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Building a Life Worth Living: Part 2DBT & the Treatment of Eating Disorders

June 13, 2016

Now that you are a little more familiar with Dialectical Behavior Therapy (DBT), you may be wondering how this type of therapy applies to eating disorders. DBT conceptualizes eating disorders as disorders characterized by emotion dysregulation, although how this is applied to each patient can vary.

Patients tend to fall on either end of a spectrum – on one end, some patients with eating disorders struggle with intense emotional experiencing that impedes with the ability to engage in behaviors consistent with building a life worth living. The task in the treatment for patients at this end of the spectrum becomes to help lessen the intensity of their emotional experiencing, such that they are able to take actions that are more in line with recovery from their eating disorder.  For example, a patient may struggle with urges to binge when she experiences an intense and unpleasant emotion, such as sadness or shame. Emotion Regulation skills can assist her in acting effectively when faced with these emotions in the moment, in addition to decreasing the frequency and intensity of these emotions over time and increasing the frequency of more pleasant emotions. 

Boy using DBT skillsOn the other end of the spectrum, the opposite extreme occurs – instead of experiencing intense emotion dysregulation, some patients struggle with emotional loneliness and emotional overcontrol. The task in the treatment of patients at this end of the spectrum involves increasing flexibility and emotional experiencing as part of the journey toward recovery. For example, a patient may struggle with noticing and identifying his emotions, and communicating about his emotional experiences to others – instead, he experiences the world in an “emotionally numb” state. Emotion Regulation skills can help him start to observe and label his emotions, and in turn, begin to express these emotions and share them with others.

In the treatment of eating disorders as a whole, the DBT skills that patients learn help them to strike a balance between accepting and tolerating challenging circumstances, often times including the experience of treatment itself, and changing unpleasant situations and circumstances over which they have some degree of control.

A wealth of DBT knowledge is available in form of readings, videos, and in-person talks, most of which can be accessed for free or at low cost online. If your loved one is currently involved in any form of treatment, be sure that you also take advantage of any family programming opportunities that are offered!

If you have questions about what may be most helpful for you and your family, do not hesitate to ask any of the treatment providers with whom you are working for assistance. As you start to learn more about DBT skills, the next step is to put your knowledge in to practice – speak the language of DBT and try using the DBT skills yourself!

As you develop fluency with DBT skills, it is important to learn more about which skills your loved one finds to be helpful, and how you can best support them in using skills when challenges arise.

Stay tuned for Part 3 in our “Building a Life Worth Living” series for a deeper look at the DBT skill called Core Mindfulness.


Written by Alyssa Kalata, Ph.D.

Associate Clinical Director, Veritas Collaborative