by Sherry-Lee Smith
Psychologist, EMDR Consultant, Credentialed Eating Disorder Clinician
Director of the Phoenix Holistic Health Centre – Perth Western Australia
Trauma-Informed Treatments for Eating Disorders: Why They Matter and How to Find the Right Therapist
Eating disorders and trauma often go hand in hand. Research shows that individuals with a history of trauma, including physical, emotional, or sexual abuse, are more likely to develop disordered eating patterns as coping mechanisms. For these individuals, trauma-informed treatment can be a critical part of recovery. Recognising and addressing the underlying trauma in treatment is essential to creating lasting change, rather than merely managing symptoms.
A trauma-informed approach to treating eating disorders acknowledges that past trauma may contribute to the development or persistence of eating disorder symptoms. When trauma is overlooked, individuals may continue to experience triggers that worsen their symptoms, leading to a cycle of self-criticism, shame, and harmful behaviours. Trauma-informed treatment can break this cycle by helping individuals address their underlying pain in a safe, supportive environment.
Why EMDR and Schema Therapy Are Effective for Treating Trauma and Eating Disorders
Two evidence-based approaches, Eye Movement Desensitization and Reprocessing (EMDR) and Schema Therapy, are increasingly recognized as effective for treating the unique needs of individuals with both eating disorders and trauma histories. And many practitioners are taking the best-practice advice and beginning to integrate trauma-informed approaches into the regular treatments for eating disorders, namely, CBT (Cognitive Behavioural Therapy), DBT (Dialectical Behaviour Therapy) and IPT (Interpersonal Therapy).
EMDR Therapy: EMDR is a structured therapy that helps individuals process and resolve traumatic memories. Through guided eye movements and bilateral stimulation, individuals can reduce the emotional charge associated with traumatic memories, modifying the way information is stored in the mind and freeing them from their impact on current behaviours and thoughts. This can be transformative for people with eating disorders, as it allows them to release maladaptive beliefs and coping mechanisms tied to trauma. EMDR can address negative beliefs such as “I am not good enough” or “I am not safe,” which often fuel disordered eating.
Schema Therapy: Schema Therapy combines elements of cognitive-behavioral therapy, gestalt therapy, and attachment theory to help individuals recognize and modify deep-rooted negative beliefs, or “schemas,” that may have developed from early trauma. Many people with eating disorders hold beliefs of unworthiness or shame that drive their behaviour. Schema Therapy works by identifying and challenging these harmful beliefs, allowing individuals to replace them with healthier ways of seeing themselves as well as modifying unhelpful emotional, behavioural, interpersonal, and psychological patterns.
Both EMDR and Schema Therapy can help individuals replace trauma-related beliefs and behaviours with positive, adaptive coping strategies, facilitating long-term recovery.
How to Find a Trauma-Informed Eating Disorder Therapist
Finding a therapist who understands the relationship between trauma and eating disorders is crucial. Look for professionals trained specifically in trauma-informed care and experienced in treating both trauma and eating disorders. Many trauma-informed therapists are trained in EMDR, Schema Therapy, or both, making them well-equipped to support complex cases.
When searching for a therapist, start by asking about their training in trauma-informed treatments and experience with eating disorders. The right therapist will be able to tailor their approach to your needs, helping you address not just your eating disorder symptoms but the root causes as well.
Long term recovery from an eating disorder.
For individuals with a history of trauma, trauma-informed treatment is essential to achieving meaningful and sustainable recovery from an eating disorder. EMDR and Schema Therapy offer unique approaches that target the core beliefs and unresolved trauma fuelling disordered eating. With the right support, it is possible to heal both trauma and disordered eating behaviours, leading to a more fulfilling and empowered life.
by Sherry-Lee Smith
Psychologist, EMDR Consultant, Credentialed Eating Disorder Clinician
Director of the Phoenix Holistic Health Centre – Perth Western Australia
References
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Brewerton, T. D. (2007). Eating disorders, trauma, and comorbidity: Focus on PTSD. Eating Disorders, 15(4), 285-304.
Finlay, H. (2019). Recognising the territory: The interaction of trauma, attachment injury, and dissociation in treating eating disorders. In, Trauma Informed Approaches to Eating Disorders. Springer Publishing: New York.
Pugh, M., Waller, G., & Esposito, M. (2018). Childhood trauma, dissociation, and the internal eating disorder ‘voice’. Child Abuse and Neglect, 86, pp 197-205.
Simpson, S, & Smith, E. (2020). Schema Therapy For Eating Disorders: Theory and Practice for Individual and Group Settings. Routledge: London.
Vanderlinden, J., & Palmisano, G. L. (2019). Trauma and Eating Disorders: The state of the art. In, Trauma Informed Approaches to Eating Disorders Seubert, A & Virdi, P. (Eds). New York: Springer Publishing.
Virdi, P. & Nicholls, J. (2019). Assessing “trauma-driven eating disorders”: A road map through the maze, In, Trauma Informed Approaches to Eating Disorders Seubert, A & Virdi, P. (Eds). New York: Springer Publishing.
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