Making the Connection Between Trauma and Resulting Eating Disorders
by Dr. Kim Dennis, Medical Director of Timberline Knolls Residential Treatment Center, as published on Health Blog on DailyStrength.org
September 27, 2011
Trauma and traumatic experiences are nothing new to the human condition. Whether a child is sexually violated early in life, or an adult witnesses a horrific event during combat, such trauma can and often does have profound and long-term consequences.
Types of Trauma
In the behavioral health field, trauma is separated into two categories: big “T” trauma and little “t” trauma. Basically, these categories are predicated on frequency and severity. Big “T” trauma is a highly identifiable and catastrophic event. This includes severe physical abuse, rape, extreme injury, witnessing violence, or an unexpected death of a relative or friend. Vivid and explicit memories usually surround this type of trauma.
Little “t” trauma is less about one identifiable event and more about reoccurring painful situations or experiences. This would include ongoing parental criticism, childhood neglect, being bullied or teased, or experiencing alcoholism in the family. The ongoing nature and the more “acceptable” aspect of this type of trauma make it more difficult to treat.
Trauma and Eating Disorders
Ever increasingly, research indicates a connection between trauma and eating disorders. Interestingly, the type of trauma plays a role in whether the individual eventually presents with anorexia or bulimia. Although variations certainly occur, big “T” trauma is more likely to be associated with bulimia. Conversely, little “t” trauma is often associated with anorexia. In each instance, the eating disorder behavior allows the individual to suppress unpleasant emotions related to traumatic experience, to have a sense of control over her emotions and to disassociate from the trauma itself.
Two additional factors play a role in the advent of an eating disorder. The earlier the trauma, the more intense the impact. This is due to the person’s brain organization and development. Therefore, a young child would probably suffer extreme trauma if she witnessed a parent’s death; yet, as is commonly the case, an eating disorder would not occur until years later. Most likely, anorexia or bulimia would manifest during a time of transition or stress, such as puberty, entering a new school, or a family relocation.
The second factor revolves around the interpersonal nature of sexual trauma. Although a car accident or house fire may be a horrific event, rape or molestation is more apt to result in an eating disorder. This is particularly true if the violation was at the hand of an authority figure or family member. This type of interpersonal trauma is far more damaging to the individual. A subsequent eating disorder allows the woman or girl to avoid the pain, shame or guilt associated with the violation, and to “protect” herself from being hurt again.
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