Grieving the Thin Ideal

Posted on April 28, 2016 by StayConnected

Tali_YuzPrimary Therapist Tali Yuz Berliner, PsyD has run a body image group at Oliver-Pyatt Centers for almost three years. In her group, she works with clients on accepting their bodies and letting go of the “thin ideal”. In her writing, she shares about her use of cognitive fusion in aiding clients through this process.  

After almost three years of running body image group at the comprehensive level of care, I have learned a lot from the many incredible clients I have had the pleasure to sit with. One significant theme that is revisited time and time again in my group is the need for the women to “grieve the thin ideal.” It has been important for these women who suffer with eating disorders to not only accept that they cannot strive for thinness any longer but also to accept that the body that they have been chasing will not bring them the fantasy life they envision. I often use the ACT(Acceptance and Commitment Therapy) term cognitive fusion, to explain this concept to the group. Cognitive fusion proposes that certain attachments are made through verbal interactions that people spend endless amounts of energy trying to prove or disprove. People will do so despite the thought not being accurate in the present moment or having evidence to the contrary.

The way we (I say “we” since the process is always collaborative with the clients) tackle this theme in my group is two-fold. First, it is imperative to challenge the distorted thought that a specific body type will lead them to happiness. This is done through a variety of exercises from several modalities, such as:

Looking for evidence that challenges the thought

Exploring body image development

Identifying and connecting other values

Challenging the media

In addition to the exercises, it is important to openly process and review the topic of body image acceptance and how it occurs on a continuum. We explore how it begins with tolerating the body, then accepting the body, then liking it, and eventually one day learning to love it. Exploring where the woman is on the continuum and moving them through it allows the loss of the thin ideal to be less painful.

Second, it’s important that we validate the loss of this ideal. The work can often mirror general grief and loss work whereas the women can experience similar emotions to the loss of a loved one. It is necessary that they process how this void has and will impact them in the future. We continuously reinforce the significant need to strengthen and connect to other roles and values outside of the body/appearance and the eating disorder. The women explore the integration of values to replace what is lost and to reinforce the message that the idealized body will not bring them to a happy life but instead being connected to others and immersed in their values will lead them to life satisfaction. The above is a snapshot into a very complex process that is inherent in both group and individual sessions. My hope is for these women to start to trust their values and their healthy voice to come to the understanding that there is more to life than the thin ideal.


For more information about Oliver-Pyatt Centers and Clementine adolescent treatment programs, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram


Angie Viets, LCP is an eating disorder specialist who has dedicated her career to helping her clients recover. In her writing, Angie shares her personal journey with an eating disorder as well as her professional experience in the field. She offers a unique perspective to the view of exercise and whether it can be an act of self care or self harm.

“Strong is the new skinny.” “Nothing tastes as good as skinny feels.” “Suck it up now and you won’t have to suck it in later.” Sound familiar? You can’t spend five minutes on Pinterest or any form of social media without seeing these catchy little quotes layered on top of images of whatever the latest absurd mandate is to be considered beautiful or sexy…

Sometimes I wonder who the puppeteer is behind this charade. I imagine if we saw who is making up these insane standards it would be like the big revelation in the infamous Wizard of Oz. Just an ordinary man behind the curtain playing clever tricks on us (probably while eating Cheetos and drinking grape soda, laughing at us while we run around in circles eating egg whites).

Are you so lost and unsure of yourself that you’ve bought into this craziness? Once upon a time, I was, for sure.  My life felt controlled by getting in my next workout. I adopted the belief that a day was only as good as the workout completed. Fear pressured me into working out while sane people slept. Dark streets stretched before me, lonely and cold, yet mile after mile I ran and ran until my heart told me to stop, yet even then I kept going.

I felt so superior to my peers and colleagues; I burned seven trillion calories while they drank coffee and watched the Today Show before heading into work. People probably thought I was crazy, but instead, they said things like, “Wow, I wish I had your motivation.” (“See, you’re superior!  You have something they want but don’t have the willpower to achieve,” the eating disorder that ruled my life at the time said, reinforcing my efforts.) I failed to let them know that I was seeing a cardiologist over the lunch hour, due to becoming increasingly more convinced that my irregular heartbeat might be a sign of an impending heart attack at the premature age of 22.

I hold images of that girl in my head, and I just want to pick her up off of the dark curb where she sat, fearfully timing her pulse, instead of her miles, and tuck her into bed while secretly burning her running shoes. She was a lost soul, running away from the very thing she was so desperate to find – herself. Looking back now it just feels sad; certainly not superior. My identity was wrapped up in an all-consuming eating disorder, and excessive exercise was just one part of my obsessive and disordered life. Until…

Until the day, I walked by a yoga studio and observed people in odd postures. They looked really…well, serene, unlike me and all of the other treadmill junkies. I found the practice of yoga fascinating; it kept calling to me softly, “just one class,” as I walked by each day. But I waited a long time to have the courage to attend a class because it meant rebelling against my eating disorder and its insistence that running was the Holy Grail. My addiction to running was much louder than the gentle whispers seeping out from under the yoga mats, following me home.

The night I finally entered the sacred space of that yoga studio is forever burned into my mind. Something shifted in me that night as I laid in savasana (corpse pose). I reconnected with a part of myself while lying on my yoga mat and I heard a quiet voice softly whisper, “You can eat now.” This voice is my most compassionate self who is loving, infinitely wise, and deeply invested in nurturing me. I chanted Om three times, bowed my head while saying Namaste, rolled up my mat and walked back out into my life forever changed.

Unfortunately, I didn’t abandon compulsive exercise that night; I needed a remedy much greater at the time. But little by little I started giving myself permission to listen to my body and its desire to attend a yoga class instead of torturing my injured knees on a treadmill. At some point, I laid down running entirely. Moving my body stopped feeling abusive and slowly felt like an act of self-care. Over time, I let go of the core belief that if I didn’t exercise in an ‘acceptable’ way that something horrific would happen.

Exercise is kind and loving and very much a source of self-care when used in moderation and in ways that feel good to you. For some, that could be running, for me, it’s a long walk on a sunny day with Mosley, our Golden Retriever, a bike ride with my kids, or a walk with a girlfriend where our legs try to keep up with our words. My body craves a gentle yoga class with incense burning and Sanskrit music playing; I feel at home in my body on a yoga mat.  Sometimes it’s a quick cardio workout with my favorite audible book playing. And many days, it’s rest, because I don’t need to run away from myself anymore.

Our bodies crave movement. Exercise has tremendous benefits for our mental and physical well-being, but when abused it does far more harm. It’s not intended to be our only method of coping with the stress we experience in our lives.

Listen to the infinite wisdom of your body, it has all the answers you need.

Love + Light,


If you are concerned exercise has shifted from self-care to self-harm, I would recommend taking a minute to consider a few common symptoms:

-Working out when sick or injured

-Irritability if you can’t exercise

-Becoming depressed if you are sick/injured to the point of being unable to work out

-Fearful of weight gain if not exercising

-Arranging your entire day around a workout

-Working out more to compensate for eating certain foods or skipping a workout


This article originally published on The Angie Viets site. 


For more information about Oliver-Pyatt Centers and Clementine adolescent treatment programs, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

Melanis Rivera-Rodriguez_PsyD_Primary Therapist

Primary Therapist Melanis Rivera-Rodriguez, PsyD co-facilitates a weekly process group at Oliver-Pyatt Centers. She shares about the use of Yalom’s therapeutic factors in her work with group therapy.

When it comes to the treatment of eating disorders at a residential level of care, a sense of community and ways of one patient relating to another can be weaved into the daily focus of treatment and recovery. The concept of community and relationships dates back to our ancestors, and from a scientific perspective speaks of the gregarious nature within the instincts of survival and collaborative work that humans possess. From a therapeutic stance, Irvin Yalom, an existential psychiatrist, speaks of 12 therapeutic factors defining them as “the actual mechanisms of effecting change in the patient” (Yalom, 1995) in a therapeutic community and/or group therapy setting.

In my experience as a primary therapist, and in co-facilitating process group once a week at Oliver-Pyatt Centers, a sense of community can be observed being established among the women in which several of Yalom’s therapeutic factors can be identified in the group dynamics. Being attuned and aware of these factors has aided in facilitating not only the group process but the individual process as well. Yalom’s therapeutic factors consist of:

  1. Universality – feeling of having problems similar to others and not being alone.
  2. Altruism – helping and supporting others in their recovery process.
  3. Instillation of hope – encouragement that recovery is possible.
  4. Guidance – nurturing support and assistance.
  5. Imparting information – teaching about a problem and recovery.
  6. Developing social skills – learning new ways to communicate about feelings, concerns, and new ways of relating.
  7. Interpersonal learning – finding out about themselves and others through group feedback.
  8. Cohesion – feeling of belonging to the group and valuing the group.
  9. Catharsis – release of emotional tension.
  10. Existential factors – life and death are realities.
  11. Imitative behavior – modeling another’s manners and recovery skills.
  12. Corrective recapitulation of family of origin issues – identifying and changing the dysfunctional patterns or roles one played in primary family.

From the previously listed therapeutic factors, universality seems to inherently facilitate connections in which possibly the treatment experience creates an exchange among the women that may enhance empathy, compassion and self-awareness. Additionally, the elements of time (length of stay) and environment (24/7 care) seem to play crucial ingredients as the women begin to navigate treatment for their specific struggles with an eating disorder and/or other co-occurring issues. Change can be identified not only cognitively and behaviorally, but also holistically, in which the integration of these factors, insight of recovery and relationships might parallel the woman’s circumstances outside of treatment possibly facilitating change in deeper, consistent and meaningful ways in the path of recovery from an eating disorder.


For more information about Oliver-Pyatt Centers and Clementine adolescent treatment programs, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

Posted in Body Image, Recovery
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