Dialectical Behavior Therapy for Binge Eating and Bulimia
Debra L. Safer
Language: English
Pages: 244
ISBN: 1606232657
Format: PDF / Kindle (mobi) / ePub
This groundbreaking book gives clinicians a new set of tools for helping people overcome binge-eating disorder and bulimia. It presents an adaptation of dialectical behavior therapy (DBT) developed expressly for this population. The treatment is unique in approaching disordered eating as a problem of emotional dysregulation. Featuring vivid case examples and 32 reproducibles, the book shows how to put an end to binge eating and purging by teaching clients more adaptive ways to manage painful emotions. Step-by-step guidelines are provided for implementing DBT skills training in mindfulness, emotion regulation, and distress tolerance, including a specially tailored skill, mindful eating.
not involve binge eating. One uses rebelliousness in ways that do not backfire and result in greater difficulties. Encourage clients to describe their use of these skills, including times they have had trouble with them and times they have been able to use them to steer clear of binge eating (and purging). Review and Relapse Prevention 183 Emotion Regulation Module Enumerate each of the goals of the Emotion Regulation module, asking clients to reflect on one key idea that was important or
in producing the problem behavior. 2. Generating skills solutions by asking, “What skills could you have used here?” 3. Encouraging group members to commit to trying out the skills solutions suggested. In our research setting, at the end of the review of skills practice, therapists collect any diary cards, homework sheets, chain analyses, and so forth. Break During 2-hour group sessions, a 5- to 8-minute break should take place after the homework review to allow group members to use the
for binge eating (and purging), these functions are combined into one session. For therapists using a group format for treatment, the most challenging element of therapy involves conducting this first half of the treatment session, beginning with Session 2. Following are some of the ideas we have found helpful: •• On a white board (or handout), write general guidelines about how therapists would like clients to report on their skills practice during their allotted time (e.g., 5 minutes). In our
live the high-quality life that you want. At the same time, you must accept yourself just as you are, in this moment. Otherwise, you put yourself into a state of self-criticism, self-loathing, and selfaversion—a state in which it’s very easy to feel hopeless, to give up, and to experience urges to binge eat. A dialectical view involves accepting exactly where you are, right at this moment. It doesn’t mean necessarily approving of where you are or liking it. But it means accepting it the way you
although evidence for a causal relationship between bulimia and diabetes is mixed, it is clear that the presence of an eating disorder in addition to diabetes is linked to a worsened diabetic course—including the development of end-organ damage at a younger age (Rydall, Rodin, Olmsted, Devenyi, & Daneman, 1997). Emotions, Affect Regulation, and BN Aversive emotions may bring about, maintain, and be a consequence of BN behaviors. Bulimic behaviors are frequently related to negative affective