urges and sensations, you can always go back to just observing your breath. Remember that you’re making a choice not to act on any cravings to eat that arise right now. Just stay with them and observe what’s happening in your body and mind.
• As you get in touch with any cravings you have, see if you can drop any struggle you’re having with those cravings and just let them be. Imagine that you can expand around your cravings and make room for them inside you without having to do anything about them. Now imagine that your urge to eat is an ocean wave and that you’re a surfer, riding that wave of craving with your breath, using your breath as your surfboard. Your job is to ride the wave of the desire to eat from the beginning and as it grows, staying with it through the peak of its intensity, keeping your balance while the wave of desire rises until it naturally subsides. You’re riding this wave of desire and staying on top of it rather than being wiped out by it.

• Notice the craving with curiosity. When have you really just sat with a craving and looked at it, as opposed to reacting to it? Where do you feel it in your body? With your mind’s eye, see if you can simply touch the areas of your body where you feel the craving and trace them in your body.

• Continue imagining the presence of your desired food. Now notice how you can simply stay present with this craving instead of immediately reacting to it. Notice the thoughts that pass through your mind and the sensations you’re experiencing in your body. Be present with the craving. Try to make room for the craving without giving into it and having to act on it.

References:

James, I. A., & Barton, S. (2004). Changing core beliefs with the continuum technique. Behavioural and Cognitive Psychotherapy, 32(4), 431-442.

You can download this worksheet here.