By: Blanche Stokley LMHC, CEDS
Address: 225 S Swoope Ave #205, Maitland, FL 32751
Hi folks. Just returned from a ACT bootcamp in Raleigh, NC. ACT stands for Acceptance and Commitment Therapy, a behavioral based therapy within a relational frame. This training was intense starting at 9am to 6:45pm for four days. Basically it is a a blend of behaviorism and rogerian therapies.
The primary object in ACT is to help others achieve “psychological flexibility” as opposed to ‘psychological rigidity”. Flexibility is often a sign of health in our bodies, minds, emotions and spirit. Asking a eating disorder client to consider psychological flexibility in their selected food choices challenges them. We know this includes eating with others and eating in restaurants. Asking for such flexibility in decreasing exercise, reconsidering a sport and reducing time in the gym is difficult for a client to accept and commit to recovery.
Emotionally we are asking a client to accept feeling emotions when the eating disorder has been successfully rendering the client numb. The client is often surprised by the extent of their repressed feelings. Flexibility often means accepting that feelings have their own time table. I use the metaphor of being pregnant. Your body has its own process which you can’t control. It might be nausea, fatigue or food cravings. And when the baby is ready, then it’s delivery time. Waiting and patience takes on new meaning!
We are also asking the family to be flexible. The family’s expectations whether realistic or not play a role in recovery. The supportive family will struggle and succeed in accepting the client’s eating disorder and the perhaps the client’s new or reemerging identity. But sometimes the most challenging idea for a client is the acceptance of a parent who may never elect to change. No amount of family therapy can convince this parent to become accepting and flexible.
Rigidity is risk avoidant and it makes an eating disorder client’s life small. The longer the disorder is un-arrested the smaller the life. Slowly encouraging the client to move out into the world helps them face maturity and rejections fears.
We as clinicians are challenged to be flexible as well. It is hard when insurance companies cut off necessary treatment payment. We see clients who cling to their disorder out of fear. Progress often is slow. However the rewards can be amazing! So consider bringing in the theme of psychological flexibility as a goal in treatment. Thanks for taking the time with me.