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DBT For Eating Disorders

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When people are struggling with binge eating behavior or weight management issues, they are sometimes told to simply eat less and exercise more. This advice, perhaps well intended, will potentially make the situation worse and create an unhealthy diet cycle that focuses on a negative body image and deprivation. People need a sound treatment plan that addresses the complexity of the behaviors, thinking patterns, and relationship with food. This is where a type of treatment known as Dialectical Behavior Therapy (DBT) is helpful. DBT is a type of therapy that combines elements of cognitive behavioral therapy with principles of from Zen Buddhism. DBT has been proven an effective theoretical framework that helps promotes changes that are necessary to treat binge eating as well as other eating disorders.

What is DBT?

Dialectical behavior therapy is a specific type of cognitive-behavioral psychotherapy developed in the late 1980s by psychologist Dr. Marsha M. Linehan. The original goal of DBT was to find better treatment options for people suffering from borderline personality disorder. Dr. Linehan, who is currently a professor at the University of Washington actually developed DBT as a response to her own borderline personality disorder, which had previously not been properly treated. However, since the development of this therapy, it has been used to treat other kinds of mental health disorders.

Dialectical behavior therapy is a type of psychotherapy (talk therapy) that utilizes a cognitive-behavioral approach that emphasizes the psychosocial aspects of treatment. The main concept behind DBT is the view that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations. These emotional situations are primarily triggered by romantic, family and friend relationships. DBT theory advocates that some people’s arousal levels in such situations can increase far more quickly than the average person’s, attain a higher level of emotional stimulation and thereby take significantly more time to return to baseline arousal levels.

Dialectical behavior therapy understands that there are times when people act on emotions that do not match a social situation. This is when a skill from dialectical behavior therapy (DBT) called “opposite action” is invaluable. It’s a skill that helps us to manage our emotions, enhance our relationships and enhance our lives. It’s a skill that helps us make more healthful decisions. DBT would advocate that an opposite action is required in these situations, because it allows people to recognize that their thoughts are not facts. Individuals learn how to experience emotional urges, but take the opposite action and not act on these urges. This provides a level of self-regulation and allows people to have more control over their thoughts, feelings and actions. Not surprisingly, dialectical behavior therapy is an effective treatment approach for people struggling with eating disorders.

A summary of how DBT works:

The term dialectical is based on the principle of blending two key ideas together, acceptance and change. In therapy, both of these ideas produce better results when they are combined together. DBT has patients focus on accepting their experiences, but simultaneously working on changing unhealthy behaviors. A major goal is to provide patients with the necessary skills that allow them to cope with, and change, these unhealthy behaviors. This form of therapy was initially designed to treat people with suicidal behavior and borderline personality disorder. But, DBT has been successfully adapted to treat other mental health problems that threaten a person’s safety, relationships, work, and emotional well-being.

Traditional dialectical behavior therapy focuses on behavioral skills for four domains:

  1. Emotion regulation: Recognizing, labeling, and adjusting emotions.
  2. Interpersonal effectiveness: Navigating conflict and interacting assertively.
  3. Distress tolerance: Feeling intense emotions like anger without reacting impulsively or using self-injury or substance abuse to dampen distress.
  4. Mindfulness: Becoming more aware of self and others and attentive to the present moment.

DBT takes these four domains and applies them in a linear, multistep approach. The first step is to treat the most self-destructive behavior (suicide or self-injury). The next step is to control behavioral response such as emotional regulation, distress tolerance, and interpersonal effectiveness. The third and fourth steps promote better personal relationships and self-esteem while encouraging a sense of happiness and connection.

For additional information or questions about dialectical behavior therapy for eating disorders, contact the staff at Toledo Center (RCC). Their programs provide a full range of treatment options for both adolescents and adults. Toledo Center is located in Sylvania, Ohio.

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