NOTICING MY THOUGHTS BEFORE ENGAGING IN BEHAVIORS
The next couple of times you have the urge to engage in an eating disorder behavior, write down exactly what you want to do and why you want to do it, and any other thoughts or feelings.
(Tip: Write exactly what you want to do with food. For example, if you want to binge and purge, stay away from using those words, as they are shortcuts and donâ€™t really describe what you actually want to do or what you are thinking or feeling.)
DIALOGUE WITH YOUR EATING DISORDER SELF AND HEALTHY SELF
Now you are ready to try a full dialogue. When you feel an urge to engage in a behavior, listen to and then write what your Eating Disorder Self is telling you, including what behavior it wants to engage in, and try to include why, even if it is as simple as, â€œI want to skip dinner because I donâ€™t want to get fat. â€ Then, respondfrom your Healthy Self. Your Eating Disorder Self will undoubtedly have something else to say, so write that and then let your Healthy Self respond again. Keep going until you have said all you want to say, but donâ€™t let the Eating Disorder Self have the last word.
Eating Disorder Self (EDS): The behavior I want to engage in and why:
The following is an example of one clientâ€™s dialogue:
ED: What have I eaten today/how many calories have I had?
HS: Stop it. Itâ€™s not about the calories.
ED: I need to know so Iâ€™m not anxious. Ijust need to know.
HS: Wait, why do I need to know?
ED: Because I donâ€™t know how much Iâ€™ve eaten and I feel like Iâ€™m always eating but Iâ€™m still not sure if itâ€™s enough because Iâ€™m still thinking about food, but then I wonder if Iâ€™m eating too much. I just want to know that I am okay.
HS: How will thinking about how many calories Iâ€™ve consumed help me know I am okay?
ED: Because then I can make sure I have the right amount.
HS: What does that mean? How does that help me?
ED: Iâ€™m not sure.
HS: Knowing how many calories Iâ€™ve already eaten is not a good way for me to deal with my food. There was a time when people did not even know what a calorie was and they knew what to eat. Calorie counting will only trigger me to compare myself to my past or to others, and it then impacts my sense of how hungry or full I am when it really shouldnâ€™t.
ED: But itâ€™s helped in the past.
HS: It only made me less anxious in the moment, but counting calories actually caused more anxiety, taught me to rely on external things not internal bodily cues, and made me not trust myself. Even though I thought it would keep me in control, the truth is I ended up out of control of my life because I lost so much weight. It limited my food choices, impacted the amount I ate, and I have used a meaningless number to determine my worth, peace of mind, and happiness.
ED: Yeah, but I still want to feel better right now!
HS: If I want to feel better and Iâ€™m afraid of not being okay, I can find other ways to calm down. First, am I safe? Is there anything actually happening that is hurting me right now? Am I breathing? Am I hungry? Am I lonely? Take a deep breath, check in with my five senses, make a cup of tea, do a few simple yoga poses, call a friend, or write a blog post. If I still feel anxious after any or all of these, what could that really be about? Itâ€™s okay to be afraid right now. This is a transition period.
ED: That just seems way too hard when all I need to do is count calories and stay in a range.
HS: But that has not worked now for a few years. I have to stop believing it will. This will be hard, these feelings are normal, but once I listen to and regain trust in my body and soul, things will be much easier. People do it all the time, I believe I can do it, and I know that doing it will help me live the life I want and not one dictated by an eating disorder.
We canâ€™t overemphasize the importance of doing these dialogues. You can write them out or actually role-play dialogues with someone else. You will discover where your Healthy Self gets stuck, becomes a bully, or is mean. You will realize where the Eating Disorder Self has stronger arguments and the Healthy Self is weak and needs work. All of this will retrain your Healthy Self, bringing back its power and ability to respond.