DBT Skill for Coping with Eating Disorder Urges During the Summer

By Megan Samuels, MSW, LMSW, Therapist & Outreach Coordinator

Summer can be a challenging time for people struggling with eating disorder urges.  During the summer months, people tend to wear less clothing to compensate for the increase in temperatures.  Wearing less clothing and/or tight clothing can bring up icky body image thoughts.  I’ve found that these thoughts often lead to eating disorder urges to restrict or use other eating disorder behaviors.

For example, you may put on a pair of shorts for the first time this year and say to yourself, “I don’t like the way my legs look in these clothes, maybe I should try to lose weight.”  The body image thought of not liking the way your legs look in the shorts is contributing to the urge to restrict food intake, in the hopes of losing weight to look better in the shorts.  Then, you go on to limit the amount of carbs and fat that you take in during dinner.

But, what if you tried something different.  

DBT Skill: Separating urge from action.
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A great skill to practice to move towards recovery can be increasing the amount of time between an urge and an action.  An urge is the desire of impulse to do something and an action is actually doing that thing.  

In the example above, the urge is wanting to restrict food intake and the action is limiting the amount of carbs and fat during dinner.  If you wanted to practice separating urge from action, you could notice that you are having the urge to restrict food, and then decide to wait 20 minutes.  If you wait 20 minutes and that urge to restrict is still intense and you still want to act on the urge, then you can.  For some people, during this waiting time, the urge decreases and they realize that they do not want to act on the urge anymore.

Steps for this skill:

1. Notice the thought.

• “I don’t like the way I look in these shorts”

2. Notice the urge. 

• “I’m having an urge to restrict food.”

3. Notice the action.

• “I’m not going to eat carbs and fat for dinner.”

4. Separate urge and action. 

• “I’m going to wait 20 minutes and see if I still want to not eat carbs and fat for dinner.”
• Note that this time is variable and can change person to person.
  
  

5. Reflect.

• “It’s been 20 minutes and the urge doesn’t feel as intense.  I know that acting on urges to restrict won’t be helping my recovery journey and will only fuel the eating disorder thoughts.  I’m going to have dinner as planned and not cut out the carbs and fat.  I’m proud of myself for being able to get through this - it wasn’t easy.”  
• “It’s been 20 minutes and the urge feels just as intense.  I tried this skill and it didn’t work for me - and that’s okay.  Not every skill will work each time.  I’m going to cut out carbs and fat at dinner and then email my therapist.  I’m sure she will still be happy that I practiced this skill.  In our next session, we can talk about why this didn’t work and what alterations or other skills I can practice next time.  I’m proud of myself for being able to try this skill.”

As you can see through the reflection step, there are two different responses.  The first response shows when this skill works effectively and the second response shows what someone might say to themselves when the skill may not have worked as well.  In both cases, the skill was practiced.  In DBT therapy, the skills need to be practiced and reinforced to be effective.  Meaning, each skill may not work as intended each time.  Additionally, some skills may work better for some individuals than others.  

What I like about the second response under the reflection step is that there are aspects of self-compassion and accountability.  The person is giving themselves credit for being able to try and practice the skill and they are not beating themselves up because they still chose to engage in the action.  Additionally, they are choosing to reach out to their therapist so they can discuss in their next session ways to troubleshoot the skill and/or time to learn other skills that may be more effective.

The bottom line:
This skill can be helpful for lowering the immediate distress of an eating disorder urge.  In turn, this can decrease the amount/intensity of eating disorder actions/behaviors. And this skill takes practice and patience.  It can be helpful to consult with your eating disorder therapist before starting to practice this skill to make sure you have resources to support you in this process.

You got this!

For an introduction on what DBT is and how it can be applied to eating disorder recovery, please check out this blog.

Want more?  The majority of the therapists at The Eating Disorder Center have extensive training and experience in using Dialectical Behavior Therapy (DBT) as an effective treatment modality for eating disorders.  Contact us for a free 15-minute consultation today!

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The Eating Disorder Center is a premier outpatient eating disorder therapy center founded by Jennifer Rollin. We specialize in helping teens and adults struggling with anorexia, binge eating disorder, bulimia, OSFED, and body image issues. We provide eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney, Silver Spring, Germantown, and Washington D.C. We also provide eating disorder therapy in Arlington, Virginia and virtually throughout Virginia. Additionally, we offer eating disorder therapy virtually in New York (NYC), Florida, and California. We provide eating disorder recovery coaching via Zoom to people worldwide. Connect with us through our website at www.theeatingdisordercenter.com