The Use of Valuing in Recovery from Eating Disorders

Some eating disordered individuals especially those with anorexia nervosa can be very difficult to treat owing to the reinforcing or anxiety reducing aspects of their illness. They are frequently oriented toward the anxious details of their lives and to their immediate likes and dislikes at the expense of overaching values and goals which would give them more life satisfaction. The natural tendency of most therapies is to seek to reduce or eliminate unwanted psychological or mental events. When one completes with an eating disorder within the context of such experiential avoidance of mental events, therapists are often defeated before they begin because the eating disorder is such an effective tactic for avoiding the unwanted.

Faced with the daunting task of motivating the client or patient to give up the self-defeating behavior of the eating disorder in a context where the eating disorder functions better in diminishing the awareness of unwanted mental experiences such as thoughts, feelings, body sensations or memories than any therapy, shifting to a valued living context can be more efficacious and more vitalizing in the long run. A valued living context changes the focus from trying to avoid the unavoidable mental content and its aversive emotions such as anxiety, shame and guilt to a focus of contacting the important sources of positive emotions--core values.

In order to accomplish this transition, the client must identify her intrinsic values knowing the difference from instrumental values which generally support the eating disorder. We will review ways to access values and the goals that serve them. It is also important to track the influences on their behavior as well as the consequences of it measured against a values context. This is the essence of functional contextual analysis which underlies Acceptance and Commitment Therapy (ACT).

In order to accomplish these goals, I will demonstrate tools for assessing core values as well as tracking the effects of values based behavior. We will identify gaps between the strength of personal values and the actual practice of them. We illustrate with case material and walk through the use of the ACT Matrix as a values tracking tool.