When you don’t know what to do and are pulled to act in a way that may not be effective, sometimes doing the opposite is just the right choice. In fact, this is the motto that I teach to my clients in eating disorder recovery. For the past 30 years, I have worked with numerous individuals, in all levels of care, who are working towards recovery. I am here to tell you that full recovery is possible: the work to achieve full recovery is hard, painful, onerous AND well worth all the effort. And it involves A LOT of opposite action.
Changing unhealthy behaviors can be scary and overwhelming. For individuals with an eating disorder, they often hear, “just eat” or “just stop eating” or “ stay out of the bathroom,” etc. Although these suggestions may be well-intended, they miss the mark in understanding the complexity of eating disordered behavior, which involves shifting ones relationship with food and changing how one uses food to avoid painful emotions. Who wants to feel painful emotions? Doesn’t sound like fun, right? Yet without the tolerance of painful emotions, the experience of positive emotions is limited, if not impossible.
In the early stages of recovery, the eating disorder voice is quite loud, making it difficult to trust oneself. In these instances, I encourage people to do the opposite of what they would typically be inclined to do (as long as this does not involve any self harm behavior). In DBT, this skill is called Opposite Action.
If, for example, a client normally skips a meal, the opposite action is to eat even though nothing about that feels comfortable.
We use opposite action when our emotions do not fit the facts, or when acting on our emotions is ineffective. A lot of people tell me that their eating disorder is a “habit.” I challenge this belief by explaining that the eating disorder is not a habit, but rather a coping mechanism that has been well learned to avoid painful emotions. Experiencing the feelings without engaging in target behaviors is the goal of treatment and ultimately recovery. By using the opposite action skill, you are making the choice to fight the urge to act out on your eating disorder, and instead, you are learning to regulate uncomfortable emotions. Although intuitively we may want to avoid things that are painful, it is only once we are able to avoid avoiding painful emotions that mindful awareness is cultivated and behavior change can ultimately take place.
Navigating painful emotions needs to be done carefully and sensitively. It is therefore recommended that the underlying issues maintaining the eating disorder are dealt with therapeutically, with the support of trained professionals. Using the Opposite Action skill is one way to support eating disordered individuals in taking the next step toward reaching their ultimate goal of full recovery.