Treating Eating Disorders with DBT

One of the groups I led while working at an eating disorder treatment center was where people completed a weekly Behavior Chain Analysis (BCA). 

In Dialectical Behavior Therapy (DBT), the BCA was a way for people to look at factors that could have led up to using an unhelpful behavior - such as restricting, binge eating, and purging.

A lot of times, people use these unhelpful behaviors, as a means of coping, and do not know why. The BCA is a way to take a pause and zoom in to what happened before the behavior.

For example, let’s say you binged on food after a long day, and you are feeling perplexed as to how this happened. 

Things you want to consider:

• What were your vulnerability factors the day the behavior occurred?

  • Did you not get enough sleep the night before?

  • Maybe you forgot to take your medication?

  • Or are you feeling extra stressed preparing for an important work meeting?

• Did any of the following occur:

• Actions (What did you, or someone else, do before the behavior?) - You overslept and skipped breakfast.

• Body sensations (What did you notice in your body?) - You noticed strong feelings of hunger.

• Cognitions (What thoughts were you having?) - “I am so stupid for not setting my alarm clock last night.”

• Events (What interactions or events happened?) - You were late for your important work meeting and had to delay breakfast even later.

• Feelings (What emotions were you having?) - Embarrassed for being late. Having imposter syndrome and feeling fearful of being judged by others. 

Using this information, people can often trace it back to the interaction or event that activated the chain of factors leading up to the unhelpful behavior. 

In this example, it could be that forgetting to set your alarm started the domino effect throughout your day. Or forgetting to eat breakfast. Whatever it is, being able to identify it can be helpful in preventing future unwanted behaviors from happening. 

Also, by doing this exercise, identifying the actions, body sensations, cognitions (thoughts), events, and feelings you have before an unwanted behavior occurs can help you know when to use *coping skills* (e.g., deep breathing, calling a friend) to help prevent the unwanted behavior from happening. 

If you resonate with any of this, and you are interested in changing your relationship with food and your body…

Gaining awareness of food and body judgments (and learning where they came from) is the first part of my course: Finding Peace With Food & Body (During Pregnancy, Postpartum, & Beyond).

If you are interested in learning more about my upcoming course - and how you can participate in my free beta program -  click here!