Eating Disorders Symptoms Living in the Grey How to Challenge All-or-Nothing Thinking By Lauren Muhlheim, PsyD, CEDS Lauren Muhlheim, PsyD, CEDS Facebook LinkedIn Twitter Lauren Muhlheim, PsyD, is a certified eating disorders expert and clinical psychologist who provides cognitive behavioral psychotherapy. Learn about our editorial process Updated on February 26, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Rachel Goldman, PhD, FTOS Medically reviewed by Rachel Goldman, PhD, FTOS Facebook LinkedIn Twitter Rachel Goldman, PhD FTOS, is a licensed psychologist, clinical assistant professor, speaker, wellness expert specializing in eating behaviors, stress management, and health behavior change. Learn about our Medical Review Board Print Christos Georghiou | Dreamstime.com All-or-nothing thinking sometimes referred to as black-and-white thinking or dichotomous thinking, is one of the most common types of cognitive distortions observed in patients with eating disorders such as bulimia nervosa, binge eating disorder, and anorexia nervosa. In Feeling Good: The New Mood Therapy (1980), David Burns identified ten different types of cognitive distortions or inaccurate and problematic ways of viewing oneself and the world. Cognitive distortions may lead to negative emotions and problematic behaviors. For this reason, they are a primary target of cognitive-behavioral therapy. Some of the most common examples of all-or-nothing thinking in patients with eating disorders are creating a rigid dichotomy of good versus bad foods (and avoidance of those foods on the bad food list) and defining eating behavior as either good or bad. Let’s look at how this type of thinking may cause problems, such as binge eating, for a patient with an eating disorder. Jane: Good Foods vs. Bad Foods Jane has a food rule that she doesn’t eat candy because it is a “bad food.” Jane gets a surprise delivery for Valentine’s Day—of a box of chocolates. Jane believes that chocolate is forbidden, but she decides just this once, to indulge. She has one chocolate, and then another. It is so enticing partially because she is normally "not allowed" to eat chocolate. After two pieces of chocolate, Jane feels upset with herself. She knows she has broken her food rule – she’s “been bad.” Then Jane thinks, “Oh well, I’ve already blown it, I might as well give up and eat more of them.” She might even think, “I’d better finish the box because then they won’t be here to tempt me tomorrow. I will go back to being good on my diet tomorrow.” Sound familiar? Jim: Good Eating Behavior vs. Bad Eating Behavior Jim often goes out for a burger with his friends from work. When he does, he either gets a green salad (when he is dieting and being “good”), or he has a double cheeseburger, fries, and a shake (when he is not dieting). He notices that when he is dieting and has only the green salad while all his buddies eat burgers, he ends up feeling sad and deprived and sometimes goes home and binge eats ice cream. On the other hand, at the times he eats the double cheeseburger, fries, and shake, he feels ill and berates himself for eating unhealthy. Either way, his rules leave him feeling distressed. Learning to Live in the Gray Recovery from an eating disorder involves learning to think and live in shades of gray. Living in the gray area means accepting that all foods in moderation can be part of a balanced and healthy diet. It means learning to incorporate fear foods. It means eating in a way that is flexible enough to be sustainable. It means embracing ambiguity. What would this look like for Jane and Jim? Jane could work on relaxing her rigid rule about chocolate being “bad” and working towards all foods being morally neutral. She can acknowledge that different foods have different nutritional values, but all can be included in a balanced diet. Once all foods are permitted, it will become easier to stop after a normal portion and she won’t have to face the distress of breaking a rule. She can learn to have a few pieces of chocolate and enjoy them. Jim could learn that he doesn’t have to vacillate between restricting or overindulging when he is out to eat with his friends. If he wants to have a cheeseburger, he can have a single cheeseburger with a side salad. This way he will likely not feel deprived but will be able to enjoy a more balanced and satisfying meal. He will ultimately be relieved of the shame of binge eating. A Word from Verywell Challenging all-or-nothing thinking can be scary, but it is an important element of recovery. It is important to note that addressing dysfunctional thoughts such as all-or-nothing thinking is but one element of cognitive-behavioral therapy, a leading evidence-based treatment for eating disorders. If you or a loved one is experiencing an eating disorder please reach out for help. Trained eating disorder professionals can help you develop more balanced thinking and healthy eating behaviors. Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Burns DD. Feeling Good, The New Mood Therapy. Harper Collins; 1999. By Lauren Muhlheim, PsyD, CEDS Lauren Muhlheim, PsyD, is a certified eating disorders expert and clinical psychologist who provides cognitive behavioral psychotherapy. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Eating Disorders Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.