Developing Emotion Regulation Skills in Eating Disorder Recovery

Woman thinking about Pride in Eating Disorders

It is a universal human experience to encounter overwhelming or turbulent emotion-states and learn how to deal with them with skills such as emotion regulation. Struggling with doing so is a common trait in many psychiatric conditions such as generalized anxiety disorder, major depressive disorder, substance use disorders, borderline personality disorder, and, you guessed it, eating disorders [1].

In the mental health realm, “the process whereby a person shapes which emotions they have, when they have the emotion, and how they experience and express the emotion” is referred to as Emotion Regulation [1].

One researcher provided an apt breakdown of the abilities involved in emotion regulation such as “awareness and understanding of emotions, acceptance of emotions, ability to control behavior when experiencing negative emotions and ability to use situationally appropriate emotion regulation strategies flexibly [1].”

Often, individuals that struggle with emotion regulation avoid, suppress, or judge their emotional experiences and/or behave impulsively in the face of negative emotions [1]. These traits are also common in those with eating disorder diagnoses, making the development of emotion regulation skills valuable when it comes to working toward recovery.

Emotion Regulation and Eating Disorders

Woman speaking with treatment center about Emotion Regulation SkillsEating disorders are undoubtedly connected to challenges with emotion regulation, with research indicating that they may play a role in both the development as well as the maintenance of these disorders.

One study found that “individuals diagnosed with Anorexia Nervosa reported poorer awareness and/or low clarity of emotions and more difficulties with emotion regulation, as well as less access to emotion regulation strategies compared to healthy controls [1].”

An incredibly eye-opening founding stated that “individuals with EDs have more maladaptive strategies for regulating emotions, such as avoidance and suppression, and fewer adaptive strategies, such as acceptance and reappraisal.” Essentially, those that struggle with disordered eating tend to engage in more harmful ways of coping with negative emotions than they do effective ways.

Effectiveness in Eating Disorder Treatment

Many studies have shown the benefits of treatments that involve teaching emotion regulation skills. However, fewer studies have been conducted specifically on eating disorders.

A study very recently published in the Journal of Eating Disorders attempted to learn if “a short add-on group skills training in emotion regulation for young adults with different eating disorders was feasible in a psychiatric clinical setting [1].”

The study also “investigated if the treatment increased knowledge of emotions, and decreased self-reported difficulties with emotion regulation, alexithymia, symptoms of an eating disorder, anxiety, and depression, as well as clinical impairment [1].” Results indicated that not only was incorporating emotion regulation skills training feasible, it was also helpful in reducing the clinical impairments mentioned above.

The Skills Themselves

Emotion regulation skills are really any of those that help an individual to be more aware of negative emotions, accept them, and learn how to respond in an effective manner despite them. That said, there are specific emotion regulation skills that certain therapeutic treatments, such as Dialectical Behavior Therapy (DBT), outline [2].

One skill, known as Opposite Action, involves being aware of an emotion and the action urge that emotion brings you and intentionally doing the opposite. If your action urge is to yell because you are angry, you would instead put effort into speaking quietly and politely.

Another skill is Checking the Facts by examining what objectively happened in the situation, noting what assumptions or interpretations you added, and asking yourself if your emotional experiences match the facts or the assumptions.

Woman struggling with orthorexiaEmotion regulation also involves accumulating positive experiences. In practicing this, individuals intentionally engage in experiences that create positive emotions, and we hold onto these like pennies in a piggy bank. We have no problem collecting the negative experiences but don’t often put the same attention to doing this with the positive ones.

The emotion regulation skill of assessing one’s personal values and practicing working toward long-term positive experiences and behaviors that align with this is also an insightful process.

These are only a few of the abilities that help with emotion regulation, a skill that is crucial because we will never encounter a world where stressful or negative things do not happen. As such, we must all learn to regulate our own emotions when things do become stressful as opposed to our emotions ruling us.


Resources:

[1] Larsson et al. (2020). Emotion regulation group skills training: a pilot study of an add-on treatment for eating disorders in a clinical setting. Journal of Eating Disorders, 8:12.

[2] Linehan, M., M., (2014). DBT Training Manual. New York, NY: The Guilford Press.


About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.


The opinions and views of our guest contributors are shared to provide a broad perspective on 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.

Published May 22, 2020, on EatingDisorderHope.com
Reviewed & Approved on May 22, 2020, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.