ACT for Binge Eating: Values and Pain Exercises


Private Practice, Santa Barbara

Key Points

  1. Living in line with our values makes us more vulnerable and doesn’t protect us from pain.
  2. Choice points are moments throughout the day when a person decides to turn toward or away from their values.
  3. Values are not domains. They become actions that fall under such domains as health, family, and education.
Earn 1.25 CE Credits

Values Exercise: The Notecard

When working on values with clients, it’s important for them to identify how their pain and values are actually two sides of the same coin. You can get them to use a note card, and write down on one side something that’s really painful about what they’re experiencing.

This client wrote things like, I have a lot of pain around the shame I feel with binge eating. I have pain in my relationship with my brother as I’m always comparing myself to him. I have pain because I don’t enjoy my mom’s cooking anymore, as I’m always trying to control food.

Written on the other side of the card is what the pain says about what they care about. The examples say so much about what he cares about. It’s painful to not enjoy his mom’s food because he cares about that connection to his family, his mom, and his culture, which he’s lost as he’s been in such a struggle with his eating. He really cares about his relationship with his brother, and this comparison issue is getting in the way of that connection.

This exercise uncovered that he cared about helping people, but got so caught up in getting into medical school that he lost track of why he wanted to go in the first place. It was because he’s a very empathic, compassionate, kind person who deeply wanted to help other people.

Two Sides of the Same Card

When we examine values through this exercise, we can see that getting rid of painful things might also get rid of the things you care about. They’re two sides of the same card. Sometimes you might say, okay, let’s take away all that pain even if I’m going to lose all those values too. But the reality is, we don’t want to give away our values, we want to hold onto them. In order to do that, we have to relate to the pain a bit differently.

So living a life that’s in line with your values may make you more vulnerable, and doesn’t protect you from pain. This is a very real and important concept in ACT.

We can ask clients, are you willing to have the discomfort because it’s in the service of something that matters to you? When you can connect with that value, then you have the motivation to move toward discomfort because they often exist in the same direction.

Choice Points

We often talk about choice points in ACT, which are those moments throughout the day when we encounter the choice of either turning toward or away from our values. The good news about choice points is that, even if you choose to turn away from your values, there’ll be another choice point about 10 minutes later.

So you can always get back on track with ACT. There’s never a sense of, oh no, we went down the wrong path and we’re done for. It’s more like, I noticed I was out of alignment, I chose something not in line with my values, but I’ll have another opportunity to return to them.

Values and Domains

Getting clear that values are different from domains is another important aspect of ACT. When you start having conversations with clients about values, they’ll say things like, I value my health, my family, my career, my education. But those are domains under which values lie.

If you value your health, and I watched you throughout the day acting in line with taking care of your health, what would I see you doing? This is the sort of question to ask a client.

If you value your family, how would I see you act when you’re with your family tonight at dinner? Would you be in your head about what you’re eating, or would you engage in conversation? Would you be caught up in comparisons with your brother, or able to celebrate his successes and see that those aren’t actually a zero sum game?

Being Present and Values

The “first” two processes in ACT have been outlined, and these are often good ones to start with. But again, it’s not a protocol. It all depends on the needs of any particular client.

Being Present helps the client to identify when they’re caught in the future or the past, and helps them to be present in the here and now. With something like binge eating, it’s also being present in their bodies, paying attention to hunger, fullness, and eating experiences.

Values is about the client identifying, through questioning and deep conversations, what it means for them to have a meaningful and fulfilling life; looking at how their pain is connected to their values; helping them identify choice points throughout their day; knowing how to get back into alignment with their values; and focusing on the journey, not just the end point.

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ACT for Binge Eating: Values and Pain Exercises

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