Among the psychiatric profession and the experts at most modern eating disorder treatment centers, there is a push to provide eating disorder treatment solutions that not only allow for short-term eating disorder recovery but to provide a sustainable change in the lifestyles of the patients. This often entails examining not only the symptoms of the eating disorder but also the underlying, contributing causes of the disorder. A common impediment to sustainable eating disorder recovery is the existence of past trauma, which can trigger both the initial onset of eating disorders like anorexia nervosa and bulimia nervosa and trigger relapse after eating disorder treatment has been completed.
What Is Trauma?
Trauma is any kind of distressing, fearful, violent, or emotional experience that affects a person negatively. In the past it was commonly associated with soldiers who had been in combat, calling it “shell shock” or “battle fatigue.” However, the psychological and psychiatric communities have come to understand that a wide range of experiences can cause trauma, which can then develop into post-traumatic stress disorder (PTSD). Some examples (aside from combat) which can contribute to this in both the short- and long-term include:
- A divorce or bad breakup (or witnessing your parents’ divorce)
- Losing a job
- Failing out of school
- Being robbed or mugged
- Being in a car accident
- Witnessing a violent crime
- Domestic or sexual abuse
- Prolonged or severe illness (like cancer)
PTSD is recognized as an important trigger for many behavioral health issues. Eating disorders are certainly among them, but trauma response can influence other disorders like substance abuse disorder, obsessive-compulsive disorder, and major depression. Acute PTSD can also cause panic attacks and general anxiety. In short, trauma has devastating effects on a person’s wellbeing and quality of life.
How Does Trauma Relate to Eating Disorder Recovery?
- It’s a causative factor.
One of the most common contributing factors in people admitted to eating disorder treatment centers is the presence of past trauma. It doesn’t need to be recent. In most cases, childhood trauma is something the client has been dealing with for years, and one of the main starting points for a disorder that would require eating disorder treatment.
One frequent childhood trauma is “weight-shaming” at a young age. If a person’s parents or friends say things like, “you should lose some weight, you’re getting fat” in a shameful way, this can lead to recurring body image issues. These sensitivities regarding body weight and shape are almost always associated with the onset of eating disorders like anorexia nervosa and bulimia nervosa.
- Trauma treatment is part of an evidence-based treatment methodology.
In decades past, eating disorder recovery was mostly a combination of medication and psychiatric care, but in recent years eating disorder treatment centers tend to focus on evidence-based treatments. This means a series of techniques that have been proven to work in scientific studies over the years.
Instead of the generalized talk therapy used for many mental health disorders, specialized techniques like Cognitive Processing Therapy (CPT) can be introduced. CPT focuses on helping the client identify the traumatic experiences and the feelings that surround them which have contributed to the onset of the eating disorder. Following that, through a back-and-forth with a trained therapist, the client can begin to modify their feelings and reactions to past trauma and understand how those feelings are negatively impacting their lives.
- Trauma treatment helps a long-term recovery by avoiding triggers for relapse.
Left untreated, the negative thoughts and feelings that come with PTSD are powerful triggers for a relapse of the disordered behaviors that define eating disorders. After completing a stint at an eating disorder treatment center, clients have to put the lessons they learn into practice in the “real world,” with all the stresses that daily life can entail.
If the symptoms of PTSD are not addressed, the chances for a sustainable recovery are lowered. As noted above, past trauma is one of the most common contributing factors in the development of eating disorders in the first place, and also one of the most common relapse triggers. BY engaging in evidence-based PTSD treatment methodologies, people in recovery can become fully recovered by removing a risk factor for relapse.
Treatment Methods Used for PTSD
Psychotherapy for PTSD must be handled carefully. The feelings caused by re-experiencing a traumatic event can be overwhelming and often distressing, so the therapist should be ready to stop a session if it becomes too much. Although catharsis is an important part of treatment, it can’t be every session. Thus, most of the techniques used are centered on mindfulness and objective exploration of the emotions spurred by trauma.
There is no single “cure” for PTSD, so normally a combination of techniques is employed. In many cases, antidepressants and SSRIs are prescribed, as well as sedatives to counter anxiety attacks. However, eating disorder therapy does not usually include medication, so for our purposes, we’ll focus on psychotherapy techniques that are commonly used for both eating disorders and PTSD.
- Cognitive Behavioral Therapy.
This is a form of talk therapy, widely used in mental health treatment, that emphasizes understanding how emotions, thoughts, and behaviors relate to each other. Since disordered eating behaviors are often driven by a need to cope with negative feelings caused by trauma, CBT in an eating disorder setting centers on identifying those negative feelings. With the therapist, clients in treatment will explore how those feelings are causing them to use disordered eating. Eventually, they will learn to experience those feelings without the need to act on them.
- Exposure Therapy
Used in a variety of anxiety-related treatments, exposure therapy is useful in helping clients reacclimate to situations that might trigger PTSD symptoms. As an example, a person whose PTSD stems from being in a car crash might be afraid to get into cars afterward. Exposure therapy in this situation might include incrementally having the client sit in an unmoving car while processing their feelings. They then would ride as a passenger in a moving car, then try driving by themselves. This is simplified, of course, but the stages of exposure therapy gradually reintroduce the client to their feared situations. It also applies to eating disorders as well – situations like eating in public for a person with anorexia nervosa or eating small amounts of a favorite binge food for a person with binge eating disorder can be introduced through exposure therapy.
- Trauma-informed Yoga
Yoga is much more than a popular exercise technique. It’s a powerful tool for mindful meditation combined with movement. A series of breathing and stretching exercises that help people empty their minds and become more in tune with their bodies, yoga provides relief from stress and tensions. Mindfulness is at the core of this discipline – in a way it’s similar to CBT. Being able to experience emotions and acknowledge them without acting on them helps people in eating disorder treatment avoid resorting to disordered eating. Specifically designed for PTSD treatment, trauma-informed yoga involves gentler movement and less hands-on instruction, with more focus on emotional processing. One of the best things about trauma-informed yoga is that it can be done alone, with training. It makes yoga a useful tool for years after completing eating disorder treatment.
- Group Therapy
Calling group therapy a “therapeutic technique” is a bit of a misnomer; most techniques can be used in both individual and group settings. CBT, CPT, and yoga are all frequently performed in groups. However, it warrants special mention here because group therapy sessions are almost always part of both eating disorder and PTSD treatment. Group therapy displays some benefits that individual sessions can’t provide as easily. Group sessions provide ample opportunities for social support and bonding. This also validates a client’s feelings. Many people feel that they are all alone in their disorder, and a group therapy session can let them know that others share the same feelings. Being with people who know exactly what they’re going through allows individuals to open up and possibly make breakthroughs.
Find an Eating Disorder Recovery Center That Factors in Trauma Treatment
When you or a loved one is struggling with an eating disorder, it may feel like there’s nothing you can do. However, there are plenty of options for a full eating disorder recovery available online and locally. It’s best to do your research to find a helpful facility that not only treats the symptoms of the eating disorder itself, but also the various underlying causes that can hamper a full recovery.
With 20 years of behavioral health business development experience, Carrie combines world-class marketing, media, public relations, outreach and business development with a deep understanding of client care and treatment. Her contributions to the world of behavioral health business development – and particularly eating disorder treatment – go beyond simple marketing; she has actively developed leaders for her organizations and for the industry at large.