Many clients at Castlewood Treatment Centers have an Eating Disorder with co-occurring trauma or PTSD. Trauma can be caused by any overwhelming experience in childhood, adolescence or adulthood that is too difficult to integrate or make meaning. There are a wide variety of traumas that are commonly associated with eating disorders. These can include:
- Childhood bonding issues with caregivers
- Sexual abuse or sexual development issues
- Painful experiences at school or with peers
- Dating or other social experience traumas
Castlewood’s primary therapists are trained in the latest trauma resolution therapy techniques for both stabilization of PTSD symptoms and resolution of the trauma. For clients with both an eating disorder and PTSD, research shows that we must address and resolve the trauma in order to acheive lasting eating disorder recovery.
Each client at Castlewood works closely with a primary team comprised of a therapist, dietitian, and staff psychiatrist. Castlewood believes that treating the medical, therapeutic, and nutritional issues of each client at the same time will provide stronger, more effective recovery.
Understanding Trauma Reenactment
One of the long-term effects of unresolved early attachment and traumatic occurrences is trauma reenactments. These reenactments can take many forms, including:
- Flashbacks /Nightmares
- Chronic illnesses
- Physical pain
- Destructive relationships
- Repeated self-destructive behaviors
Eating disorders are an example of a reenactment in that the symptoms can function to reenact physical or psychological trauma onto the body or self. In certain cases, we find that working with childhood trauma is necessary for long-term symptom resolution. Castlewood’s therapists provide careful evaluation of trauma related issues, and work with the treatment team to develop a customized treatment plan to keep the recovery process moving forward. Castlewood uses a variety of evidence-based therapeutic approaches to help clients with trauma resolution. These therapies are used in conjunction with other treatments to provide integrated care of the trauma, eating disorder, and any other co-occurring problems.
Trauma Treatment Center Approaches
The most common evidence-based and innovative trauma resolution therapy approaches utilized at Castlewood include:
Eye Movement Desensitization Reprocessing
Clients who have suffered for years from anxiety or distressing memories, nightmares, insomnia, abuse or other traumatic incidents can often gain relief from a revolutionary therapy called EMDR (Eye Movement Desensitization Reprocessing). Research shows that EMDR is safe and effective for trauma resolution. EMDR does not involve the use of drugs or hypnosis. It is a simple, non-invasive patient-therapist collaboration that can be highly effective for a wide range of disorders, including chronic pain, depression, panic attacks, and other issues.
Exposure and Response Prevention
Castlewood utilizes exposure and response prevention therapy, a specific type of cognitive-behavioral therapy, to treat anxiety disorders. Clients are asked to identify anxiety-provoking situations that they typically avoid altogether or have difficulty tolerating without using ritual or harmful behaviors. The treatment team then gradually and repetitively exposes clients to these situations, while requesting that they not engage in ritual behaviors to cope with the anxiety or fear that they experience. With this consistent exposure to feared situations, clients allow themselves to see that what they fear will happen in a given situation will not actually occur, and as a result their anxiety about a previously feared situation reduces naturally.
In conjunction with exposure and response prevention therapy, Castlewood also utilizes other cognitive and behavioral therapies in the treatment of PTSD and anxiety disorders that allows us to challenge belief systems that maintain fears and ritual behaviors, as well as to provide clients with alternative skills to help them in managing their anxiety.
The constant availability of a caretaker in infancy and childhood to provide safety, a healthy exploration of the environment, and help to learn to regulate emotions effectively results in secure attachment. The result of secure attachment is a person’s sense of security, a sense that the world is a safe place that one can rely on others for protection and support, and one can feel effective in exploring and operating in their environment. The result is a sense of both self-identity and esteem.
Very few eating disorder clients have secure attachment or a solid sense of identity, or feel confident in establishing adult relationships. Castlewood has developed a unique program involving group and individual therapy to increase secure attachments, which is critical for long-term symptom remission. We work with clients to help them develop a cohesive coherent collaborative narrative and life timeline to assist in the development of an earned secure attachment.
Internal Family Systems Therapy
Internal Family Systems (IFS) therapy is a powerful tool in working towards trauma resolution with eating disorder clients. It does not involve the use of hypnosis or drugs. The cornerstone of IFS is to facilitate self-leadership and integration of “parts of self” that may become fragmented, split off and polarized within an individual. IFS allows for working with injured parts of self that may hold traumatic experiences and facilitate integration.
IFS therapy provides techniques to help the client heal the pain, shame, or fear from their pasts that the eating disorder protects them from experiencing. When these injured parts are healed, eating disorder symptoms begin to remit. The eating disorder part of self is no longer forced into such an extreme role and it can begin to take on other healthy ways of helping the client cope.