Living with your Body & Other Things You Hate: How to Let Go of Your Struggle with Body Image Using Acceptance & Commitment Therapy
By Emily Sandoz, PhD and Troy DuFrene
Emily Sandoz, PhD and Troy DuFrene joined us for the following book interview. What follows are our questions in italics, and their thoughtful responses.
In addition to your print book, Living with your Body & Other Things You Hate: How to Let Go of Your Struggle with Body Image Using Acceptance & Commitment Therapy, you
offer the reader access to audio files at www.newharbinger.com/21044. What kind of feedback have you received on this option?
Readers we’ve heard from really seem to benefit from the guided exercises available on audio. This seems to allow them to let go of having to remember the steps of the exercise and participate more fully. We’ve also received feedback that they felt more 
connected with us, the authors, by being able to put a voice to the words on the page.
For those unfamiliar with Acceptance and Commitment Therapy (ACT), can you please provide a description and some examples of this framework?
Acceptance and Commitment Therapy is based on the idea that our psychological struggles are primarily attributable to psychological inflexibility. Psychological inflexibility is characterized by our unwillingness to contact the full range of human experiences, the cognitive rigidity that functions to protect us from the confusion, complexity, and pain that is fundamental to life, and the loss of meaning and purpose-driven action that occurs when our efforts become more about managing difficult experiences than living fully. For example, if I experience my body as “disgusting,” I am likely to be driven to manage my appearance, others’ opinions, and even my own thoughts in ways that buy me some relief from “disgusting,” but pull me away from things that matter to me. I may avoid meals with friends so that I can restrict my eating. I may limit intimacy in relationships because I don’t want to be touched. I may be underemployed because I don’t want to be in a job where I interact with people who might judge how I look. ACT aims to facilitate psychological flexibility, or willingness to contact the full range of human experiences – pleasurable, painful, predictable, unpredictable, tangible, abstract – in service of some chosen value. Through ACT, I might learn that my relationships and my work are important enough to me to feel “disgusting” and come to embrace that willingly.
This book aims to help readers use ACT-based work to increase body image flexibility, or to contact fully with their complex and dynamic bodily experience in service of action towards the things they care about.
You invite your readers “to take a risk …we invite you to risk feeling uncomfortable, disappointed, disgusted, and frustrated.” A unique invitation.
What are some suggestions you offer to support those who accept your invitation?
I would suggest that folks accept this invitation only if it feels like a real choice. We come at this work, not as experts who know what folks must do to get free from their struggles with body image. Rather as fellow travelers, offering a perspective on a path that might be useful. We want folks to follow this path, only if they have a sense of what it might be worth when doing something new and hard. In other words, we would like them to start by identifying why this work is worth it for them, and to come back to that when it gets really difficult.
The guided exercises you present include the use of breath work. Can you please speak to this?
The use of breathing is threefold. For one, deep breathing exercises facilitate relaxation, which positions folks to gain more, psychologically, from exposure to difficult experiences. In addition, breathing is a process that is always occurring in the present, and to which we can return our attention when our minds get lost in thoughts or concerns. Our breath can act as a tether, helping us to repeatedly come back to our ongoing experience. Finally, breathing is something our bodies do, and attending to our breath carefully and with compassion means approaching our bodies with something other than loathing or avoidance. In this way just noticing breathing is a little step toward body image flexibility.
Can you please explain the skill of body defusion and how this can impact body hatred?
Cognitive fusion is when rigid thoughts dominate our experience and our behavior is limited by these thoughts rather than being sensitive to everything that is happening in and around us. Body hatred is an example of body-related fusion. When my body hatred comes up, I’m likely to tune out from everything else that is happening, as that hatred fills my mind, coloring my experiences and taking over my behavior. Body defusion is a skill that involves noticing an unwanted aspect of the bodily experience, such as hatred, without it dominating. In this way, body hatred may come and go as we intentionally broaden our awareness to incorporate the hatred along with everything else that comprises our experience. I might notice my hatred, and my breath, and my concern about a project at work, and the air conditioning being particularly loud, and my stomach growling… This is particularly important when folks have struggled with body image inflexibility for a long time because any negative experience begins to be translated into body hate or disgust. Defusion allows me to make contact with the more nuanced experiences I might not even realize I’m avoiding. For example, I’m hating my body because I’m scared I might not navigate this new project effectively.
You develop the concept of experiential acceptance. Can you please explain what this is and what it is not?
By experiential acceptance, we mean a willingness to feel the full range of experiences as they occur in the moment. Experiences of events that occur outside the body, those that occur within the body, and those that occur within the mind. With body image acceptance, we simply mean being willing to experience the body, and our thoughts and feelings about the body, even when that experience is painful or unwanted. In this way, body image acceptance does not mean liking the body or having good thoughts about the body. It means being open to not liking the body sometimes, to having painful thoughts about the body when they come up. Body image acceptance doesn’t even mean forbidding efforts to manage or change the body itself. We can fully accept things and still strive to make them different. In fact, my clinical experience suggests, that it is often through making peace with the body as it is that folks find themselves effective in changing the body to better fit the lives they want to live.
Are people surprised to learn your book is about living their lives with freedom, purpose and committing to their values versus about tips to conquer body image distress?
They are. Almost invariably, folks are surprised. I haven’t heard from anyone that they are disappointed with that, however. Most folks seem to know, on some level, that there’s no real way to manage distress that doesn’t have serious costs to their lives. And most folks seem to be relieved to turn from that job to one that’s more important – being the person they want to be!
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About the authors:
Dr. Emily K. Sandoz is the Emma Louise LeBlanc Burguieres/BORSF Endowed Professor of Social Sciences in the Psychology Department at the University of Louisiana at Lafayette. Emily is the Director of the Louisiana Contextual Science Research Group and an Associate Editor of the Journal of Contextual Behavioral Science. She has co-authored three books on acceptance and commitment therapy for struggles with eating and body image, along with chapters and journal articles on ACT, values, the therapeutic relationship, and psychological flexibility. Emily has led 41 professional training workshops around the world, and serves as a peer-reviewed ACT trainer. She also practices as a Clinical Psychologist in Lafayette, Louisiana, where she lives with her husband and three children.
Troy DuFrene is president of Praxis Continuing Education, a California-based company that provides training services to behavioral-health professionals. He has cowritten nine books on various psychology topics, including Things Might Go Terribly, Horribly Wrong and Mindfulness for Two. He is currently serving on the board of directors of the Berkeley Zen Center and lives in Alameda, CA.