PTSD & Eating Disorders
“Approximately 1 in 4 people with an eating disorder have symptoms of Post Traumatic Stress Disorder (PTSD).”
Trauma specialist Gabor Maté, MD says, “Trauma, from the Greek for “wound”, “is not what happens to you; it is what happens inside you as a result of what happens to you … It is not the blow on the head, but the concussion I get.” A wide variety of experiences can be traumatic. It is often described as anything that is overwhelms our nervous system beyond its ability to cope, it can be something that was either too fast, too much, too soon - or not enough for too long..
It is not always the event that’s traumatic, it can be what happened after - or rather, what didn’t happen but should have. Trauma can happen to anyone and seeking care as soon as possible is recommended. At Molly Bahr Counseling, LLC, we use Internal Family Systems (IFS) and Eye Movement Desensitization Reprocessing (EMDR) to heal trauma.
Eating disorders are incredibly complex and unique to each person. They tend to come into our lives at a time when we really “needed” them to cope with something. After experiencing trauma, eating disorders can often develop to numb, avoid, and/or re-gain a sense of control. For some, it can help feel positive emotions they are otherwise unable to experience, even if only for a short time. It’s also important to note that what maintains the eating disorder is not always the same reason why it started.
Healing from both PTSD and eating disorders is possible! There can be a lot of factors that make it difficult to “just stop dieting/bingeing/purging/over exercising/counting macros/weighing yourself/etc.” If you’re struggling, it’s “enough” to ask for help.
Finding the right treatment team for you can be really tough and frustrating. Maybe you find a Health At Every Size (HAES) aligned therapist but they aren’t trained in any trauma modalities. Or you find a trauma specialist who isn’t HAES aligned or experienced with eating disorders. It can feel like finding a needle in a haystack and sometimes we need to piece together a treatment team that addresses each component. Financially it can be difficult to meet consistently with a therapist, registered dietitian, and medical doctor. Treatment for eating disorders is often long term (2+ years) and maintenance sessions may be necessary. There are programs like Project HEAL or Open Path Collective that can help connect you to affordable treatment options.
*I’m happy to share HAES aligned trauma providers licensed in your state, feel for to e-mail me.
*Stat found from the NEDA website if you want to read the study.
8 Tips To Cope With Food Guilt
Feeling guilt after eating is a common experience when you’re healing your relationship with food. It doesn’t mean you’re failing, doing it wrong, or unable to change. Feelings like this are hard to work through and we can learn to tolerate, make space for, and get curious with what’s coming up.
A few questions to ask yourself when you experience food guilt:
What food rule did you break?
Where did you learn this rule? Who profits from this?
Would you tell a child or loved one to follow this rule?
What are your values, what’s important to you? Does following this rule align with that?
What is a more helpful thought and action you can take that will get you closer towards the relationship you want to have with food?
Neutralize and name what is happening. This is neither good nor bad, it’s just (name it: ex. food, eating past comfortable fullness, a midnight snack).
Self compassion: I’m having a hard moment and it’s ok to feel this way. It makes sense I’d feel guilty after following all these food rules for so long. Unlearning years of diet mentality while living in a culture obsessed with thinness is really hard! I can extend kindness, warmth, and understanding towards myself, I’m doing the work to repair my relationship with myself.
Repeat: I am enough, lovable and worthy as I am right now. I am not broken, I don’t need fixing, and can regain trust in myself and my body. I am working on my relationship with myself and it is going to take time.
These are just 8 of many routes you can take when you feel a wave of emotion.
It’s important to have a few options that speak to you since these might not always fit the circumstance.
Remember:
•Thoughts are not facts or orders.
•We don’t have to take all our thoughts seriously.
•We are going to have all kinds of thoughts (“good” ones and “bad” ones) because that’s what our minds are designed to do: Have thoughts!
•We can notice the unhelpful thoughts, not get hooked by them, and think of what would be a more helpful thought - what would get us closer to the relationship with food we want to have (and/or life we want to have, type of person we want to become).
Change takes time, be gentle with yourself. Consider how long you have been in the diet mentality, it’s probably going to take longer than you want to deprogram from it. Diet culture is everywhere and thin privilege exists, we may not be able to completely eliminate some of these thoughts but we can learn how to work through them.
Signs You Are Becoming An Intuitive Eater
You are able to eat the foods you want and like.
You are not feeling anxiety, guilt, or shame around food.
You are not punishing yourself, over-exercising, or restricting before or after meals.
You can eat and move on with your day.
You are not thinking about food all the time.
These are just some signs that you’re repairing your relationship with food. If you’re not here yet, you’re not doing it ‘wrong’. You’re unlearning a lifetime of diet culture messaging while regaining trust in yourself, accepting your preferences, honoring body cues, connecting to your inner wisdom, becoming more flexible in your choices, and learning how to care for yourself with compassion and kindness. It takes practice, experimenting, and tiiiiiiime.
The 10 intuitive eating principles guide us back to being the eaters we were before diet culture sent us down the rabbit hole. Keep in mind that “normal eating” means that sometimes we...
•Eat past comfortable fullness
•Nothing really sounds good
•Don’t have access to what we’re craving
•Didn’t pick something satisfying
•Eat to cope with emotions
•Are hungry again in an hour or 2
•Eat too fast
•Watch tv, the phone, or are otherwise distracted while eating
•Look forward to meals
•Don’t feel like exercising
•Meal prep to make life easier, diet culture doesn’t get to keep that
All of these things and more are normal, they happen to all of us, and are part of being human. Intuitive Eating can feel like a lot in the beginning. Like learning how to drive, it might feel like you have to think of a hundred things at once but eventually you’ll be scream singing down the highway, with a burrito in your hand, the wind in your hair... towards a bigger, fuller life.
Am I Doing Intuitive Eating Right?
Things that do not indicate if you’re doing Intuitive Eating right:
Your weight
Your food choices
How much you’re eating
How much you like how you look
There isn’t a ‘right’ way to do Intuitive Eating.
It’s not black/white, all or nothing! The 10 principles are guidelines, not rules. There is no expectation to practice all 10 principles, at once, all the time. There’s so much nuance when it comes to Intuitive Eating - this might be some lingering diet mentality.
Intuitive Eating (IE) is about repairing our relationship with food. It’s a framework that guides us back to the eaters we were born as. The eaters we were before diet culture and all these external, made up rules created a distrust in ourselves and our body’s internal wisdom.
Some notes about the list above:
1. Many people believe they will lose weight with IE, I thought I would, too. Some even sell IE as weight loss programs (this is a diet in disguise). But just because your body doesn’t lose weight, or even gains weight, does not mean you’re doing it “wrong”. It’s not about that, it’s about healing your relationship with food and your body.
2. We often think that once we get over the initial honeymoon phase and habitation kicks in, we will not crave certain foods or won’t want dessert every night. This may be true for a lot of things, many people discover they didn’t even really like the Oreos they couldn’t ‘control themselves’ around a few months ago. However, diet mentality may be sneaking in if you’re judging yourself based on food preferences, the food you have access to, or the cravings you have.
3. Just because we are eating more than we did when we were dieting doesn’t mean we’re ‘overeating’. On the flip side, eating less than we did doesn’t automatically mean it’s ‘better’ or ‘healthier’ either. Of course if the behaviors you were struggling with the most are no longer an issue that’s awesome, high fives!!
4. It’s not really about liking how we look, it would be nice of course, but it’s not necessary to live a big meaningful life. This can set us up for another unrealistic expectations to like how we look all the time. And based on what? Is this still through a narrow, rigid, white, oppressive idea of beauty? You are more than a body and your body is not your worth. You are here for so much more, your life’s purpose is not to fixate on food and your body.
Intuitive eating introduces 10 ways to help improve your relationship with food and your body. nuance and flexibility is required when it comes to this process!
The Fastest Way To Stop Feeling Controlled By Food And Weight
STOP DIETING
It’s not you, it’s the diet.
We think we are controlling food and our weight… when in reality, they are often controlling us.
Steps to take to stop feeling controlled by food and your weight:
Cancel weight loss goals
Delete food and weight tracking apps
Throw away your scale (and food scale)
Remove judgements (good, bad, junk, healthy, unhealthy, dirty, clean, etc) around food
Unfollow people who keep you in diet mentality, mute if they’re loved ones
Reject diet trends (Noom, WW, Whole30, Keto, Intermittent Fasting, Macros, Clean Eating..)
Learn about Intuitive Eating, Health At Every Size, Body Liberation, and Diet Culture
This is a hot take and it’s usually easier said than done. If any of these steps are hard, you aren’t alone. Working with a therapist and/or registered dietitian who specialize in Intuitive Eating can help. There is a lot to learn… and un-learn to heal your relationship with food and your body.
Note: When I say ‘fastest’, I might be talking weeks and months, not hours and days. Think of how long you’ve been in diet mentality AND how many years you’ve lived in diet culture (take your age and subtract 0). People usually start with whichever one stands out to them and builds from there.
Taking Steps Towards Body Acceptance And Body Appreciation
We’ve been swimming in diet culture since the day we were born, our body image is crap as a result, now what?
It’s unrealistic and unsustainable to move from “hating” the body we have to “loving” it. There’s nothing wrong with this goal but we don’t have to love our bodies to have an awesome life. This can set us up for another endless pursuit of something that keeps us stuck and still hyper-focusing on how our bodies look.
Enter: Body Acceptance and Body Appreciation
Acceptance: Does not mean you have to like it, want it, choose it, or throw positivity on it. It means you are accepting what is, not what you wish it was. Radically accepting yourself as you are right now is a practice in mindfulness, noticing when you are resisting, and becoming aware of your thoughts. Some find it helpful to add “…and I (am learning how to) accept myself/my body” after these thoughts.
Appreciation: Showing gratitude, expressing thankfulness, and appreciating our qualities. Set aesthetics aside for a moment. How amazing is it that our hearts beat, lungs breathe, and blood pumps without our conscious awareness? Many of us have been bashing our bodies for years, putting them through the wringer, meanwhile our bodies are out here just doing what they can to keep us alive. That deserves some appreciation.
Additional Steps:
Develop an awareness of diet culture, notice how it is everywhere, and mentally send it to the trash
Challenge the “thin or fit ideal”, body standards, and food rules - these are all made up
Cultivate the belief that all bodies are worthy of respect no matter the size, shape, weight, or how they look
Embrace and celebrate body diversity - we could all eat and move the same amount and still look different
Note what your body allows you to do, see, smell, taste, hear, and experience. Soak in those glimmers.
When you notice resistance or negativity towards your body:
Where did you learn this from?
Does someone profit or gain power from planting this insecurity?
Would you say this to a loved one?
Does this thought help you get closer to the kind of relationship you want to have with your body?
What would be a more helpful thought to get you there?
Tap into self compassion, respect, and kindness