This chapter provides a brief description on trauma-focused cognitive behavior therapy (CBT) and eating disorders (EDs). CBT has proven to be the most well-supported approach for EDs in the empirical research. It is considered the first-line “treatment of choice” for individuals diagnosed with bulimia nervosa and recommended for the treatment of anorexia nervosa (AN), atypical EDs, and binge eating disorders (BED). Furthermore, multiple studies have demonstrated the efficacy of using CBT for post-traumatic stress disorder and trauma symptoms. CBT for EDs is approximately 20 sessions for treating bulimia nervosa or BED, whereas treatment for anorexia nervosa can require a much longer treatment, typically lasting 1 to 2 years. Addressing trauma work will add to the number of sessions. CBT for EDs and for trauma can be done concurrently or sequenially. Deciding on the format can be done on the basis of clinical presentation and in collaboration with the client.

Neurofeedback therapy is a modality that can help a stuck brain get unstuck and learn new and better ways to fi re and function. This chapter describes what neurofeedback therapy is, how it works, and how it can be a valuable part of treatment for eating disorders (EDs). Neurofeedback therapy, also called EEG biofeedback or neurotherapy, makes use of the brain’s capacity for change to reshape brain networks. Neurofeedback uses EEG information to provide feedback to the trainee. Neurofeedback is a powerful training tool that can be used within a comprehensive treatment plan to assist clients to begin to have more control over how their brain fires. Neurofeedback therapy shifts arousal in the brain, which helps clients to alter the state they experience and to create a new narrative about themselves and the world around them.

Accelerated experiential dynamic psychotherapy (AEDP) is an attachment-oriented, emotion-focused model of psychotherapy and trauma treatment. This chapter details the course of AEDP treatment for clients with active eating disorders (EDs). It uses vignettes and a transcript from a live therapy session to highlight salient concepts and illustrate AEDP interventions in action. AEDP is fundamentally an experiential model. AEDP uses two versions of the triangle of experience to conceptualize the process and the piece of work. The first represents what AEDP calls the client’s self-at-best, or the resilient self. The second represents what AEDP calls the client’s self-at-worst, or compromised self. At the beginning of treatment, AEDP interventions are focused on building safety and regulating anxiety so that core affect can surface. Metaprocessing is an essential element of any AEDP treatment process. It undoes our clients’ aloneness with dysregulating new experiences and helps them to metabolize them instead.

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.

Eating disorders (EDs) are common chronic illnesses that most clinicians, regardless of specialty, will encounter at some point, and trauma is universal in those who have EDs. Trauma from physical and/or psychological injuries overwhelms the mind and body’s capacity to adapt, and can set off or perpetuate an already present ED. The nutritional support of an individual who struggles with an ED and is a trauma survivor can be one of the most challenging tasks a dietitian encounters. One of the most accurate ways to assess the nutritional status of the body is to do two types of tests: metabolic testing and body composition analysis. Physicians, dietitians, and nutritionists who treat EDs will be treating trauma. Physicians, specifically, have a critical role in diagnosing and treating EDs. Medical caregivers need to let the patients know that they will stay the course and support them for as long as it takes.

The chapter analyzes the gestaltists view, psychoanalytic view, feminist and sociocultural views, and tries to come to some understanding of where one might be going in promoting change from body image disturbance (BID) to positive experience. The gestaltists sought to recognize the incredible power of the mind to organize information, so that one can effortlessly make sense of all we take in via one’s senses. The psychoanalytic view greatly helped our understanding of BID in various forms of psychopathology. However, the denial of the traumatizing effect of sexual abuse, it also greatly limited the potential for care. For many disorders, treatment models followed the historical sequence from psychoanalysis to behavioral to cognitive behavioral. The treatment of BID in eating disorder drew in one more viewpoint in1970s, that of the feminist view. Finally, the cognitivists sought to explore the internal processing that links cultural influence and learning history to psychopathology.

This chapter provides a brief description on eating disorders and the case for emotions. Throughout this chapter, the author have used the terms “emotion” and “feeling” interchangeably, although neurologically they can be understood as different stages of the emotional experience. Much of this chapter is how the author teach clients emotional courage and competence, but it has also helped many clinicians in their own journeys. Change is what we most often fear, even if it means shaking off toxic residue and stepping into the unknown of a different and healthier identity. So-called “good” feelings often end up scaring us as much as the “bad” ones, because they, too, invite change. Feeling requires courage. The emotion knocking on your door is letting you know that you have reason to be excited or fearful and that your aliveness is calling you to a larger version of yourself.

Overwhelming evidence exists that traumatic experiences leave traces in our minds and bodies. Traumatic experiences such as sexual, physical, and emotional abuse have a negative impact on our capacities to relate to and trust other people, but also on the neurobiological functioning of our brain and thus our mind. They also affect our immune systems. Hence, traumatic experiences make dealing with emotions, both positive and negative, quite challenging. In this chapter, a “state-of-the-art” review reveals the presence of a wide variety of traumatic experiences and their consequences in anorexia nervosa, bulimia nervosa, and binge eating disorder patients. Almost all studies investigated the association of retrospectively reported childhood abuse with current ED symptoms using cross-sectional designs. A special focus is on the presence of dissociation in ED patients, as it is one of the main characteristics in EDs with severe trauma.