Trauma Healing: The Missing Link in Eating Disorder Recovery
When we first met, Carol shared how clearly she saw her path to recovery and the many resources she had in place to help manage her eating disorder behaviors when triggered. But then she asked a very important question: “If I know all the right things to do, why is it so difficult for me to follow through on my action plan?”
Carol bravely identified the need for what I call the “missing link” of most recovery plans from maladaptive or self-destructive behaviors: the need to heal unresolved trauma to restore the nervous system.
I explained to Carol that when trauma is resolved, one finally has the mastery over one’s nervous system to bypass triggers and fully implement the recovery action plan. According to Peter Levine (1997), founder of Somatic Experiencing (the body-based therapeutic modality I practice) trauma is not about an event, but the energy that gets locked in your body when the body experiences real or perceived threat. This “trauma energy” locked in our bodies creates imbalance in our nervous systems. Often, the path to recovery is not linear, and the ED voice can get louder as we recover. This happens because our nervous system is not yet comfortable with the “new normal” of life without behaviors.
“By resolving the trauma energy locked in the body, we begin to develop a stronger nervous system that can tolerate the ‘new normal,’ and life without behaviors becomes more comfortable over time.”
Chronic Stress and Eating Disorders
Carol, like many people with an eating disorder, has a history of chronic stress. Her childhood was filled with a combination of abuse and neglect. As a result, Carol’s nervous system constantly lives in a state of fight and flight, even when danger is not present. The eating disorder developed because Carol’s nervous system was looking for relief from the lack of safety she experienced during her childhood. She discovered early in her life that an eating disorder allowed her to escape the chaos and emotional pain she experienced at home. In my practice of working with eating disordered patients, I have yet to see an ED client who doesn’t have a history of chronic stress and trauma. EDs do not happen in a vacuum. They are the cumulative response/effect of long-term stress and trauma; ED behaviors are maladaptive ways to manage the aftermath of the chronic stress and trauma.
In the short-term, ED behaviors serve a purpose by giving a person relief from emotional pain. However, the long-term consequences lead to the vicious cycle of shame and disappointment, which are then managed (and triggered) by more ED behaviors. If you are nodding “yes” as you read this, you are not alone.
“I see this paradox in many of my patients with eating disorders, and the way to stop this cycle is to resolve trauma by bringing the body into the healing process for full nervous system recovery.”
Disordered Eating and The Nervous System
Have you ever experienced someone who is so upset that there is no way to reason with them? This is exactly what happens to us when our eating disorder takes over. What is really happening is that our nervous system feels out of control and cannot manage the intensity of its emotional states. And this is why we need to support our nervous system health to fully recover. When our nervous system feels calm, we have more capacity to make sound decisions about our behaviors. In order to recover, we need to teach the body to be able to tolerate the discomfort and safely move through the intense emotions we are experiencing. Somatic Experiencing, which I’ve practiced with many ED clients, does this by using the bodies survival instincts to move a person out of fight, flight, or freeze.
Through accessing sensation, imagery, spontaneous movements and emotions, we teach the body to have a physiological completion of the events that brought them into the traumas. We begin to rewire the nervous system and gain more capacity to feel safe within ourselves.
When our nervous system has unresolved trauma energy locked within, we will continue to use maladaptive ways to try to make it feel better. And this is why full and everlasting recovery happens beyond the cognitive process. Carol, like many of my patients, was still experiencing the remains of unresolved trauma energy locked in her body, despite the understanding of her issues she’d gained through traditional talk therapy. We brought the body into the process through a series of exercises that helped her create boundaries around her body. In doing so, Carol began to experience herself, sensation in her body, and her emotions differently. We also used her verbal story to help her access the images, emotions, and meaning in her life in a safe and contained way. This created a path to the unresolved trauma energy locked in the body, which Carol began to release through spontaneous moving, as well as heat, shaking, and tears (i.e., the “physiological completion”).
This process enabled us to create a full connection between Carol’s body and mind. We did this slowly, through working with Carol’s senses and helping her tolerate the discomfort she often experienced in her nervous system. We restored the body’s feelings of safety, and her nervous system organically became less agitated and triggered. This is also how we brought the body out of the survival physiology it had been living in.
When The Body Is Stuck
When we have a history of chronic stress, our bodies get stuck in using their survival physiology of fight, flight, or freeze. While these skills are helpful for acute states, our bodies are not meant to stay in these states for extended periods of time. Also, because the body is under threat, it disconnects from its physical experiences. This explains why so many eating disordered patients have lost connection to their hunger and fullness cues.
When we can restore the body to a sense of safety many things change. For starters, when we are safe, we have greater capacity to be present. We are also more resilient; we’re able to tolerate and move through emotions rather than use ED behaviors to attempt to balance our nervous system.
Once this happens, we are released from the grips of ED and are free to develop deep and meaningful relationships with ourselves and the world around us. Connecting the body and mind shifts our perception to a more accurate experience of our internal and external environments. We begin to navigate life with more ease and fluidity. So, the big question is...how do we begin to do this? Ideally, one works one-on-one with an SE practitioner to guide the process. SE uses the body’s most primitive instincts to help resolve trauma. The good news is that you will not need to go back into the traumas and stories you have already shared so many times in your recovery. To find a practitioner near you, go to www.traumahealing.org.
In the meantime, there are many things you can do each day to improve your body/mind connection, such as intentional movement, mindfulness practices, or a combination of the two.
Here are two exercises you can do each day to begin to safely connect to your body:
This exercise is designed to help calm the nervous system and begin to build boundaries and safety in the body. Physical and emotional boundaries go hand and hand and help us form our distinct identity. Boundaries help us protect ourselves and define what is acceptable to us.
Put on some gentle music, something melodic so that you can connect with the sound.
Wrap your arms around yourself and hold the safe container of your body. See what it feels like. What do you notice when you hold yourself?
Rub your palms together. Notice the heat, energy, and friction being created in your body. Now, rub the bottoms of your feet together and, again, notice the heat, energy, and friction.
Place one hand on your stomach and the other hand on your heart. If it feels comfortable to you, close your eyes. Feel your breath rise and fall as you listen to the music. Observe any sensation you might be feeling in your body. Do you feel your heart beating? Do you feel the movement of your stomach?
If you ever watch animals in the wild, they are constantly scanning their environment to make sure they are safe. Orienting is about using our five senses, and it is a great tool to use to increase nervous system regulation. It helps us more accurately sense whether we need to use our survival instincts of fight, flight, or freeze.
Begin by looking around the room where you are. Turn your head in all directions and notice where the entry to the room is. Now notice what it feels like to be supported by the chair or floor. Notice what it feels like to have your feet on the floor.
For about one minute, scan the room for objects colors and shapes. Begin to connect with your other senses. What smells do you notice? What do you hear? Is there a taste in your mouth? “Nothing” can be a taste. Continue to do this for a few minutes each day and notice the difference you feel before and after the exercise.
Orient yourself to your environment and experience it. Notice the changes around you when you walk into a different room. When you’re not in a safe place, it helps to notice the entrances and exits, as well as particular visual elements or smells. Start paying attention to what’s around you instead of disconnecting from the environment.
I invite you to get curious about these exercises. When we can connect to our bodies in safe ways, our perspective of the world changes. Trauma robs us of our connection to ourselves. Life is about connection, and connecting to others only happens when we are aligned with ourselves. Daily steps of self-care culminate in living a healing lifestyle, which gives us mastery over many parts of our lives, including the ability to successfully implement our ED treatment plans.
ABOUT THE AUTHOR: ILENE SMITH
Ilene Smith is a Somatic Experiencing Practitioner (SEP) whose work incorporates attachment theory, touch work, movement, and therapeutic dialogue. Through healing trauma, her clients develop a safer and deeper relationship with themselves and increase their capacity for resilience and joy. Ilene holds master’s degrees in Mental Health Counseling and Exercise Physiology and is a Certified Professional Coach through the GROW Training Institute. She completed the three-year training program at the Somatic Experiencing Institute and has conducted research on Somatic Experiencing for eating disorder treatment. Her forthcoming book on body-based psychology, Stop Asking Why, will be published in early 2020. She holds workshops on Somatic Experiencing online and worldwide. For more information, visit www.ilenesmith.com.
Levine, P. A. (1997). Waking the tiger: healing trauma: the innate capacity to transform overwhelming experiences. Berkeley, CA: North Atlantic Books.