The Role of Cognitive Behavior Therapy-Based Treatment

February 14, 2020 By Pat Hartman

A volcano may appear dormant, but underneath, seething scorching lava waits to erupt. Often, a distressing life situation causes an overstock of energy to accumulate within a human being. In a very basic, instinctual way, the boiling energy wants to find expression in fighting, fleeing, or engaging in some other activity to “let off steam.”

Displacement behavior can also fill the role of stress reducer. When a person’s preferred form of displacement behavior is overeating, the results can be dismal and long-lasting.

Dr. Pretlow asks, “Can the displacement mechanism serve as a basis for a weight-loss intervention?”

As we see in the illustration from Slide 25 of his presentation, “Food/Eating Addiction and the Displacement Mechanism,” in a situation with no good prognosis, the feeding drive is one way to ameliorate — at least temporarily — the distress factor of situations with no good prognosis. He says of the displacement mechanism,

It is thought to involve opposing drives, for example, the fight versus the flight drive in the brain… And it is thought to re-channel to another drive, whatever drive is readily available, for example, the feeding drive.

Among the drives that are readily available, might there be such a thing as the not-feeding drive? Maybe it can be cultivated in people, especially the young ones before they become set in their ways. It can help them direct their energy, even the negative energy, into positivity. Maybe awakening the not-feeding drive is the secret of why some treatment modalities can work.

In the recently published article by Dr. Pretlow and three co-authors in the journal Eating and Weight Disorders — Studies on Anorexia, Bulimia and Obesity, we see a very encouraging message. When children and teenagers used their pent-up energy to follow Dr. Pretlow’s staged withdrawal method, they lost weight. More importantly, followup at five months showed that they maintained overall weight loss.

Dr. Pretlow and his co-authors, Carol M. Stock, Leigh Roeger and Stephen Allison, draw the distinction between food addiction and eating addiction, and point out that in either case, not much effort has been made to test interventions. They suggest that cognitive behavioral therapy “has the potential to improve motivation, emotional regulation, coping strategies, and relapse prevention among patients with addiction, and go on to say,

Our research has focused on CBT-based treatment for E[ating] A[ddiction], which we conceptualize as having sensory and motor components.

The study described here also concludes that for young people, the effectiveness of staged food withdrawal is increased by the addition of therapies based on cognitive behavioral therapy, and designed to deal with Body Focused Repetitive Behaviors.