Trauma Therapy in Eating Disorder Treatment

Eating disorders often co-occur with another diagnosis such as post-traumatic stress disorder (PTSD). As program director for an eating disorder center, I’m often asked if it is clinically appropriate to do trauma therapy such as EMDR, TF-CBT, and SE while patients are working on their eating disorder. The answer that I continuously give is that it is very much individualized to each person. No treatment approach is the same, just as not everyone has the same response to trauma.

If you are struggling with an eating disorder as well as a past trauma experience, what could you expect when addressing that trauma in treatment? First, you should understand that no matter which type of trauma therapy you and your clinical team decide is best suited for you, you would notice that it gets worse before it gets better. By this, I refer to the fact that since you are working on processing a traumatic life event, it is very normal to experience the same emotions you felt during that time which then increases your defense mechanisms. Oftentimes, people will try to avoid trauma therapy because it is emotionally very difficult and can create heightened physical discomfort. However, in order to heal the wounds, you will need to work through the trauma and not around it. A quote that I like regarding this process is, “The only way out is through.”

There are many benefits to completing trauma therapy while in a residential eating disorder treatment program such as Remuda Ranch at The Meadows. First, because it is difficult to process trauma, which could increase emotional instability and eating disorder thoughts and behaviors, it is imperative to have round-the-clock supervision. The caring staff at Remuda Ranch are by your side 24/7 to provide support and keep you on track with your recovery. Additionally, so often when you only work on one issue at a time, the other issue heightens and vice versa. Therefore, working on your trauma and eating disorder concurrently at a specialized treatment center like Remuda Ranch will build a strong foundation for lasting recovery.

How We Can Help

At Remuda Ranch at The Meadows, we work to meet the needs of the individual patient. Our goal is for patients to process the traumas and recognize the impact on their lives, which may manifest in any number of ways including, but not limited to, eating disorder behaviors. We see patients as complex individuals with common needs of nurturance and respect. Our staff strives to support each patient in learning to live in peace with others, with food, and with themselves. We find that a solid foundation in recovery is possible using the multitude of resources made available to those who seek treatment at Remuda Ranch.

For more information, please call us at 866.330.1456.

Edle Aasland LPC, Program Director, Remuda Ranch at The Meadows

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Why Comprehensive Eating Disorder Treatment for Teens is a Must

Eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder, are complex mental disorders that can be potentially fatal if left untreated. Although eating disorders are associated with damaging physical, emotional, and psychological consequences, many women are unable to connect to the help and treatment that is needed for recovery.

Eating disorders, like other mental conditions, are often stigmatized, which can make it more difficult for someone to reach out for help. When it comes to teenagers, it can be especially painful to confront an eating disorder, for both the individual and their loved ones. Many teens who experience an eating disorder may not understand what they are struggling with, and parents can feel helpless when it comes to knowing how to best support their child. 

The Nature of Eating Disorders

If your teenager is suffering from an eating disorder, you may likely feel overwhelmed about how to help them through these struggles. In order to know how to best help your teenager overcome and heal from an eating disorder, it is first important to understand the nature of these conditions. In doing so, you can feel better equipped in knowing how to support their eating disorder recovery.

To begin, it is crucial to understand that the eating disorder was not your causing and that parents are not to blame. Research has identified that eating disorders develop as a result of many complex factors, including biological components, environmental conditions, and psychological influences. There is no single thing, person, or factor that can be said to have caused an eating disorder, as these diseases develop from the cumulation of many different components. As a parent, you may feel a degree of responsibility when it comes to your teenager having an eating disorder, but removing blame from your mind can better empower you to support their recovery.

It is also important to understand that eating disorders are severe and chronic illnesses with biological underpinnings. This means that an eating disorder is not simply a fad or tactic to change one’s body size or a rebellious phase that will pass over time. If left untreated, eating disorders can cause damaging consequences and become potentially fatal. While it is difficult to confront the reality of an eating disorder, ignoring these serious conditions can be harmful. If you are aware that your teenager is struggling with an eating disorder or feel like something may not be right, it is crucial to seek out professional help and intervention as quickly as possible.

Why Comprehensive Treatment is Necessary

Because of the nature of eating disorders in teenagers, comprehensive and professional treatment is absolutely imperative for healing and recovery. Researchers have also found that eating disorders in teenagers are associated with other complex conditions, including mood disorders, role impairment, and substance abuse addiction [1]. In one survey of teenagers with eating disorders, researchers found that the majority also met criteria for at least one other psychiatric disorder, such as depression. In addition, eating disorders were associated with higher levels of suicidal thinking compared to those without an eating disorder [2].

Conditions that co-occur with eating disorders can and should be addressed simultaneously within the context of professional treatment to help a teenager find complete healing and recovery. Comprehensive treatment for eating disorders effectively treats all aspects of the disease with an evidence-based approach toward healing. This means encompassing medical, nutritional, and psychological care in a manner that promotes recovery on a holistic level.

In many cases, eating disorders may also be influenced by underlying trauma, which can also add to the complexity of these mental illnesses. If unresolved trauma has contributed to the development of an eating disorder in a teenager, it is necessary to address this accordingly within comprehensive eating disorder treatment.

How Remuda Ranch Can Help

At Remuda Ranch at The Meadows, we believe that lasting recovery from an eating disorder is possible with the right treatment and professional intervention. Seeing someone you love struggle with an eating disorder is overwhelming. By offering evidenced-based medical and psychiatric care, nutritional rehabilitation, experiential therapy, culinary arts and more, Remuda Ranch provides the safe, healing, compassionate and nurturing environment for eating disorder recovery to occur.

Remuda Ranch also believes that families are an essential part of the healing journey. We embrace the whole family from the beginning of treatment and provide a five-day family week devoted to building healthy family relationships. We teach patients and their families to understand one another through effective communication and assist family members in practicing validating healthy behavior. This approach helps nurture their relationships in an effort to build interpersonal trust and confidence.

If you or a loved one is struggling with anorexia, bulimia, or binge eating disorder, please feel free to give us a call at 866-239-7381 or send us a message online. Our intake specialists talk to people every day who are in various stages of eating disorders and are happy to answer any questions you may have.

References:

[1]: National Institute of Mental Health, “Most Teens With Eating Disorders Go Without Treatment”, https://www.nimh.nih.gov/news/science-news/2011/most-teens-with-eating-disorders-go-without-treatment.shtml Accessed 29 December 2017.

[2]: Swanson SA, Crow SJ, LeGrange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry. Accessed 29 December 2017.

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Reality! Who needs it?

Individuals in recovery have generally spent a lot of time avoiding their painful, shameful or fearful reality. Using chemicals, relationships, busyness, spending, eating, not eating, fantasy, gambling, sex, etc. to escape reality.

What is your reality anyway?

As a baby, your brain was in a receptive mode and you downloaded and duplicated everything around you. As you grew up, you kept imprinting within you, all of the thoughts, feelings, beliefs, and things that happened and you became you.

From Pia Mellody’s Model of Developmental Immaturity, we learn that this programming creates a belief system. You interpret everything that you perceive through your own belief system, particularly as you interact with others. That’s why people frequently disagree about a shared experience. For example, let’s say that Jason had a disagreement with his sister while they were at a social event and shared about it with several friends. Sara identifies with Jason’s sister, feels empathy, and defends her. Jennifer is reminded of being embarrassed by her mother in public and feels pain and shame. Mark feels annoyed about the very topic of conversation and thinks about something else. Everyone has his or her own reality.

In emotional recovery work, it is extremely helpful to understand your reality and how to work with it. First, your reality is your experience in the present moment and includes your body, thoughts, feelings, and behaviors. Think of a recent time when you felt reactive in an interaction with someone and experienced some strong feelings come up. Now, breathe, take a moment, and fully experience the sensations in your body. Those sensations inform you about your feelings. Identify what the feelings are. Is it pain, hurt or sadness, or is it fear or anger? If you are not used to identifying your feelings, it can take some practice. Truthfully, your feelings are generated by the thought you had. When you are reactive, it’s hard to think straight and it can take some time to identify what the actual thought was, or where in your history it originated.

The most helpful way to think about this is with curiosity and owning it rather than judging yourself or blaming someone else. You are in a disempowered victim mode when you blame someone else for your reaction and that keeps you stuck. When you own that your reaction came from your own programming, then you are empowered to understand yourself better and can change.

So how do we do that? How do we change our reactivity, our thoughts, and feelings, and why go through the trouble? 

Scott Peck wrote, “Mental health is staying in REALITY at all costs.” You’ve had those experiences when you are fully present, connected with yourself, aware of your senses, and feeling alive. Joy, passion, love, and the sense of connection with yourself are present moment experiences. You miss out on life when you are not present. Everyone checks/spaces-out at times; it is the human condition. However, the more present you are, the happier and healthier you will be.

Here are the steps to working with your reality when you are triggered or become reactive:

• Take slow deep breaths and be curious about what you are experiencing and why it is coming up.
• Notice and describe to yourself the sensations you are feeling in your body and identify the emotional feeling word or words that fit. (Hurt, fear, anger, irritation, shame, guilt, for example.)
• Stay present and curious about the feelings or issues that are underneath the surface feelings. It could be abandonment, feeling threatened or unsafe, used or manipulated, blamed, shame, guilt, or a memory of an incident from your past. You could discuss this with a therapist.
• When appropriate, you can own your own experience in the present moment and share it with that person you were reactive to by using your talking boundary. For example, in the previous story, Jennifer becomes very quiet and moody. She might share with Jason, “When I heard you say that your sister made a scene at the family dinner, what came up for me was a time when my mother was embarrassingly loud and rude in public and I’m feeling some shame and pain.” In sharing her reality in this manner, Jennifer’s friends will understand her better and she will likely have a sense of relief from the pain and shame.

Only do this when you feel like a functional adult. Listen to the other person’s reality. Be open to getting to know them and to learn about yourself.

Practicing this will likely bring insight as to how the programming in your brain hijacked the situation and gave you a distorted reality. That insight creates a new reality, even a new neuropathway in your brain. This practice begins to create a new, healthier, happier reality, which makes it easier for you to be present. So who needs reality? We all do.

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Eating Disorder Treatment Options for the Adolescent Impacted by Trauma

As a parent, you have likely planned and envisioned only the best for your child, including desires for their future, saving for college, and more. One thing that you may never anticipate is that your little girl will develop an eating disorder, which can dampen the hopes, dreams, and aspirations that you wish for your child.

Eating disorders, including anorexia, bulimia, and binge eating disorder, are often connected with negative stigmas and stereotypes, which can leave you feeling more confused about what your child is confronting. It is important to know that there are resources and support to help you and your child through this journey and that you do not have to navigate this alone.

The Connection between Trauma and Eating Disorders

Research has uncovered multiple factors that may influence the development of eating disorders in adolescents, including both biological, psychological, and environmental components. The combination of these influencing factors can increase a child’s susceptibility to developing an eating disorder. While it is not necessarily possible to determine a child’s risk factor, there are warning signs that may indicate the susceptibility of forming an eating disorder.

For example, the experience of trauma or traumatic events, including physical, emotional, psychological, and/or sexual, can increase an adolescent’s risk of developing an eating disorder. The high levels of stress and anxiety that trauma often produces can lead to destructive methods of coping, including maladaptive eating behaviors associated with eating disorders.

Studies have found that emotional abuse, physical neglect, and sexual abuse were found to be significant predictors of eating psychopathology [1]. Research has also found that women who reported both childhood physical and sexual abuse were three times as likely to develop eating disorder symptoms as those who reported no abuse [2]. With the experience of childhood trauma associated with a range of serious long-term psychiatric complications, including eating disorders, it is important to recognize the necessity to address these concerns effectively.

Effective Treatment Options

Adolescents with eating disorders who have been impacted by trauma will require specialized and comprehensive care to find healing and recovery. Given the nature of eating disorders and the influence of unresolved trauma, it is necessary to find treatment options that can help address both simultaneously. In healing from trauma, many adolescents find that they are also able to recover from their eating disorder, as destructive eating behaviors are no longer necessary to cope with trauma stressors.

Thankfully, there are many treatment options available to help your adolescent facilitate healing from the inside out and address any unresolved trauma in a therapeutic and healing manner. The level of care for treatment that may be best for your child will depend on a number of factors. Having a complete assessment done by an eating disorder professional can help determine what level of care is best suited for meeting your loved one’s individual needs, including medical, nutritional, and psychological concerns. This may include critical care/inpatient, residential treatment, and transitional care for eating disorders impacted by unresolved trauma.

Establishing medical stability is a priority of eating disorder treatment, including nutritional rehabilitation and psychiatric safety. Once this has occurred, the process of uncovering complex psychological factors contributing to an unhealthy relationship with food can begin. Various forms of therapy can be helpful for trauma resolution, rebuilding self-esteem, and gaining confidence over the eating disorder.

Choosing the Right Treatment Center

At Remuda Ranch at The Meadows, we understand the unique challenges that young girls aged 8-17 face when impacted by eating disorders and trauma. Our treatment program is specifically equipped to effectively address the complex issues stemming from these conditions and empower recovery through our innovative treatment approaches.

Through the devastation and confusion that you and your loved one have experienced, we want you to know that you are not alone. We will work with your adolescent in a nurturing and safe environment to help them regain their health, find healing from trauma, and eliminate eating disorder behaviors. Connecting with the specialized care at Remuda Ranch at The Meadows can make all the difference in recovery from eating disorders impacted by trauma. Connect with us today and learn more about how we can help you and your family find whole-person healing and restoration. Give us a call at 866-239-7381.

References:

[1]: Seongsook Kong, et al. (2009) Childhood trauma as a predictor of eating psychopathology and its mediating variables in patients with eating disorders. Journal of Clinical Nursing 18, 1897-1907

[2]: Rayworth, BB, et al. (2004) Childhood abuse and risk of eating disorders in women. Epidemiology 15, 271-278.

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Utilizing Psychodrama as an Effective Therapy in Treating Eating Disorders

“Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and freedom.” -Viktor Frankl

I will never forget this one particular group. I was sitting in a treatment center in Tucson, Arizona in the spring of 1986 and the facilitator asked for a volunteer. I froze. There were 30-35 patients sitting in a circle in a large conference room with a wide-open space in the middle as the facilitator moved gracefully around the center. After a few moments, a young woman, who I believe came in two weeks ahead of me, timidly raised her hand. The therapist thanked her and for the next 90 minutes I observed sublime human connection.

What did I just witness? Here was this peer publically sharing voices and experiences long kept silent within herself. Here was this peer showing vulnerability, courage, and strength. Here was this peer who seemed to have gained new insights and awareness about past events, and subsequently, new insights and awareness about herself. Here was a clinician who showed expertise, restraint, and seemed to allow the patient to tell her story without an agenda.

As an observer, there was a juxtaposition of fascination and emotional fragility. The intellectual and the emotional were at war. What I know now, and didn’t then, was that she was telling a human story. My story. Her pain connected to my pain. Her loneliness connected to my loneliness. I thought I would be safe as an observer, but little did I know the impact of that afternoon.

This was my introduction to the term, the concept, and reality of Psychodrama. I was a patient barely two weeks sober trying to grasp themes of sobriety, unmanageability, and powerlessness, and at the same time, having difficulty identifying and expressing feelings. What I witnessed that day was a brave woman, a skilled therapist, and a room full of patients “magically” connected in a moment of healing.

Fast-forward thirty-one years. I have spent the past 28 years as a clinician, and for the last 10 years, I have used group psychotherapy utilizing psychodrama and other experiential techniques with eating disorder patients.

Psychodrama and other action-oriented techniques developed by J.L. Moreno, and later by his wife Zerka Moreno, can be especially effective in the treatment of addiction and trauma. It can be extremely effective in the treating of eating disorders. An effective clinician has done his or her own work and will attain regular monitoring and supervision. Clinical judgment is needed, as those with medically compromised weights and those detoxing or actively psychotic are not appropriate for such work.

If clinically appropriate, Psychodrama, Sociometry, and group psychotherapy provides the chance for an individual or individuals in a group setting to heal and connect. Psychodrama creates a space for the safe expression of emotions. This therapeutic space can provide an opportunity for the patient to understand themselves and their history better, to resolve loss and trauma, to overcome fears, to improve their intimate and social relationships, and to practice new skills to prepare for the future.

We Can Help

Remuda Ranch at The Meadows incorporates a variety of treatment methods and therapies to help our patients achieve long-lasting recovery from their eating disorder. Our specialized approach combines proven medical and clinically intensive treatment to help restore balance to the lives of women and girls struggling with an eating disorder.

To learn more about the treatment therapies we offer, visit our treatment page. For immediate help, please call to speak to a Counselor at 866-329-7713.

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5 Reasons Why You Might Need Residential Treatment for Your Eating Disorder Today

Seeking treatment at the appropriate level of care is important for helping you progress in your eating disorder recovery.  Thankfully, there are many eating disorder professionals and resources that can help you or your loved one decide what level of treatment might be most suitable for your specific needs.

When it comes to eating disorder recovery, there is a variety of options available for support and treatment. From residential treatment to outpatient care and everything in between, there are resources that can help you find hope and healing. How do you know which level of care is right for you?

Understanding Treatment Options for Eating Disorders

Seeking treatment at the appropriate level of care is important for helping you progress in your eating disorder recovery.  Thankfully, there are many eating disorder professionals and resources that can help you or your loved one decide what level of treatment might be most suitable for your specific needs. It is recommended that you work with a professional to determine what level of care is the most beneficial for your recovery. This might be an eating disorder therapist, counselor, physician, or psychiatrist. By understanding your concerns as well as the signs and symptoms you are experiencing, a qualified professional will make treatment level recommendations that meet you exactly where you are currently. The most common levels of eating disorder treatment include:

• Inpatient Treatment
• Residential Treatment
• Partial Hospitalization
• Intensive Outpatient
• Outpatient

Typically, a more acute or inpatient level of treatment is necessary for someone who may require medical and/or psychiatric stabilization.  Many individuals will often transition to the different levels of eating disorder treatment as they progress in their recovery journey.  Less acute levels of treatment, including intensive outpatient and outpatient treatment, are more suitable for a person who does not require supervision and monitoring and who is relatively stable from any medical or psychiatric complications.  

Why Residential Treatment Can Best Support Recovery

Residential treatment is an important option available for eating disorder recovery. Residential treatment programs offer a safe and structured environment where individuals can find healing from even the most destructive of eating disorders. At this level of care, residents are provided with continual support and monitoring as well as comprehensive treatment from a multi-disciplinary team, including physicians, psychiatrists, therapists, dietitians, and more.  Residential treatment offers the best level of support required for individuals suffering from a severe eating disorder, including anorexia, bulimia, or binge eating disorder and co-occurring conditions.

Making the choice to seek out residential treatment can feel overwhelming, but it is important to know that you are not alone in this process.  Consider some of the following reasons why residential treatment might be a positive option for your recovery:

1. You are struggling with medical complications: Eating disorders are complex illnesses that can result in serious medical consequences. Maybe you have found yourself in and out of doctor's offices to deal with eating disorder symptoms. Alternatively, maybe you have found the quality of your life negatively affected by physical complications resulting from an eating disorder. Eating disorders, if left untreated, can be life threatening, often due to medical complications, such as heart failure, electrolyte imbalance, or malnutrition. In these cases, residential treatment can help you safely recover from these conditions by providing resources needed for medical stabilization.
2. You are overwhelmed, emotionally or psychologically: It is not uncommon for eating disorders to develop alongside other issues, such as anxiety, depression or addiction. These co-occurring conditions can make it more complex for you to find the underlying cause of your eating disorder and start healing. Residential treatment can give you the structure and environment needed to heal from these complex factors.
3. You find it difficult to feed yourself: Sometimes something as simple as feeding your body appropriately can feel immensely challenging if you are living with an eating disorder.  Because of the severity of eating disorder behaviors, you may not even be sure how or what to feed yourself. Engaging in destructive eating habits, like restricting, purging, and/or binging, can make food seem chaotic. You may feel like you cannot trust your body or are intensely fearful of gaining weight. Residential treatment can be an invaluable resource for helping you normalize your eating behaviors and develop healthier eating patterns.
4. The quality of your life is compromised: Eating disorders can deprive you of enjoying life, making it difficult to flourish in school, work, and relationships. You may have had to drop out of school, lost your job, missed out on a promotion at work, or are suffering in relationships with those closest to you because of your eating disorder. Residential treatment can give you the strong foundation you need in your recovery journey to deal with the underlying causes and gain the tools necessary to rebuild relationships.
5. You have a poor support system: Eating disorders can be isolating, and you may not have adequate support to help you through the recovery process. It is important that you do not fight this alone and that you surround yourself with others who understand how to help you. The treatment team available at the residential level of care can give you the support and structure you need to recover.

While the decision to seek out residential treatment can be tough, it is important to realize what you will gain by prioritizing your healing and recovery. Living life to your fullest potential and ultimately being able to thrive in every aspect of your life are gifts that you will never regret.

The risks of not seeking out residential treatment for your eating disorder must be taken into consideration. Left untreated, you could potentially endanger your life or even lose what matters most to you. Consider how you want your future life to look and ask yourself if your eating disorder is part of that picture.

How Remuda Ranch Can Support Your Healing

At Remuda Ranch at The Meadows, we understand what is needed to help you find lasting recovery from your eating disorder. Our residential level of care provides the highest quality of comprehensive treatment to ensure that you are supported every step of your journey.  Our eating disorder professionals are dedicated to seeing you thrive and will support you with an individualized care plan that is designed to meet your unique needs.  Wherever you may be on your journey today, we stand ready to support you in recovery.  For additional information about the treatment of eating disorders, please call to speak to an Intake Coordinator at 866-842-1245

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