Radical Acceptance

In Dialectical Behavior Therapy (DBT), "Radical Acceptance" is an important component.  DBT is a type of cognitive behavioral therapy that tries to identify and change negative thinking patterns and pushes for positive changes. 

The four major skills DBT tries to teach are:

• Interpersonal effectiveness
• Distress tolerance / reality acceptance skills
• Emotion regulation
• Mindfulness skills

I found this blog on the National Eating Disorders Association website. I'm sharing the parts that really hit home with me (full blog can be accessed by clicking on the title): 

Dialectical Behavior Therapy in the Treatment of Binge Eating Disorder

How many of us who struggle with binge eating and/or weight management have been given the guidance to simply eat less and exercise more? 

A diet and exercise plan alone will not suffice for someone who binge eats. 

In adapting traditional DBT to target binge eating, it also includes developing an individualized food plan that will support their goals.

I have found the most effective way to treat binge eating behavior is a concept straight from DBT—it's called dialectical abstinence, and it really gets to the heart of the bind inherent in binge eating treatment. One of the core concepts of DBT is finding a dialectical “middle path,” or a synthesis, between two opposing ideas. For people with BED, the two great opposing ideas in dialectical abstinence are 1) You need to be fully adherent and comply with your food plan that includes abstinence from certain triggering foods AND 2) Doing just that perfectly is a complete and utter impossibility. What a pickle! 

On the one hand, in order to make long-term solutions, you need to follow an individualized food plan, and work your program like a boss, with a serious level of precision. But, if it were as easy as “go follow a food plan perfectly,” then no one would be in any sort of food struggle predicament. The problem here is that with those who binge eat, the alternative to being on plan is historically getting off the road completely. Or, as we formally call it in DBT, the abstinence violation effect: if you have a longstanding struggle with a food plan, it's easy to fall off track in major ways. And, you don't usually return to any level of a healthy program until cued by health concerns or shame. 

The opposing idea to food plan compliance is that food plan imperfection (having slips) is inevitable. And, if you allow yourself to ONLY hang out in that headspace, slipping becomes the norm, and treatment is not effective. Four of the most dangerous words that I hear from clients are "It's No Big Deal" in reference to a slip from the food plan. The fact is, if you don't pay attention to slips, they become relapses, and our slips become slides. The problem here is that you don’t see any long-term or sustainable change. 

Dialectical abstinence says that lapses are going to happen AND you can't plan for them. Dialectical abstinence says that we strive for recovery/adherence all day every day—and calls for acceptance that lapses are an inevitable part of the journey. 

In DBT for BED, distress tolerance skills are used to help clients get through a hard moment (including a food craving or lapse) without making the situation worse by engaging in a harmful eating coping behavior. Finally, mindfulness skills are introduced to increase awareness and combat the out-of-body-and-mind experience...(of a binge)