A well-known and serious eating disorder which is defined by episodes of eating large amounts of food immediately followed by purging behaviors (most often vomits) to avoid gaining weight, it’s estimated that two percent of adult women will develop bulimia nervosa in their lifetime. Although bulimia nervosa, like all other eating disorders, can be difficult to overcome, evidence-based bulimia nervosa treatment is increasingly able to provide paths to recovery for people who’ve developed this disastrous disorder.
In addition to the well-established evidence-based therapeutic techniques dialectical behavioral therapy (DBT) and cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT) is another exciting psychotherapeutic technique that therapists are beginning to use. In treatment focusing on bulimia nervosa, clients learn to rationally evaluate and identify unpleasant or negative emotions and thoughts without feeling compelled to act on them.
Bulimia Nervosa Treatment Using ACT
One of ACT’s main goals is to help the people in treatment slowly enter what’s known as a state of “creative hopelessness,” in which they recognize disordered eating behaviors as an essentially counterproductive response to anxiety and/or depression. For example, during an ACT session, the therapist might point out (as an example) that although the client may have a significant amount of weight, they still feel “fat”and flawed, with a poor body image. This can lead to a “breakthrough” in which the client realizes that their negative emotions and disordered eating are cyclical, influencing and exacerbating each other.
Inducing “creative hopelessness” helps clients develop a stronger sense of mindful awareness of and acceptance of the existence of unwanted emotions. As a form of behavioral therapy, acceptance and commitment therapy works well in conjunction with traditional behavioral approaches to bulimia nervosa and other eating disorders, such as self-monitoring and exposure therapy.
ACT also inspires clients to, by using mindful acceptance techniques, to isolate negative feelings and acknowledging the dangerous behaviors they create. As the client internalizes that they can change their behavior, the therapist will help by providing fundamental coping techniques that further promote the motivation to let go of eating disorder behaviors. Key among these is replacing flawed self-perceptions with more realistic ones– and helping the clients realize they don’t need to keep adjusting how they appear and restricting food intake to achieve their idea of perfection.
ACT and Mindfulness
Mindfulness is learning how to maintain focused awareness of the moment instead of drifting off into memories or worries about the future. The people enrolled in bulimia nervosa treatment recovery programs are often instructed on mindful meditation and other techniques that help them center themselves and simply exist away from their disturbing emotions and thoughts. ACT doesn’t try to stop or eliminate unwanted feelings or thoughts but instead encourages practitioners to isolate them and examine them from a certain remove.
Mindful awareness is an essential part of rationally self-examining, which is itself an essential part of understanding how disordered eating behaviors are destroying a person’s life. It allows people in recovery from bulimia nervosa to recognize negative thoughts like “I am so fat” and change the thought to “I think I am so fat.”
This cognitive exercise separates clients from the self-identifying aspect of negative thoughts and significantly reduces the ability of that thought to provoke fearful, anxious emotions. The psychologists performing ACT may instruct clients experiencing anxiety during treatment sessions to breathe deeply and use the previously taught mindfulness techniques to allow themselves to “make room” for the anxious feelings without placing undue importance on them.
ACT is only one of several modern therapeutic techniques used in treating bulimia nervosa – there are dozens of possible combinations of treatment techniques used in eating disorder recovery because there is no single cookie-cutter approach that’s guaranteed to work for everyone. Contact your doctor if you or a loved one has bulimia nervosa and see if ACT is right for you.
