Opposite Action in Eating Disorder Recovery: How to Make Recovery-Focused Decisions Now

Written by CCTC Staff Writer

All of us have bad habits. You may stay up too late scrolling through social media, despite knowing you’ll regret it in the morning. Maybe you procrastinate, even when you know you’ll panic trying to finish your work at the last minute. While these bad habits aren’t extremely destructive, they — like very destructive eating disorder behaviors — are a maladaptive response to emotions. In all these cases, opposite action, a simple but powerful DBT skill, could make the difference between doing something positive for yourself, and doing something that feels good in the moment, but is ultimately harmful.

If you routinely use destructive eating disorder behaviors, even though you know they’re not serving you in the long run, this post is for you.

You’ll learn:

What dialectical behavioral therapy (DBT) is and how it applies to eating disorder treatment
What opposite action is, and how it works
How to start using it to further your eating disorder recovery

This skill is simple to use, extremely helpful for your recovery, and — admittedly — it takes a lot of practice. And it’s definitely worth it.

What is DBT and how is it used in eating disorder treatment?

Dialectical behavioral therapy (DBT) is a variation of cognitive behavioral therapy that focuses on becoming more aware of negative emotions and reacting to them in less destructive ways. The “dialectical” part comes from the idea that both acceptance of your experiences and working on change in therapy is the best way to change your behaviors.

DBT in eating disorder treatment involves identifying your emotions when you feel the urge to use eating disorder behaviors, deciding whether your emotions “fit the situation” or are an extreme reaction to something, and finding better ways to manage intense emotions.

What is opposite action in DBT?

Opposite action is a pretty straightforward DBT skill that anyone can use.

When you feel the urge to do something that you know is driven by emotion and won’t benefit you in the long run, you do the opposite of what your emotions are telling you to.

There’s another way to look at it, too.

Whatever your eating disorder voice is telling you to do, acknowledge it, and then do the opposite of what it’s telling you to.

Why does opposite action work?

The skill is based on the idea that most times, emotions do serve a purpose. If you’re staring at a lion that may attack, your mind and body produce a fear response to tell you that you’re in danger. You feel thirst, which tells you that you need to hydrate. Fatigue arises to let you know that you need to rest.

But at other times, your emotional response to a situation might not be an appropriate one. It is often an extreme reaction, which may cause a negative behavioral reaction.

For example, if you’re having a really bad body image day, then seeing yourself in a mirror can cause extreme feelings of sadness, anxiety and distress. Your eating disorder voice may be screaming at you to restrict your intake for the rest of the day.

These feelings don’t quite “match the situation.” Seeing your reflection doesn’t put you in danger, so feeling anxiety is an extreme emotional response.

In this situation, you would recognize that the emotional response is extreme, and that doing what your eating disorder tells you to right now might help you alleviate those emotions, but it won’t help you in the long run.

And then, you would do the opposite of what your eating disorder tells you to — you would eat normally throughout the day.

How to Use Opposite Action in Eating Disorder Recovery

In theory, opposite action is a simple and straightforward DBT skill: just do the opposite of what your eating disorder tells you to. Do what will help your recovery, rather than committing to actions that will set you back.

In reality, using opposite action is hard, because you have to:

Cultivate mindfulness skills (which is another skill in DBT)
Slow down during periods of distress
Stop using eating disorder behaviors to cope with strong emotions
Find a way to deal with those emotions
Believe that over time, doing opposite action will get easier
Choose to actively pursue the recovery-oriented option every single time.

It’s also critical that you do the opposite action over and over again, so that your emotional response to a situation is no longer intense.

Here’s how to start using opposite action in distressing situations, ones that have the potential to trigger an eating disorder behavior.

Note: Most times, patients work with a therapist to analyze a potentially triggering situation before they actually find themselves in one. This way, you don’t have to figure out how to use opposite action while you’re in distress. You can just start the process.

1. Use mindfulness skills to identify your feelings.

In this situation, mindfulness skills involve slowing down and asking yourself what you’re feeling during a distressing situation.

For example, say that you go to a family dinner and someone comments on your body (which no one should ever do.) You may have a severe emotional response, one that will ultimately cause urges to use harmful behaviors.

Before acting, slow down and ask yourself what you’re really feeling in the moment. If you’re not sure how to identify your feelings in eating disorder recovery, this post and the resources included in it will really help.

2. Identify the urges that come along with those emotions.

In the family dinner example, you identify feelings of shame, disgust, self-loathing, anger, and anxiety.

In response, you feel the urge to restrict your dinner and go exercise in secret.

3. Determine whether the action urge fits the situation (not your emotions.)

Considering that your emotional response to a situation may not be a reasonable one, consider the facts of the situation. Then consider whether the action response to that situation makes sense.

In the family dinner example, does it make sense to avoid nourishing your body because of something an insensitive person said? Would someone without an eating disorder do this?

The answer is no. So, the action urge doesn’t fit the situation. It’s not helpful, then, to follow through on those action urges.

4. If the feelings and the action urges do not fit the situation, then tap into your inner strength and do the opposite action.

In our example, the opposite action would be to not restrict your dinner and exercise in secret. You would sit down and eat, then do another activity after dinner to avoid acting on exercise urges. You might need to eat mechanically, using distractions, to cope with the emotional distress of doing the opposite action — that’s a completely acceptable response to your emotions.

Continue doing the opposite action until you notice a decrease in the intensity of your emotional response. This could mean using distractions until you are capable of being present in the moment again, or taking a step away from a triggering situation.

It could also mean using radical acceptance (another DBT skill) to embrace the fact that you are doing something extremely uncomfortable by defying your eating disorder, and you know that opposite action is worth it in the long run.

Remember: Opposite action in eating disorder recovery is hard. And it is also worth it.

It will also get easier over time, just like everything will in recovery.

If you or a loved one is suffering from an eating disorder, take the first step today and talk to someone about recovery or simply learn more about the holistic, flexible eating disorder recovery programs we offer.

Ai PonoDecember 7, 2021