Eating Disorders :: Mindfulness Or Distractions--What Works Best

As a therapist who treats clients with Eating Disorders, I am constantly reminded of the need for an integrative treatment approach and psychotherapy that addresses the complexities that ED's present for clients. Does Mindfulness help or hinder eating disorder recovery? The best answer may be that it depends on the nature of the eating disorder, and the stage of treatment. This is a much-debated topic within the ED treatment community.

Mindfulness, in addition to DBT Skills can be incredibly helpful for patients and clients in recovery, and in many aspects of their lives, especially when trying to manage powerful emotions and regulate mood. Some clients have reported that attempts at mindfulness early in recovery, especially during meals, creates intolerable anxiety and distress that interferes with the process of eating. Clients with Anorexia Nervosa find that distraction is the most helpful way to eat. "Thinking" about what's being consumed and eaten in early ED recovery is described as excruciating by clients. Distraction allows them to "pair" an enjoyable activity with mealtime, which is a very different experience than meals with the demand that they be "mindful" of excruciating feelings of fullness and any other sensations.

Because mindful eating is used to help clients attend to feelings of satiety and hunger, many in early treatment are unable to do this because their "cues" are impaired. The goal is to get ED clients eating again in a supportive way. Eventually and with time, mindfulness can play an important part of life after an eating disorder.

That said, mindfulness-focused treatment may be more helpful for BED or binge eating clients who may find themselves binging to relieve painful emotional states such as anxiety, anger, shame and feelings of worthlessness. The binge is a means of relieving tension or numbing negative feelings and emotions. A mindfulness-based approach can help clients learn to connect with the feelings and emotions that drive a binge episode and fuel the cycle of shame related to BED.