Eating disorder recovery tip #3: Twelve DBT mental health tools to fight an eating disorder
Dialectical Behavior Therapy (DBT) is a type of therapy with the goal to “teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve relationships with others.” When I went to eating disorder treatment at Bellatore Recovery, we were given a “DBT Cheat Sheet,” which was a list of science-based tools we could use instead of engaging in eating disorder behaviors.
Keep in mind, these DBT tools aren’t a “one size fits all” type of thing. What works for you might not work for someone else. Or, you may find only parts of a tool are helpful. (For example - with Tool #10, progressive relaxation doesn’t really work that well for me). That’s ok! Take what works for you, approach each of these with curiosity, and use them to support you in your eating disorder recovery and life.
Let’s get into the 12 DBT mental health tools to fight an eating disorder, and thank you again to Bellatore Recovery for giving me this exact list on day 1 of treatment!
ACCEPT
A: Activities. Do an activity like watch a movie, go or a walk, do a puzzle, etc.
C: Contribute. Do something nice or surprising for someone or volunteer.
C: Challenge. Challenge the thought that you’re the only one suffering / you haven’t come far enough. Remember all the progress you’ve made!
(Ok, so technically “C” is supposed to stand for “comparison” but I never recommend comparing, so I replaced it with a word that resonates better for me. :)
E: Emotions. Read books, listen to music, or watch movies with an emotion that is opposite to the one you’re feeling.
P: Push away. Block the situation in your mind for a period of time. Each time it comes up, tell it to go away or put thoughts in its place, especially happy thoughts.
T: Thoughts. Distract with other thoughts, counting stars in the sky, pointing out colors you see, etc.
Accumulate Positive Experiences
Do things you genuinely enjoy without judging yourself or feeling guilty. If you are used to feeling negative emotions, this may feel strange, but these positive experiences can add up and help make room for positive emotions over time.
Build Mastery
Do an activity that makes you feel a sense of accomplishment that has nothing to do with food or your body. This doesn’t have to be something you’re good at, but instead something that makes you feel victorious instead of a victim / helpless. You could do volunteering, socializing, painting, etc.
Observe, Describe, Participate
Observe: Observe what you feel, sense, see, taste, touch and hear without labeling it, reacting to it, or judging it. Allow your immediate experience to happen without pushing it away or trying to change it. This might mean observing your breath, sounds around you, or watching what’s passing in front of you. The point is to help you feel in the moment instead of lost in the past or future.
Describe: Put words to what you observe. You describe by sticking to the facts without adding your own interpretations or assumptions. Label emotions as emotions, thoughts as thoughts, and sensations as sensations without adding opinions, labels, concepts, assumptions or judgments.
Participate - Throw yourself completely into an activity, letting go of self-consciousness, judgments or fears. It is the opposite of sitting on the sidelines and watching. For example, going out with your friends, cleaning your room, or doing something fun. Not participating can keep you feeling on the outside, like you’re witnessing your life instead of living it.
Opposite Emotion to Action
Act opposite to your urge. Emotions usually have urges attached to them. When you feel anxious, you may want to avoid. When you feel depressed, you may want to isolate. But acting on these urges aren’t in your best interest. In fact, it usually just intensifies the emotions you’re experiencing. Identify the urge that is attached to the emotion and do the opposite.
PLEASE
This is a way to ensure you’re taking care of your basic physical needs because the physical impacts the emotional.
P: Physical well-being. See your doctor, take your medication (if you have any), meet with your care team.
For women, consider what time of the month it is (hormones can often impact how we think and feel).
L: Listen to your body.
E: Eat. Fuel your body!
A: Avoid mood-altering drugs, avoid alcohol if needed, and avoid caffeine if needed.
S: Sleep. Try to get 7 - 9 hours of sleep, wake up and go to bed around the same times if you can, limit napping, and get exposure to the sun during the day.
E: Exercise / not exercising.
Note that for many people struggling with eating disorders, taking exercise off temporarily can be healthier than exercising because of the physical, mental, and emotional stress exercise can cause.
Pros and Cons
Look at the pros and cons of engaging in a destructive eating disorder behavior or other negative behavior before doing it. Look at long-term and short-term consequences of the behavior.
Radical Acceptance
Accept your pain, fears, and anxieties. Don’t judge yourself for experiencing these things. You are only human. It’s when we judge ourselves and our feelings when suffering and spiraling happens. Accept things as that are, understand what you can and cannot control, and allow yourself to be perfectly imperfect.
STOP
When a crisis is happening and you notice your emotions are hard to tolerate, just STOP.
S: Stop.
T: Take a step back. Step back from the situation and take a couple of breaths.
O: Observe. Notice what is going on inside and outside you, what your thoughts and feelings are, and what the actual situation is.
P: Proceed mindfully. Act with awareness and consider your thoughts and feelings as you proceed.
TIPP
T: Temperature change. Can be ice in the hands, taking a warm bath or a shower, or getting a heating pad.
I: Intense exercise (if you can do so in a healthy way). Run around the block, do jumping jacks, dance for a little bit.
P: Paced breathing. Slow your breathing down to focus on the length of the breath. Some people like to do the 4-7-8 breathing method where you inhale through your nose for 4 seconds, hold your breath for 7 seconds, and exhale out of your mouth for 8 seconds. (If you can’t hold your breath for that long like me, no worries - focus on the long inhale and exhale. :)
P: Progressive relaxation. Tune into your body and relax each area at a time.
Turning the Mind
Instead of judging your current situation or giving into your emotions, “turn your mind” by accepting your feelings, thoughts, and situation, even though it’s uncomfortable or painful.
You can practice sitting in the discomfort of your emotions, and try to learn more about your thought patterns by getting curious instead of judging yourself.
WISE Mind
Use your WISE mind. There are 3 different ways we think about things:
Rational or Reasoning Self: The part of our brains that think logically and aren’t emotional.
Emotional Self: When your emotions are so intense that they control how you act. You react from the urges the emotions create in you rather than choosing how to act in a situation.
Wise Mind: Combine your reasoning with your emotions, so that neither mode of thinking is controlling you and you’re able to consider the consequences of your actions, and act in your own best interests.
I hope you can use these tools in your eating disorder recovery and any stressful situation that life may bring you way!
Sending you so much love!
xx tori
Other blogs on DBT tools to help fight an eating disorder:
“6 helpful DBT skills for eating disorder recovery” by Cityscape Counseling
“Dialectical behavior therapy (DBT) for eating disorders” by Within Health
Other resources on DBT tools to help fight an eating disorder: