DBT Spotlight: Positive Self Talk in Eating Disorder Treatment

When you or a loved one is struggling with an eating disorder, it can feel on the surface like it’s all about food, size, and appearance. The preoccupation with what you eat, how you exercise, and how these impact your perceptions of your size and appearance are hallmarks of eating disorders, but they’re symptoms, not causes.

Eating disorders are, fundamentally, a response to difficult-to-manage emotions reinforced by strong negative self-beliefs. Disordered eating behaviors like restricting, purging, and bingeing are all ways to try to cope, but they only provide temporary relief. Unfortunately, eating disorders often reinforce and worsen underlying beliefs and intensify distressing emotions.

Emotional dysregulation and negative self-beliefs are the root of eating disorders

Emotional dysregulation is the foundation of eating disorders

People with eating disorders often have a harder time with emotional regulation, and their negative self-beliefs can regularly trigger bouts of emotional dysregulation. Their emotions may be more strongly felt, last longer than expected, and may be disproportionate in intensity. They may also struggle to come up with helpful emotional regulation practices, making the destructive and uncomfortable symptoms of eating disorders a last resort to try to manage these feelings. Eating disorders then further escalate emotional dysregulation, reinforcing a cycle of hurt.

Negative self-beliefs feed eating disorders

While a preoccupation and negative perception of appearance is often clearly expressed by people with eating disorders, these negative beliefs are not the only ones that escalate eating disorders. Deep-seated beliefs of unworthiness, unlovability, and inadequacy are often core beliefs in people with eating disorders. These beliefs can easily lead to intense fear of abandonment or rejection, empty and numb feelings, a sense of worthlessness, and much more.

They can also make people resistant to changing self-beliefs: when you’re unlovable, why would you try to love yourself? Why would you believe anyone else when they say they love you? These negative self-beliefs make it easy to accept other negative beliefs, potentially leading you to be highly critical of your size and appearance and to readily believe what those traits mean about your value as a person.

DBT for eating disorders teaches a better way to cope

While nutritional support and mindful movement are crucial to eating disorder treatment to ensure your physical well-being, eating disorder treatment has to address underlying causes to provide meaningful, long-term healing. Dialectical behavior therapy (DBT) for eating disorders incorporates emotional regulation skills as a core pillar of the modality, making it uniquely suited to treating the underlying emotional dysregulation and negative self-beliefs of eating disorders.

Let’s take a look at one emotional regulation skill that can help people with eating disorders manage their emotions while also addressing negative self-beliefs: Positive Self-Talk.

Positive self-talk in DBT step by step

First, it’s important to remember that even though your negative self-beliefs might tell you that positive self-talk is stupid, a waste of time, or something you don’t deserve, you should try it anyway. By changing your behavior, you’ll start to change the intensity of your emotions in response to negative self-beliefs, and you’ll reduce the persuasiveness of those same negative self-beliefs. Positive self-talk reduces your susceptibility to these emotional challenges as part of your eating disorder treatment.

Step 1: Notice your automatic negative thoughts

Negative self-beliefs may pop into your head more regularly than you realize. Next time a negative self-belief comes up, notice it for a moment. State to yourself, “that’s an automatic thought” or “that’s a negative self-belief”. You might even write down when you’re experiencing them, and what they center on, to give yourself an idea of how often you repeat these beliefs to yourself.

Step 2: Decide on some positive responses to negative thoughts

Write out 3 or more positive responses you can make to negative thoughts. Make sure they are powerful, positive, realistic, and that they directly address your negative self-beliefs. Here are some examples

• For a negative self-belief like “I have no value and am worthless,” a positive response could be, “I don’t have to prove my worth, I have value no matter what.”
• For a negative self-belief like, “I am fat and gross,” a positive response could be, “I don’t have to feel bad about myself, I’m able to do so many wonderful things!”
• For a negative self-belief like “Everyone will abandon me unless I look a certain way,” a positive response could be, “I am always here for myself, and I know the right people for me will stay in my life no matter what.”

Step 3: Start using your positive responses every time you experience negative self-beliefs

Every time you notice a negative self-belief, pull up your list of positive self-talk responses and use one. At first, this won’t feel like it’s doing much, but keep practicing. It took time for your negative self-beliefs to stick, so it will take time for positive self-talk to start feeling true for you.

It might feel silly when you start using positive self-talk to combat your eating disorder. Still, in time, and with the full support of a DBT program, you’ll reach for positive self-talk before you reach for eating disorder behaviors when trying to cope. You may find yourself looking for more positive self-beliefs to use as responses. As you practice, you’ll find you are more able to believe the positive truths you come up with about yourself, and your negative self-beliefs lose some of the emotional punch they had before.

DBT for eating disorders at THIRA Health helps Bellvue teens and adults to heal

DBT provides a structured, supportive, and actionable approach to healing from eating disorders. Girls, women, and gender-diverse people in DBT programs for eating disorders benefit from individual and group therapy support, using it as a space to address underlying mental health concerns and to develop life skills that support emotional regulation, as well as distress tolerance, interpersonal effectiveness, and mindfulness.

THIRA Health offers residential adult and teen mental health treatment programs that use DBT as a foundational component of holistic eating disorder treatment. DBT, coupled with nutrition support and holistic mental health treatments, returns agency to you with skills such as positive self-talk. DBT empowers you to change your life by learning to trust (and even like) yourself, even when dealing with the harsh and distressing thoughts and emotions that eating disorders cause.

Instead of leaning on restriction, purging, or bingeing to manage emotional dysregulation and quiet your negative self-beliefs, DBT skills learned in THIRA Health’s eating disorder programs give you ways to cope that are healthy and supportive, not destructive. If you’re ready to get started on living a life worth living, connect with us today to learn more.