Background: Those with eating disorders speak about the constant need for and desires to control their external world and internal experiences. Statements such as "My eating disorder helps me control everything" are not uncommon. This presentation will introduce how and why ACT can address the illusion of control in eating disorders.
I will provide an overview of why Acceptance and Commitment Therapy (ACT) can be difficult to understand, and will explain why it is important for therapists who treat those with eating disorders learn to use ACT in a way that is meaningful to clients. The role of cognition and emotions in eating disorders and how controlling these events are counterproductive and intensifies suffering will be introduced. The basic premises of ACT will be reviewed before addressing the agenda of control in those who struggle with eating disorders. The concept of creative hopelessness will be reviewed and several examples and experiential activities will be used to learn how to apply and provide interventions. Participants will directly participate in learning interventions that they will be able to use in individual or group psychotherapy.
Then, ACT’s model of psychopathology, the hexaflex, will be broken down into pieces so that participants will learn about each part of the hexaflex and how each psychological process are seen in individuals who struggle with eating disorders. Metaphors and experiential activities will be used to demonstrate concepts of defusion, acceptance, mindfulness, values, committed action, and self as context.
Finally, participants will learn about being an ACT informed practitioner and how this stance can help those who struggle with the illusion of control in eating disorders. Overall, I will guide the audience participants in learning several experiential exercises to facilitate awareness and full understanding of the concepts. These experiential activities will require active audience participation. Therefore, I will engage the audience in learning how to apply and adapt specific ACT-based interventions in both individual and group psychotherapy. Case examples of individuals struggling with a variety of eating disordered behaviors will be presented in order to further demonstrate ACT concepts and interventions. This presentation will be interactive and experiential and will encourage participation, discussion, and inquiry.
Individuals who struggle with eating disorders often speak about the constant need for and desires to control both their external world and their internal experiences (i.e., thoughts, feelings, physical sensations). Statements such as “I need to control my feelings” or “My eating disorder is the only thing I have control over” are heard time and time again by clinicians. Individuals who struggle with the wide range of eating disorder symptoms oftentimes work hard to “solve the problem” of negative body image thoughts, for example, by attempting to avoid, get rid of, or change their difficult thoughts or feelings. However, efforts to control, change, or avoid internal experiences are futile and intensifies suffering. These individuals create an illusion of control that makes change difficult.
Acceptance and Commitment Therapy (ACT) is a third-wave behavioral approach rooted in mindfulness- and acceptance-based principles that addresses experiential avoidance, which is commonly seen in the wide range of eating disorders. Despite the resources available to clinicians on using ACT to treat eating disorders, effectively utilizing ACT is not without its challenges and new clinicians are often perplexed by the terms, concepts, and use of metaphors that are used to intervene. The notion that clinicians are the agents of change in the therapeutic process represents a model that promotes and advocates for clinicians, not technicians. Clinicians who want to integrate ACT into their work benefit from learning the stance of the ACT-informed practitioner and provide interventions in a way that is meaningful for the client.
In this presentation, I will introduce why and how ACT can be incorporated into both individual and group psychotherapy with individuals who struggle with eating disorders. Ways to intervene with individuals who are in various levels of care (outpatient, partial hospitalization) will also be addressed. Special attention will be given to considering the stage of treatment individuals are at, as some ACT interventions (e.g., creative hopelessness, use of metaphors) require timeliness, compassion, understanding, and a strong ACT-informed therapeutic stance. Throughout this presentation, participants will be invited to engage in learning interventions that are designed to strengthen the core psychological processes of ACT.
Dr. Danielle Doucette is a Licensed Clinical Psychologist who specializes in assessing and treating individuals who struggle with eating disorders and non-suicidal self-injury. She is committed to applying Acceptance and Commitment Therapy in both her group and individual work and strives to help individuals develop a sense of self-understanding, psychological flexibility, and the capacity to self-reflect. Dr. Doucette presents at local and national conferences on topics related to eating disorders, the use of humor in psychotherapy, non-suicidal self-injury, and Acceptance and Commitment Therapy. Her practice is located in Chicago, where she is also an adjunct instructor at Roosevelt University.
