According to the National Eating Disorder Association, about 30% of individuals with an eating disorder have been abused at some point in their lifetime. This is only a measure of individuals who know that what they’ve experienced is abuse, and that they are willing to disclose it. It is likely that this percentage is much higher as many folks do not believe that abuse can be verbal, emotional, physical, and sexual. Furthermore, some men and women do not know, or do not believe, that they have the right to say no to anyone, including a domestic partner or spouse. Nevertheless, this statistic shows us that three out of 10 of those admittedly struggling with an eating disorder have also disclosed trauma.
Due to the seemingly overwhelming amount of patients that appeared to be struggling with managing symptoms of PTSD, I decided to do a quick data study of the patients that presented to our clinic in South Windsor, CT. In the month of July 2014, 74% of our patients acknowledged a trauma history. According to McGinty&Thompson (2014), clients with co-morbidity experience both a longer length of stay and an exacerbation of eating disorder symptoms such as:
- Harm avoidance, including higher degrees of:
- Worry, or anticipatory anxiety
- Intolerance of uncertainty
- Body image dissatisfaction
For this reason, I created a separate trauma/eating disorders treatment track for our patients in order to address these comorbid issues simultaneously, as there are limited programs that will address trauma, and out of those, even fewer will take on patients with an active eating disorder.
Often times, eating disorder symptoms are “born” as a way to cope with flashbacks, body memories, self-loathing and self-blaming that are common feelings associated with those who have PTSD. It would be nearly impossible for these individuals to achieve recovery from their eating disorder without learning coping skills that are specific to symptoms associated with their trauma(s). Thus, the trauma track is designed to do just that. Patients that are appropriate and willing to participate in Walden’s trauma track focus on safety and containment skills specific to trauma. Containment focuses on managing flashbacks, overwhelming feelings, body memories, self-injurious behaviors, and extreme fear and rage. For example, our patients do not discuss flashbacks in detail, they simply learn about skills that are useful in containing their experiences. Learning containment skills can also help many individuals with PTSD who struggle with body memories which cause them to feel the physical sensations of reliving a traumatic event, a symptom that some are not aware is common for those with PTSD. Patients also work toward developing their own “container” for their difficult thoughts and feelings which can be their therapist’s office or putting their experience on a shelf, inside a lock box, bank vault, envelope or a paper bag. They will learn and practice grounding techniques such as reminding themselves of where they are, that they are safe, and that they are older now. Other grounding techniques include identifying a safe place, carrying a picture of their safe place, noticing their surroundings using their five senses, breathing, calling a support person, listening to music or reading affirmations. Patients also participate in psycho-educational sessions to learn about how trauma affects the brain, as well as creative expression groups.
For more information about our trauma track at Walden’s South Windsor, CT clinic, please call 860-533-4672.
About the author:
Rebekah Bardwell Doweyko is the Director of Walden Behavioral Care’s South Windsor, CT Clinic. In this role, she is responsible for providing clinical, administrative and fiscal oversight as well as development for the clinic. Formerly, she was an Intensive Care Manager at the Connecticut Behavioral Health Partnership (Value Options, Inc.) in Rocky Hill, CT where she assisted providers in the treatment and discharge planning for patients identified as high utilizers of inpatient hospitalization and detox services, conducted clinical trainings on Eating Disorders for staff and managed CT Medicaid cases with complex Eating Disorder issues. Prior to this role, Ms. Doweyko has held several clinical positions at various facilities including founding and directing the Intuitive Eating Program (IOP) at Hollywood Pavilion Hospital in Hollywood, FL. She has also held various positions at The Renfrew Center in Coconut Creek, FL acting as a Primary and IOP therapist. There she developed the “Real-Life Excursion” program allowing patients to begin their transition from Residential treatment. Rebekah also specializes in substance abuse, and has worked as a Primary Therapist at The Caron Renaissance Institute and Alternatives In Treatment, Inc. of Boca Raton, FL. She was featured in the Emmy Nominated HBO Documentary “THIN” and composed the foreword to the highly acclaimed “Maintaining Recovery from Eating Disorders” Self-help book by Naomi Feigenbaum. She earned her Master’s degree in Mental Health Counseling from Florida Atlantic University in Boca Raton, FL and is a Licensed Professional Counselor in the State of Connecticut.