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4 Reasons Why Group Therapy Is a Key to Eating Disorder Recovery

According to the National Eating Disorder Association, eating disorders are among the most common forms of mental health disorders affecting teenagers and young adults in the United States. Any eating disorder can wreak havoc on a person’s life – they might become trapped in a recurrent pattern of compulsive eating, binging and purging, food restriction, or compulsive exercise that affects social life, mental health, and importantly, physical health. Left untreated eating disorders inevitably lead to a plethora of negative health consequences.

While the symptoms of each type of eating disorder vary, they share many aspects – body image distortions, perfectionist tendencies, and desire for control over some part of an individual’s life are all present in most examples. They also share similarities with other kinds of mental health conditions. In many ways, eating disorder is similar to a variety of anxiety disorders. The disordered eating behaviors are compulsive in nature and in some ways resemble the compulsive acts that come with obsessive-compulsive disorder. The actions fill the same stress-coping void as OCD as well, releasing serotonin and dopamine in the brain.

Thankfully, there is a well-established protocol of mental health care that’s become standard for treating eating disorders as well as anxiety. This often includes group therapy sessions. Group therapy during eating disorder counseling is common, and it is so for good reason. Take a look at some of the ways group therapy can help people with eating disorders recognize and overcome their conditions and attain a recovered life.

Group Therapy Helps with Social Anxiety

Social anxiety is a common thread among many (although certainly not all) people who enter an eating disorder recovery program. When someone has social anxiety, it can be almost crippling. Intense fear or worry about being judged by others, or mocked, or even an inability to face social situations are common symptoms of social anxiety.For instance, someone entering treatment for the first time may have anxiety about eating around others, because they fear those others might think or say they are “fat” or otherwise flawed (even if that’s a distorted perception).

Through therapy, individuals might open up about their feelings, which can help clients see they are more apt to be socially accepted that their disordered thoughts are leading them to believe. Group therapy, especially when performed with others that have social anxiety, can put people more at ease with social discussions.

In some ways, group sessions can act as a form of exposure therapy in which a person faces their fears, with the added benefit of having others to support them. One common thread of eating disorders is a disinclination or inability to talk about them with other people. Usually, this is out of a fear of being judged or even the disordered thoughts telling the person not to discuss it because they might be forced to stop. When several people in the same boat come together to discuss their common fears, they become easier to face.

Group Therapy Helps Overcome Specific Phobias

Phobias, such as phobias relative to food, social interactions, or others, are a common problem for those who enter eating disorder recovery programs. For instance, someone in binge eating disorder counseling may have a phobia about eating certain foods in public or at meals with others. Or a person with orthorexia nervosa might have a phobia about eating a certain kind of food they choked on as a child, leading to a lifelong resistance to eating that food again. Group therapy encourages those with phobias to garner strength from the surrounding people, so they can face their fears.

Many forms of therapy can help erase phobias or simply ease them to the point of being manageable, and they are usually available in both group and individual therapy forms. In either form, the key is to help the individual understand the root causes of their phobias and objectively understand them. Gaining an outside perspective via fellow clients’ stories is helpful in this regard, as is their feedback to your participation.

Group Therapy Helps People Reduce Feelings of Isolation

Eating disorders are often responsible for increased self-isolation because many individuals struggling with disordered eating feel a sense of guilt or shame about their behaviors. Because of this, they never share their troubles with the people around them. It is for this reason that binge eating counseling is often put off. Group therapy helps encourage individuals to come out of their feelings of isolation, as they are shown that others face some of the same problems. Because of this, eating disorder treatment centers tend to make group counseling sessions as central a part of each recovery plan as mindful movement and nutritional education.

Anecdotally, many former clients also point to group therapy as their favorite part of treatment. The bonds between clients (and therapists) formed in these groups often go on to become lifelong friendships. This extends to the time after formal treatment as well.

Most eating disorder treatment programs include an aftercare component. Often this includes outpatient or day treatment sessions with the same therapy team, which involves group therapy sessions. However, alumni groups are even more common. In these groups, people who’ve completed a treatment program regularly get together (in a post-COVID world, this is normally virtual) to lend support and discuss recovery together.

Group Therapy Provides New Perspectives and New Ways of Looking at Things

Even if they’re actively engaged in recovery and making every effort to heal, everyone has certain blind spots when it comes to their eating disorder. There are simply certain things you just can’t understand without an outside perspective. As a metaphor, consider that without a mirror, no one can see their own ears. These blind spots can be difficult to address, even with a therapist guiding the process – it can come off as criticism or judgment even coming from a professional.

What group therapy does is “hold up a mirror” to people in treatment, in the form of other clients who are expressing their experience with the same disorder.

People in group therapy sessions are encouraged to participate and express how they feel about their disorder and the recovery journey, but listening is just as important. Epiphanies about an individual’s particular situation can be highlighted by another client discussing their case. For example, something that may have seemed like a reasonable justification for using disordered behaviors might suddenly be clarified as disordered. Some examples might include a person with bulimia nervosa saying they only purged after a particularly big meal, or a person with atypical anorexia nervosa justifying restriction as “just a diet” because they were still overweight.

Breakthroughs are common during group therapy sessions because individuals can see in others what they can’t necessarily perceive in themselves. This makes group therapy a powerful tool for gaining new perspectives and encouraging self-examination.

Individual Therapy Has Its Place, Too

Group therapy can help with phobias, social anxiety, and talk therapy, as discussed above, but some more frequently individualized therapies are useful too. Cognitive Behavioral Therapy, CBT, is one such individual talk therapy method. In CBT sessions the client and therapist work together to identify which thoughts and thought patterns are objectively flawed. Once they are identified, they can both work to replace those distorted thoughts with more constructive and accurate ones.

Other individual therapy techniques are also instrumental in treating eating disorders. As an example, Cognitive Processing Therapy (CPT) is a key aspect of many eating disorder treatment plans. It’s a form of CBT that was developed in the 1980s specifically to help people resolve past trauma and PTSD. Trauma is a causative factor in many eating disorders, and also acts as a trigger for disordered eating patterns, which act as a flawed coping mechanism for the negative emotions associated with PTSD. Organized into 12 structured sessions, CPT has been proven effective in helping individuals identify, process, and overcome trauma in patients ranging from military veterans to survivors of abuse.

People considering entering an eating disorder treatment center should look for a program that incorporates both individual and group therapy sessions as part of their core curriculum. A full continuum of care finds the best combination of therapeutic techniques, nutrition, and medical assistance for each client.

Seek Help for Eating Disorders Sooner, Rather Than Later

If you or a loved one is ready to get help for an eating disorder, don’t worry – there are many eating disorder treatment facilities that can help. Make sure they can accommodate your financial and emotional needs, and importantly, make sure they offer group therapy sessions. Although each disorder and each person is different and has unique treatment needs, modern eating disorder treatment centers are prepared to tailor each treatment program into an individualized plan. Reach out as soon as you can if you or someone in your life is struggling with an eating disorder – a recovered life is within your grasp.

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.