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The Role of an Eating Disorder in Staying Stuck in Trauma

Shari Botwin, LCSW has been counseling survivors of trauma and eating disorders for over 20 years. She has been published and gone on air with several national media outlets. In this week’s post, Shari discusses the role of an eating disorder in staying stuck in trauma. 

I will never forget my first week working as a clinician in an eating disorder clinic in the mid 90’s. I was sitting in a meal support group and one of the patients spoke about how she was saving her life by confronting her sexual abuse during childhood. I remember thinking, “What does abuse have to do with anorexia, bulimia or binge eating disorder?” As the months and years continued more and more men and women were coming to my private practice with a long history of being stuck in an eating disorder.

Early in my career I got myself into therapy to explore the role of my eating disorder in staying stuck in my abusive childhood. For years I obsessed about my weight and at times ate to feel better.   I focused on my body parts, mostly the parts of me that represented being a woman and did whatever I could to try and make these parts disappear. As my recovery progressed I realized my eating disorder was protecting me from years of painful and horrific memories of my abuse. In my early adulthood I decided I want a full life and I was sick of “this stupid eating disorder.” I wanted to trust myself and others and I wanted to live life in a body I could sit in.

Something incredible happened around my 10th year in private practice. More and more patients were uncovering abuse, domestic violence, sudden family losses and tragic events like watching the planes crash through the world trade center during 9/11. As I digested and understood the role of my own eating disorder in staying stuck in my abuse I was able to help others realize the way their symptoms were not allowing them to move through their feelings of shame, fear and loss associated with the tragic events that led to a primary relationship with their eating disorder.

I can think of several examples even in the last year of being in practice where patients and I could make that connection. For example, I worked with one young woman who came to me at the age of 17. It took her 4 years to say goodbye to her anorexia. Within six months of being relatively symptom free she asked me, “Is it possible to be sexually assaulted by my own boyfriend?” From that point forward the floodgates opened. For months she reported incidents when she was hurt so deeply by her boyfriend. We began to understand that spending those 4 years prior obsessing and restricting food allowed her to keep the truth about her relationship secret from herself.

I remember working with another woman who came to me in her late twenties. She had been bingeing and purging for over 10 years. Very early into our relationship she shared with me about the tragic loss of her mom when she was 17 years old. Life went on as usual after her mom passed. In fact, many acted like nothing ever happened. She told me many family members on her mom’s side disconnected immediately after her mom died. So she suffered multiple losses at a time when she needed guidance and stability. Years into our work we began to understand that her bulimia filled the role of her missing mom and all the others who walked away. She was so afraid to connect with people that she unconsciously choose her bulimia as her best friend. We would talk about how “her eating disorder would never die or betray her.” Once we made that connection she was able to make a choice about having bulimia versus connecting to people.

Over the years it has become so clear to me that so many people stay stuck in their abuse or trauma as a way to not know. How do we accept things like, losing a mom at such a young age, or that my boyfriend who was supposed to love me also sexually assaulted me? How do we live with the loss of our childhood after abuse? How do we cope with the images of planes crashing into the world train center? There is not a simple answer to these profound questions. However what I bear witness to time and time again over the last 20 years is that if we allow ourselves to know what we feel and how our trauma affects us, we no longer need an eating disorder to cope with or not cope with the pain associated with these events.

 

Shari Botwin is conducting on-going podcasts for Mental Health News Radio. She is working on her second book, Conquering Trauma. To read her publications or listen to previous podcasts visit www.sharibotwin.com.

Below are two of Shari’s recent podcasts:

Sexual Assault Survivors: Voices of Experience and Healing 04/25 by Mental Health News | Psychology Podcasts can be found here:

http://www.blogtalkradio.com/mentalhealthnews/2017/04/25/sexual-assault-survivors-voices-of-experience-and-healing

Shari’s newest podcast focuses on the role of an eating disorder in staying stuck in trauma and loss. She talks with the host and another clinician about their personal and professional experience of working through trauma and moving past the ED. Shari demonstrates how someone goes from surviving, recovering to thriving into a full life. 

Counselors Corner: The Link Between Eating Disorders and Trauma 05/25 by Mental Health News | Psychology Podcasts

http://www.blogtalkradio.com/mentalhealthnews/2017/05/25/counselors-corner-the-link-between-eating-disorders-and-trauma

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.


Surviving Spring Break while in Eating Disorder Recovery

Angie Viets, LCP is an eating disorder specialist who has dedicated her career to helping her clients recover. In this week’s post, she discusses a common challenge for college-aged clients—spring break. Angie shares some tips on how to manage the stress of spring break while in eating disorder recovery.

Weeks leading up to spring break the refrain during therapy sessions with my college-aged client’s in recovery sounds like this, “Everyone, literally everyone around me is on a diet and losing weight to ‘prepare’ for spring break. And guess what I’m losing? My f’ing mind! How am I supposed to gain, or even maintain my weight in a world where it’s ok for everyone else to lose weight?”

The frustration is palpable and it’s real. Spring break while you are recovering from an eating disorder, is the equivalent to a recovering alcoholic walking down Bourbon Street during Mardi Gras. “It so sucks,” I say, “I get it; it’s messed up and unfair. I wish I could make it go away for you, but I can’t. So, let’s find a way to survive it.”

A few tried and true tips:

1. Personal responsibility
I learned in my own recovery that no one, I mean NO ONE can protect the sacred space of your recovery like you can. Of course, it’s hurtful when people you are close to continue to talk about their weight loss strategies even after they know you have an eating disorder. However, the reality is we are 100% responsible for our recovery. Period. Once that really sinks in it can be liberating (after you finish freaking out about it). Of course, you need tons of support along the way, but ultimately it’s up to you! And what I know about you, just like me, is that once our minds are made up, you better move out of the way.

2. Get in alignment
Purposefully staying in alignment with your recovery goals is huge, especially during high-stress situations! Here are a few suggestions to lighten the load. Meet with your treatment team a little more frequently until things settle down a bit. Listen to podcasts on recovery. Read daily affirmations that resonate with you. Follow blogs that are recovery oriented. Adopt a mantra to carry you through the next couple of weeks.

3. A visualization
Close your eyes and imagine being lovingly wrapped in a ball of golden light. This light gently warms your skin; it protects you. Your body, illuminated by the light, is a sacred space, a sanctuary where you are healing. The light creates a protective bubble around you that cannot be penetrated by the noise that once was so triggering. The noise never goes away; nor is it your responsibility to make it go away.

Honor the light by remembering that you have the ability to protect what you’ve worked so passionately for – Your Recovery.

4. Surround yourself with positivity
Choose the company you keep wisely. We don’t have the ability to change other people and what they focus on. We can, however, decide which relationships we invest our energy in. Consciously surround yourself with people who aren’t caught up in perfecting their body. (Believe it or not, they do exist; I promise). Love yourself enough to walk away from anything that makes you question your recovery. Your recovery tribe will believe in and encourage you. They will lift you up and nourish you. Be so grateful for them!

5. Be an observer
Notice that this flurry of activity around you is short lived. Sit back as though you’re a writer planning to tell the story of the “Spring Break Freak-out.” An observer story from a former client: “It’s starting again! All of my sorority sisters are ‘preparing’ for spring break by doing a Brazilian butt workout.” Years into her recovery she was able to see the absurdity of these trends and also recognized the sadness of feeling inadequate. She found it interesting to notice that as soon as spring break was over, so were those silly butt workouts.

When the volume is too loud around you and your brain feels cluttered with the competing agendas of recovery or commitment to your eating disorder, step outside. Notice that spring is here; which is truly a time of renewal. You are preparing for something a hell of a lot more important than spring break, you are preparing to Bloom!

Know that I’m thinking of you and am confident that you can ride the waves as they rise and fall. Be gentle with yourself. I’m so very proud of you!

 

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.


Article Inspiration

Join us in reading soulful articles we have cultivated from across the web. If you have found an article you feel is inspirational, explores current research, or is a knowledgeable piece of literature and would like to share with us please send an e-mail here.

Mindfulness: A Path to Self-Acceptance Psych Central

Pain and Eating Disorders Denver Health 

A 5-Minute Meditation to Help You Find Your Calm Now Health

Cave Person Brain (Part II) Project Heal

To Be of Substance: A Personal Recovery Call to Action NEDA

If You Only Have Two Minutes to Meditate, Do This Mind Body Green 

 

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.


Dual-Diagnosis Programming

In the field of eating disorder treatment, we understand that patients who seek care are typically presenting with ranging types and degrees of co-morbidities. Particularly delicate is the treatment of a patient who presents with both an Eating Disorder (ED) and a Substance Use Disorder (SUD). To meet the individualized needs of our patients who fall in this population, Monte Nido and Affiliates has developed specific protocols for addressing dual-diagnoses. At Monte Nido Newport Beach, the implementation of these protocols allows for specialized treatment of our dual-diagnoses patients.

Current evidence and expert clinical consensus suggest that integrative treatment of SUD and ED is the best model since both diagnoses are linked by common underlying factors that influence the stress response. Despite the many commonalities in a person’s experience of the two conditions, EDs and SUDs are different illnesses with different courses and treatment needs. When working with eating disorders we want to “remove the ‘–ic’” to help a patient understand they are not “anorexic” or “bulimic”, rather they had anorexia or they had bulimia. This speaks to the classically cited difference between the two illnesses, which is that abstinence from substances is possible, while abstinence from eating is impossible. With this in mind, we hold our belief that full recovery from an eating disorder is possible, while respecting that individuals remain “in recovery” from their substance use disorder.

The goals we set in our Co-Occurring Programming are driven by the aforementioned commonalities and discrepancies between eating and substance use disorders. The overall goal of treatment is to reduce rigidity and control over eating while increasing control over substance use urges. The initial focus of treatment is to re-establish a normalized pattern of eating and substance use sobriety. Once this stabilization has been achieved, the treatment team is able to help a patient narrow in on the transdiagnostic etiology, factors that maintain the disorders and common treatment targets. At this stage of treatment the team can help a patient explore trauma history, for example, a common underlying contributor to the development of both disorders. The continuum of containment encourages patients to develop increasing levels of accountability, self-awareness and capacity for tolerating distress. Since both disorders are driven by stress avoidance, our treatment plan is substantiated in decreasing emotional and experiential avoidance by encouraging people to utilize grounding techniques and healthy coping mechanisms instead of their disorders.

We are well equipped to contain substance use issues and integrate SUD treatment into the treatment plan for an individual who has a primary diagnosis of an eating disorder. If detoxification of the substance is indicated pre-admission, the patient will be referred to a detox program and transferred to a Monte Nido and Affiliates program directly upon completion. At almost all Monte Nido and Oliver-Pyatt Centers programs we offer a sober living environment and support both 12 Step and SMART recovery work. At Clementine adolescent treatment programs, co-occurring treatment is provided in both individual and family therapy. At the Partial Hospitalization Programs, our expert nurses provide additional medical oversight and safety of our patients who enter with Substance Use Disorder.

Monte Nido Newport Beach provides a specialized program for our patients who present with dual-diagnoses. Clinical Director, Kelly Souza, MA, PsyD is specifically trained in the treatment of Substance Use Disorders and has experience working in a substance abuse facility. She is currently working on obtaining her CADC certification and runs a specialized breakout group for dual-diagnoses patients. Additionally, Program Psychiatrist, Dr. Vicki Berkus, MD, PhD, CEDS, specializes in SUD and ED and provides on-site medication management. The expertise of our staff, combined with care that is tailored to the needs of each patient, allows us to provide the most effective treatment for individuals with a need for specialized care.

Monte Nido and Affiliates’ dual-diagnosis programming was developed based on the latest research and best practices by chief clinical staff with the intent to continue to provide outstanding care to diverse populations with the primary diagnosis of an eating disorder. As we further develop this programming, we will expand the specialized level of treatment offered at Monte Nido Newport Beach to more of our programs. For inquiries about the specialized programming at Monte Nido Newport Beach, please reach out to Regional Outreach Manager, Andie Hollowell at ahollowell@montenidoaffiliates.com.

 

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.


Staying Power: How To Tolerate What Feels Intolerable

Jennifer Kreatsoulas, PhD, RYT is a yoga teacher and yoga therapist specializing in eating disorders and body image. In recovery herself, Jennifer is extremely passionate about helping others reconnect with their bodies and be empowered in their lives. Jennifer works with clients in person and via Skype. She also teaches yoga at the Monte Nido Eating Disorder Center of Philadelphia, is a partner with the Yoga and Body Image Coalition, and leads trauma-sensitive yoga classes. In this week’s post, Jennifer discusses the idea of “staying power” in tolerating what feels intolerable.

While on my healing path from anorexia I’ve had to learn how to tolerate what often felt positively intolerable (my body, food, treatment, calorie increases, exercise restriction, gaining weight, drinking supplements, painful therapy sessions, and much more). I was taught to sit with uneasy feelings and physical discomfort and to wait for them to pass. The reality is that that space and time of “waiting” can be in itself intolerable and set off habitual negative thoughts and behaviors. Yes, learning to be present to discomfort is an important life skill, and that awareness is key, however, I believe that approach can sometimes feel passive and leave us feeling helpless in a difficult moment or situation.

Staying power is what I call super-charged presence. It’s actively and directly taking on intolerable feelings — those feelings that set off negative thoughts and coping behaviors. It’s about staring those painful thoughts down and not letting yourself off the hook with sabotaging and destructive behaviors — like hiding food, over exercising, being dishonest with support people, or checking out by starving, purging, and bingeing. The more we practice staying power and get comfortable with what feels intolerable, then the door to acceptance and the deeper work of healing can open. But first, we have to learn how to NOT escape the feeling.

The minute you have the awareness that you want to dodge, push away, or ignore a feeling or situation is the exact time to tap into your staying power. In yoga, we have a saying: the pose begins the moment you want to come out of it. The same with recovery: the real work begins when we choose to stay and push ourselves to withstand what feels awful. In my experience, practices like mantra, deep breathing, and yoga poses cultivate staying power by creating focused positivity. For others, prayer, art, music, cooking, and nature brings a peace and calm from which to harness clarity and strength.

To learn your power source, reflect on these questions:

  • When in your life do you feel empowered?
  • What activity are you doing?
  • What thoughts, feelings, and emotions do you sense when you feel empowered?
  • How do you hold your body in that moment?

The qualities and activities you identified are your power source. To “stay” with what feels intolerable, you need to plug into your personal power source. It will both protect you from self-sabotaging behaviors and empower you to call on your strengths and not be defeated by what you believe you can’t tolerate.

I get that it’s not easy to REMEMBER your strengths when you feel consumed by an intolerable feeling and you want it to go away ASAP. Most likely, you have habitual responses that will need rewiring. To help you remember your strengths, I encourage you to create an intention that aligns with your power source or carry a grounding stone to help pull yourself out of ED Head and into the moment. You might even ask yourself “WTF” (What’s the Feeling?) when the urge to check out comes on or try this simple yoga practice to interrupt habitual eating disorder rituals.

Here’s the thing: we need to get creative and test out little tricks to begin to make small shifts in our recovery. We can’t cultivate staying power if we don’t actively, directly, and deliberately pull ourselves out of ED Head and use our personal power to rise above the challenge of tolerating what feels intolerable.

For more information about Monte Nido please call 888.228.1253, visit our website and connect with us on FacebookLinkedInTwitter, and Instagram.