Dialectical Behavioral Therapy and Eating Disorder Treatment – By Margot Rittenhouse (June 2020)

Dialectical Behavioral Therapy (DBT) is a cognitive-behavioral treatment approach created by Marsha Linehan to treat Borderline Personality Disorder. Over time, it has proven to be helpful in treating many other mental illnesses, eating disorders included.

DBT “create(s) a controlled environment for individuals to have the opportunity to practice regulating their emotions and managing their behaviors [1].”

The foundational format of DBT includes 4 treatment modes – weekly individual therapy, a weekly skills group, a weekly consultation meeting for DBT therapists, and 24-hour access to the primary therapist.

DBT skills are a huge contributor to the success of the treatment and are organized into 4 categories – Mindfulness, Distress Tolerance, Interpersonal Effectiveness, and Emotion Regulation.

These skills help individuals to identify their thoughts and feelings, engage in the present moment mindfully, accept the current reality, regulate their emotions, communicate their thoughts and feelings with others, and coping with circumstances that are beyond their control.

It’s understandable how all of these skills could be applied to other disorders or, really, any aspect of life in general.

When it comes to eating disorders, DBT treatment is incredibly effective.

One Psychology Today article pointed out that “anxiety levels increase when people recovering from an eating disorder are put in environments that trigger old responses. DBT can help to shift negative and impulsive thinking into positive self-talk and mindful eating behaviors [1].”

Mindfulness skills taught in DBT help individuals to live in the present moment, observing their thoughts, feelings, and reality non-judgmentally and participating fully in their recovery skills.

Eating disorders often come about as an unhelpful coping skill amidst uncontrollable circumstances and DBT is created precisely for that, as those diagnosed with BPD often engage in ineffective communication and coping skills that they have learned over time.

DBT skills teach individuals how to accept and cope with circumstances that they cannot control using effective methods that, at the very least, don’t make the situation worse by using harmful behaviors.

The effectiveness of DBT to treat eating disorders is proven in practice, with numerous studies proving that it reduces the frequency of eating disorder behaviors [2].

In fact, one study examined using DBT to treat anorexia nervosa and found an incredible 83% remission rate [2].

Research indicates that DBT reduces both disordered eating behaviors as well as their psychopathology [2].

With results like this, DBT is becoming more popular and accessible as a method of treatment for those struggling with disordered eating.

Resources:

[1] Gleissner, G. (2016). What is DBT? Psychology Today, retrieved from https://www.psychologytoday.com/us/blog/hope-eating-disorder-recovery/201609/what-is-dbt.

[2] Bankoff, S. M. et al. (2012). A systematic review of dialectical behavior therapy for the treatment of eating disorders.” Eating Disorders, 20:3.