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Cognitive Behavioral Therapy, or “CBT,” is largely considered the most effective and widely recognized therapy approach for addressing many mental health disorders. While it is not considered appropriate for all mental health challenges or all patients, it is considered an evidence-based, effective choice that is very useful for patients that are struggling with most psychological challenges.

It is one of the most common approaches for those with eating disorders, especially for addressing very specific components of eating disorders that many people experience. CBT is often utilized by therapists to address what are known as “cognitive distortions,” a common issue that affects many – if not most – of the people struggling with disordered eating.

What Are Cognitive Distortions?

Cognitive distortions are the term used to describe irrational or exaggerated thought patterns that affect many patients with anorexia, bulimia, and other forms of disordered eating. Examples of these may vary between patients, but include:

  • All-or-Nothing Thinking – Viewing situations in only two categories instead of on a continuum – for example, you are either 100% perfect or a total failure.
  • Catastrophizing – Anticipating the worst possible outcome in a situation, such as extreme weight gain from a single meal.
  • Emotional Reasoning – Believing something is true because it feels true, like feeling fat, therefore believing one is overweight.
  • Body Image Distortion – A significantly distorted perception of one’s body, leading to an unrealistic view of body size and shape.

Cognitive distortions both create and contribute to disordered eating, which is why part of treating eating disorders often requires addressing these distortions

Brief Introduction to CBT and How it is Related to Cognitive Distortions

We encourage you to read more about cognitive behavioral therapy on our CBT page, which goes into more depth on the topic and also discusses our CBT services. But the core features of CBT are that it is a therapy approach that addresses thoughts, feelings, and behaviors.

Through CBT, the goal will be to identify the distorted thoughts, challenge them, and ultimately change them. Together, we also learn more about these distortions and teach patients more about how eating disorders are developed and maintained by them. This is known as psychoeducation, because sometimes, the mind needs to know something in order to change it.

What CBT Techniques Are Used to Address Cognitive Distortions?

Perhaps unsurprisingly, cognitive distortions are not addressed in any one specific way. Instead, you and your therapist work together to determine what approach(es) make the most sense, even within CBT. We may decide to use strategies that include:

  • Cognitive Restructuring – Identifying and challenging distorted thoughts about food, weight, and body image, and replacing them with more balanced and realistic thoughts.
  • Exposure and Response Prevention (ERP) – Involves gradual exposure to feared foods or situations (like eating in public) and learning to refrain from typical disordered responses (like purging).
  • Behavioral Experiments – Patients test their beliefs in real-life situations to see if their predictions (like significant weight gain after eating certain foods) come true.
  • Mindfulness and Acceptance Strategies – Involves teaching patients to observe their thoughts and feelings related to food and body image without judgment, reducing the emotional impact.

We may also want to address body image distortions with CBT. We can use techniques like mirror exposure therapy to help patients confront and become desensitized to body image fears, or we may integrate exercises and activities that promote a more positive body image.

CBT as an Individual or Combination Treatment

At Flourish Psychology, we truly believe in CBT. But we also believe that it is not appropriate for everyone. Some people may benefit by including CBT with other treatments. Sometimes, we may need to explore other therapies that address underlying trauma. CBT is an effective tool for cognitive distortions, but it is not the only one.

Still, CBT has an excellent success rate, both on its own and as part of a broader treatment strategy. If you’d like to learn more about CBT, or you or a loved one is struggling with eating disorders and would like to seek help, contact Flourish Psychology, today.

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