Body Image & ACT: Q&A with Author and Psychologist Emily Sandoz, PhD


The collective response to negative body image often includes an attempt to convince people to love their bodies, to embrace every imperfection and to do away with all negative thoughts.  These can be difficult, if not impossible, tasks for most people, particularly amidst the backdrop of a culture that encourages body bashing and a very narrow ideal of “beauty”.  For many individuals, negative thoughts about their bodies are so deeply entrenched that it feels too big of a leap to move from hating their bodies to falling madly in love with them. So if you’re not ready to love your body, what’s left to do?  Emily Sandoz, PhD, along with co-author Troy DuFrene, propose a different path in their new book, Living With Your Body & Other Things You Hate: How to Let Go of Your Struggle with Body Image Using Acceptance & Commitment Therapy. 

In anticipation of our upcoming Fall Community Event, we conversed remotely with Dr. Sandoz to find out more about her work with body image, Acceptance & Commitment Therapy (ACT), and of course, the soon-to-be-released book.  Read on to learn more about ACT and don’t forget to RSVP for Dr. Sandoz’s free presentation in Baltimore on November 17th, 2013, or download the event invitation (pdf).

 

Q & A with Emily Sandoz, PhD

Q: What was your  motivation for writing Living With Your Body & Other Things You Hate: How to Let Go of Your Struggle with Body Image Using Acceptance & Commitment Therapy (due out Jan. 2013)?

ES: Well, a couple of things. First, I find myself more and more aware of how body conscious we are.  At a very early age, people begin evaluating themselves in terms of their body’s appearance or functioning. For many, this can become a primary means of self-evaluation, becoming more of a focus than other things that person really values or strives for.  Further, I think the general public receives mixed messages about what they are supposed to do with those evaluations.  Are they wrong evaluations? Should they always evaluate themselves positively, always love the body? Should they change their bodies? Is it our responsibility to look good, to be strong and physically capable?  This book suggests that all that struggle to manage our thoughts and feelings about our bodies, or even manage our bodies themselves, can just lead to more and more struggle. We suggest that healthy body image is about body image flexibility – being able to receive our experiences of our bodies, good and bad, and to relate to ourselves and the world meaningfully, regardless of those body experiences.

Q: Many people engage in deep and serious battles with body image on a daily basis.   What are the possible repercussions of going through life hating your body? 

ES:It stands in the way of other things that are more important. You can’t help being critical of the way your body is.  That’s what minds do – they are critical.  They have to be!  But hating is getting entrenched in those self-criticisms.  Letting them drive your behavior, so you end up living your life more about managing your self-criticisms than about your relationships, or your career, or your spirituality – whatever is most important to you.

Q: What are the main tenets of Acceptance & Commitment Therapy?

ES: ACT (said as the word “act”) is based on the idea that healthy living is characterized by psychological flexibility, or the ability to experience ourselves, others, and the world fully and without defense, while taking action toward the things we care about, even when it is painful or scary. Not having this psychological flexibility is actually a driving factor in creating psychological stress and problems such as depression, anxiety and eating disorders.  It’s not our experiences (our thoughts or feelings) that are problematic, it’s all the things we do to try to get rid of them.  Those things interfere with the life worth living.

[Psychological flexibility spans a wide range of human abilities to: recognize and adapt to various situations; shift mindsets or behavior to preserve personal or social functioning; maintain balance among important life domains; and commit to behaviors that are congruent with our values. source: Kashdan & Rottenberg, 2009]

Q: What does the research say about the effectiveness of ACT for body image and eating disorders?

ES: This is a relatively new area, to be sure, but preliminary data coming from a number of different labs are largely supportive of the application of ACT to body image and eating disorders.  My own work in this area has recently moved to basic research, focusing on the nature of body image inflexibility, how it develops, and how flexibility can be trained. My hope is that this work can complement the treatment research by promoting continued development based on better understandings of body image flexibility and inflexibility.

Q: Many people are familiar with Cognitive Behavior Therapy (CBT) and Dialectic Behavior Therapy (DBT) but may be less knowledgeable about ACT.  What are the main differences between ACT and other evidence-based treatments for eating disorders and body image such as CBT and DBT? 

ES: Well ACT is a cognitive behavior therapy, but it differs from many CBT’s in that it challenges the idea that thinking must change for observable behavior to change.  In this area, ACT posits that healthy body image and eating does not depend on challenging critical thoughts about the body. It depends on learning to engage in meaningful, values-based action regardless of what thoughts are coming up.

Q: “Acceptance” can be a difficult concept for people to really understand and put into practice.  Why is this?  And what’s the most effective way to define or describe acceptance as it relates to body image?

ES: It’s tough because we sometimes think acceptance means liking or tolerating tough experiences.  Applied to body image, acceptance simply means making room for all thoughts and feelings about the body, whether we like them or not.

Q: What are the potential barriers to “letting go” of one’s struggle with body image? To that same point, what are the possible benefits?

ES: We are trained from a very early age that things that hurt are wrong, that we are responsible for managing our feelings.  In the case of body image, we are also taught that managing our bodies is our responsibility.  We are taught that it’s right to struggle, that we should feel good and look good, and we should be willing to struggle to get there. Because of this, considering letting go of that struggle is hard to even imagine. We find ourselves wondering what would happen to our experiences of our bodies if we stopped struggling. Would our bad feelings about the body completely overwhelm us if we weren’t managing them?  And what about our bodies themselves? If we weren’t struggling – Would we suddenly become grotesque? Would our bodies become completely disabled?  Of course, letting go of the struggle does mean that we expose ourselves to all kinds of hurt that we don’t like having.  Only letting go of that struggle frees us up to do other things that are more important – to allocate all those resources to the things we really care about, even when it hurts. And we know it’s going to hurt because we feel most vulnerable when we’re going after the things we want. So in ACT, we practice doing that, in the presence of the worst kinds of body hurt.  It’s not just hurt anymore, though, it’s hurt with a purpose.

Q: You talk in your new book about the idea that acceptance “isn’t something you do once”.  Can you elaborate on that notion?

ES: Well, it’s not like we pass through some portal where suddenly we are all-accepting and the work is done. It takes practice.  We think we’re doing great, then we suddenly notice all these new ways of inflexibility showing up, these new scary or painful thoughts coming up.  It’s just human nature.  Working on body flexibility is a lifetime commitment to making the things that matter to you more important than managing your experience of your body.

Q: Where does the element of “Commitment” come into play when working on body image struggles?

ES: Building a lifelong pattern of flexibility takes commitment. From an ACT perspective, commitment means noticing when we are being inflexible, when we are working to move away from ourselves and our own experiences, and simply turning back.

Q: What are some of the other areas in life in which the principles of ACT might be beneficial?

ES: Any area of life that is, for you, characterized by attempts to manage your experiences instead of managing the meaning in your life is an area of life that might benefit from the ACT principles.  And the ACT community provides a wealth of resources for people looking to do this kind of work. The Association for Contextual Behavioral Science website has a whole section for folks who are looking for support applying these principles in their lives, and New Harbinger publishes a number of self-help books for a range of difficulties people experience.

Q: On November 17, 2013 you will be in Baltimore speaking about How to Let Go of Your Struggle with Body Image.  What do you hope people will take away from this event and who could benefit from attending?

My main hope is that people may leave curious. Curious about how they struggle with their body image and what costs that has in their lives. Curious about how their lives might look different if they let go of the struggle with body image and embraced their experiences of their body, painful or pleasurable.  Curious about how they might use the time and energy if they weren’t spending it on the body image struggle.

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Emily K. Sandoz, PhD, is assistant professor of psychology at University of Louisiana at Lafayette, LA. She is a therapist who specializes in treating clients using acceptance and commitment therapy. Sandoz is coauthor of Acceptance and Commitment Therapy for Eating Disorders and The Mindfulness and Acceptance Workbook for Bulimia. She received her doctorate from the University of Mississippi, and she lives and works in Lafayette, LA.

On November 17th, Dr. Sandoz will be the featured guest speaker at The Center for Eating Disorders at Sheppard Pratt‘s fall event, How to Let Go of Your Struggle with Body Image.  Click on the link to find out more about the FREE event and to reserve your seats.

The Center for Eating Disorders at Sheppard Pratt offers outpatient therapists trained in Acceptance & Commitment Therapy. If you’re interested in this type of therapy and would like to find out more about starting treatment for an eating disorder and/or body image, please call us at (410) 938-5252.