When Comfort Food Doesn't Comfort: Helping Eating Disorder Patients Feel Safe in Their Bodies and Minds
Trauma and eating disorders are often interwoven in the fabric of our patients' lives. For patients who have experienced trauma, there is a particular confluence of factors that impact their eating disorder (ED) behaviors.
In this talk we explore the interrelationship between psychological, biological, nutritional and cultural factors and their effect on eating disorders. In particular, we examine the intersection of trauma, biology and psychology on eating disorders as expressed through the autonomic nervous system. The role of polyvagal and nervous system processes in ingestion, digestion, and elimination is explored, as well as their effect on mental status.
Starving, bingeing and purging serve to promote dissociation or occur as a result of dissociation. These complex bidirectional dissociative processes serve to undermine an eating disordered person’s capacity to eat in an attuned way with their hunger, further removing them from their bodily self and hampering their ability to cope with internal and external difficulties. This also makes EDs uniquely challenging to treat. Through the presentation of case studies, we illustrate how an understanding of the relationship between the biological and psychological processes can be used in treatment strategies. Cultural contributors will also be addressed.
This joint presentation by a nutritionist and psychotherapist, will show how interdisciplinary collaboration is essential for effective treatment of these often very difficult patients.
This session was originally presented as a live conference session in April 2021.
At the conclusion of this session participants will be able to:
- Name two reasons eating disorder behaviors can be considered dissociative
- Name three reasons why eating disordered clients who have a history of maltreatment have a more severe illness than someone who doesn't have a history of child maltreatment
- Name three digestive symptoms of a dysregulated nervous system that impacts eating disorder symptomatology
- Identify four ways mental status symptoms that are directly caused by starvation
- Formulate a therapeutic strategy for an eating disorder behavior which take into account the biophysiological, dissociative and psychological components of the behaviors
Presenter: Deborah S. Cohen, LCSW, BCD
Presenter Bio: Presently a faculty member of ISSTD Professional Training Program, Deborah Cohen, LCSW has been involved in treating individuals with eating disorders and dissociation for much of her career. Certified in family and couples therapy, she is also the former Coordinator of both the Outpatient Eating Disorders Program at North Shore University Hospital in Manhasset, NY as well as the Inpatient Eating Disorders Program at Holliswood Hospital in Queens, NY. Ms. Cohen worked as a research clinician for first responders who developed PTSD in response to the 9/11 attacks. She has taught at the undergraduate and graduate level, maintains a private practice in Manhasset and Croton-on-Hudson, NY and consults privately. She has presented workshops on eating disorders and dissociation at ISSTD's yearly conference and at the Renfrew Center for Eating Disorders' annual meeting.
Presenter: Annie Goldsmith, RD, LDN
Presenter Bio: Annie Goldsmith, RD, LDN holds an undergraduate degree from the University of Rochester in Brain and Cognitive Sciences and attended Winthrop University for her graduate coursework in human nutrition. She has worked in eating disorder treatment at the PHP, IOP, and outpatient levels of care. She founded her group practice, Second Breakfast Nutrition, in 2015; her practice is rooted in the Health at Every Size® and Intuitive Eating models of weight inclusive care. She has presented on weight-inclusive care at the NCAND regional meeting and at the annual AHEC diabetes symposium in Charlotte, NC. Annie became interested in somatically-oriented and trauma-informed approaches to nutrition therapy in eating disorder treatment in 2018, when she began training with the Embodied Recovery Institute. She realized that an understanding of how nervous system state impacts eating is missing from many traditional approaches to ED treatment. She is passionate about bringing the body into the conversation and providing education to colleagues about trauma-informed approaches to nutrition therapy.
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