Eating disorder therapists have long recognized the correlation between female clients who were sexually or physically abused having problems with food. I suspect there might be a correlation for men and even one for emotional abuse as well. Science is only beginning to understand the magnitude of stressing our nervous systems early on. “Abused Girls May Binge on Food as Adults” by Salynn Boyles (MedPage Today, 5/30/13) talks about this correlation and draws from a study in the journal Obesity entitled, “Abuse victimization in children or adolescence and risk of food addiction in adult women” (Mason, SM, et al, 2013, DOI:10.1002/oby.20500). Its conclusion: “Women who experience both sexual and physical abuse during childhood had a more than twofold increased risk for food addiction in adulthood. The analysis of data on 57,321 women enrolled in Nurses Health Study II (NHSII) revealed that severe physical and sexual abuse were each associated with a...

Reading an article about vets finding a way out of post-war depression, anxiety, and PTSD, I got to thinking about disregulated eaters’ fanatic absorption in food and weight obsessions and how they would benefit from finding a greater purpose in order to be done with that obsession. You don’t want your tombstone to read, “Spent a lifetime struggling to eat ‘normally’ and lose weight,” do you? Believe me, I understand the pain of compulsive eating and being or feeling overweight. But it cannot remain the be all and end all of life as some of you have made it. Although I encourage you to read my books and blogs and join my Food and Feelings message board, I’d rather see you out there doing things you’re passionate about which gives you a sense of satisfaction, belonging, and a focus greater than yourselves. There’s something highly unhealthy and excessively self-absorbing about spending...

It’s not unusual for people with eating difficulties to have problems with self-care in other areas as well—drugs, alcohol, hurtful/damaging relationships, or simply treating yourself poorly. It’s common for folks in their teens, 20s and 30s to struggle with issues of self-worth and self-care due to rebellion against family or culture or from plain ignorance and poor role modeling. In fact, it’s often a rite of passage into adulthood; improved judgment comes with experience and maturity. What of those of you who continue to harm yourself into your 40s, 50s and beyond—drinking, drugging, eating, smoking and treating your bodies as if they were disposable? In these decades, you’re no longer struggling to form an identify. Yours is solidified, but your values and actions regarding self-care haven’t evolved from your early years. You may climb a career ladder as high as you can go, but you probably never feel deserving of your...

When you read books like mine and other authors trying to help you become a “normal” eater, do you wonder if everyone can become one or just some people? Ever think about whether you’re spinning your wheels with this intuitive eating stuff or how long you should try it before giving up? Based on posts I read on eating message boards and what clients and students say, my guess is that these are red hot questions for you. I’d like to tell you that I have definitive answers, but I don’t. Here’s what I do know. Biology plays a huge part—some 50-70%—in determining your weight. Genetic loading inclines you toward fat or thin. A traumatic childhood or stressful life may predispose you to food regulation problems or eating disorders. Depression and anxiety impact metabolism on a biochemical level and also may exacerbate appetite problems. Your eating habits begin in the womb...

During a telephone therapy session, a client expressed frustration about what to do about his binges. He knew he needed to do something to stop them, but was at a loss regarding exactly what was needed. My response took him back to what we often require in childhood to thwart unwanted and wanton impulses: to be contained and comforted. We really do need both; either one is not quite enough. The goal of containing an impulse is to not let it move from thought or intention into out-in-the-real-world behavior. When driving, I might want to do something nasty to the driver of a car that has just cut me off, but I refrain. I contain or hold back the impulse because I know it is not in my best interest to convert my wish into action for good reasons. We learn containment in childhood when adults do it for us—they yank...

Those of you who have suffered trauma in childhood may find yourself having problems regulating your food intake. Psychology used to lump together all trauma, but now distinguishes between what is called Big T trauma and Small t trauma. The former includes rape, sexual/physical abuse and continual/excessive emotional abuse, severe neglect, living through war, and major catastrophe striking at a young age. Being badly injured in childhood, losing your family, or having to abandon your home through abrupt dislocation are all examples of Big T trauma. They are the stories that make headlines. However, Small t trauma can affect you as strongly as (maybe more than) Big T trauma precisely because you probably underestimate its impact. Examples of Small t trauma include frequently living in fear, suffering low level but continual emotional abuse, growing up in a home in which there is drug and/or alcohol abuse or other kinds of destructive...

It came as no surprise to me to run across an article entitled “Constant family arguing can lead to childhood obesity” by Herb Scribner (Las Vegas Review-Journal, 4/24/15). I had that kind of experience and know that it had a huge effect on my eating, especially when the arguing happened at the dinner table. Although I never became obese, I had eating problems and weight concerns from my teens through my thirties. A study published in Preventive Medicine concludes that “The effects of too many family arguments can have a lasting impact on a person’s health” and “that constant family conflict can lead a child toward obesity.” Dr. Daphne Hernandez cites the main causes of stress in families as: “arguments, what happens after a family member gets divorced, remarried or incarcerated, financial stresses, and poor maternal health.” The study conclusion is shocking: “girls from families who had constant arguments—independent of the...

Recently I attended a seminar on Domestic Violence and have been thinking about its connection to eating problems. I suspect that a number of you may be victims of domestic violence and use food to turn negative feelings against yourself rather than toward your abuser, causing you to feel even worse about yourself. Domestic violence includes chronic anger, blaming, arguing, name calling, threatening violence and other verbal abuse as well as battering and sexual coercion (even between spouses). It is found in every socioeconomic class, race, and age and its victims are characterized by low self-esteem, dependence on a partner for self-worth or believing a partner is dependent on them, and isolation due to few or no emotional or social supports. Victims may suffer from depression or substance abuse and typically deny, minimize, rationalize, and/or defend a partner’s abusive behavior, accept blame and responsibility for it, fear and walk on eggshells...

We can’t help, at times, getting stuck in “the past” and sometimes end up abusing food because of it—a new friend fails to invite you to a birthday bash and you feel slighted, a co-worker claims credit for a job you busted a gut doing and you lose it, or your child screams she hates you after a time out and you burst into tears. I’ve said it before and I’ll say it again (and again!) that the bulk of our hurt is rooted in the past. Let’s look at the examples above. First, the birthday bash. If your reaction was overwhelming hurt that you weren’t invited, you may have had too many experiences in childhood—in your family, school or neighborhood—in which you felt left out and excluded. Maybe you often felt as if you were on the outside looking in. So, naturally, when you’re not included now, you feel stung....

For both men and women, being sexually harassed or abused can take a toll on your psyche and trigger emotional eating as a way to relieve stress or to numb feelings. Your eating problems may be connected to violations caused by sexual harassment or abuse and eating is how you’ve been trying to cope with your feelings about it. “Harassment can include ‘sexual harassment’ or unwelcome sexual advances, requests for sexual favors, and other verbal or physical harassment of a sexual nature…it can include offensive remarks about a person’s sex. For example, it is illegal to harass a woman by making offensive comments about women in general…Although the law doesn’t prohibit simple teasing, offhand comments, or isolated incidents that are not very serious, harassment is illegal when it is so frequent or severe that it creates a hostile or offensive work environment or when it results in an adverse employment decision (such...

To re-cover means literally to go back over developmental ground that is lost to an eating disorder, especially if yours began in adolescence or young adulthood. In the normal course of maturing through your teens and early 20s, your work is to develop internal resources and practice effective interpersonal skills to be more independent, take risks, rebound from mistakes and failures, think for yourself, and make meaning of your life. Through dysfunctional eating, however, your emotional and social growth gets stunted as you substitute focusing on food for feeling and experiencing life. If you developed an eating problem in childhood, adolescence or early adulthood, you’ll need to go back and acquire the life skills you missed the first time around. Don’t feel badly—no one reaches adulthood fully formed emotionally or socially. Everyone has to go back and re-cover what they missed. The point is to identify the gaps and not hesitate...

Everyone has a story, even if they don’t realize they’re living it out. It’s our view of our history—the reasons we are as we are and why we cannot be who we want to be. A story may be that you’re the exceptional one in your family, the overachiever, the one who made it and must remain perfect so that others can enjoy your success. Or that you’re the black sheep, the one left behind when everyone else went on to fame and fortune. Or that you’re the rebel flaunting convention, the idealist tilting at windmills, the drummer marching to her own beat. When eating goes awry, we look to our stories to understand how we entered the dysfunctional food arena in the hopes of finding an exit. Sometimes the process helps us find out way out, but often, instead, we become invested in the telling of the tale as the...

When we are unhappy in a romantic relationship and lack a blueprint for what constitutes functionality, we may wish for improvement but not know how to achieve it and, in frustration, turn misguidedly to food. Most of us know what physical and sexual abuse are and are clear that we need to put a stop to them, but we’re less clear about what makes for or how to handle emotional abuse or neglect. Hence, it continues and we continue to rely on food for comfort, consolation, and distraction. Lots of folks, mostly women, who are victims of emotional abuse or neglect, lay low, hoping it will end on its own. Let’s call this Phase 1. They walk on eggshells and try to fly under their partner’s radar, all too well aware of how they feel when their partner flagrantly rejects, belittles, shames, ignores, yells or curses at them, but unsure of...

What makes recovery more or less likely? Is it true that folks with disregulated eating who’ve had a really rough childhood have more problems recovering than those with a less difficult childhood? My answer to this question is both yes and no. On the one hand, if you’ve suffered trauma, abuse or neglect in life, especially growing up, you are not starting your recovery from the same place as others who did not have such maltreatment. Trauma, abuse or neglect can change your brain chemistry by putting you in a state of chronic alert and messing with your cortisol and neurotransmitter responses. This can lead to chronic anxiety or depression, difficulty self-soothing and regulating affect, and interpersonal problems relating to trust, dependence, vulnerability, setting boundaries, abuse, and intimacy. There are numerous studies showing a correlation between early abuse and eating disorders. So if you’ve had a hard childhood, encountered later trauma,...

We may assume that only clear cut sexual abuse in childhood can cause problems with sexuality and intimacy in adulthood. Although there’s a strong correlation (not a cause and effect) between childhood sexual abuse and eating disorders, this is not the whole story. Abuse, neglect, or any kind of mistreatment—overt or covert—all fall on a continuum and can shape your attitude and influence your behavior as an adult. Obviously, sexual abuse would have a strong impact on your view of your body, but what of other behaviors which may not fall strictly into the “abuse” category? What if your parents couldn’t keep their hands off each other in front of you—not just a quick kiss, hugs, or hand-holding, but touching each other inappropriately? What if a parent regularly got drunk and made sexual advances towards neighbors or relatives with you watching? What if you saw your parent making strangers uncomfortable by...

It’s heartening to see my perceptions from 30 years of working with troubled eaters validated once in a while. This is the case with a recent article in Psychotherapy Networker entitled “As the Twig Is Bent: Understanding the health implications of early life trauma” by Mary Sykes Wylie. The article discusses the correlation between early trauma and health issues, including some related to obesity. The following conclusions come from research done by Vincent Felitti, founder of Kaiser Permanente’s Department of Preventive Medicine. “In a study of 286 obese people in the program…Felitti discovered that half had been sexually abused as children—more than 50% higher than the normal rate reported by women and 300% higher than the rate reported by men. In fact, for these people, overeating and obesity weren’t the central problems, but attempted solutions.” This research was followed by a joint study between Kaiser Permanent and the Centers for Disease...

As we learn more about the workings of the brain, it’s evident that childhood trauma often plays a crucial role in the development of lifelong emotional—and emotional management—problems. They manifest themselves not only through eating, mood, and anxiety disorders, but in addictions and unhealthy relationships. The greater your understanding of how trauma affects your sense of self, the better your chance of making changes in adulthood to overcome early dysfunctional influences. In Children of Trauma: Rediscovering Your Discarded Self, author Jane Middleton-Moz makes a powerful point: “Children live out what they see reflected in their parents’ eyes. If what is reflected is the disdain and unacceptability of the developing self, that self will be discarded in order to meet the image in the reflective mirror of the world.” This means that if your parents regularly mistreated you, you may have come to believe that there was something intrinsically wrong with you...

When people come to me for therapy, it’s most often about eating and weight problems (although I treat the gamut of mental health and relational issues). Clients generally recognize that their poor relationship with food is rooted in childhood dysfunction, but may not know what to do with that information. In fact, understanding the dysfunctional events in one’s history and connecting to the emotions they evoke are two different animals. Clients frequently become stuck because they have difficulty facing the past or doing whatever is needed to heal from it. Don’t let that be you. If specific people—Mom, Dad, a sibling, boss, neighbor—or certain types of people—authority figures, competitors, manipulators, victims—continue to trigger your abuse of food, it’s time to turn back the clock and discover why you’re locked into such intense reactions. That means exploring your early emotional relationship with parents and other family members. Does anyone in the present...

It’s not uncommon for people who have suffered emotional, physical or sexual abuse at the hands of their parents or other primary caretakers, to allow themselves to be abused in adult relationships. Although the idea appears to be paradoxical—wouldn’t abuse survivors go out of their way to be around people who are not abusive?—that is not how things often work out. Understanding why you’re drawn to or surround yourself with abusive people will help you unhook from them and from abusing yourself with food. When parents who are supposed to be loving are abusive or, alternately, are abusive and loving, a paradigm of “love wedded to abuse” is established. In a child’s mind, the two go hand in hand: love equals abuse or, at the least, is accompanied by it. This association occurs whether the abuse is constant or intermittent. The experience cuts deeply into a child’s psyche and forms the...

Over the years, I’ve treated many individuals (mostly women) in emotionally abusive relationships, a major cause of food abuse, and have identified three stages of abusee response. Emotional abuse is everything from constantly or intermittently being humiliated, threatened, yelled or cursed at, ignored, shamed, put down or invalidated. Specific behaviors include the abuser making fun of you, eye-rolling when you speak, walking away when you’re talking, telling you that what you think or feel is stupid or untrue, belittling you, or trying to control you through words, tone, or body language. In Stage One, abused individuals are hopeful, wishful and walk on eggshells. They try to please the abuser and truly believe that if they don’t upset him or her, all will be well, misunderstanding that the problem of abuse resides in the other person, not themselves. They fear standing up to the abuser, so they remain passive, ignoring bad behavior...

Traumatic childhoods, those that involve chronic neglect, emotional/physical/sexual abuse, or sudden abandonment by a parent, make it harder to recover from eating disorders. These occurrences which happened decades ago continue to have major reverberations in our current lives and often get played out in difficulties with food, self concept, relationships, and impairment of effective life skills. I regularly explain to clients who are frustrated with and disappointed in themselves that people like them who’ve experienced serious, denied, unattended, ongoing or intermittent emotional wounding in childhood will take longer to work through their eating (and other) problems than people who did not suffer in these ways. This conclusion is based on decades of scientific research with trauma survivors, but clients rarely believe me. Instead, they beat themselves up for making the same mistakes with food or relationships over and over and easily fall prey to hopelessness. If you experienced trauma, abuse or...

A while ago, I was listening to a client tell me how she cringes at her own voice scolding her for not having overcome her binge-eating. You know the voice, it beats up on you for not “getting it” more quickly, for falling back on old patterns, for not doing what you know you “should” do, for not being able to recover once and for all. It struck me during our conversation how much like an abuser this voice is. When someone mistreats or abuses us—say, they scoff that we’re stupid, not good enough, or won’t ever amount to anything—the healthy, natural response is to get angry at their insult and defend ourselves. This rational, self-protective response directs our anger outward at them, to make them, not us, wrong. But many people, especially women, have difficulty getting angry at the person abusing them. Instead, they turn anger inward and beat up...

All of us have felt stuck at one time or another in emotional pain, in reaction to childhood wounding or as a response to our brain having imprinted a traumatic memory. We all can stop hurting in the present, however, through understanding why the process of intense emotion happens, how it effects us, and what we can do to eliminate its impact. Emotional pain—all pain—occurs for one reason: to spur an animal to do something, eg, to avoid getting hurt again. When my cat charges around and barrels into a cabinet, pain warns her to slow down to avoid a repeat performance. This cause-effect imprint immediately gets laid down neurologically in our brains. Similarly, if your parents shamed you for eating more than they thought you should, you may have an imprint of overeating and shame (pain). The difference between you and my cat is that, because her brain can’t do...

Did you know that our ability to make meaning of experience is one aspect of human behavior which distinguishes us from so-called lower-order animals? A part of our brain has evolved in such a way as to automatically assign significance to actions to keep us safe and secure. Unfortunately, most of us rarely examine our interpretations, and may not realize that they are outdated and way off base. Human desire to make meaning is rooted in a need to avoid mistakes to stay alive, while animals assume this function through instinct, without reflection and interpretation. An example illustrates our differences. My friends’ former dog, Damien, got into a fight with a porcupine (true story) and came staggering out of the woods one day with quills shooting out of his poor mouth. Damien was in pain and used his fear of pain to stay away from porcupines ever after. However, he did...

Reading a book written on the origins of war (BLOOD OF THE BELOVED by Mary Coleman), I was struck by two useful concepts about aggression which seemed relevant to the population I often serve: victims of physical abuse who become disregulated eaters. If you fit this description, I hope these ideas speed your recovery. If you feel defective or “bad” as a result of having been physically abused by a parent, it’s time to stop blaming yourselves. A 2006 study (“Neural mechanisms of genetic risk for impulsivity and violence in humans,” Meryeer-Lindenberg et als, Proceedings of the National Academy of Science U.S.A., 103:629-6274) identifies three factors which are needed together to produce a violent adult.” (BELOVED, p. 12): 1) gender (being a boy) combined with 2) a gene (MAOA) associated with violence3) maltreatment during childhood Coleman writes that “Societies that tilt toward guilt are actually more likely to avoid war than...

Many disregulated eaters recognize that they’re set off by stress and distress more than other people seem to be. A major reason for hyper-sensitivity is disregulation of brain chemistry due to childhood abuse or neglect. For those of you who’ve suffered this way, understanding the cause of your hyper-sensitivity will help you be more compassionate toward yourself for not always managing your food urges as well as you’d like to. “Suicidal threads” by Laura Sanders (Science News 11/3/12) explains how childhood abuse—emotional/physical/sexual—affects the developing brain and is a risk factor for suicide. “Neuroscientists and psychologists now believe that childhood trauma, including violence and neglect, sears itself into the brain in ways that can have devastating effects later”…” and “may throw off-kilter the hardware responsible for the brain’s response to stress.” Sanders goes on to say that, “due to childhood abuse and resultant stress, there may be problems with a protein called...

Many disregulated eaters never learned to regulate affect. Knowing what happens to the nervous system due to major trauma or chronic family dysfunction may help you understand why you now turn to food when you’re upset and can teach you effective ways of re-regulating. Let’s start off by accepting that humans have very fragile and finely tuned nervous systems whose goal is to keep us out of harm’s way. When the system is triggered, we not only feel distress, but may lose the ability to deal with reality in a way that keeps us safe and healthy. Below are some wonderful insights from the May/June 2014 issue of Psychotherapy Networker on why we emotionally disregulate and ways to re-regulate to reduce distress. “We know now, without a doubt, that trauma affects the developing nervous system. When the primary caregiver is unwilling or unable to regulate an infant’s stress through attunement, the...

I bet all of you have heard of Post-traumatic stress, but I wonder how many of you know about Post-traumatic growth. We so often think of the downside of trauma—depression, hypervigilance, anxiety and flashbacks—but it turns out that there’s an upside to it as well. The term, post-traumatic growth, was first used by Richard Tedeschi, Ph.D. and Lawrence Calhoun, Ph.D. in 1995 at the University of North Carolina to describe the positive changes that they saw in patients  who had been affected by and were struggling with trauma. If you are someone who’s been impacted by trauma, you might find it hard to believe that there’s anything positive about it, but research tells us that there is. "People develop new understandings of themselves, the world they live in, how to relate to other people, the kind of future they might have and a better understanding of how to live life," says Tedeschi....

If you’re often mistreated by one other or many others, you may have a high tolerance for abuse. This happens when you learn to put up with abuse to survive as a child. As an adult, not allowing yourself to be abused is certain to improve your eating. For example, one client complained about a life-long battle with her brother who had never liked her and always tried to push her around. These siblings grew up with abusive parents, so I wasn’t surprised that one of them grew up to be an abuser and the other to be an abusee. My client put up with her brother turning up at all hours of the night demanding to crash at her place, stealing money from her (he didn’t even have the excuse of being a drug addict), and using her as a dumping ground for his misery. Mostly she used our therapy...

Every so often I come across a book that’s not about eating, but whose subject matter may cause us to turn to food for solace. Healing from Hidden Abuse: A Journey through the Stages of Recovery from Psychological Abuse by Shannon Thomas, LCSW is such a book, and I’m grateful that a client recommended it to me. If you’re in any kind of relationship with a toxic person who abuses you psychologically—friend, colleague, boss, family member, lover, spouse, neighbor—you need validation, understanding of the dynamics that are occurring, and practical solutions, all of which this book provides. Thomas, an abuse survivor, calls hidden abuse “chronic and repetitive secret games being played by an individual, or a group of people against a target. These actions are so well disguised that their venom frequently goes unnoticed” by others while crushing its victim. This happens when someone is “present physically but checked out emotionally,”...

One of my clients mentioned that she feared letting down her guard around people because of the many abusive people who’ve been in her life. Although she understood that she could pick more appropriate, mentally healthy people now, she wasn’t quite sure she was ready to. What she said she was ready to do is to give up her emotional eating when these people got her upset. Her comments led me to thinking of how many dysregulated eaters I’ve met are often too trusting and open with those who hurt them repeatedly, but hyper-vigilant and closed off from folks they actually could benefit from being more vulnerable to. Somehow, they got things exactly backward. The fact is that these are patterns learned in childhood that get carried into adulthood when we don’t regularly need either type of behavior any more. Sometimes people evolve to swing between both operating styles so that sometimes...

Let me tell you at the outset that this blog reports on disturbing news, and that the research and conclusions of a study I’m going to tell you about ring absolutely true to what I’ve encountered during 30-plus years of treating people with eating and weight concerns. The article summarizes the conclusions of a study about parenting and childhood obesity (article: “Parents’ harsh tactics raise child’s obesity risk,” Futurity Health and Medicine, 4/20/16; study: “Harsh parenting, physical health, and the protective role of positive parent-adolescent relationships” by Schofield, Conger, Gonzales and Merrick, Social Science and Medicine, vol. 156, 5/16, pp. 18-26). “Harsh parenting may increase a child’s risk for poor physical health and obesity as they get older. And attempts by one parent to counterbalance the harsh behavior are not always effective in lessening the risk. Harsh parenting was defined as parents who reject, coerce, are physically aggressive, and are self-centered,”...

What keeps people stuck in abusive relationships? One answer is that we’re all rats at heart. No, not bad people as in calling someone “you dirty rat.” I mean that, like the rats in psychologist B.F. Skinner’s conditioning experiments, we form behavioral patterns through experiencing reinforcement of pain and pleasure. On the positive side, rats fed food pellets will continue to seek them out, and humans who are loved will come back for more. On the negative side, rats who receive electric shocks will turn tail and run away, and humans who are mistreated (well, most of us, anyway) will say game over. But what happens when rats receive intermittent reinforcement, if sometimes they get food pellets while other times they get shocked? What do you think they do then? The drive for food is so strong that they remain hopeful and continue to head for what they hope is the...

Most of us think about trauma as just about the worst thing that can happen to us. And for many, it is. Even if you’ve survived trauma, you still may be dealing with its physical and emotional aftermath, which perhaps includes emotional eating. How, then, can trauma ever have an upside? In “How trauma can change lives—for the better,” Jim Rendon, author of Upside: The New Science of Post-Traumatic Growth, says yes, indeed, it can (TIME 8/3/15, p. 29). Therapists and the general public have long been schooled in the notion that trauma is terrible and nothing more, he says, one that changes peoples’ lives for the worse and stays with them to death. Post-traumatic stress disorder, with its nightmares, hyper-vigilance and flashbacks, can be frightening to experience or live with in a loved one. What, then, is science telling Rendon that makes him believe that trauma sometimes can be anything...

My previous blog about the stages of abuse (http://eatingdisordersblogs.com/?p=4864) will help you understand this one. Read it first, then return here to learn how to detach from hurtful comments in abusive relationships. In a Stage One response, you placate the abuser, believing you are at fault and this will stop the abuser. If he or she says something unkind about you, you mistakenly make the meaning that it is true. You think that the other person is right that you are “whatever” he or she says you are and respond by trying to correct this person’s negative view of you by acting nice—agreeing with him or her, promising that you’ll change, or apologizing because you’ve been bad. You reinforce the legitimacy of his or her illegitimate words by responding to them as if they’re true when they’re really false. In Stage Two, tired of being nice, turning the other cheek to...

We’ve all had “bad” things happen to us and some of you have had “terrible” things or many “terrible” things befall you—sexual/verbal/physical abuse, poverty, neglect, rape, bullying, accidents, and other events which were out of your control. Does that mean you must experience pain and suffering due to these events? You likely believe that pain and suffering are inevitable by-products of such happenings and cannot be separated from the distress you (or anyone) will experience in their aftermath. If so, you’re wrong. Fact is, the meaning we make of trauma and “bad” things happening to us is the sole determinant of how much, if any, pain and suffering we experience. Michele Weiner-Davis, MSW, LCSW, proves this point by relating the story of Sally, a single, outgoing, 35-year-old friend of hers. An avid runner, Sally was attacked by a knife-wielding, masked man on the way into her apartment building after a run....

We have long known that a correlation between trauma and eating disorders exists, and now the picture is becoming clearer and clearer according to “The Power of Treating Eating Disorders and Trauma Simultaneously” by Megan Ross, Director of Program Development and Trauma Awareness at Timberline Knolls Treatment Center (Eating Disorder Hope’s March 2015 Professional Newsletter). There are two types of trauma: big “T” and little “t.” The former includes catastrophic events such as physical abuse or injury, sexual assault or abuse, or natural disasters. The latter are not so much about the severity of an occurrence, but about its painful, repetitive nature, like bullying and emotional abuse by parents or relatives. According to Ross, “Big ‘T’ trauma is more likely to be associated with bulimia, while little ‘t’ trauma is often associated with anorexia” and “the earlier the trauma occurs, the more intense the outcome. This is due to the state...

In 2009 I wrote a blog, Stages of Relationship Health, that I often refer to when discussing abuse. I suggest that you read it before reading this one. The blog describes three stages people move through to get out of an abusive relationship: 1) passivity and compliance, 2) anger, and 3) leaving the relationship. Talking with a client about anger at her narcissistic, abusive daughter and son-in-law, we established that she was moving from stage 1, passivity and compliance, to stage 2, anger, fluctuating between the two. Moreover, she was now thinking a good deal about stage 3, detaching from these relationships, a new focus. We discussed her shifts between stages 1 an 2 and what generated each response. She agreed that when she was in recall, an emotional state of fear triggered by memories of parental and spousal abuse, she became passive/compliant. But when she was in reality and in...

Do you ever feel as if things are going swimmingly in your life—even as you’re waiting for the proverbial other shoe to drop? If you frequently feel this paradoxical tug of simultaneous joy and fear, let me explain this dynamic and what you can do about it, the goal being that you lose the fear and keep the joy. That’s what you want, isn’t it? Somewhere along the way (okay, probably in childhood), you weren’t in charge of making yourself happy and had to share that job with parents, siblings and maybe even other relatives. Perhaps you’d be right in the middle of some joyful activity and something not so good would happen to pull the rug out from under you. In this way, you learned to become wary of feeling too good for too long because you figured that that there was a shoe out there ready to drop and end...

Many dysregulated eaters bounce back and forth between two states: wildly emotional or detached and unfeeling. Both are a product of traumatic experiences and can lead to mindless, emotional and binge eating. By understanding why this happens to your mind/body, you will be better able to recognize these states, cope with them more effectively, and manage your eating more appropriately. These states, often the result of emotional, physical or sexual trauma, are hyperarousal and dissociation. The former is what we call the “fight or flight” response and is defined as “a state of increased psychological and physiological tension marked by such effects as reduced pain tolerance, anxiety, exaggeration of startle responses, insomnia, fatigue and accentuation of personality traits.” (“Hyperarousal” by Eileen Bailey, Health Central, http://www.healthcentral.com/anxiety/c/1443/159977/hyperarousal/). Hyperarousal occurs when you’re highly agitated and so overwhelmed with emotion that you can’t think straight. Hyper-vigilance, or heightened fear, often goes along with hyperarousal. Dissociation...

Image by Debbie Digioia The other day I got to thinking about what many of my clients lives would be like if they’d been more valued and loved growing up. Relentlessly down on themselves, they harbor strong feelings that something is inherently wrong with them and that their defects are unfixable. The fact is, however, that they have no more flaws than the rest of us and lots fewer than many folks. There’s not a thing basically wrong with them, but everything wrong with the meaning they made of their value because of how they were treated in childhood. I raise this subject because feeling defective, more often than not, comes before eating problems. Clients describe it as experiencing a sense of not belonging, that others fit in better than they do, as not being adequate or good enough, as walking around with a stigma that they are less than and that nothing...

 Image by Debbie Digioia If you were a victim of trauma in childhood, it’s essential to understand that you may have a more complex set of problems than a dysregulated eater who hasn’t had traumatic experiences. This fact was brought home to me while I was reading “How Trauma Can Make a Victim a Victimizer: Using Empathy to Help Abusers Make Amends” by Noel Larson (Psychotherapy Networker online 7/12/16). Childhood trauma—including neglect and sexual/emotional/physical abuse—more often than not, produces a dysregulated nervous system. Larson tells us that, “When the primary caregiver is unwilling or unable to regulate an infant’s stress through attunement, the child suffers extreme anxiety, even terror. The child who doesn’t get the message that everything’s going to be all right can grow up unable to regulate his or her own affect. Without attunement, the infant’s brain has two major options: hyperarousal or dissociation. A hyperaroused child’s world is dominated by...