Repetitive negative thinking in eating disorders : Identifying and bypassing over-analysing coping modes and building schema attunement

This chapter outlines the potential importance of Repetitive negative thinking (RNT) processes to eating disorder (ED) pathology, before discussing how to conceptualise and treat ED cases from a schema therapy perspective where high levels of RNT may present as a threat to emotional processing. RNT processes such as worry and rumination have been hypothesised to be problematic for cognitive behavioural treatments because they tend to have the effect of blocking emotional processing. Schema attunement is potentially the most important intervention strategy the schema therapist has to offer; perhaps even ‘the glue of schema therapy’. The horizontal axis serves to keep therapists aware that they will also need to balance connection tasks with the tasks of empathic confrontation and setting limits. Treating RNT as representing ‘over-analysing’ coping mode activity represents a promising approach to formulating and managing these difficult clinical phenomena within a schema therapy approach.