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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Eating disorders (EDs) may be among the most self-destructive and persistent behaviors that emerge in the aftermath of trauma. Researchers are becoming curious about the role of the body, and, in particular, the nervous system, as it relates to ED symptoms and the management of dysregulated affect states. This chapter highlights the psychobiological processes that somatic experiencing (SE) is built upon with regard to working with trauma, with specific considerations for its application when working with the ED population. A natural starting point for understanding the intersection between trauma and EDs involves a brief overview of the effects of trauma on the nervous system. SE treatment goals are accomplished not only by listening to the client’s narrative but also by closely watching the body’s expression of the nervous system to slow the process down and explore the various elements of an experience.