Cognitive Fusion: The Fuel of an Eating Disorder

National Eating Disorder Awareness Week 2020 is here! This is a time to spread awareness about the harmful consequences of eating disorders, to remember those who have lost the battle, and to instill hope in those who are currently suffering.

An eating disorder is very complex and develops for a myriad of reasons and causes, including biological, societal, psychological, and more. Those who experience an eating disorder are generally sucked into it, similar to being in the eye of a hurricane. Sufferers may find it difficult to see a way out because of the messages that their eating disorder has inundated them with.

Eating Disorders seem to take on a life of their own, creating rules, statements, stipulations, and mantras around food, weight, and body image. When an individual is in the midst of an eating disorder, it becomes easy to believe these thoughts and thus, live in accordance with them. This is where the eating disorder takes power. It can basically say whatever it wants and the individual will likely take it as truth, leading to destructive behaviors. This is cognitive fusion at work.

Let’s take just a minute to discuss fusion. In Acceptance and Commitment Therapy, cognitive fusion is defined as “a process by which verbal events exert strong stimulus control over responding, to the exclusion of other contextual variables. Phrased differently, fusion is a kind of verbal dominance in behavior regulation” (Hayes, Strosahl, & Wilson, 2012, p. 69). Fusion is basically when we buy into and believe our thoughts, and choose behaviors based on our thoughts. It is important to note that fusion is certainly not always harmful – it is useful at times. For example, if I am driving and the light turns red, my mind might tell me to stop the car, so I do. This happens very quickly, and I stop and I don’t get into an accident. I fused with the thought to stop at the red light and it kept me safe. With eating disorders though, fusion is not often helpful.
When fusion occurs within the context of an eating disorder, the individual is listening to and acting in accordance with thoughts such as “You ate all this food. Now you need to go get rid of it,” or “You need to exercise for three hours to burn off calories to lose weight.” These are just two examples of thoughts that someone with an eating disorder may experience. In the midst of a struggle, an individual’s eating disorder thoughts may feel so powerful that it feels like s/he has to listen to them. Listening to these thoughts often lead to unhealthy behaviors, such as bingeing, purging, restricting, over exercising, laxative abuse, etc. So, what can help when someone realizes that they are struggling and have fused with their eating disordered thoughts?

One method of helping with this is defusion in which “the person can voluntarily step back, separate from the mind, watch its ongoing processes…and not be caught in its products” (Hayes et al., 2012, p. 245). Defusion is when an individual becomes aware of their thoughts and does not automatically get sucked in by them. This technique can be a very powerful tool in a quest for recovery from an eating disorder. For example, if an individual thinks, “I ate too much yesterday. I need to restrict today,” s/he can increase awareness of that thought by saying, “I am having the thought that I ate too much and need to restrict,” or “My eating disorder is saying that I ate too much and need to restrict.”

The technique and practice of defusion helps to create separation between the self and the eating disorder, which is an essential part of recovery. At first, it may be difficult to do this and your eating disorder might tell you that you can’t do this, but you don’t have to believe and buy into that thought either. This is not a quick fix for curing an eating disorder. But, by defusing from your eating disorder thoughts, you can begin to create meaningful change in your life. The eating disorder thoughts do not have to dictate your life anymore. You can and will start to base your behavior and decisions on your values and goals rather than on the thoughts that an eating disorder throws at you. There are countless defusion techniques available and it can be helpful to work with a therapist who specializes in eating disorder treatment and Acceptance & Commitment Therapy. Recovery from an eating disorder is possible and help is available.

If you or someone you know if struggling with an eating disorder and is in need of resources, please contact the National Eating Disorder Association (NEDA) at (800) 931-2237 or the National Association for Anorexia Nervosa & Associated Disorders (ANAD) at 630-577-1330.

If you are in the Chicagoland area and are in need of counseling services, please contact Olive Branch Counseling Associates, Inc. located in Tinley Park, IL at (708) 633-8000. 

Written By: Samantha Maciaga, MA, LPC

References

Hayes, S.C., Strosahl, K.D., & Wilson, K.G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2^nd edition). The Guilford Press.

(picture from: https://dfw.cbslocal.com/2020/02/25/plugged-in-to-dfw-national-eating-disorders-week/)