Treatment and Values in ED

Values and Aspirations Clarification

Cognitive treatment seeks to expand the patient's identity beyond the number on the scale.

It works on the identification of vital values that have been neglected because of the obsession with weight, such as family relationships, intellectual development, art or professional career.

The therapist helps the patient see how the eating disorder is sabotaging these other important values.

The key question is, "How is malnutrition and isolation helping you to be the creative/friendly/successful person you want to be?"

The goal is to create dissonance between anorexic behavior and long-term life goals.

Exposure and Response Prevention.

Exposure techniques are used to reduce fear of bodily sensations and food.

A typical intervention is to expose the patient to the sensation of "feeling full" without allowing the patient to engage in compensatory behaviors (such as exercising or restricting the next meal).

The patient is taught that the feeling of fullness is temporary and does not equate to immediate weight gain.

The patient can also be exposed to wearing tight clothing or looking in the mirror without performing obsessive "checks", learning to tolerate the anxiety this causes until it diminishes by habituation.

Cost-Benefit Analysis of Restriction

To motivate change, the analysis of advantages and disadvantages is used. The perceived "benefits" of anorexia (sense of control, security, avoidance of maturity) are explored against the actual costs (chronic fatigue, social isolation, hair loss, constant cold, mental obsession).

By putting on paper that the disadvantages of maintaining the disorder massively outweigh the illusory advantages, resistance to change is weakened.

The idea that thinness brings happiness is confronted, evidencing that in rea