The Voice of the Eating Disorder

 EDIT™ Worksheets | Love Your Self
Self-Image #1 | ED-IT Dialogue


Ugghhh! My thighs are so fat and disgusting…
I shouldn’t have eaten that, now I’ve got to get rid of it…
I’ve had this eating disorder my whole life, I’ll never get better…

Have you heard your clients make statements like these, or something similar? That’s the “Voice of the Eating Disorder” – or, ED. Explain this to your client, saying something like, “That’s ED talking right now. ED makes critical statements, like the ones you just said.” You can further explain to your client that ED can seem to dominate their mind, as if ED thoughts are the only thoughts they think. In early stages of recovery, the voice of ED can be very loud, chattering on and on with judgments and criticisms – but it’s often like background noise in your client’s mind, because they may not be aware of everything ED says. However, because these are the dominant messages in your client’s mind, the voice of ED can be very destructive to their physical, mental, emotional and spiritual wellbeing. These ED thoughts are what drive ED behaviors – as you re-read the three examples above, can you think of ED behaviors that might follow those thoughts?

Encourage your client by saying something like, “You are not ED!  You have another voice within you, which gently counters the voice of ED, and encourages you on a path of recovery.” This “recovery voice” is what you are modeling for them as their therapist, especially when you offer compassionate feedback or guidance to take that next small but healthy step. When you are speaking to your client in this way, you are likely accessing your own intuitive wisdom. In this sense, you are modeling the “Voice of the Intuitive Therapist” – or, IT.  Intuitive wisdom goes beyond the analysis and thought processes of the logical mind. And while intuitive wisdom is typically heartfelt, it goes beyond raw emotion. From a Dialectical Behavior Therapy (DBT) perspective, you can consider the Intuitive Therapist (IT) as the “Wise Mind.” Here are some words of wisdom that IT might say:

Wow! There are so many amazing things about you…
That was exactly what you wanted, and it’s OK to have eaten it…
Complete recovery is possible, by taking one small recovery step today…

In a session with your client, you might find yourself engaged in an ED-IT dialogue with your client. They reveal the critical messages which keep them stuck in their eating disorder behaviors, while you try to counter these messages with intuitive wisdom. Note that you’re not just saying the opposite of what your client says. For example, you would NOT want to have a dialogue like this:

ED’s critical thought: Ugghhh! My thighs are fat and disgusting.   
Opposite of ED: Your thighs are not fat, they are beautiful!
ED’s critical thought: You’re lying to me. Anyone can see how fat my things are.

What happens if you say the simple opposite of ED to your client? They don’t believe you. In part, this is why basic affirmations are not effective to shift the deep rooted inner critic. These “opposites” or what might seem like affirmations can actually make the client’s ED voice even stronger. Your client feels stuck. And you as their therapist feel stuck! Let’s look at another example. Refer to the ED-IT Dialogue worksheet:

ED’s critical thought: Ugghhh! My thighs are fat and disgusting.   
IT’s compassionate reply: Another possibility is that your thighs are strong.

ED’s argument: How can they be strong when they’re so fat and gross?
IT’s nonjudgmental observation: That’s interesting… so what does strong look like?

ED’s retort: Lean, toned, muscular legs!
IT’s curious query: What would happen if you noticed how strong your legs feel?

In this example, you as the therapist are guiding the client to shift away from how the body looks to how the body feels. This is one way to model intuitive wisdom for your client. Remember, as the Intuitive Therapist, you are guiding your client to go within themselves to access their “hidden” parts – from their mind and body, into their heart and soul. The above example guides clients to go into their bodies to feel sensation, and hopefully into their hearts to feel emotion as well. Going to a deeper level – the level of the soul – you might say something like this:

ED’s critical thought: Ugghhh! My thighs are fat and disgusting.   
IT’s compassionate reply: Another possibility is that your thighs have a beauty you can’t see with your body’s eyes.

ED’s argument: My eyes see just fine. And they see fat thighs!
IT’s nonjudgmental observation: That’s interesting… that’s what your body’s eyes see. But what do the eyes of your soul see?

ED’s retort: What do you mean, eyes of my soul?  
IT’s curious query: What would happen if you closed your eyes for a moment? I’ll guide you to see with your soul’s eyes… 

Now, you have your client’s interest – and trust – and you can guide them with a visualization to imagine what their soul’s eyes might see. Perhaps their soul doesn’t have any labels to describe thighs from a physical perspective. Perhaps their soul can sense the amazing experience of “having a body.” Perhaps their soul feels gratitude for their whole Self, exactly as it is in this moment, serving a spiritual purpose on the physical plane. Meet your client where they are – and gently guide your client to explore the deeper parts of themselves.

Complete this ED-IT Dialogue worksheet in a session with your client, filling in the text bubbles for the conversation. Suggest to your client that they refer to this worksheet as an example, so they can practice their own ED-IT dialogue. Encourage your client to write ED-IT dialogues in their journal, and consider using different color pens to represent the different voices of ED and IT. With practice, your client will be able to “talk back to ED” in a consistently compassionate way, using their own voice of IT to guide their next healthy steps of recovery!