Cognitive Behavioural Therapy for Substance Use, Food & Body Image

Many people turn to food, substances, or body control as a way of coping with stress, difficult emotions, or feeling overwhelmed. A drink helps you switch off, eating numbs or soothes, restricting or exercising restores a sense of control. These strategies can bring short-term relief, but they often lead to guilt, shame, or self-criticism — and the cycle continues.

You may notice a pattern of over-control followed by loss of control. Periods of discipline, restraint, or “doing well” are hard to sustain. When pressure builds, behaviour swings in the opposite direction — bingeing, overusing substances, compulsive exercise, or avoidance. Afterwards, the urge to regain control becomes even stronger.

From a CBT and ACT perspective, these behaviours are not the problem in themselves. They are attempts to manage internal experiences — thoughts, emotions, bodily sensations — when safer or more flexible ways of coping don’t feel available. Avoidance, suppression, or rigid rules may reduce discomfort in the short term, but they often increase distress over time and narrow your life.

From a compassion-focused perspective, these patterns often develop in the context of high self-criticism, shame, or fear of losing control. Many clients are capable and responsible with others, but harsh and punitive with themselves. Using food, substances, or body control becomes a way of self-soothing — followed by self-attack.

In therapy, we work to understand these patterns without judgement. Together, we:

  • Map the cycles that maintain substance use, eating, or body-related difficulties

  • Reduce shame and self-criticism that keep the behaviour going

  • Develop emotional regulation and self-soothing skills that don’t rely on control or escape

  • Loosen rigid rules around food, rest, exercise, and “shoulds”

  • Build a more compassionate and workable relationship with your body and internal experience

The goal is not perfect control, abstinence, or “getting it right.” The aim is to increase flexibility, self-trust, and choice — so you can respond to stress and emotion in ways that support your health, values, and quality of life, rather than fighting yourself.

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