Eating Disorder Acceptance And Commitment Therapy Worksheets

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Acceptance And Commitment Therapy Worksheets
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This article contains Acceptance and Commitment Therapy worksheets and exercises that have been tailored to help with eating struggles.

In addition, I try to present a holistic understanding of how Acceptance and Commitment therapy works.

You may know already that Acceptance and Commitment Therapy (ACT) shows clinical effectiveness in treatment for eating struggles. 

However, many of the Acceptance and Commitment Therapy resources online are for general purposes and not specifically for eating.

In addition, many articles don’t talk about how the various pieces all fit together. 

How awareness precedes acceptance, and how acceptance of the present leads into commitment.

This blog article presents common Acceptance and Commitment Therapy exercises with slightly modified instructions for Eating Disorder treatment.

I typically help people with overeating, so I tend to speak from that perspective of treatment.

In addition, there are links at the bottom of the post to common Acceptance and Commitment worksheets that you can download for free. 

But if you want to truly ‘get something’ from this article, you’ll need to actually go through each of the steps in each of the acceptance commitment therapy exercises presented below!

How Acceptance and Commitment Therapy Works Generally Speaking

Acceptance And Commitment Therapy cycle in visual worksheets

Here is the cycle that all of these Acceptance and Commitment Therapy worksheets are based upon.

  • First you accept your internal experiences and stop avoiding the present moment. 
  • With acceptance, you gain “emotional distance”, or “psychological flexibility”. This is where you recognize your thoughts and emotions are ‘outside of yourself and separate from yourself’. You gain a valuable sign of maturity, that you recognize you are more than your thoughts. This helps greatly with decision making.
  • With distance and flexibility, you gain a new perspective. 
  • Then, you can start taking different actions that will lead you closer to achieving goals that are based on your values.

The Acceptance and Commitment worksheets down below and at the very bottom of this post contain other exercises presented in this article are based on this cycle. You may also want to learn about Cognitive Behavioral Therapy (or the limitations of Cognitive Behavioral Therapy).

We’ll start at the top of the cycle with a commitment therapy ACT exercise to help with acceptance of the present moment.

Then we’ll transition to the right towards exercises that explore ‘distance’ and values.

If you’d like to know more about how the Acceptance and Commitment therapy worksheets actually work, see my other article “What is Acceptance and Commitment Therapy?” here.

Acceptance and Commitment Worksheet Exercise #1

Understand How You Avoid The Present Moment

Acceptance is key in ACT, and it means paying attention to what you are feeling in the “present moment”.  

But many people try to avoid their feelings, especially negative ones.  

So to get to acceptance, first we need to see how we avoid that negative present moment.

Binge eating is a straightforward example. You may binge eat if you are feeling too overwhelmed. 

In this situation you are trying to avoid your uncomfortable feelings by turning to food as a distraction and escape.

However, binge eating is obviously horribly ineffective in bringing you closer towards your goals and personal values!

Fortunately, you don’t need to wait until a binge to start changing your relationship to the present moment!

By going through these four steps, instead of binge eating and using food to avoid the present moment, you can start to shift to accepting the present moment.

  1. Start by recalling an eating disorder experience. 
  2. Think about how binge eating affects you over the short term and why you binge eat. For example, binge eating can distract you from having to deal with work. Think of as many effects as you can: numbing, escaping, blanking out, taste, excitement, making cravings go away, fantasy, etc. Even brain fog can be effective in the short-term if you normally can’t stop thinking!
  3. In a very straightforward, objective way write down how effective binge eating was in helping you in both the short term and then long term. For example, if you are binge eating because you are stressed out, consider, “how effective is binge eating in helping you to reduce stress in your life in general?”  Does it provide some short-term relief but not really solve your problem?   Oftentimes people doing this exercise will see that binge eating causes greater stress in the long term.
  4. Go back to the beginning of this cycle when you first started binge eating. What feelings, emotions, or thoughts were you trying to avoid? Consider if avoiding these feelings, thoughts and emotions helped you in the long-term.

This is the first step upon which Acceptance and Commitment Therapy is based. 

In this step you just begin to turn towards your feelings and emotions. You are beginning to see how avoidance doesn’t work and is harmful.

For many people who use food to cope, this can be a new way of relating to their experiences.

For many people, acceptance may seem scary. Fortunately, there are other steps designed to make acceptance less scary.

Acceptance and Commitment Worksheet Exercise #2

Cognitive Defusion Exercise

psychological flexibility of thoughts exercise in acceptance and commitment therapy

Over the course of your mental, emotional, and spiritual evolution you will learn one simple lesson again and again:

You are not your thoughts. 

Yes, your brain has thoughts, but you are not your thoughts. 

Now this may sound simple, but this wisdom can be very difficult to apply to your life!

Oftentimes we become scared of our thoughts and feelings. We get scared of our thoughts and feelings because we believe them to be true.

However, a key principle in acceptance commitment therapy is learning that you are not your thoughts!

This Cognitive Defusion exercise is meant to help you better understand this simple lesson in a practical way:

  1. When you are beating yourself up mentally after making a mistake, take notice of what your negative thoughts are actually saying. 
  2. Write down a short statement that summarizes your negative thoughts. For example, “I am an eating failure deep down.”
  3. Then, add this phrase “I’m having the thought that …”. For example, “I’m having the thought that … I am an eating failure deep down.” This step is to help you realize that you are not your thoughts.
  4. Then, add this next phrase “I notice”. For example, “I notice … that I am having the thought that … I am an eating failure deep down.”
  5. Briefly consider the new mental shift in perspective. Before you started with “I am an eating failure deep down.” After, you ended with “I notice that I am having the thought that I am an eating failure deep down.”

This is the “psychological flexibility” concept I mentioned earlier. 

A key sign of adult maturity is understanding that you are more than your emotions, or getting a sense of perspective from your emotions.

For example, a child will feel very upset at the idea of going to bed early. However, if they could just see their emotions from a different perspective, they would realize that ‘Yes, it sucks to go to bed early, but it’s going to be ok in the bigger scheme of things’.

Acceptance and Commitment Worksheet Exercise #3

Mindfulness of Senses

The next part of Acceptance and Commitment Therapy involves practicing mindfulness and learning to stay present.

The overall premise is that your physical body is always in the present moment. If you can get grounded in your physical body, then you can more easily see thoughts as passing by you without believing the thoughts to be necessarily true or relevant.

Or, conversely, you may see your thoughts as not useful or serving you at all. 

If you are thinking you are a loser, that may be true in some sense, but just wallowing in misery about being a loser isn’t going to help you NOT be a loser.

You can grow out of being a loser. Everyone is a loser at some point. Being a loser doesn’t define your forever.

But, it’s hard to reach that type of thinking about ‘losing not defining you’ if you are too caught up in your thoughts. This is why it’s useful to practice mindfulness 🙂

This next mindfulness exercise builds on the previous Acceptance and Commitment Therapy lessons you have done so far.

  • You know that avoidance doesn’t work.
  • You’ve also started to separate yourself from your thoughts.

Now the key is remaining and returning to mindfulness of the present moment.

Remember, you are not your thoughts!

  1. Sight: Start by noticing the colors in your visual field. What do you notice? What sorts of objects are there in your immediate vicinity? What’s around you and not in your head?
  2. Sound: Continue by noticing the various sounds all around you. What sorts of background noises do you hear? 
  3. Touch: Continue noticing what you feel in your body. Remember, you are simply noticing here. For example, “I am noticing that I am feeling anxious.” Or, “I am noticing a relaxation in my shoulders.”
  4. Taste and Smell: What do you taste and smell in the present moment?

Coming back to your mindfulness senses is an important part of creating space between you and your thoughts. The more space the better.

Being in the present moment and having space from your thoughts allows you to gain perspective and start taking action towards your values and goals.

Acceptance and Commitment Worksheet Exercise #4

Personal Value Exploration

Now that you are in the present moment you have a chance to make a conscious decision.

Instead of avoiding the present moment you now have space from the things you are avoiding.

With this space you can more easily make a conscious decision to live according to your values.

This Acceptance and Commitment exercise is pretty simple and you may have seen it before in other self-development books.

values of life  exercise in acceptance and commitment therapy
values of life

For each of the life categories in this diagram, give yourself a rating of where you are. This can help you identify what areas of your life need more attention.

For example:

  • Romance/love: 3. 
  • Recreation/fun: 6.

10 is on the perimeter of the circle whereas 0 is in the middle.

By using the diagram above, you’ll see how you can do your ‘circle of life’ across the various domains of life.

Then for each category you explore how you can grow this circle outward across these domains of life.

For example:

  • Romance/love: What sorts of behaviors do you wish to bring as a partner? What’s your ideal relationship look like?
  • Recreation/fun: How do you ideally relax on your downtime? What do you enjoy doing in your spare time?
  • Food: Can you see yourself enjoying a brownie peacefully? Can you see yourself being free with food, and using food to nourish yourself?
  • Spirituality: Are you incorporating mindfulness into your life or other forms of contemplation and prayer?

Of course, as you start thinking about growth and how you want to expand, you’ll come across various challenges …

Acceptance and Commitment Worksheet Exercise #5

Commitment Through Obstacles

CommitmentPotential ObstaclesStrategies for Boosting Commitment
In this column, write your goals in the various domains that you wish to improve.For each life area or commitment, list some potential things that may stop your progress. Brainstorm some ways that you can get around those obstacles!

Commitment is the other key in ACT.  In this ACT exercise, you first write down your goals for the various life domains that, based on the previous exercise, you wish to improve.

For each of these life areas, list some potential things that get in the way of your progress. 

Then, brainstorm some ways that you can get around those obstacles!

The idea behind this exercise is pretty simple. 

If we anticipate obstacles, then we are less likely to get discouraged and we’ll be able to maintain our mindfulness of the present moment without getting caught up in negative thoughts. 

I hope you are seeing how all these exercises flow together.

While you may have heard of mindfulness or goal setting before, what’s unique about Acceptance and Commitment Therapy is that all these resources get tied together.

First you use mindfulness to get grounded in the present moment.

  • You allow for discomfort.
  • Then you create space and allow your thoughts to be there, without identifying with your thoughts.
  • You see that your thoughts are not necessarily true.
  • With this space, you can then think about your values and how you want to act.
  • With your goals and personal values in mind, you can find a new way to live.

And then you just need to keep moving forward, one small step at a time, one present moment at a time!

With that being said, this  winds up our section of Acceptance and Therapy exercises that I’ve modified for addressing eating disorders.

If you are curious to learn more about the acceptance commitment therapy approach to life then …

Here are Acceptance and Commitment Therapy “You Are Not Your Brain” Worksheets

I am calling these Acceptance and Commitment Therapy worksheets the “You are not your brain worksheets” because this phrase encompasses a primary teaching of Acceptance and Commitment Therapy.

These worksheets are based on treatment for all types of struggles – gambling, alcohol, internet shopping, etc – that benefit using Acceptance Commitment techniques…

Like other ACT approaches, these worksheets are similarly based in mindfulness, acceptance and personal values.

Why are acceptance and commitment to values found throughout all these exercises?

Well, it turns out that regardless of the problem, the primary lesson in any Acceptance Commitment Therapy is the same:

You are not your brain!

If you can accept and get space from your thoughts, then you can live according to your values and actually live a life that you want to live.

Hopefully these ACT worksheets can help you use this new way of relating to life directly!

These pdf worksheets have ACT exercises and are available for free here, at Act Naturally.

RAIN

rain mindfulness exercise in acceptance and commitment therapy

This exercise can help you create space between your feelings and thoughts.

Notice how you start by recognizing, and then investigating.

This is the pattern that everything else is based upon. 

First you feel, then you notice. Noticing then leads to space. 

20,000 Days Exercise PDF

discover your values worksheet acceptance and commitment therapy exercise

This values worksheet can help you identify your values.

This ACT question is simple:

You probably have around 20,000 days to live, give or take a few thousand 🙂

What do you want to do 20,000 more times?

Group Therapy Worksheet

couples group therapy worksheet acceptance and commitment therapy exercise

This acceptance commitment therapy pdf is meant to highlight new ways of relating to your partner. 

This exercise can help remind you of the values and beautiful moments you’ve had with your partner.

By focusing on these beautiful moments you can find new inner resources to recreate these moments.

Visit the website to see the rest of the Acceptance and Commitment Therapy worksheets!

Let me know if you have any questions!

And if you want another great therapy resource, be sure to check out my Cognitive Behavioral Therapy article here!

About the Author

Jared Levenson is a former binge eating wrestler turned Zen Buddhist Monk, Internal Family Systems counselor and nutrition wellness coach. He's helped hundreds of people through universal meal principles and internal family systems to make peace with food, stop binge eating, and find true health and wholeness.

@jared_levenson

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