For those suffering from Bulimia, the disorder takes hold of their minds and daily life in a way that disables them to live fully and with awareness. Acceptance and Commitment Therapy (ACT) is a valuable tool for Bulimia recovery.
According to Hudson, “Acceptance and Commitment Therapy (ACT) provides patients with an alternative to attempting to ‘get rid of their ED thoughts and feelings.’ The alternative involves a shift in attention from what is often largely out of their control to what is in their control.”
In this modality, patients are encouraged to actually sit with their thoughts and feelings instead of using the maladaptive coping mechanisms of the Eating Disorder to manage unwanted emotions. Through ACT, patients learn to accept that they are having these thoughts but that they can sit with them and work through them rather than immediately trying to force them out.
Just like in several other treatment modalities, such as CBT, ACT employs different metaphors that help teach patients different techniques to lower the intensity and power that the Eating Disorder thoughts have on them. One technique taught in ACT is, according to Hudson, “learning to ‘defuse’ from unhelpful thoughts that one has become ‘fused’ with.”
For example, the patient with Bulimia may have become connected to an idea that they cannot survive their sadness. They may use their Eating Disorder rituals as a way to numb out their sadness because they believe they cannot handle it.
Through ACT, the patient begins to separate from this unhelpful thought. They may, for example, speak the thought using different accents. This technique allows the patient to view the thought from different, even humorous, angles and through doing so, lessen the power that the thoughts have over them.
In Bulimia recovery, a technique taught in ACT is moving from the experience of avoidance toward acceptance. Patients with Bulimia mask their emotions by numbing or avoiding, and they use their maladaptive behaviors to achieve these goals.
Emotional avoidance, however, will keep the patient stuck in their disorder because they believe that they must rely on these behaviors to get them through the day. According to Eating Recovery Center, “ACT is focused on helping people change their relationship with difficult emotions so their lives are not ruled by them, and they are free to make the choices toward their valued lives.”
When a patient is able to sit with their emotions instead of numbing or avoiding, they can learn through actual experience that they can survive the emotions and that their maladaptive behaviors are not necessary for survival.
Another piece of Acceptance and Commitment Therapy is mindfulness. When a patient practices mindfulness, they become more aware of their emotions and also their physical surroundings.
In tuning into themselves and their surroundings, the patient can begin to objectively see what they are doing and how they are speaking to themselves, and they can begin to decide whether this behavior is wanted.
According to Baer, “In particular, mindfulness-based interventions appear to increase self-efficacy and sense of control around eating, promote non-judgmental self-acceptance, and reduce the frequency of binge episodes.” Through a mindfulness perspective, a patient in Bulimia recovery can begin to accept themselves and actually reduce the frequency of their symptoms.
Altogether, ACT is an extremely effective technique for helping those in Bulimia recovery. According to Eating Recovery Center, “the goal of ACT is to help patients create and meaningful life while accepting the pain that inevitably goes with all of our lives.”
Through ACT, patients can begin to develop meaning in their lives, which have been taken over by the Eating Disorder rituals and thoughts. Patients will learn to be better able to healthfully tolerate their pain, and accept that pain is a part of life.
Overall, through ACT, those in Bulimia recovery will learn that they do not need to use their symptoms to navigate life because they will have all of the necessary tools within them to live a healthy and effective daily life.
References: Hudson, Chelsea. Acceptance and Commitment Therapy (ACT) in the Treatment of Eating Disorders.” (2017) https://www.mirror-mirror.org/act-eating-disorder-treatment.htm  Eating Recovery Center. Behavioral Therapy for Eating Disorders and Trauma. (2018) https://www.eatingrecoverycenter.com/recovery-centers/levels-of-care/adult/acceptance-and-commitment-therapy  Baer RA, Fischer S, Huss DB. Mindfulness-based cognitive therapy applied to binge eating: A case study. Cognitive and Behavioral Practice. 2005;12(3):351–358.
About the Author:
Emma Demar, LMSW is a therapist at Intrinpsych Woman on the Upper East Side of Manhattan. She holds an LMSW from Fordham University and holds a BA in Creative Writing from Trinity College. Emma recently completed a 2-Year Fellowship at Intrinpsych where she was expertly trained in Eating Disorders and DBT.
She uses a holistic approach in working with her patients, drawing from her background in Psychodynamic, CBT, and DBT, and she likes to begin where the client is and work from a strengths-based perspective. She specializes in Eating Disorders, OCD and related mental health disorders. Emma uses a direct, honest and open approach in working with her patients, who are generally women ages 12 to 32. She freelance writes for various mental health websites, and she blogs on her own website, thattrendytherapist.com.
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 a 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.
Reviewed & Approved on February 10, 2020, by Jacquelyn Ekern MS, LPC
Published February 10, 2020, on EatingDisorderHope.com