Can compassion-focused therapy (CFT) help treat eating disorders?
*DISCLAIMER: I am not a therapist, psychologist, or medical professional. The words below are based on my own research and my own personal experience. Please do not take the information below as clinical advice. If you feel you need support, please click here.
Cognitive behavioral therapy (CBT) has been an effective method of therapy for all kinds of mental health ailments for decades. But what if there were an alternative method to try for eating disorder recovery, one that focuses more on compassion for the self?
A recent article from the Journal of Eating Disorders has brought a new (to me) treatment modality to light. Compassion-focused therapy (CFT) emphasizes “a compassionate self-approach…focusing more on body image acceptance and potentially breaking the shame-cycle caused by stigma.”
Naturally, I’m curious. I was a terrible teammate to myself during the majority of the years spent under the control of my eating disorder. As much as I tried flipping the negative narrative through self-talk and sessions with treatment providers, practicing compassion toward myself on a regular basis wasn’t always a priority.
In this post, I want to explore:
what is compassion-focused therapy (CFT)?
how can CFT improve eating disorder recovery outcomes?
what does a modality like CFT mean for the greater mental health community?
Let’s dive in.
What is compassion-focused therapy (CFT)?
In its most straightforward definition, compassion-focused therapy (CFT) focuses on helping the individual develop compassion for themselves. This may look like addressing feelings of shame and negative body image, and teaching patients how to practice body acceptance.
Because many cases of eating disorders are rooted in self-criticism and poor body image, learning how to be compassionate toward yourself by replacing self-critical thoughts with compassion-led reframes can be the first step in taking back power.
By reducing the layers of judgment we apply to ourselves, whether mental, physical, or both, we can start shedding the harmful effects and stigma surrounding body dissatisfaction. If we practice self-compassion effectively enough, researchers suggest that we may be more likely to address (and lessen the severity/frequency of) disordered eating behaviors.
How does CFT work?
The Journal of Eating Disorders reviewed eight studies with a total of 651 participants and found that integrating CFT with other methods of eating disorders treatment helped reduce body image dissatisfaction. Among adult women with binge eating disorder, CFT was also shown to help reduce symptoms (i.e., behaviors).
According to JED, CFT works on three psychological systems:
The threat system, which relates to self-criticism and body surveillance.
The drive system, which involves the pursuit of societal approval, like meeting standards of beauty.
The soothing system, which allows the individual to practice self-kindness and emotional regulation.
CFT aims to balance these three systems to help “reduce eating pathology and foster body acceptance.”
How is CFT different from CBT?
CFT can be a promising alternative to cognitive behavioral therapy (CBT). These two psychological approaches to therapy have many similarities, but they also have distinct approaches, theoretical foundations, and therapeutic goals.
Therapeutic focus
While CBT focuses on identifying and working to change distorted thoughts and behaviors that contribute to disordered behaviors, CFT emphasizes not just symptom reduction, but also emotional regulation, body acceptance, and a supportive internal dialogue.
CBT leans more into the content of the thought and works to replace negative thoughts. On the other hand, CFT targets underlying emotional and psychological processes, like feelings of shame, self-criticism, and self-image.
The specific psychological techniques used for these two therapies can include the following:
CBT
Cognitive restructuring
Exposure and preventing disordered responses
Challenging distorted beliefs about food, weight
CFT
Compassionate imagery, self-talk, and mind training
Developing kindness toward the self
Learning how to soothe the inner critic and regulate emotions
Targeted psychological systems
In CBT, the treatment concentrates on the relationship between thoughts, feelings, and behaviors in a linear direction. CFT, however, works with three interconnected systems, as mentioned above.
CFT might not always follow the linear fashion found in CBT. The goal, instead, is to restore balance among these systems.
Applications in eating disorders
Historically, CBT has been considered the gold standard for eating disorders treatment, but JED notes that only half of patients with eating disorders have reported CBT as effective in their eating disorder recovery. The limitation lies in its inability to reduce persistent body image dissatisfaction and shame.
CFT, however, shows promise in its approach to reducing body image dissatisfaction and the impact of stigma. The research cites that it may be particularly helpful for people with binge eating disorder and bulimia nervosa.
Is CFT effective for eating disorder recovery?
Based on preliminary (and limited) research on CFT, researchers have seen promise in CFT as an effective component of eating disorder treatment, especially for specific disorders. However, there are some limitations to CFT and JED’s study:
Lack of diversity. Currently, the research from JED represents a small, homogeneous sample (young adult women). More diverse populations need to be studied to determine CFT’s effectiveness on a broader scale.
Group settings only. The researchers reviewed studies that only investigated CFT’s effects on eating disorders in small groups. The conclusion called for further research into the therapeutic approach in a one-to-one environment.
Only two eating disorders were included. Before a blanket statement can be made about CFT’s effectiveness for eating disorder recovery, research needs to include eating disorders beyond BED and BN, including anorexia nervosa and its subtypes.
Is CFT right for you?
CFT is still a relatively new treatment modality, one in which some treatment providers may be less practiced. If you think CFT might be a helpful approach to your eating disorder treatment, talk to a therapist (one who specializes in eating disorders).
Pause & Prompt
Make a list of fears you have about recovery.
What scares you the most and why?
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