By Lesley Kollikho, Ellern Mede Integrative Psychotherapist
Eating disorders are notoriously difficult to treat due to the deep ambivalence towards recovery that the sufferer will experience. Often eating disorder treatment can be a revolving door of services; therapy, dieticians, recovery coaches, and community teams. What keeps the eating disorder as a viable method of coping is a question I keep coming back to in my work with patients. Garner & Garfinkle, 1987, proposed a model of the development of eating disorders that focused on predisposing, precipitating and perpetuating factors. I use this model as a guide to understand and to inform my overall treatment plan.
Treatment starts with the perpetuating factors and works backwards. A patient will need to be monitored physically in order to be able to engage in deep psychological work. Trauma work is inherent in the treatment of ED as it often underlies the disorder. Not every client will have a ‘big T’ trauma, but those ‘little t’ traumas often get overlooked and can cause such a detrimental impact on a person’s sense of worth and self-esteem. An eating disorder can be a way of coping and managing with life. If the underlying causes are not addressed, the eating disorder will not be effectively treated, and the sufferer will remain stuck in this cycle.
At Ellern Mede I use EMDR as a tool for addressing and processing trauma. EMDR stands for Eye Movement Desensitisation and Reprocessing. It is an evidence-based trauma treatment that helps to resolve unprocessed traumatic memories in the brain. Once a trauma is effectively processed it can alleviate the distressing symptoms and make day to day more manageable. This can in turn help the viability of an eating disorder as a coping strategy, as the patient now has mental space to develop other, healthier coping mechanisms.