Overcoming Trauma and Eating Disorder

If you have an eating disorder and have also experienced trauma at some point in your past (or current) life, you may feel that you’re destined to remain miserable, alone, insecure, fearful, and misunderstood. It doesn’t have to be this way. It is possible to overcome trauma and eating disorder with appropriate treatment and effective support.

Prevalence of Trauma and Eating Disorder

According to statistics available through the National Eating Disorders Association (NEDA), as many as 10 million females and 1 million men are fighting an eating disorder such as anorexia or bulimia. Many millions more are suffering from binge eating disorder.

National statistics on child abuse show that over 3 million reports of child abuse are made every year in America. These can, however, involve multiple children. In 2007, according to Childhelp (http://www.childhelp.org/pages/statistics), about 5.8 million children were involved in an estimated 3.2 million child abuse reports and allegations. Other alarming statistics include the fact that 60 percent of people in drug rehabilitation centers report being abused or neglected as a child, and 80 percent of 21-year-olds that were abused as children meet the criteria for at least one psychological disorder (including eating disorder).
As for domestic violence, one statistic cited by the American Bar Association Commission on Domestic Violence (http://new.abanet.org/domesticviolence/Pages/Statistics.aspx) shows that approximately 1.3 million women and 835,000 men are physically assaulted by an intimate partner annually in the United States.

Types of Eating Disorders

The main types of eating disorders include anorexia nervosa, bulimia nervosa, and binge eating disorder. All can be life-threatening conditions. Anorexia nervosa is characterized by self-starvation and excessive weight loss. Bulimia nervosa is characterized by a cycle of bingeing and compensatory behavior such as self-induced vomiting or excessive use of laxatives. Binge eating disorder is characterized by recurrent episodes of binge eating without the use of compensatory behaviors to counter the effects of binge eating.

Eating Disorder Often Results from Childhood Trauma

The severity of binge eating disorder, in particular, is often related to childhood histories of sexual and emotional abuse. When someone suffers childhood abuse, they often become extremely self-critical, especially with respect to dissatisfaction with their body. One suggestion for why this occurs is that repeated and excessive criticism, insults, or some form of sexual/physical abuse during childhood causes the individual to view themselves in this extremely harsh light.

Trauma survivors also frequently blame themselves for both the abuse they experienced as well as their failure to win others’ love and approval. The body may become the focus of all this self-hatred and self-blame with the result that the person eats too much or too little, or binges and purges. The more they engage in this unhealthy behavior, the more the pattern is reinforced. It’s a vicious cycle, and one that requires coordinated professional treatment to overcome.

Overcoming Shame and Guilt

Trauma survivors and those with eating disorders have deep and enduring feelings of shame and guilt. After having your mind and body violated, your spirit abused, you retreat into what makes you feel that you have some measure of control: your eating habits. Abuse results in shame, in a feeling that you must somehow be innately bad or worthless. You may feel unlovable, ugly, unintelligent, or broken and defective. You blame yourself for the abuse, but the reality is that the abuse is to blame for why you feel so bad about yourself.

Psychiatrists and treatment professionals say that children are never to blame for the abuse inflicted upon them by others. There is no exception. The children are innocent. But getting the child (who may now be a fully-grown adult) to believe that they are not to blame requires a great deal of work.

Why is it so difficult? As children, we look upon the world first through the lens of our parents. They are our all-knowing protectors, and when we suffer abuse at their hands (physical, sexual, or emotional), we are crushed by the humiliating and dehumanizing experience. We may have been told at the time of the abuse that it was the result of something we did, that it is our fault. Over time, this feeling of self-blame is internalized, coloring our entire world outlook. We only have our self behavior as an indicator of how much control we have over our lives, and by believing we are to blame gives us an illusory sense of being in control. If only, we tell ourselves, we can figure out the right things to do, things would be all right and abuse would stop (or, if the abuse was in the past, if we only knew then what to do, we could have stopped the abuse). Facing the reality that adults were untrustworthy and that we were powerless against the abuse is just too terrifying for most trauma survivors to do on their own. That’s why they need professional counseling.

If the abuse came at the hands of family members, self-blame allows the victim to protect those individuals, and thus maintain some form of attachment. In their minds, having some family attachment, however negative, is preferable to being abandoned and alone. So, they internalize the self-blame and the shame and guilt that go along with it.
In addition, society’s tendency to blame the victim contributes to survivor self-blame.

Where to Start to Overcome Trauma and Eating Disorder

Don’t try to figure things out on your own. It’s simply too complex and frustrating to attempt to deal with powerful emotions and hidden or repressed memories. You need to have an objective professional to listen to your concerns, to help you sort out what’s real and what’s not, and learn new and healthier coping mechanisms for dealing with your issues – past and present. The best choice is a residential treatment facility that specializes in treating dual diagnosis disorders – trauma and eating disorder, in this case.

Until recently, the primary focus for treatment of eating disorder has been to get the life-threatening symptoms of the patient under control. In the process, the underlying trauma issues were left unattended. Today, the philosophy is to treat both conditions concurrently in a comprehensive and integrated approach.

During treatment, counselors will help you to understand the function of your eating disorder. Together with your therapists, you will work on establishing safety, increasing trust, developing a sense of mindfulness, learning stabilization strategies, and how to successfully replace your eating disorder habit. During your treatment, you will also learn about eating disorders as communication, means for gaining control, substitute for intimacy, and traumatic re-enactment.

Treatment is important for you to begin to realize that you have every right to dare to dream, to have goals that you strive to achieve, and to reclaim your life. Of course, every treatment plan for individuals with trauma and eating disorder is unique, and there are many different approaches and treatment modalities that may be used. Psychotherapy has proved enormously effective in helping trauma survivors to heal. It can help you as well.

Many persons with trauma and eating disorders respond well to outpatient therapy, including individual, group, or family therapy and medical management by their primary care provider. Support groups, nutritional counseling, and psychiatric medications under careful supervision have proven effective for some individuals. This may be more in line with your own expectations and situation than a full-on residential care facility. But, don’t sell yourself short. If you have a severe eating disorder and have experienced significant trauma, you may benefit more from residential treatment.

In addition, an eating disorder that has resulted in life-threatening physical problems or is associated with severe psychological and/or behavioral problems will most likely require hospital-based care (including inpatient, partial hospitalization, intensive outpatient and/or residential care in an eating disorders specialty unit or facility.

Will You Ever Be Normal?

One of the most understandable concerns you may have is will you ever be normal? For some, this means returning to normal, the kind of normal life that existed prior to trauma and eating disorder. For others who suffered childhood trauma and developed an eating disorder, it may mean becoming normal for the first time. The answer is that, with appropriate treatment and ongoing support, you can have every expectation of having a normal life, of being able to dream, set goals, make plans, and establish healthy relationships.

You do need to recognize that overcoming trauma and eating disorder means you will need to give yourself adequate time to heal. This won’t happen overnight. You will have good days and bad days, times when you feel confused and in turmoil and times when you begin to see a glimmer of hope for your future. What you need to do is establish trust in your therapist and give therapy your complete commitment. Don’t hold back. Have the courage to face your fears and move beyond them. Be open to change. Begin to look at yourself as the unique and special individual that you are.

There is no set timetable for how long treatment lasts for trauma and eating disorder. But, working with your therapist and medical professionals, you will make progress. You will heal.

Working to Build Healthy Relationships

One of the most satisfying parts of undergoing treatment for trauma and eating disorder is what happens when you are at the point when you’re looking forward to meeting others and establishing new friendships. When you are ready to begin building healthy relationships, there are some things you can do to help ensure you make the right choices:

• Avoid extremes and go slow: You don’t want to remain isolated from others, but at the same time, you don’t want to go overboard and obsess over gaining as many new friends as you can. Just because you meet someone doesn’t mean that they are or will become a healthy relationship. Take it slow and ease into new relationships. It is important to get out there, but don’t let your desire to have new relationships push you too fast.

• Get to know people first: Before diving headlong into a relationship, get to know the other person first. Share information about yourself with other people you meet on a gradual basis. It could be about a hobby or recreational activity you enjoy, or that you come from the same hometown, like the same interests, or have similar backgrounds. When you communicate, be sure that you’re sharing different parts of your. Remember that you are more than just facts or statistics. You are an individual with unique personality, intelligence, and interests.

• Listen to your inner voice: Sometimes known as a gut instinct or intuition, your inner voice often tells you something important that you need to pay attention to. When it comes to your inner voice telling you to stay away from another person, there may be a valid reason for it. The person may truly be bad for you, in which case you’d be wise to heed the warning. It may also be your own sense of self-blame and self-hatred telling you that you’re not worthy of having this person in your life. In either case, it’s worth exploring to see whether there’s a basis for such a warning.

• Do a reality check with a trusted friend: If you have someone you trust in your life, whether that person is a friend, counselor, or family member, talk with him or her and get their advice about this new relationship you’re about to enter. Talk about your concerns as well as your joy, but also listen to the feedback from your trusted friend as to things about your new relationship you may tend to overlook.

• Trust needs to be earned: Developing healthy relationships after trauma and eating disorder involves earning trust. And it takes time to earn such trust. Look for consistency between what the person does and says. Is the relationship mutual or one-sided?

• Sort out your reactions: This is something you need to learn to do. Sort out whether your reactions to new relationships are due to something in the present or the past. Are you angry or upset because something this person does or says reminds you of experiences in your past? Or is this person violating what you consider to be your personal boundaries? It may be both, and your therapist can help you sort these reactions out and learn what to do about them.

Tags: PTSD, trauma