Can we treat trauma while an eating disorder is active?

Is an eating disorder the result of past trauma? When we see someone stuck in self-destructive and potentially life-threatening behaviors, it’s natural to ask what terrible event created this?Clinicians often debate the importance of addressing past trauma in eating disorder treatment, versus targeting present symptoms. Psychodynamic and embodied approaches typically emphasize past history and complex roots of a disorder, whereas behavioral approaches, such as family based treatment and cognitive behavior therapy, generally focus on reducing eating disorder behaviors and the associated distorted perceptions. In defense of both positions, people like to cite research studies identifying the percentage of individuals with eating disorders who have a trauma history versus those who don't. As a clinician, while percentages and probabilities can help me understand general trends, they cannot tell me what is true for the individual or family that is right in front of me.In this episode EMDR certified psychotherapist, Angela Harris, discusses how she assesses whether someone is using eating disorder behaviors to mask or cope with trauma, how recovery might differ between someone whose disorder is trauma-driven versus someone whose symptoms are driven by other factors, and what happens when a client with a trauma history is treated using a primarily behavioral approach.We also discuss the timing of trauma treatment relative to eating disorder recovery. Many clinicians delay addressing trauma until a client achieves symptom reduction, because trauma work can surface painful memories and be temporarily destabilizing. This creates a kind of double bind: the person is expected to reduce symptoms before trauma can be addressed, yet cannot reduce symptoms without addressing the trauma driving them. In some cases, this leads to cycling from treatment center to treatment center, repeatedly relapsing. In our conversation, Angela explains how she balances safety while treating trauma and eating disorders simultaneously.Angela is a Licensed Clinical Social Worker, Certified Eating Disorder Specialist Consultant, and an EMDR Consultant in Training. Angela specializes in treatment of eating disorders, trauma, and dissociative disorders. Angela owns a private practice, Angela Harris Counseling, in Dallas, TX and is dually licensed in Oklahoma.