Mindful Eating and Dialectical Abstinence in DBT for Eating Disorders

United States Department of Homeland Security

Mindful eating and mindfulness of the body are especially relevant for clients with eating disorders. It’s virtually impossible to mindfully eat and binge at the same time.
Mindfulness practices need to focus on physical states, such as degrees of hunger vs satiety, as well as all aspects of the eating process, including the food itself: taste, texture, smell, color, temperature, etc.
Clients with eating disorders need to move beyond an artificial dichotomization of food, in which all foods are conceptualized as either inherently good or inherently bad, into a more nuanced, balanced, and dialectical view, in which all food can be potentially healthy or unhealthy, depending on how we use it.
The purpose of dialectical abstinence is to counter the abstinence violation effect, in which people tend to give up following a relapse, as opposed to recommitting to abstinence.
The SLIP acronym encapsulates the essence of dialectical abstinence: skills learning in progress. The concept of dialectical abstinence has 2 main goals:
- Prioritize and plan for complete abstinence from bingeing and purging behaviors.
- Prioritize and plan for a return to abstinence in the event of a relapse.