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As a therapist in private practice specializing in helping adolescents and adults struggling with eating disorders, body image issues, depression, and anxiety, I employ a variety of strategies to help my clients to reclaim their lives and uncover a sense of meaning. I tailor treatment to each person, however I often enjoy using elements of cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT).

For those who are struggling with an eating disorder, depression, anxiety, or another mental illness, there are often a variety of unhelpful urges that they experience. For example, people who are experiencing depression may feel the urge to isolate from others. Individuals who are struggling with anxiety might experience the urge to avoid situations that cause them to feel anxious. People who are suffering from eating disorders may experience the urge to avoid events or social occasions that involve food.

These urges come from a good place, as the individual is often trying to “feel better.” However, in the long-run they only serve to make the person feel even worse.

One DBT skill that can be very useful is called “opposite action.” The first step is to identify and name the emotion that you are experiencing. The next part is to determine whether the emotion (including it’s intensity and duration) “fits the facts of the situation.” Additionally, a person can ask themselves whether acting on the urge will be effective in the long-term. Then, based on these answers, a person decides whether to act on their urge or to do an action that is opposite to the urge.

An Example of Opposite Action

Emotions are important in that they provide us with information and signals about things to pay attention to in our lives. There are times when an emotion “fits the facts of a situation” and motivates us towards effective action. For instance, feeling anxiety about an important exam could serve as a motivator to study. Or feeling anxious while walking home alone at night could help someone to maintain a better awareness of their surroundings.

However, there are times when an emotion “does not fit the facts of the situation” and when acting on an emotional urge is not effective. For instance, feeling intense anxiety about eating dinner at a restaurant does not “fit the facts of the situation,” and could cause someone to feel the urge to avoid socializing and going out to eat. Over time, this avoidance behavior only serves to make the anxiety worse. Additionally, it could start to negatively impact an individual’s relationships.

In this instance, it would be helpful to note that you are experiencing the urge to avoid eating out and to the take an “opposite action,” which is more in alignment with your life values. For instance, pushing yourself to have meals out at a restaurant (despite feeling afraid), would be taking an opposite action.

Seek Help

If you are struggling with a mental illness and are having trouble putting this exercise into practice, it’s so important to reach out for help from a trained professional. Seeking help when you are struggling is a sign of true strength, not weakness.

Additionally, it’s important to note that behavior change can take time. I often ask that clients begin to challenge themselves in gradual and manageable steps. Further, it’s helpful to be compassionate with yourself, wherever you are in your healing journey.

If you are interested in learning more about DBT, I’d highly recommend checking out The DBT Skills Workbook.

Jennifer Rollin, LCSW-C
Source: Jennifer Rollin, LCSW-C

Jennifer Rollin, MSW, LCSW-C is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping adolescents and adults struggling with eating disorders, body image issues, anxiety, and depression. Jennifer offers eating disorder therapy to individuals in Maryland and D.C. and eating disorder recovery coaching via phone/Skype.

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