Sponsored By: The Refuge – A Healing Place
Many people who develop anorexia, bulimia, binge-eating disorder, and other eating disorders also have a history of trauma.
When these individuals seek professional help, selecting a facility whose approach to treatment incorporates trauma-informed care can be a vital step on their path to improved health.
The Relationship Between Trauma and Eating Disorders
An October 2020 article on the website of the Society for the Advancement of Psychotherapy  discussed the prevalence of post traumatic stress disorder (PTSD) and other effects of trauma among men and women who have various forms of eating disorders.
The article’s authors, Zoe Ross-Nash, M.S., and Paula M. Brochu, Ph.D., cited statistics such as:
- About 70% of women who have been diagnosed with an eating disorder have a history of trauma.
- In a 2012 study of people who have binge-eating disorder, about 98% of male subjects and 91% of female subjects told researchers that they had experienced at least one traumatic event in their life.
- The rate of post traumatic stress disorder (PTSD) among people who are receiving care for eating disorders may be as much as four times higher than among the general public.
- A 2011 study of women who have anorexia revealed that 76% had a history of sexual assault.
In a Feb. 20, 2018, post on the National Eating Disorders Association (NEDA) blog, Carolyn Coker Ross, M.D., MPH, noted that eating disorders and PTSD share certain similarities.
“[Eating disorders and PTSD] both have high rates of dissociation. Eating disorder behaviors may be a way to distance oneself from disturbing thoughts, emotions, or memories associated with PTSD,” Dr. Coker Ross wrote .
“Along with the shared characteristics between PTSD and eating disorders, there are also similar genetic and biological factors that might explain this correlation,” she added later in the same article.
The Impact of Trauma
NEDA reports that trauma can be “a significant risk factor”  for eating disorders, especially for types that involve episodes of binge eating or compensatory purging behaviors.
Bingeing, purging, and certain other symptoms of eating disorders can be types of avoidant coping mechanisms, which are self-defeating attempts to respond to stress by punishing oneself or changing one’s behaviors in order to avoid thinking about or dealing with distressing thoughts or memories.
In the aftermath of trauma, disordered eating behaviors, though harmful, can provide temporary distraction from or numbness to the intrusive, upsetting thoughts that can be characteristic of PTSD.
Failing to address concerns such as PTSD and other effects of trauma can significantly undermine a person’s ability to achieve and maintain long-term eating disorder recovery. If the underlying cause of the disordered eating is not resolved, the patient may remain at elevated risk for eating disorder relapse.
When a patient’s treatment is guided by the principles of trauma-informed care, they may be more likely to have a successful treatment experience and remain in recovery.
The Fundamentals of Trauma-Informed Care
Trauma-informed care is neither a distinct service nor a stand-alone treatment technique. Instead, this term describes a comprehensive, holistic approach to treatment that includes patients and families, clinicians and other caregivers, and organizational leaders.
As described by the Center for Health Care Strategies (CHCS), when organizations adopt trauma-focused care, they “shift the focus [of patient care] from ‘What’s wrong with you?’ to ‘What happened to you?’”
This perspective shift can have a significant positive impact on people who are receiving care for eating disorders, many of whom are likely to have also been struggling with shame, guilt, low self-esteem, and a diminished sense of self-worth.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA) , treatment centers that employ a trauma-informed approach to care will take steps to:
- Realize the widespread impact of trauma and understand the many potential paths a patient may follow to achieve and maintain recovery
- Recognize the signs and symptoms of trauma in patients and clients, their loved ones, and staff members
- Integrate insights, knowledge, and understandings about trauma into the center’s policies, procedures, and practices
- Seek to actively resist retraumatizing patients, families, or staff by identifying procedures and techniques that may trigger distressing memories or otherwise cause emotional pain among people who have a history of trauma
While taking these steps, SAMHSA notes, centers that incorporate trauma-informed care should also:
- Ensure that patients, families, and staff feel safe
- Operate the organization in a way that promotes trustworthiness and transparency
- Include mutual self-help and peer support services in programming
- Prioritize partnerships throughout the organization to emphasize that all staff members have a role to play in trauma-informed care
- Promote a culture of empowerment and choice so that patients know that their voice will be heard and that their choices will be respected in the process of setting goals and making treatment-related decisions
- Identify and eliminate biases and stereotypes that may limit access to or participation in any treatment services
Features of treatment at eating disorder centers that follow SAMHSA’s standards for trauma-informed care include compassionate services, a commitment to patient empowerment, and comprehensive support from all staff members, all within a safe, welcoming, and nonjudgmental environment.
- Ross-Nash, Z., & Brochu, P. (2020, October). The importance of trauma-informed care in eating disorder treatment. The Society for the Advancement of Psychotherapy. http://www.societyforpsychotherapy.org/the-importance-of-trauma-informed-care-in-eating-disorder-treatment.
- Coker Ross, C. (2018, February 20). Eating Disorders, Trauma, and PTSD. National Eating Disorders Association. https://www.nationaleatingdisorders.org/blog/eating-disorders-trauma-ptsd-recovery.
- National Eating Disorders Association. (2018, February 22). Trauma & PTSD. https://www.nationaleatingdisorders.org/learn/general-information/trauma.
- Center for Health Care Strategies. (2020, April 13). What is Trauma-Informed Care? Trauma-Informed Care Implementation Resource Center. https://www.traumainformedcare.chcs.org/what-is-trauma-informed-care/.
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4884.pdf.
About Our Sponsor:
The Refuge, A Healing Place is a nationally respected provider of treatment for adults who have been struggling with substance use disorders, the effects of trauma, eating disorders, and mental health concerns. Located on 96 acres amid the beautiful Ocala National Forest in Ocklawaha, Florida, The Refuge’s campus is an ideal treatment environment for clients to step away from everyday stress to focus on their health. Treatment options include residential care and a partial hospitalization program, along with medical detoxification, a relapse prevention program, and four-day intensive retreats that incorporate family and friends.
The opinions and views of our guest contributors are shared to provide a broad perspective on 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 July 16, 2021, on EatingDisorderHope.com
Reviewed & Approved on July 16, 2021, by Jacquelyn Ekern MS, LPC