A prominent eating disorder which is defined by binge eating episodes that are followed by purging (for example, self-induced vomiting) to avoid gaining weight, bulimia nervosa affects almost two percent of adult women in the United States at some point in their lives. Although bulimia nervosa, like all other eating disorders, can become deeply ingrained in its sufferers’ states of mind, evidence-based bulimia nervosa treatment methodologies are being applied by therapists and facilities, to great effect.
As established forms of therapy such as dialectical behavioral therapy and cognitive behavioral therapy have been accepted into the mainstream of treatment, acceptance and commitment therapy (ACT) has gained traction in professional circles. A focused psychotherapeutic technique, ACT helps participants learn to rationally evaluate and accept negative or flawed emotions, without feeling a compulsion to act on them.
Acceptance and Commitment Therapy in Bulimia Treatment – Applications
In the attempt to expose the irrationality of the disordered thoughts associated with bulimia nervosa, ACT introduces individuals to the concept of “creative hopelessness,” which is the act of stepping back rationally and seeing that the disordered behaviors like purging do not alleviate feelings of anxiety, but rather perpetuate them.
For example, a therapist using ACT might point out to their charges, that despite their feelings of being overweight, they’ve actually lost 40 pounds and their bones were standing out. They then progress to ascertaining why all that weight was lost. By showing clients that struggling to control or repress distressing emotions, the therapist shows how, in reality, they continue those emotions.
Inducing “creative hopelessness” helps the patient rationally assess their own actions and thoughts. As an offshoot of behavior therapy, ACT also integrates well with self-monitoring practices and other much-practiced techniques like exposure therapy.
ACT can also inspire individuals to increase their motivation to engage in recovery. Bulimia nervosa therapists often point to clients’ clinging to their disordered beliefs and body image as a factor in resistance to change – i.e. how they appear and restricting food intake to achieve their idea of perfection. By applying a rational look at these factors, ACT can break this cycle of resistance to change.
The Role of Mindfulness in Acceptance and Commitment Therapy
Mindfulness, a mainstay of therapy as well as spirituality, is the act of maintaining a focused awareness of the moment, ignoring the distracting thoughts that tend to cloud our minds. Recovery programs often teach their clients how to be mindful by using evidence-based techniques that help increase awareness of the five senses while staying in touch with “in the moment” emotions. ACT uses the clarity and detachedness regarding our feelings that come from mindfulness techniques to help isolate disordered behavior and identify its destructive results.
Mindful awareness is an important part of replacing harmful thoughts and behaviors that result from bulimia nervosa and other eating disorders. For example, individuals are taught to recognize negative thoughts like “Everyone thinks I am too fat” and alter them to something more clinical like “I am having a thought that people think I am fat.”
This cognitive exercise separates the individual from the self-focused aspect of negative thoughts and reduces their ability to further perpetuate flawed self-image. Therapists might use mindful meditation techniques when anxiety arises during treatment – to breathe deeply and use mindfulness techniques to be aware of the anxiety without succumbing to it.
Bulimia nervosa treatment programs available at quality residential or day treatment programs will contain individualized treatment plans, including ACT, to match each client’s unique needs for recovery. If you or someone you know is suffering from an eating disorder, call today to learn more about getting help for bulimia nervosa, anorexia nervosa, binge eating disorder and all other types of eating disorders.
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ABOUT THE AUTHOR: CARRIE HUNNICUTT
With 20 years of behavioral health business development experience, Carrie combines world-class marketing, media, public relations, outreach and business development with a deep understanding of client care and treatment. Her contributions to the world of behavioral health business development – and particularly eating disorder treatment – go beyond simple marketing; she has actively developed leaders for her organizations and for the industry at large.
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