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Explore how difficulty tolerating emotions drives eating disorder behaviours — and develop alternative ways to manage intense feelings.
Some people use eating disorder behaviours (bingeing, purging, restricting, exercising) to manage emotions they find intolerable. This worksheet helps you identify the link between emotion and behaviour, and develop alternatives.
Use in broad CBT-E when mood intolerance has been identified as an additional maintaining mechanism. Appropriate when binge-purge cycles or restriction are functionally linked to difficulty tolerating intense emotional states.
Help the client see the link between intense emotions and eating disorder behaviours — many use restriction, bingeing, or purging as a way to modulate affect. Frame the module as building alternative ways to manage intense feelings.
For clients with comorbid emotion regulation difficulties (e.g., borderline features), this module may need extending and supplementing with skills-based approaches. For those with trauma histories, ensure emotional processing is paced appropriately.
If the client is actively dissociating during sessions or has untreated PTSD, address safety and stabilisation first. Mood intolerance work requires the capacity to tolerate some emotional activation in session.
Map the sequence: trigger → intense emotion → eating disorder behaviour → temporary relief → guilt/shame → further restriction or compensation. Build a repertoire of alternative responses and test them through behavioural experiments. Address the belief that emotions are dangerous or intolerable.
Suitable for clients working with eating disorder, mood intolerance, cbt-e, emotional regulation, binge triggers. This tool can be used as a standalone worksheet or as part of a structured homework plan.
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Track body checking and body avoidance behaviours, their triggers, and function.
Identify rigid dietary rules and design experiments to test what happens when you break them.
Track weekly weight to observe natural fluctuation and reduce the power of daily weighing.
The core CBT-E self-monitoring tool — record what you eat, when, where, and how you felt, including any binge/purge episodes and triggers.