An international study of over 9,500 people from 78 countries recently published findings that “suggest that public health initiatives should target people without social support and those whose finances worsen as a result of the lockdown. Interventions that promote psychological flexibility may mitigate the impact of the pandemic.” Are you wondering how to help your loved one suffering from an eating disorder or other mental health issues during the pandemic? Read on for how support persons can promote psychological flexibility with help from Acceptance and Commitment Therapy (ACT).
What is Psychological Flexibility?
Oftentimes, those who are available and want to offer support wonder how best to do so. As the study above suggests, interventions that promote psychological flexibility may be helpful. So what is psychological flexibility? As defined by Kashdan and Rottenber psychological flexibility “spans a wide range of human abilities to: recognize and adapt to various situational demands; shift mindsets or behavioral repertoires when these strategies compromise personal or social functioning; maintain balance among important life domains; and be aware, open, and committed to behaviors that are congruent with deeply held values.”
Steven Hayes and colleagues developed Acceptance and Commitment Therapy (ACT) almost 40 years ago and have been studying the processes by which people can increase psychological flexibility in over 400 randomized controlled trials. One of those core processes in ACT is a focus on who and what is important to you -- in other words, what you value in life. Another core process is committing to actions that take you towards what you value.
My Experience Using Acceptance and Commitment Therapy
In my clinical experience of using ACT in the treatment of eating disorders and other mental health issues, it always impresses me how much time people spend on the struggle of how to solve the problems in their life and how little time is spent on the things that truly matter. In my view, this imbalance is a call to action for support persons. If we can help loved ones focus on things they can do to move towards a life worth living, we will be promoting two researched, evidenced-based processes that can help increase psychological flexibility.
How do you put ACT into practice? Here are a few suggestions:
Before I wrap things up, I want to encourage those who are supporting loved ones to take a look at these same processes. My guess is that you value relationships and family, or you wouldn’t be reading this blog. I absolutely want to give you permission to spend time with who and what you value too, allowing you to promote your own psychological flexibility and mitigate the impact of this pandemic! It is with small steps that we can make lasting changes. A little shift can steer you towards a much different destination.
Social support can come in the form of family, friends, online support groups, therapy, and more. Please visit my resource page for some helpful links.
For more information, check out my website or reach out to me via my contact page. I offer free, 30-minute consultations to new clients.
¹Gloster AT, Lamnisos D, Lubenko J, Presti G, Squatrito V, Constantinou M, et al. (2020) Impact of COVID-19 pandemic on mental health: An international study. PLoS ONE 15(12): e0244809. https://doi.org/10.1371/journal. pone.0244809 Editor: Joel Msafiri F
²Todd B. Kashdan, Jonathan Rottenberg, Psychological flexibility as a fundamental aspect of health, Clinical Psychology Review, Volume 30, Issue 7, 2010, Pages 865-878, ISSN 0272-7358, https://doi.org/10.1016/j.cpr.2010.03.001.
Image credit: Layers
When most people think of interventions, they have an example in their minds from a television show, most often related to someone with a substance use disorder. Although interventions are used frequently to help convince persons with addictions to begin treatment, it is my belief (thanks to my experience tracking and staffing cases for a large eating disorder organization) that it is quite rare for people with eating disorders to have a formal intervention. This realization, then, begs the questions: Can an intervention be done for patients with eating disorders? And if so, why are they not used more frequently?
Below, I discuss some points to consider when answering these questions:
First, we must look at the difference in temperament and presentation of eating disorders versus substance use disorder.
Persons with eating disorders and their families do not have the same access to support groups as addictions.
Eating disorder treatment programs may require specialized admission procedures.
With mindfulness to the considerations above, I believe that persons struggling with eating disorders can benefit from intervention services. It is imperative for the family network to have support from others to help navigate the road to recovery while their loved one is in treatment and once they return home.
If you are interested in learning more about eating disorder interventions, please visit my website (EatingDisorderIntervention.com) and reach out to me via my contact page. I offer free, 30-minute consultations to new clients.
My Child is an Adult with an Eating Disorder, Addiction or Mental Health Challenge—Should I be Involved in Their Treatment?
Most parents of children who are now adults will tell you that parenting doesn’t magically stop at age 18. We are connected to our children and loved ones through our neurobiology throughout our lives. As the saying goes in Emotion Focused Family Therapy (EFFT), developed by Adele Lafrance and Joanne Dolhanty “once connected, always affected”.
It is completely normal for us to hold in one hand the desire to help our loved ones when they are struggling and in the other hand a desire to see them work through their problems and gain independence. However, when mental health challenges such as eating disorders, addictions and mood disorders start to affect areas of daily functioning, relationships, ability to engage in school or work and safety is at risk, the person affected needs help and support to get back on track. Parents and other caregivers such as partners, spouses, extended family and friends have the neurobiological power to be very effective healing agents of change, even more so than clinicians!
Plus, family involvement and support is endorsed by national organizations such as The Substance Abuse and Mental Health Services Administration (SAMHSA) and The National Alliance on Mental Illness (NAMI).
So why do we question our involvement?
As a parent who has been there and as a clinician who has seen it in action, I can say that in general we question ourselves because we have difficulty seeing how our efforts may be helpful. EFFT describes this as the experience of caregiver burden. The feeling of burden does not depend on how much time you spend on the situation or the resources you have committed to it, rather it is the sense that what you have to offer isn’t helping, the situation isn’t changing or the worry that you may make it worse. It can show up in all kinds of ways. For example, here are a few more common thoughts I’ve heard parents and caregivers express:
All these thoughts and more may be true. And, with EFFT as our guide, we also know that:
What can I do to be involved?
[i] Lafrance, A., Henderson, K. A., & Mayman, S. (2020). Emotion-focused family therapy: A transdiagnostic model for caregiver-focused interventions. American Psychological Association. https://doi.org/10.1037/0000166-000