# 176 Acceptance and Change

Wanting to change a behavior generally begins with disliking or even hating the behavior. This often gets mixed up with hating ourselves. Ironically, hating ourselves does not support the process of change. It has the opposite effect and keeps us stuck. Compassion for ourselves is the first step to real change. Unfortunately, self-hate is common among our clients, and just telling them not to hate themselves gets nowhere. Another option is to turn toward a troublesome behavior with acceptance. People often resist acceptance because they see this as saying they like or even condone what is happening. In this Tip, we look at acceptance as a step toward real change.

Surrender is inner acceptance
of what is, without any reservations…
Surrender does not transform what is,
at least not directly. Surrender transforms you.
Eckhart Tolle

Replacing judgment with curiosity
is a key element in becoming unstuck.
Francie White

Hating one’s body and wanting it to change is a whole other topic. People tend to believe it is hating their body that will motivate them to change their behaviors. This tends to be a short-term motivator, if at all. Accepting our bodies and wanting them to be as healthy and functional as possible focuses the mind on the behaviors that will serve us best. In addition, extreme focus on body size or shape is a hallmark of eating disorders. Encouraging such a hyper-focus increases the risk of eating disorders. We can support the process of positive change by helping the client separate how he looks at his behaviors from how he looks at his body.

Behavioral approaches to change ask the client to figure out what the troublesome behavior is trying to accomplish and then search for other ways to do this. A classic example is turning to food to soothe uncomfortable emotions or states. The client can brainstorm other ways to calm, such as calling a friend, taking a bath, etc. This implies acceptance of the intention as a reasonable one. We can help clients acknowledge and accept the intention and separate it from the behavior.

In some cases, the underlying intention is easy to find, and the client can find other ways to achieve it. More often, though, it is much more complicated or counterintuitive. One common example is the client who wishes to weigh less and diets, only to discover that she begins to get more attention from men and finds this frightening. She may then begin to eat beyond appetite or to binge and soon weigh more again. This intention may be clear to her or may be completely unconscious and puzzling. Acceptance that there is always an underlying positive intention is the first step. We can hold the belief that behind each behavior is a positive intention even when it doesn’t seem to make sense.

Sometimes, the intention is confusing or even disturbing. For example, the client says the reason she restricts her eating is that she doesn’t deserve to eat. These more extreme, alarming beliefs are characteristic of eating disorders. Of course, with such clients, a team of professionals is necessary. A deeper understanding of these confusing beliefs and behaviors allows the dietitian to support the process of true healing. Our role in the team can include hearing when the client shares what she is learning in therapy and accepting these connections, even when they don’t seem logical to us. Arguing directly with these irrational beliefs puts us in the middle of a conflict within the client. We are allying with one side of the argument. This will inevitably bring up the other side more strongly (Tip # 55 Ambivalence to Change). By arguing about what is true, we inadvertently strengthen a client’s irrational beliefs. For example, clients struggling with an eating disorder often refer to certain foods as “safe” or “unsafe.” It’s tempting to launch into explaining how all foods fit and that no food is inherently unsafe. It’s counterproductive to do this before the client is open to hearing it. We have a role in providing this reality-check, and it works best when the client is ready for it. Jumping in right away to argue will likely bring resistance (Tip # 59 Providing Advice Effectively & # 65 The Righting Reflex).

We can also play a role in guiding the client to decode the associations with certain foods. These meanings play a unique role for each client. Just fighting them does not allow understanding and a possible shift to happen. We can acknowledge the meanings that certain foods represent for the client, and we can offer curiosity. Fear obscures curiosity (Tips # 90 & # 163), so part of our role can be to encourage curiosity about what associations these foods have for this person. As these links come up, we then suggest that the client bring them up in therapy. Eventually, when the client is ready, we encourage taking risks with previously “unsafe” foods to extinguish these old associations. Forcing risk-taking prematurely (i.e., with no curiosity present) tends to backfire.

We will continue this topic next month, including addressing critical self-talk.


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