Trauma-Informed Approaches to Eating Disorders is clearly a much needed and long overdue book about treatment, written by a diverse group of clinicians and carefully edited to focus on the needs and strengths of clinicians. The complexities and challenges that undergird, surround, and even haunt the nature, diagnosis, treatment, management, and understanding of eating disorders (EDs)-in-relation-to-trauma are so great, even for veteran clinicians, that they can leave practitioners at any level of experience feeling helpless and exhausted. This book, in a way that would be appreciated by practitioners of acceptance and commitment therapy, accepts the reality of those feelings and is committed to improving treatment, understanding, and compassion. The book is designed to foster respect for complexity and link it to humility in the presence of tragedy, tribulations, and suffering, framed all too often by our own shortcomings as healers. EDs are dangerous, ubiquitous, usually chronic in nature, and difficult to treat. Anorexia nervosa (AN) has the highest fatality rate (4%) of any mental illness. Bulimia nervosa reveals a fatality rate of 3.9%. EDs offer an enormous challenge to therapists because of their complexity, which includes severe medical risk, co-occurring anxiety, depression and personality disorders, an addiction component, and body image distortion—all of this within a mediadriven culture of thinness in which starving and purging can for some become lifestyle choices. This complexity is further exacerbated by the presence of painful life experiences or trauma. The book elucidates the connection between trauma and EDs by offering a trauma-informed phase model, as well as chapters describing the ways in which various therapeutic models address each of those phases. It offers an in-depth exposition of a fourphase model of trauma treatment.
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This chapter provides an overview of recovery and beyond: dealing with triggers and setbacks. Recovery means holding tight to foundational ways of living that were learned in treatment and generalized into daily life during the healing process. Recovery can be inconsistent and unpredictable at times, demanding strength and courage to continuously redefine ne one’s self-story and live from one’s authentic self. Negative life events, whether they are large or small traumas, can act as powerful triggers, leading to the return of the eating disorders (ED). Stressful life events and daily life stressors can easily disturb unprocessed traumatic material, activating memory networks and causing pain and suffering, along with adding new traumatic material to the brain and body system. In the end, the therapist supports and celebrates the unique image of recovery that is self-defied, value-based, inclusive of fractures and imperfections, and created by the client.
- Go to chapter: The Many Faces of Eating Disorders: Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED), Other Specified Feeding or Eating Disorder (OSFED), Bulimarexia, and Orthorexia
The Many Faces of Eating Disorders: Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED), Other Specified Feeding or Eating Disorder (OSFED), Bulimarexia, and Orthorexia
Feeding and eating disorders (EDs) are severe mental illnesses. This chapter gives a concise overview regarding EDs, their diagnostic configuration, and comorbidity with other mental illnesses. Moreover, the focus included vulnerability and psychological aspects of EDs, with particular attention given to the impact of dysfunctional attachment dynamics and relational trauma on the onset of each type of ED. The chapter covers EDs such as anorexia nervosa, bulimia nervosa, binge eating disorder, and other specified feeding or eating disorder (OSFED). Types of EDs also included those that are not present in Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5), but are frequently found in clinical practice. Such disorders (e.g., bulimarexia or orthorexia) are symptomatological manifestations that require further investigation to clarify risk factors related to their onset and to shed light on their mechanism of action.
Eye movement desensitization and reprocessing (EMDR) is an integrative, client-centered psychotherapy developed by Francine Shapiro, PhD, in 1987. EMDR engages the natural information processing systems in the brain to process disturbing life experiences that are, according to Shapiro, the bases of pathological behaviors. The Adaptive Information Processing (AIP) model was developed by Francine Shapiro to explain the effects of EMDR therapy; guide case conceptualization, treatment planning, and interventions; and predict treatment outcomes. The AIP model assumes that both pathology and health are the development of early life experiences that are stored in neurobiological memory networks. Early life experiences, therefore, are the building blocks of perception, attitudes, and behaviors. Neurobiologically speaking, our life experiences get translated into physically stored memories on which we rely to guide us in life choices and interpretations.