Mindfulness in Eating Disorder Treatment: Why and How to Use It
Written by CCTC Staff Writer
Mindfulness is a bit of a sticky subject — you know that it’s important and good for you, but what exactly is mindfulness? Is mindfulness a destination, a journey, or something to be obtained? Do treatment centers teach mindfulness in eating disorder treatment, and how do you apply those teachings in real life?
Read on for the answers to these questions, as well as:
What mindfulness is and what it is not
Why it makes sense to teach mindfulness in eating disorder treatment
How you might encounter mindfulness in treatment
At-home mindfulness practices for eating disorder recovery
Mindfulness is a concept, a movement, and a practice.
Mindfulness is commonly understood as the awareness that arises when paying attention to the present moment without judgment. The term mindfulness is derived from the Buddhist word sati, meaning memory, recollection, calling-to-mind, being-aware-of, certain specified facts. It has also been described as “lucid awareness” of the present moment.
It is a “movement” in that mindfulness based treatments for mental illnesses developed in waves. The first mindfulness-based intervention, mindfulness-based stress reduction, was designed by Jon Kabat-Zinn. It combined traditional Buddhist insight practices with modern theories about stress management to help patients cope with stress, pain, and chronic issues. This is where many popular mindfulness practices started: body scans, sitting meditations, mindful breathing.
Mindfulness is not always the same as meditation.
Mindfulness and meditation are used so interchangeably that you may not even realize the difference between them.
Meditation is an intentional, attentive practice designed to relax the body and mind. There are many types of meditation: spiritual meditation, yoga, music meditation, and more. You usually set a specific goal to achieve a state of stillness.
While active practice of meditation opens the mind up to being more aware of the moment, not all meditation is mindfulness, and not all mindfulness is meditation.
Mindfulness is just being aware of the present moment with a sense of curiosity and openness, and without reacting to or judging it. It requires no equipment and can be done anywhere — you are simply “dropping” into the present moment from whatever your mind was focused on before.
Most mental health providers do teach mindfulness meditation. These specific practices help people who tend to automatically react to stressful situations by using maladaptive behaviors.
Five Facets of Mindfulness
At its core, mindfulness has the five following qualities:
Nonreactivity: perceiving thoughts/feelings without reacting
Observing: paying attention to internal and external sensations
Acting with Awareness: staying focused on present-moment experience and acting deliberately
Describing: describing/labeling thoughts/feelings with words
Non-judgement: accepting thoughts/feelings without evaluating them
Mindfulness may be “warm” or “cold”, meaning that your perception may be warm and loving, or your awareness may simply “be”, without any emotion attached to it.
Studies have found that, for eating disorder treatment, all facets except for observing are associated with lower eating disorder symptoms. This is most likely because “observing” practices often include observing one’s bodily sensations. Observing the body can be distressing for individuals with eating disorders. Individuals in treatment for an eating disorder are especially unlikely to benefit from focusing on a changing body.
Why use mindfulness in eating disorder treatment?
Increased Awareness of one’s Physical and Emotional State
Individuals with eating disorders have difficulty determining their hunger cues and cravings. After a period of prolonged restriction, or of eating even after extreme fullness, the body doesn’t send hunger cues correctly anymore.
Consistently practicing mindfulness enhances your introspective awareness, which is your ability to identify, access, comprehend, and respond to your body’s internal signals. These signals include hunger and fullness cues, as well as the physical processes that come with stress (rapid heart rate, shaky palms, etc.)
Mindful breathing and focusing on the tangible sensations of the moment when thinking about and eating food can help you learn when you are hungry, and when you are satisfied.
Note: Some individuals may find it too distressing to bring their full awareness to food in early recovery, and that’s okay. You may need to use a meal plan and other coping skills to get through meals for now.
Related: This is how meal plans and meal support works in eating disorder treatment.
Reduction in Negative Ruminations
Rumination is a distress response that involves constant, passive focus on the causes and consequences of that distressing situation.
People with eating disorders — especially individuals with bulimia or binge eating disorder — often ruminate on the causes and consequences of eating certain foods, eating in excess, and generally not following their eating disorders’ rules.
The overwhelming negative evaluation of one’s actions is so powerful that an individual will use eating disorder behaviors to make those repetitive negative thoughts go away.
For example, when someone suffering from bulimia binges, they quickly and automatically compensate through some form of purging. They do this to stop the constant thoughts of weight gain, of loss of self control, and of low self-worth.
By focusing on breathing, or on objects around the room, or on relaxing tensed muscles, an individual can slow down their repetitive thoughts.
Hopefully, they can slow down their thoughts for long enough that they don’t automatically go towards an eating disorder behavior. Inserting some time and space between you and distressing thoughts/situations gives you a better chance to let your logical mind take back control from the irrational eating disorder part of your brain.
Related: Here is how to tell the difference between your eating disorder voice and your own voice.
Improvement in Emotion Regulation
Eating disorder behaviors are used, in part, because of the inability to regulate distressing emotions. When feelings of sadness, fear, anxiety, and/or depression arise, sufferers of eating disorders often have difficulty sitting with their feelings — with tolerating them.
So, they use behaviors to avoid feeling those feelings.
Using mindfulness teaches you to sit with those feelings without going towards behaviors. It also shows you that whatever horrible things you think may happen if you don’t use eating disorder behaviors will not actually happen.
As you continue to expose yourself to hard situations, such as sitting with discomfort after eating or refraining from compulsive exercise, it will get easier to be in those situations.
Related: Here are coping skills and other self-care tools to use in eating disorder recovery.
Six mindfulness-based coping strategies to use on your own
Each of these mindfulness practices can be done at any time, for as long as you need.
They are designed to make you more aware of your surroundings and get unstuck from repetitive thoughts. They will also help delay automatic reactions until your logical mind can start making decisions again.
Mindfulness Walk (if you are allowed movement in treatment)
Remember: Mindfulness is something you practice, not a state you get to.
Unlike things like visualization and yoga, your goal is not to get somewhere other than where your body is right now. It is not to chase some ideal state that, if you were really good at mindfulness, you could just get to whenever you wanted.
Mindfulness, and the mindfulness meditation exercises listed above, are things that you have to practice. And as you practice, you will cultivate a greater sense of awareness in your everyday life, without having to practice as much.
If you or a loved one is suffering from an eating disorder, take the first step today and talk to someone about eating disorder recovery or simply learn more about the inclusive, mindfulness-based eating disorder treatment programs we offer.