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Who Am I Without Anorexia? Finding Purpose, Meaning, and Your True Self in Recovery – Part 7
Key Contributing Factors to the “Eating Disorder Self”
Family Dynamics
In regards to the eating disorder self, some of the questions that are important to explore regarding family dynamics and upbringing are:
- How was criticism handed down?
- How was punishment dealt with?
- How would your family deal with failure?
- How would your family deal with forgiveness?
- Were you continuously reminded of your errors or was your family able to forgive and forget?
What these questions get down to is that, when people aren’t forgiven for their errors, and they’re kind of beat up about any mistake that they have made, they will often internalize that dialogue and will begin speaking to themselves that way.
This can lead to problems with how they view their body, such as that it’s never good enough because maybe they were never good enough as a child. As such, it is important to take the time to acknowledge successes, and when we truly forgive people and allow them to move on rather than continuously bringing up past errors.
Social influence is another really important thing to consider, especially in schools. Groups of people, often in either high school or college, will sometimes even teach one another eating disorder behaviors. I have heard stories of individuals purging with friends or compulsively exercising with a girlfriend or a boyfriend.
These kinds of social influences need to be taken into account as well as the pressure in social situations and pressure to perform or engage. If somebody is hyper-critical of themselves and their self-worth is based on their bond, they may not even seek out social supports because they’re too embarrassed even to leave the house.
Trauma
An important aspect of trauma is to be careful not to delve into trauma work prior to stabilizing an individual and helping them build the coping skills to deal with the distress that inevitably comes up through trauma processing.
One of the things that can happen when somebody enters into treatment is that they may be very eager to address the underlying issues that are fueling an eating disorder. It is up to the practitioner to pace them and make sure that they’re not taking on too much too quickly because that could be really detrimental to their safety.
Make sure you have somebody stabilized medically and psychiatrically. Also, ensure that they have the coping skills they need to deal with the distress that will be evoked when trauma work begins.
Medical Concerns in Eating Disorder Self
A great example of these contributors is to consider, for example, that when someone is binge eating, they may actually have some kind of nutritional deficiency.
Individuals working in this field want to make sure that we’re looking at bloodwork and making sure that any other medical problems that might be creating eating disordered behavior are addressed.
I once worked with someone that wasn’t presenting the cognitive or thinking patterns of somebody with anorexia, yet, they were severely underweight.
Upon going on to an interview, I discovered that he had multiple gastric problems and his body was not absorbing nutrients in the way that it needed to in order for him to sustain his weight.
Consider these contributors because we don’t want to pathologize somebody or give them an eating disorder diagnosis if they have low weight, or the problems that they’re facing can be better explained by a medical problem.
Psychiatric Concerns
The same is true for psychiatric problems. For example, when somebody has a severe stimulant addiction, the stimulant may be suppressing their appetite.
They may become underweight or be presenting as though they have an eating disorder, but, in the absence of the substance (and after they are allowed to regain the weight that they lost in the course of their substance use disorder), we don’t necessarily see that they have an eating disorder.
We have to make sure that we’re not too quick to diagnose and too quick to assume that a person has an eating disorder when it could be better explained by a different psychiatric problem.
TO BE CONTINUED IN PART VIII…
Please See
Who Am I Without Anorexia? Finding Purpose, Meaning, and Your True Self in Recovery – Part 1
Who Am I Without Anorexia? Finding Purpose, Meaning, and Your True Self in Recovery – Part 2
Who Am I Without Anorexia? Finding Purpose, Meaning, and Your True Self in Recovery – Part 3
Who Am I Without Anorexia? Finding Purpose, Meaning, and Your True Self in Recovery – Part 4
Who Am I Without Anorexia? Finding Purpose, Meaning, and Your True Self in Recovery – Part 5
Who Am I Without Anorexia? Finding Purpose, Meaning, and Your True Self in Recovery – Part 6
Source:
Virtual Presentation by Nicole Karst in the May 17, 2018, Eating Disorder Hope Online Conference II: Anorexia Hope & Healing in 2018.
Please view the press release Here.
Author: Nicole Karst, MA LVN
– Lead Therapist at Rebecca’s House Eating Disorder Treatment Programs
Nicole Karst has 17 years of combined experience in the health and mental health fields. After completing her service in the military as a Fleet Marine Force Corpsman, she started a career in nursing. It was through her nursing experience that she began working with those diagnosed with eating disorders, substance use disorders, psychotic disorders, and mood disorders. This experience inspired Nicole to return to school, and she is graduating this spring with a doctoral degree in Clinical Forensic Psychology.
Nicole’s experience includes individual and group therapy, psychodiagnostic assessments, mindfulness meditation, and medical assessing/monitoring of complications related to eating disorders. She joined the leadership team at Rebecca’s House Eating Disorder Treatment Program from Casa Palmera.
Nicole combines a psychodynamic case conceptualization with cognitive behavioral interventions, guided imagery, logotherapy and somatic awareness in her treatment approach. She works with those she serves to cultivate their ability to eat intuitively, exercise mindfully, engage life with purpose and meaning, and discover who they are in the absence of maladaptive behavior.
About the Transcript Editor: Margot Rittenhouse is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.
As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published on July 30, 2018.
Reviewed & Approved on July 30, 2018, by Jacquelyn Ekern MS, LPC
Published on EatingDisorderHope.com
