• Many of us use food as a crux sometimes but eating too much too often can easily become a problem and a way of covering deeper issues

  • Psychologist Jane Mccartney shows how therapy can help us identify the root causes of overeating and overcome these psychological patterns in order to address our weight issues.

  • If you are struggling with any kind of disordered eating, you can find a therapist here

By the time I saw Maggie she'd been on just about every weight loss plan and diet going for 40 years. She was in – if not so much a state of utter despair – certainly a state of utter resignation about her weight.

Maggie came to me because she wanted to lose weight for her daughter's wedding in 18 months time. She knew rejoining her local slimming club would not be enough and was already well aware of all the types of food she should and should not be eating. What I was first struck by was her capacity for self-blame. The slimming club plan hadn't worked because she didn't do it right. The exercise programmes did little because of her own failure at them. And the expensive pre-prepared meal replacement products didn't work because she couldn't administer them correctly.

Maggie realised her pattern of adopting the blame for everything had been a way of coping with her home life.

A hangover from my systemic training is the use of genograms – diagrams of people's family relationships and medical history. I always like to get the background of the client as soon as I can – they speak volumes right from the start. I ask them about their relationships, their original family, their new family, who they work with and what friends they enjoy having. As I was drawing Maggie's genogram, she asked why her symbol was in bold whereas all the others were not. I explained that this was because it represents her and she's the centre of focus in therapy. After a few moments thought, Maggie simply said that'd she'd never been the centre of anything before. She was a twin, with siblings either side. She'd had one child who she'd adored – she'd only wanted one child, unlike her husband who maintained he didn't care if he had 1 or 10 children, as long as he didn't have to change any nappies or have his Saturday morning golf game disrupted.

When we started to examine the situations and events which had led Maggie to overeating, again Maggie was always keen to blame herself, whether it was something wrong at work, her husband being moody, money problems, she was always first in the fault queue. Her capacity for self-blame seemed to be a major problem for her. Once deeper examined, we saw it acted as a defence for Maggie. If she could keep the focus of any negative feelings on an external object, both for others, but most importantly for herself, she could avoid any exploration of what an internally emotionally provoking situation actually meant and her capacity to deal with it, which she didn't believe she had. Maggie said every time she sought help to deal with upsetting situations when she was younger, she would be rebuffed, downplayed or ignored. She said her parents would do anything and everything for their local community, but very little for their own children.

Once Maggie stopped instantly externalising her feelings ... she was able to start addressing her weight issues much more successfully.

Maggie realised her pattern of adopting the blame for everything had been a way of coping with her home life, “I'd usually end up getting blamed for anything anyway, so I might as well leave the frustration and anxiety of trying to defend myself and accept it, it was my role I guess." We looked at challenging Maggie's set pattern of response by not always accepting the blame and thus keeping everything at “arms length" as she put it. Over time Maggie became more aware of her default response and managed to reduce it. She also discussed what had been going on with her very supportive daughter who had always been very keen to help her mum.

Once Maggie stopped instantly externalising her feelings and began to really think about what she had been doing, she was able to start addressing her weight issues much more successfully. One exercise was to look online at other dieters' experiences with meal replacement options and she was buoyed when she realised others had experienced similar problems with this approach – it was fussy, complicated and tasted awful. Maggie rejoined the local slimming club and was finally able to process the advice because she stopped always blaming herself for every little slip-up or hiccup.

Further reading

Why healthy weight loss is an issue of both mind and body

Paradoxes in therapy: blame, responsibility and ownership

Moving from self-criticism to self-compassion

3 steps to challenge your self-limiting beliefs