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Clinical Director Zanita Zody, PhD and the Clementine Portland team help clients to empower the voice of their healthy self in order to challenge the eating disorder self voice. In her blog post, Dr. Zody gives insight into how to strengthen the healthy self voice and support client’s journey to full recovery.

Anyone who is intimately familiar with an eating disorder knows how damaging and destructive that voice can be. “You are disgusting,” “I can’t believe you ate that,” “If you don’t exercise every day you will get soft and gross.” This voice taunts and torments in a way that no one should have to endure. For those of you who have held on to hope and seen it first hand, you have also heard the voice of the healthy self; reminding you that there is more to life than the eating disorder. “I know how hard it is to nourish your body but it is worth it,” “your value is not determined by the size of your jeans,” “your friends like you for who you are, not how you look.” Differentiating between these two voices and empowering the healthy self (HS) can be an important part of recovery.

It is widely accepted that Cognitive Behavior Therapy (CBT) is one of the treatments of choice for eating disorders. CBT challenges distorted and irrational thoughts that lead to maladaptive behavior. Reiff and Reiff (1998) found that individuals with a DSM-defined eating disorder think about food and weight between 70% and 110% of the day (dream time accounting for the additional 10%). The voice of the HS can be used to challenge those ED thoughts and behaviors. Initially, this voice may be difficult to identify so it can be helpful for the therapist to point it out. From there, the individual can start journaling dialogues between the HS and ED or engaging in them internally. However it is done, the HS should have the last word.

Fear and uncertainty often accompanies the reduction of eating disorder thoughts and behaviors and in their absence emptiness is often felt. Returning to the eating disorder or other self-destructive behaviors may fill this void. On the other hand, if the healthy self is simultaneously nurtured and strengthened, there will be no room left for the eating disorder. It is also important to honor and respect the eating disorder as it is part of the individual and has served an important function in his or her life. Discovering what that is and allowing the healthy self to take over those responsibilities in adaptive and supportive ways can help lead to lasting recovery.

Reiff, D. and Reiff, KKL, “Time Spent Thinking About Food.” Healthy Weight Journal 12(6) (November/December 1998): 84.

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