Managing our Emotions: An ED Therapist's Perspective

By: Trixie Hennessey

What do I mean when I say “managing our emotions”, and what is the link between our emotions and the onset and maintenance of eating disorders? These days it is almost universally understood that our ability to manage or regulate our emotions contributes very positively to our mental health. Individuals who are less able to manage their emotions (particularly difficult emotions related to feelings of shame, anger, and fear) often find themselves at increased risk for a number of mental health disorders, ranging from anxiety and depression to eating disorders.

From a therapeutic perspective there is evidence that eating disordered behaviours momentarily soothe uncomfortable emotions and feelings of distress, while paradoxically leading to intense physical and emotional suffering in the long term. As a consequence, the use of eating disordered behaviours to avoid or escape particularly painful emotions and intense feelings such as shame, anger, fear, and judgment can be powerfully reinforcing in the moment. And when such behaviours are very reinforcing, we can expect to see an increase of similar behaviours in the future.

Characteristically, individuals who are struggling with eating disorders have more difficulty making sense of and managing their emotional states, and their physical symptoms (lack of nutrition, fatigue, poor sleep habits) heighten their emotional vulnerability further and impair their capacity to manage whatever difficult emotions they are experiencing. The unfortunate result is that supportive family members and friends are less able to connect with their emotional experiences in ways that feel empathic or supportive to them. As a result, ED sufferers are left feeling even more misunderstood, invalidated, and disconnected from those around them; in many cases sufferers may begin avoiding certain social situations altogether. This negative feedback loop creates even stronger and less manageable negative emotions, and further increases that individual’s vulnerability to invalidating experiences in the future. Ultimately, those difficult feelings that began as momentary states can begin to be perceived in the mind of sufferers as permanent traits that define their sense of identity and their relationships to others.

From the earliest moments of life, our empathic connection to supportive family members and friends helps to calm the storm of difficult feelings and emotions that we experience from time to time. We are social beings and our need for empathy and connection to others can feel as important as the air we breathe. We communicate with others through our emotions, and our ability to shift emotions based on the social context allows us to connect meaningfully with others. Our emotions tell us what is important or meaningful, and help us cope with change.

It is for these reasons that treatments such as DBT (dialectical-behavioural therapy) focus on supporting individuals to better regulate their emotional states and to tolerate intense emotions through the use of more healthy and adaptive strategies. Treatments such as Emotion Focused Therapy and mindfulness-based approaches also support individuals to more clearly identify and label their emotions, integrate them in their personal narratives, and express them in appropriate ways. By encouraging individuals to adopt a curiously compassionate stance and the non-judgmental acceptance of emotions as neither good nor bad, they can begin to shift from emotional avoidance to acceptance of all emotions as valid. In time they come to recognize that emotions are often fleeting, and they can give themselves permission to experience previously uncomfortable emotions such as anger or shame without becoming emotionally dysregulated. This capacity to adapt our emotional state in response to change and stress in our environment is a core feature of resilience.

As therapists we support those with eating disorders to build up those internal resources that foster a sense of competence and empowerment so that sufferers become less reliant on maladaptive ED behaviours as a means to self-soothe. In essence, individuals become better able to “feel and deal “and are more successful at matching their emotional expression to the changing stresses and demands of daily living.

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Trixie holds a Masters of Social Work degree from the University of British Columbia- Okanagan, where she also completed post-Masters training in Neurosequential Therapy. Trixie has been part of the team at the Looking Glass Foundation since 2011. She is also a Therapeutic Consultant at Optimal Family Wellness. She lives in Vancouver, BC and loves hiking, photography, and being mom to her two children.