At Castlewood, we believe in treating the underlying causes of our clients´ eating disorders. Many of the clients we treat struggle with anxiety disorders in addition to the significant levels of anxiety they experience around eating disorder-related issues such as food, weight, body image, and so on.
In fact, many of our clients struggled with their anxiety disorders even before the eating disorder appeared; some studies have shown that this is true for as many as two-thirds of people struggling with both of an eating disorder and an anxiety disorder (Kaye et al., 2004).
Clients with anxiety disorders who come to Castlewood typically describe their eating disorder and their anxiety to be intricately linked together. Anxiety is among one of the many contributory factors found to be at the root of eating disorder symptoms, and results in higher degrees of perfectionism, obsessionality, avoidance, and body image dissatisfaction among clients who experience both an eating and anxiety disorder (Kaye et al., 2004). Anxiety is also an emotion that our clients have difficulty regulating without using their eating disorder or self-injury, and therefore becomes a trigger for many self-destructive behaviors.
Clients often have had either treatment exclusively for their eating disorder, or only for their anxiety disorder; many have not had treatment for both simultaneously. Given the identified links between the two disorders, Castlewood´s treatment philosophy is that both disorders need to be treated at the same time in order to give clients the best chance at long-lasting recovery.
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. We then gradually and repetitively expose 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 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.
Kaye, W.H., Bulik, C.M., Thornton, L., Barbarich, N., Masters, K. & Price Foundation Collaborative Group (2004).
Comorbidity of anxiety disorders with anorexia and bulimia nervosa. American Journal of Psychiatry, 161 (12), 2215-2221.