This chapter discusses what happens in the aftermath of trauma, abuse, and disordered eating. This aftermath includes connection to illness as identity and disconnection from sense of self, spiritual identity, higher power, and significant others. Furthermore, there is disconnection from spirituality, passion, purpose, meaning in life, internalized principles, dreams, and deepest desires. We have also provided a few of the many interventions that we have found valuable in reducing suffering and helping clients to reclaim their identity. It focuses our attention on the processes of assessment and therapeutic intervention, and, by so doing, directly addresses the building and nurturing of self. The chapter attempts to describe the journey from ED and trauma identity to knowing, strengthening, valuing, honoring, and sharing self. It is through this that an individual is able to withdraw trust and faith in illness as a way of dealing with life.

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.

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.

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.