Why is Trauma Treatment Necessary for Full Eating Disorder Recovery?
Written by CCTC Staff Writer
Trauma and PTSD both have the potential to cause or sustain an eating disorder. But many eating disorder treatment centers recognize the connection between trauma and eating disorders, and have employed trauma therapies — including Eye Movement Desensitization Reprocessing (EMDR) therapy— to tackle both mental health issues.
Read on to learn more about:
How trauma is defined
Types of traumatic events and circumstances
How trauma and eating disorders are related
What EMDR is and how it’s used for eating disorder treatment
Traumatic events and environments are awful to experience, and hard to face in therapy. It’s even more difficult to face an eating disorder at the same time. But it’s possible to live a full and happy life once you start healing.
What is Trauma?
Trauma is a physical, emotional, and/or psychological response to a distressing, traumatic event. Individuals who experience trauma may display a range of responses, and the severity of trauma symptoms varies depending on the support, environment, and resilience of the individual.
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) defines a traumatic event as:
Exposure to actual or threatened death, serious injury, or sexual violence.
This “exposure” can be the firsthand experience of a traumatic event like abuse. It could also be through witnessing or being in close proximity to someone who has experienced trauma, like being the child of two people in an abusive relationship.
Not all Trauma Comes From a Single Event
Many images come to mind when thinking about trauma: childhood neglect, domestic abuse, car accidents, incidents while in military service. But trauma can result from more than these specific events.
Bullying, childhood neglect, poverty and food scarcity, job loss, hate crimes, and attachment issues are all considered traumatic. These are all less abrupt, but more prolonged, instances of trauma that build up over time.
How Do You Know if You’re Experiencing Trauma?
After a highly distressing event or being in a chronically stressful environment, there are several psychological/emotional responses you may experience, such as:
Denial
Anger
Fear
Sadness
Shame
Confusion
Anxiety
Depression
Numbness
Guilt
Hopelessness
Irritability
Difficulty concentrating
You may also have a physical reaction to trauma. This can range from insomnia to loss of appetite, from hypersomnia to overeating.
These are all valid responses to trauma. Your personality, past experiences, additional stressors, and support system, among other things, determine how long you will feel the effects of trauma.
Trauma vs. PTSD
For many people, trauma does not just “go away.” If the aftereffects of trauma continue or get worse in the weeks or months after a traumatic event, then you may have developed post-traumatic stress disorder (PTSD).
PTSD sufferers often develop comorbid conditions such as depression, anxiety, and eating disorders.
How is Trauma Related to Eating Disorders?
A Method of Control
Victims of traumatic experiences often feel like they have no control in their lives and their environment. This causes distress and anxiety, and sufferers want nothing more than to stop this perceived uncertainty.
An eating disorder is, for many, a mode of control. Your food, your body, your level of movement — these are all things that you can control. This makes eating disorder rituals, routines, and behaviors a viable way to gain control when you feel powerless.
An eating disorder can develop as a maladaptive way to manage trauma symptoms and emotions.
For example, a victim of child neglect may restrict their food intake, overexercise, or use purging behaviors to feel in control after feeling powerless for so long.
A Coping Mechanism
Trauma causes intense emotions, and without a way to cope with them, many turn to substance abuse, overexercise, and/or binge eating as a way to “numb out” from those emotions.
For example, someone who has lost their home in a fire may develop binge eating disorder as a way to cope with pain and grief.
A Form of Self-Punishment
Unfortunately, many victims blame themselves for the trauma they have faced. They believe, or are forced to believe, that things like abuse, neglect, or rape are their own fault. These sufferers then use eating disorder behaviors to alleviate feelings of guilt.
For example, a woman who has survived sexual assault may believe it was her own fault. She might then restrict her food intake or overexercise as a way to punish themselves for what happened.
What Should be Treated First: Trauma or the Eating Disorder?
An eating disorder is a mental health problem, but there can also be physical side effects. And you can’t begin to heal mentally if your body is not properly nourished. So most eating disorder treatment programs focus first on getting patients physically stable and reducing behaviors.
But several studies have shown that it’s much more effective to treat an eating disorder and trauma at the same time. There are two reasons for this:
Trauma can fuel an eating disorder, so addressing it is beneficial for eating disorder recovery.
Eating disorder behaviors may be used to cope with trauma. When you start eating disorder recovery, you need to process your trauma and learn new ways to cope.
Many eating disorder treatment providers use cognitive behavioral therapy and narrative storytelling therapy to address trauma. They also teach dialectical behavioral skills to cope with intense emotions. Eye Movement Desensitization Reprocessing (EMDR) is a therapy specifically designed for treating trauma in a revolutionary way.
Related: Trauma recovery is draining. Add in eating disorder recovery, and you can end up exhausted. Here’s how to maintain motivation in recovery.
What is EMDR Therapy and What is it Used For?
Eye Movement Desensitization Reprocessing, is a psychotherapy designed to help trauma sufferers be able to process their experiences. It’s based on the idea that present problems are the result of unprocessed memories, unmanaged current stressors, and the failure to prepare for future distressing events.
The function of EMDR, then, is to access a painful blocked memory and gather more information about the traumatic event or environment. During EMDR sessions, you can identify negative self beliefs surrounding your trauma, replace them with more neutral or positive ones, and store away a more accurate, compassionate memory of your trauma.
Throughout EMDR sessions, you will also become desensitized from your trauma. You won’t feel the urge to suppress your painful thoughts or memories, because you won’t feel them so intensely.
Related: Trauma treatment is intense. Here are six forms of self-care to help you get through it.
Why does eye movement matter?
Rapid Eye Movement (REM) is commonly associated with deep sleep. You access, process and store information during this stage of sleep. Your eyes move rapidly back and forth as you do this.
Clinicians can use this rapid movement to help patients access their memories. In an EMDR session, a clinician has their patient follow their finger or a light as they move it back and forth, which causes a REM response.
Once this happens, clinicians can ask patients to recall the event objectively, talk about negative self beliefs that resulted from trauma, and help patients learn to cope when painful memories arise outside of the session.
EMDR in Eating Disorder Treatment Setting
EMDR sounds confusing. To understand it more, let’s see how EMDR has been used for eating disorder treatment.
The goals of EMDR for eating disorder treatment are to be able to:
Manage triggers (which can be reminders of past trauma, or things that make you want to engage in behaviors)
Identify and disprove negative core beliefs that may sustain an eating disorder
Replace negative core beliefs with more objective or positive ones
Minimize intense emotions and get to a more manageable level
For example, if you were bullied because of your weight when you were younger, EMDR would allow you to:
Access those memories, which you may have used eating disorder behaviors to block out
Identify negative self beliefs that you hold because of your trauma, ones like: “I am worthless.”
Replace those with more neutral beliefs like: “My size does not matter, and I did not deserve to be picked on at such a young age, or ever.”
Reduce the intensity of your emotional response when things like old school photos trigger memories of your past trauma
If You Have Experienced Trauma and an Eating Disorder
First, know that your experiences, and your eating disorder, are not your fault.
Second, ask for help. Find an eating disorder treatment program or therapist with specializations in trauma and PTSD treatment.
Related: Someone who’s qualified to treat trauma and eating disorders is one of four important factors to consider while you find an eating disorder therapist.
Third, remember that it’s never too late to start recovery. If you work on healing your trauma, there is nothing that can stop you from making a full recovery.
If you or a loved one is suffering from an eating disorder, take the first step today and talk to someone about recovery or simply learn more about the holistic eating disorder recovery programs we offer.