The Role of Therapy in Anorexia Recovery: Insights from Raleigh, NC Eating Disorder Therapist
Eating disorder therapy is an important part of addressing the needs of people dealing with anorexia nervosa. There are so many aspects to consider when healing from an eating disorder - medical, social, spiritual, emotional, mental - and eating disorder therapy provides the time to sort through factors driving it. Eating disorder therapists who help people heal from anorexia and other eating disorders have licensing and training beyond graduate school. They help address things like dealing with food fears and negative body image, making behavior changes, and helping folks connect with resources to prevent relapse back into their eating disorder. I’ve answered some common questions about the role of therapy in anorexia recovery below.
Why is therapy important for anorexia recovery?
Therapy provides a comprehensive approach to anorexia recovery, addressing things such as:
Underlying Issues. Anorexia nervosa often stems from deeper psychological issues such as low self-esteem, trauma, or perfectionism. Therapy helps individuals explore and address these underlying issues that contribute to their disordered eating behaviors.
Behavioral Modification. Therapy particularly approaches like Cognitive Behavioral Therapy (CBT), helps individuals recognize and change harmful thought patterns and behaviors associated with anorexia. It teaches coping mechanisms and healthier ways to manage emotions and stress.
Nutritional Education and Support. Therapy provides education about nutrition and helps individuals establish healthier eating habits. This might involve meal planning, learning about balanced nutrition, and addressing fears or anxieties around food.
Emotional Support. Anorexia recovery can be emotionally challenging. Therapy offers a safe space for individuals to express their feelings, fears, and frustrations without judgment. Having a supportive therapist can provide comfort and encouragement during difficult times.
Relapse Prevention. Therapy equips individuals with the skills and strategies needed to prevent relapse. This includes identifying triggers, developing coping strategies, and creating a support network to turn to during times of struggle.
Improving Body Image. Anorexia often involves a distorted body image, where individuals perceive themselves as overweight even when severely underweight. Therapy helps individuals develop a more realistic and positive body image, fostering self-acceptance and self-esteem.
Family Support and Education. Family-based therapy can be particularly effective for adolescents with anorexia. It involves the whole family in the treatment process, providing support, education, and strategies for creating a healthy home environment conducive to recovery.
What are types of therapy for ED recovery?
There are a number of approaches used for eating disorder therapy. The list below isn’t exhaustive, but I’ve included ones that have the best track record and help people get better faster.
Cognitive Behavioral Therapy (CBT):
CBT is a widely used therapeutic approach that focuses on identifying and challenging negative thought patterns and behaviors. It helps individuals recognize distorted beliefs about body image, food, and weight. CBT also teaches them how to replace these with healthier perspectives. CBT can equip individuals with coping strategies to manage difficult emotions and situations without resorting to disordered eating behaviors.
Family-Based Therapy (FBT):
FBT, also known as the Maudsley Method, involves the entire family in the treatment process. It recognizes the role of family dynamics in the development and maintenance of anorexia and aims to restore healthy eating habits and relationships within the family unit. FBT empowers parents to take an active role in supporting their child's recovery, with therapists providing guidance and education to facilitate this process.
Acceptance and Commitment Therapy (ACT):
Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that blends mindfulness and acceptance strategies with commitment and behavior change techniques. ACT aims to help individuals develop psychological flexibility, which involves being open to experiencing difficult thoughts and emotions while still pursuing meaningful goals and values.
Somatic Experiencing Therapy (SE):
Somatic therapy, also known as body-centered therapy, is an approach that focuses on the connection between the mind and body, recognizing that psychological issues can manifest as physical symptoms and vice versa. In somatic therapy, therapists help individuals explore and process emotions, memories, and trauma through bodily sensations and movements. This approach incorporates techniques such as mindfulness, breathwork, movement, and touch to increase awareness of bodily sensations and promote healing.
Dialectical Behavior Therapy (DBT):
Explanation:
DBT combines elements of CBT with mindfulness techniques to help individuals regulate their emotions and develop healthier coping mechanisms. It teaches skills such as mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. All of which are particularly beneficial for managing the intense emotions often experienced by individuals with anorexia.
Eye Movement Desensitization and Reprocessing:
EMDR, or Eye Movement Desensitization and Reprocessing, is a psychotherapy approach primarily used to treat trauma-related disorders. It involves a structured eight-phase process that integrates elements of cognitive therapy, exposure therapy, and bilateral stimulation (such as eye movements, tapping, or auditory tones). This approach is to help individuals process distressing memories and experiences. EMDR can be a valuable adjunctive therapy in anorexia recovery. Especially for individuals with co-occurring trauma-related symptoms or difficulties. By addressing underlying trauma, reducing emotional distress, and promoting cognitive and emotional restructuring, EMDR can help individuals overcome barriers to recovery and achieve lasting healing. It's important for EMDR to be used as part of a comprehensive treatment plan that includes other evidence-based interventions tailored to the individual's needs.
Nutritional Counseling:
Explanation:
Nutritional counseling is an essential component of anorexia recovery, often provided alongside other forms of therapy. It involves working with a registered dietitian or nutritionist to create a balanced meal plan tailored to the individual's nutritional needs and goals. Nutritional counseling provides education about healthy eating habits, portion sizes, and meal timing, while also addressing any fears or anxieties related to food.
These therapies may be used individually or in combination, depending on the needs and preferences of the individual undergoing treatment. Each approach offers unique strategies and techniques to support anorexia recovery, emphasizing the importance of a comprehensive and personalized treatment plan.
What’s the difference between what you do and what my CBT therapist has done?
I consider myself primarily a somatic-oriented therapist who integrates cognitive strategies. Some therapists only use cognitive (or thinking-based) talk therapy.
The biggest difference between a somatic-oriented therapist and one who uses cognitive therapy lies in their therapeutic approach and focus:
Somatic-Oriented Therapist:
Approach:
Somatic therapy, also known as body-centered therapy, emphasizes the connection between the mind and body and the role of bodily sensations and experiences in psychological well-being. Somatic therapy focuses on how the autonomic nervous system (a part of your brain/body you’re not automatically in control of) may be driving your thoughts, feelings, and behaviors. This type of therapy can be good for people who have done cognitive therapy but get lost in their thoughts or continue to find their body reacts despite doing their best to think their way out of it. We call somatic therapy a “bottom-up” approach because we’re addressing the oldest of your brain (which is located near the bottom or base of your brain).
Focus:
Somatic-oriented therapists focus on helping individuals develop greater awareness of bodily sensations, regulate emotions through bodily processes, and process trauma or unresolved emotions stored in the body. They may use techniques such as body scanning, grounding exercises, or somatic experiencing to facilitate this process.
Cognitive Therapist:
Approach:
Cognitive therapy, also known as cognitive-behavioral therapy (CBT), is a structured, goal-oriented approach. This approach focuses on identifying and challenging negative thought patterns and beliefs that contribute to emotional distress and maladaptive behaviors. Cognitive therapists believe that changing dysfunctional thinking can lead to changes in emotions and behaviors. Cognitive therapy is a “top-down” approach. This means you’re using the newer part of your brain called the prefrontal cortex (located near the top front of your brain).
Focus:
Cognitive therapists focus on helping individuals recognize and reframe distorted thoughts and beliefs, develop more adaptive coping strategies, and change behavior through goal-setting and behavioral experiments. They may use techniques such as cognitive restructuring, thought monitoring, and behavioral activation to achieve these goals.
Integrating approaches in eating disorder therapy
While somatic-oriented therapists and cognitive therapists may use different techniques and approaches, both aim to alleviate psychological distress and promote well-being. The choice between these approaches may depend on individual preferences, the nature of the presenting issues, and the therapist's expertise. Some individuals may benefit from a combination of both approaches, integrating cognitive and somatic techniques to address a broad range of psychological concerns.
Eating disorders are not simply a thinking problem. People struggling with anorexia and other disorders have often done SO MUCH THINKING over the years and are highly sensitive, intelligent people whose nervous systems are overstimulated. They have often developed highly complex systems and symptoms (called eating disorders) to deal with the world, relationships, trauma, etc. Anorexia becomes like an escape mechanism that offers a sense of control, safety, and predictability. There’s definitely a place for cognitive therapy in eating disorders work, but I find we also have to go around our thoughts to do the deep healing work needed to recover.
How does therapy help make my body a safe space when it has been unsafe for so long?
Eating disorder therapy at Counselor Kate can help make your body a safe space, even if it has felt unsafe for a long time, through various therapeutic techniques and approaches. Here's how:
Validation and Empathy. In eating disorder therapy, I work hard to create a safe, nonjudgmental space where your experiences are validated and understood. I’m not there to judge you or make you immediately change your life - I know change is hard! I acknowledge the challenges you've faced and the validity of your feelings. Over time, my hope is you build trust in our therapeutic relationship so that you can have a place to come with the thoughts, feelings, and reactions that get overwhelming in the “real world.”
Exploration of Body Sensations. Our therapy sessions help you build tolerance for exploring your body sensations and feelings. It may take time and we’ll go at your pace. The goal is to gently help you reconnect with your body in a safe and supportive environment. We may include mindfulness exercises, body scans, or somatic experiencing techniques so you can learn to recognize and regulate your bodily responses to stress and trauma. Over time, you’ll learn to restore a sense of safety and control over your physical experiences without the use of your eating disorder.
Processing Trauma and Pain. Therapy provides a space to process and heal from past traumas or painful experiences that may have contributed to feelings of unsafety in your body. As we work together, I’ll help you explore these experiences at your own pace. Together, we can gradually integrate and make sense of them in a way that feels manageable and empowering.
Building Self-Compassion. As you work with me, I’ll teach you to cultivate self-compassion and kindness towards yourself. We can counteract the self-criticism and self-blame that may have contributed to feelings of unsafety in your body. Through compassionate self-talk, self-care practices, and nurturing guidance, you can learn to treat yourself with gentleness and understanding. Overall, creating a more nurturing internal environment.
Developing Coping Strategies. Building distress tolerance for challenging feelings, thoughts and sensations requires practical coping strategies and skills. With practice, you’ll learn to manage distressing emotions or sensations that arise in your body through relaxation techniques, grounding exercises, or emotion regulation strategies. You can learn to soothe yourself and create a sense of safety even in challenging situations.
Reframing Beliefs About the Body. Therapy helps challenge and reframe negative beliefs or perceptions you may hold about your body, such as feelings of unworthiness or shame. Through cognitive restructuring and positive reframing, you can develop a more compassionate and accepting view of your body, fostering a sense of safety and acceptance within yourself.
I hope this helps answer your questions about therapy for eating disorders and anorexia. It is possible to get better and I’m here to help you. Contact me to get started.
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