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Dysfunctional Thinking in Individuals with Bulimia Nervosa
Contributor: Jennifer Rollin, MSW, LGSW, writer for Eating Disorder Hope
Part of what makes eating disorders so difficult to treat is the variety of dysfunctional thoughts and beliefs, which serve to maintain and perpetuate the illness. Although each person’s thought processes are unique, there are some common themes regarding the dysfunctional beliefs and thoughts that individuals with eating disorders often experience.
According to Dr. Patrick Keelan, a psychologist, “thoughts and beliefs related to low self-esteem, dissatisfaction with appearance and body image, and the need to be perfect are among the cognitive themes associated with eating disorders.” [1]
We all experience cognitive distortions. However, individuals with bulimia nervosa often experience, such distortions more frequently and intensely-especially in relation to topics such as, weight, body image, and food. The following are some common cognitive distortions and examples of how they might be experienced by someone with bulimia nervosa.
1. All or Nothing Thinking: This is when you think of things in terms of black and white categories. For instance, “I can either eat the whole box of doughnuts or none at all.”
2. Overgeneralization: Seeing one event as indicative of a larger pattern. For example, “I binged last night, so I won’t be able to stop binging for the rest of the week.”
3. Magnification or Minimization: Exaggerating one small negative event or underemphasizing a positive event. For instance, “I relapsed and purged last night. I might as well give up on recovery completely.”
4. Disqualifying the Positive: You try to insist that something positive that happened doesn’t count. For example, “I’ve only been maintaining my recovery because I’ve just been lucky so far.” [2]
For individuals with bulimia nervosa, part of the recovery process entails challenging some of the lies that the eating disorder tells them. Here are some tips that could be helpful in working to identify, challenge, and distance yourself from dysfunctional thoughts when struggling with bulimia nervosa.
Cultivate a mindful awareness of your dysfunctional thoughts.
The first step in working to challenge or distance yourself from dysfunctional thoughts is to begin to cultivate an awareness of them. I would urge you to begin to be curious about the thoughts that you are having-especially as they relate to food, body image, and self-worth.
Rather than judging or shaming yourself for having these thoughts, work to simply acknowledge the thoughts that you are having.
Throughout the week, try to examine what situations or stressors seem to trigger some of your unhelpful thoughts-which may lead to your binging and purging behaviors. It could be helpful to write down some of your thoughts throughout the day so that you can begin to identify the things that your mind is telling you.
Work to separate your “eating disorder voice” from your “healthy voice.”
Starting to see your “eating disorder voice” as separate from your “healthy voice” can help you to learn how to externalize your disorder and disregard the lies that it tells you. Rather than getting angry at your eating disorder for telling you lies, try to examine the purpose that the eating disorder is serving in your life.
Ultimately, an eating disorder is a maladaptive coping strategy for numbing feelings, attempting to deal with past trauma, and experiencing a false sense of control. To try to uncover what is behind your eating disorder, one exercise that could be helpful would be to write a letter to your eating disorder.
In the letter, you could express the ways in which the eating disorder has served you until now, and then state the ways that it is harming you.
You could also externalize your eating disorder by writing a list of the unhelpful things that it tells you. Underneath each dysfunctional thought you could write something from the perspective of your healthy voice. Here are some ways that you could work to challenge some of the earlier examples of cognitive distortions:
Eating Disorder Voice: “I can either eat the whole box of doughnuts or none at all.”
Healthy Voice: “I can mindfully enjoy and savor one doughnut.”
Eating Disorder Voice: “I binged and purged last night, so I won’t be able to stop doing this for the rest of the week.
Healthy Voice: “I binged and purged last night. I wonder what was bothering me, which triggered this? Next time I am having urges, I will reach out to someone in my support network.”
Eating Disorder Voice: “I relapsed and engaged in one destructive behavior. I might as well give up on recovery completely.”
Healthy Voice: “I relapsed. I think this is probably a sign that I could use some more support because the eating disorder voice has gotten louder. I’m going to keep working on my recovery so that one day I can finally be free from this.”
Eating Disorder Voice: “I’ve only been maintaining my recovery because I’ve just been lucky so far.”
Healthy Voice: “I’ve been maintaining my recovery because whenever I’m triggered, I practice a positive coping strategy or reach out to my support network.”
The more that you can work to challenge and distance yourself from your eating disorder voice, the less control that it will have over your feelings and behaviors. It is also important to note that just because your eating disorder is telling you to do certain things-does not mean that you have to listen.
No one would choose to have bulimia nervosa, however you can choose to work towards recovery at any time. You shouldn’t have to suffer with this in silence. If you are struggling, it is important to reach out for help from a treatment professional. If you can work to identify, challenge, and distance yourself from distorted thoughts and beliefs, you will be closer to finding freedom from your eating disorder.
Community Discussion – Share your thoughts here!
What tools have been helpful for you in your journey to a healthy voice in eating disorder recovery?
References
[1]: Keelan, P. ( 2015). Eating Disorders: Address The Emotional Causes. Retrieved from http://drpatrickkeelan.com/counselling/eating-disorders/[2]: Hutson, N. (2012, December 12). Cognitive Distortions for Eating Disorders. Retrieved from http://www.walkerwellness.com/cognitive-distortions-for-eating-disorders/
Jennifer Rollin, MSW, LGSW, is a therapist who specializes in working with adolescents, mood disorders, eating disorders, and with survivors of trauma. Jennifer has worked in a variety of settings including, an outpatient mental health clinic, therapeutic group homes, and a sexual assault hotline. Jennifer is an expert blogger for The Huffington Post and Psychology Today. For self-love and body-positive inspiration connect with her on Facebook.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on December 19, 2015
Published on EatingDisorderHope.com
