Mindfulness treatment of eating
disorders: A qualitative analysis of
therapists’ experiences
Nadia Mysliwiec
&
Dr. Mark Thorpe and Dr. Rhoda Scherman
Counselling Psychology
Aim
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To gain in-depth knowledge of the lived
experiences of therapists using mindfulness as a
therapeutic tool with clients diagnosed with an
eating disorder.
Background
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What is Mindfulness?
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Lifetime prevalence of eating disorders is currently
around 5%
Anorexia Nervosa – 0.6%
Bulimia Nervosa – 1%
Binge-Eating Disorder – 3%
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(Treasure, Claudino & Zucker, 2010)
Issue and Context

Studies offer a strong case for the use of
mindfulness-based therapies and the consequent
benefits for individuals diagnosed with an eating
disorder.
Method

Qualitative research using Thematic Analysis
(Braun & Clarke, 2006)
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5 Participants
Thank you again!
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Interviews and case studies
Themes
Primary Themes
Sub-Themes
Mindfulness Benefits the Therapist
A sense of calm
Building the therapeutic relationship
Crafty and Creative
Mindfulness needs to be relevant to the individual
Age matters
Mindfulness needs to be applicable to specific ED diagnosis
Working through the pain
Building mindfulness capacity
Motivation and Practice are Key
Motivation is vital
Practice, practice, practice
Mindfulness Feels Relevant
Mindfulness feels logical
Mindfulness alleviates anxiety
The philosophy of mindfulness feels satisfying
Mindfulness Benefits the Therapist
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A sense of calm
Building the therapeutic relationship
A sense of calm
Mindfulness has been crucial in me feeling calm in
this job… When I reflect back on when I was feeling
really stretched I wasn’t doing mindfulness, but now
that I am again I’m feeling really calm and I don’t get
stuck like that. The more relaxed I am now, the better
therapist I am. I think mindfulness is crucial,
particularly with these eating disorders, which are so
highly charged.
(Jasmine)
Building the therapeutic relationship
It always feels very connecting. There is a realness
felt; a heart felt connection, or something that feels
more real versus other symptoms, such as anxiety. So
there’s something about more of a felt, real,
connection with another human being… a positive
connection.
(Rachel)
Crafty and Creative
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Mindfulness needs to be relevant to the
individual
Age matters
Mindfulness needs to be applicable to
specific eating disorder diagnosis
Working through the pain
Building mindfulness capacity
Mindfulness needs to be relevant for
the individual
There’s skill in making something acceptable and
useable, and that’s the bit that I really enjoy. I sometimes
feel a bit crafty about it… Potentially quite powerful stuff
too… Mindfulness is potentially a way to get through
eating disorders… So, you’re not teaching them how to
observe sound specifically; rather, it’s an exercise to
demonstrate a concept… I suppose it brings it down to
something less abstract, not necessarily concrete but less
out there. I suppose that’s why I reframe it, and I mean it
makes sense for me too to reframe it.
(Esther)
Age matters
I have found that generally it’s harder with
adolescents doing mindfulness. It’s much easier with
adults, because there’s something about a level of
depth or a level of psychological understanding that
a teenager might just criticise [mindfulness].
(Rachel)
Mindfulness needs to be applicable to
specific eating disorder diagnosis
I use mindfulness in a different way, or perhaps I get a
different success, with the [different] client groups… If I were
to rate them I would find it harder with anorexia, I find it
relevant with binge-eating disorder, but it also takes quite a
long time, whereas people with bulimia seem to, in my
experience, pick it up quicker… Someone with bulimia is more
chaotic and their emotions are stronger, so I find that
mindfulness can be quite good to help… Anorexia is different
again... they’re so overwhelmed with their anxiety often, and
they don’t even recognise it as that, so [mindfulness] just
doesn’t seem relevant for them.
(Rachel)
Working through the pain
A lot of the times I think when people use mindfulness
skills they tended to avoid their emotions a lot, and then
they end up feeling a lot worse, well not worse, just
feeling, which then feels worse… So noticing what
happens when you pay more attention to difficult
behaviours, and we also have to notice that we feel bad
about it… people tend to collapse into a lot of shame, but
they still need to recognise that binging all evening
actually makes them feel awful, and that’s valid.
(Josephine)
Building mindfulness capacity
Those who consistently think [mindfulness is] hard…
are told to read a magazine for a couple minutes and
then try again. So it’s very much about building a
capacity, even if that’s just thirty seconds to start
with… They have to be willing to give it a go.
(Josephine)
Motivation and Practice are Key
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Motivation is vital
Practice, practice, practice
Motivation is vital
At the beginning of treating eating disorders it’s
more about motivation… If they haven’t got that
motivation they won’t have motivation to do
mindfulness… It’s not something you can force
someone to do.
(Anne)
Practice, practice, practice
If you’re building an arm muscle you do things with
weights that you don’t do anywhere else in your life
and you’re doing it to increase something and get
stronger, and it’s the same with mindfulness
exercises, like when we just observe sound, which we
don’t usually do on a day to day basis, however,
doing it helps us build this ability.
(Esther)
Mindfulness Feels Relevant
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Mindfulness feels logical
Mindfulness alleviates anxiety
The philosophy of mindfulness feels satisfying
Mindfulness feels logical
My sense is that this works beautifully for eating
disorders, like in terms of them normally being so
wrapped up and connected to their thoughts. If they
can separate themselves from it… like it makes
logical sense that it would work really well. It just has
so much potential. For anorexia there are so few
things that do work, I think that this really could be
quite ground breaking.
(Jasmine)
Mindfulness alleviates anxiety
Because she’s so anxious, I would say it would be
quite hard [not to use mindfulness]… A lot of it is
about bringing herself back, so like a grounding use
of mindfulness. For her it’s quite essential, and I’ve
seen her now for three years, and it’s still very
crucial.
(Anne)
The philosophy of mindfulness feels
satisfying
I really enjoy mindfulness techniques. It feels more satisfying. It feels
more rich, or deep, or philosophically relevant… It feels relevant and
philosophically in tune.
(Rachel)
It’s sort of the opposite to what a lot of things, and our culture, seems
to be going towards. And so I think there is this tension between life
speeding up and people working harder… I can only see it becoming
more and more required actually… It’s good to be able to package
something up, which mindfulness does, and describe something that is
fundamental to how you live an emotionally less distressing life… I
think that the fact people are speeding up may potentially open up the
fact that people need mindfulness.
(Josephine)
Conclusion
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Mindfulness for the therapist
Mindfulness for the client
The general relevance of mindfulness
Avenues for future research
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My Masters research:
The aim of my current research is to gain in-depth
knowledge of the turning points in therapy, as
experienced by therapists using mindfulness as a
therapeutic tool, with clients diagnosed with
Bulimia Nervosa.
A big thank you to the Institute of
Counselling Psychology for your support.
QUESTIONS?
Thank you