Acceptance and Commitment Therapy for Eating Disorders by Emily Sandoz

Author:Emily Sandoz [Emily K. Sandoz, Kelly G. Wilson, and Troy DuFrene]
Language: eng
Format: epub
Tags: Eating Disorder, mindfulness in therapy
ISBN: 9781608822348
Publisher: New Harbinger Publications

9. Training Valued Living

Often the struggle with disordered eating has taken the focus off of the aspects of life the client values. Time, energy, and other resources are spent on maintaining disordered eating while life continues with little or no chosen direction. Hopes and dreams are tucked away as intentions for later, “after all this gets sorted out,” for “when I’ve got my weight under control.” And life continues, and the individual feels farther and farther from the things she cares about. ACT focuses on building valued living in the present, without the world or the individual having to change.

Tracking Valued Living

Valued living involves living in such as way so as to facilitate active engagement with the ways an individual chooses to work and live. Individuals struggling with disordered eating and related disturbances often have difficulty reporting what they value. Some may find it difficult to even imagine pursuing anything that really matters to them while in the midst of their struggles with eating and body image. Others may report valuing what they perceive as socially acceptable, and deny any difficulty living consistently with these values. Still others may deny valuing anything other than being able to maintain a particular body weight.

Deficits in valued living may also be apparent in session. In order to determine what these struggles look like for a particular client, ACT clinicians intentionally create contexts in which contact with values is expected to be more or less likely, and observe subsequent shifts in behavior. Clients may discuss important life decisions based entirely on practical necessity rather than a sense of free choice. For example, they may identify placating doctors or family members as their purpose for treatment. Clients may seem engaged and motivated only when things are going well, and seem lost when they are confronted with obstacles or setbacks. When clients identify values, they may be held defensively and rigidly. For example, a client may express the value of being a parent as her reason for treatment, but hold this as a burden rather than a choice. She may engage in discussions of these values with hesitation and excessive judging, justifying, explaining, or apologizing.

Presenting Opportunities for Valued Living

Individuals struggling with disordered eating often benefit from learning to contact chosen values. Valued living is difficult because of the inherent relationship between values and vulnerabilities. In contacting her values, an individual must also contact the distance she is from living them. Values work in ACT involves presenting opportunities for an individual to shift from a life dominated by aversive control to a life guided by chosen values.

Early Values Work

Early values work involves introducing conditions under which an individual’s behavior is not dominated by aversive control. Often, at this stage, the only moments not dominated by aversive control are moments of relief. The clinician is challenged to facilitate contact with this experience, but only with the client’s permission. Values work at this stage does not involve values clarification or an acknowledgement of values deficits. Rather, the clinician is aiming to create a context in which later values work might occur.

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