Dialectical Behavioral Therapy (DBT) is utilized to help individuals identify, understand, and manage difficult emotions. The major areas of focus in DBT include mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. The purpose of DBT is to help people become more mindful and present with their emotions, manage difficult or even painful emotions, regulate how they feel, and communicate their experiences in healthy ways.
DBT was originally developed to help individuals with borderline personality disorder, but it has been found to help people with other conditions such as eating disorders.
Eating disorders often develop as a coping mechanism for difficult and even painful emotions, memories, and experiences. The binging, purging, or restricting can serve as a way of managing or escaping difficult emotions. Eating disorders can be difficult to treat and can present as addictive behaviors. One of the major components of DBT is skills training, which can provide helpful techniques for treating eating disorders. These skills include:
Mindfulness
This skill is all about being in the present moment even if that moment is painful. Eating disorders can create an escape route or a way to avoid the issue below the surface. Being more mindful can be difficult. However, it allows people to be aware of what is going on rather than being on autopilot and reactive.
Individuals can become more mindful of triggers that lead to the disordered eating. Mindfulness creates awareness that allows for individuals to act in a different way rather than turning towards the eating disorder for comfort.
Emotion Regulation
When triggers occur, it can cause a great deal of distress. DBT can help people learn how to regulate emotions through adjusting distorted thinking and accepting negative feelings rather than ignoring them. This skill teaches coping strategies outside of binge eating.
Distress Tolerance
Even when emotions are upsetting, distress tolerance can allow people to experience difficult emotions. They can learn skills like deep breathing or healthy ways to channel those negative emotions in the midst of a trigger or stress response. These areas of DBT empower individuals by teaching them to become self-aware and then how to intervene in healthy ways for themselves rather than turning to harmful ways of coping.
Interpersonal Effectiveness
Conflict or issues within both current and past relationships can be sources of distress or trigger negative emotions. Those negative emotions can lead a person towards disordered eating. Emotional regulation and increasing distress tolerance can help with interpersonal effectiveness. Utilizing self-awareness and insight, they can learn how to express and communicate their thoughts and feelings in healthy ways. Not only will they have the opportunity to express themselves in positive ways, but also the interpersonal skills will help them have healthier relationships.
In Summary
DBT focuses on providing people with skills needed to promote acceptance and change. Individuals are validated in their pain, but they are shown how avoidance and numbing are harming them in the long run. DBT encourages people to be present with what is difficult and helps them learn to cope in healthier ways. For many people, including those struggling with an eating disorder, it is difficult to break the cycle because it can be the only way they know to cope. The skills learned in DBT can help equip them to successfully face their pain and deal with it in healthier ways.
Sources
- Lenz, A. S., Taylor, R., Fleming, M., & Serman, N. (2014). Effectiveness of Dialectical Behavior Therapy for Treating Eating Disorders. Journal of Counseling & Development, 92(1), 26–35. https://doi.org/10.1002/j.1556-6676.2014.00127.x
- Ekern, B. (2020, February 13). Binge Eating Disorder And How Emotional Eating Can Quickly Turn Into It. Eating Disorder Hope. https://www.eatingdisorderhope.com/information/binge-eating-disorder/emotional-eating-can-quickly-turn-into-binge-eating-disorder
- Wisniewski, L., & Ben-Porath, D. D. (2015). Dialectical Behavior Therapy and Eating Disorders: The Use of Contingency Management Procedures to Manage Dialectical Dilemmas. American journal of psychotherapy, 69(2), 129–140. https://doi.org/10.1176/appi.psychotherapy.2015.69.2.129
Michelle is a Licensed Marriage & Family Therapist working as a counselor for students, faculty, and staff at Abilene Christian University in Texas. She works with athletes, bridging the gap between athletics and mental health at ACU. Michelle ran her own private practice in Austin, Texas where she worked with a diverse population, including couples and families.