Among the third generation cognitive therapies ofAcceptance and Commitment Therapy (ACT) is the subject of more and more insights and studies concerning the application of this paradigm to the various problems that patients report.
One of the fields where the ACT can be applied is that of eating disorders.
The most influential cognitive-behavioral model for the treatment of anorexia and bulimia nervosa It is that of Fairburn and Harrison from 2003, which focuses on body and weight control therapy and on their hypervaluation and, as recently confirmed, on the intolerance to emotions that generates avoidance behaviors.
THE’Act He founded one of his cornerstones on the conception that intolerance to emotions is the main source of psychological suffering, opposing the western myth of the “healthy normality”, on the basis of which happiness is intended as an absence of pain, a conception of normality that includes the presence of suffering as a common experience.
In a recent review Manlick, Cochran and Koon wanted to put together the latest searches on Act and eating disorders To focus on how much and how this theoretical approach can be considered a valid help for these problems.
As we know the goal of the Act is to increase psychological flexibility through the application of the six fundamental processes: defusion, acceptance, contact with the present moment, values, committed action and if as a context.
The authors analyzed the six processes, relating them to the components of anorexia and bulimia and research in this regard. As for the defusion, we know that with the act you learn to observe your thoughts (defusion) and not to be your own thoughts (merger).
We also know that patients with eating disorder They tend to be merged with thoughts and beliefs about the weight and shape of the body, which generate negative emotions such as shame, anxiety and sadness.
Learning to “determine” yourself from these thoughts considering them part of one’s experience can help not identify with them and not to react with dysfunctional behaviors.
From the merger with the verbal processes of thought arise a series of processes such as hypercontrolle, suppression or avoidance of unpleasant internal experiences which are conceptualized in the Act experiential avoidancepreventing acceptance of their internal experiences.
In patients with eating disorders The emotional and experiential avoidance is associated with the severity of the disorder, and some research shows how to encourage the acceptance process facilitates the reduction of binge-purging behaviors and lowers dissatisfaction with one’s body.
There awareness of the present moment It is another of the cornerstones of the Act, which helps to understand the fullness of the experience moment by moment, thanks also to the techniques Mindfulnessfacilitating psychological flexibility and contact with one’s values.
One of the cognitive processes that accompanies the eating disorders It is precisely to focus on limited aspects of the experience present (“I see my legs big”), losing sight of other components of the moment and keeping the merger with that only perspective.
The self as a context is part of the full awareness of the present moment, allowing patients not to identify with their own descriptions of themselves but promoting contact with a coherent and persistent sense of self that observes and accepts the flow of experience.
Finally, the values and committed action represent the way for a significant life, replacing pathogenic and contingent purposes and allowing a long -term vision, but put into practice daily, of a well -being not understood as the absence of pathology, but as a valiant direction to travel.
This, in some research, has been highlighted as an important part in maintaining the results of therapy in eating disorders and as a useful tool for the prevention of repercussions.
The ACT model and the standard behavioral behavioral therapy model have been compared in a Jurascioscio and colleagues study of 2010 by comparing two groups of subjects to treatment for eating disorders.
The patients treated with the Act model have reported a greater reduction of symptoms, however further research is needed to perfect the conceptualization of the symptoms of Anorexia and bulimia in the ACT perspective, to determine the real effectiveness of this approach.
Fairburn, CG, & Harrison, PJ (2003). Eating Disorders. The Lancet, 361407–416.
Juarascio, As, Forman, EM, & Herbert, JD (2010). Acceptance and Commitment Therapy Versus Cognitive Therapy for the Treatment of Comorbid Eating Pathology. Behavior Editation, 34175–190.
Manlick, CF, Cochran, Sv, & Koon, J. (2013). Acceptance and Commitment Therapy for eating disorders: ratio and literature review. Journal of Contemporary Psychotherapy, 43115-122.
