At the 2012 USABP Conference in Boulder, CO, Tory Butterworth, PhD gave a presentation on Binge Eating Disorders (BED). She laid the groundwork for looking at the underpinnings of the disorder and how it can affect one in adulthood.
She noted that it is important to understand that people can be overweight and not be binge eaters. Also, that 95% of diets fail and extreme diets have been shown to create eating disorders. That is a high statistic for a country that is obsessed with food.
She mentioned that societal factors can play a role in developing BED and recommended the book “The Obesity Myth” by Paul Campos for more information on those factors.
The real emphasis of the workshop was more geared toward looking at the underlying trauma that causes BED.
First, let’s look at what constitutes someone who is a healthy eater:
- Eats a wide variety of foods
- Eats when hungry
- Stops when full
- Enjoys what eating
- Do not obsess over what “not” to eat
Now let’s briefly look at how the DSM-IV (Diagnostic and Statistical Manual for Mental Disorders) defines Binge Eating Disorder:
- Eating amounts of food that is definitely larger than most people would eat in a similar period of time under similar circumstances.
- Feeling lack of control over eating
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Eating large amounts throughout the day with no planned mealtimes
- Eating alone because embarrassed by how much eating
- Feeling disgusted with oneself, depressed or feel guilty after overeating
- Marked distress
Looking at BED closer, Dr. Butterworth stated that to really heal BED one must look at the underlying trauma that caused the eating disorder. Diets are not the answer, and therapists should rather look toward healing trauma.
There are two kinds of trauma that were discussed:
- Shock Trauma
- Developmental Trauma
Shock trauma is defined as a brief, intense experience that activates the sympathetic nervous system: fight/flee/freeze response.
Where as developmental trauma happens through repeated negative social interactions with caregivers. The actual traumas will be different for every person because our histories are all unique in their own way.
In this workshop Dr. Butterworth only looked at developmental issues that can occur from ages zero to four. She noted that when wounding occurs in early developmental stages, certain muscles will become either hyper-responsive (muscle over engaging) or hypo-responsive (muscle is not engaging). Learning to recognize this in the body, body centered therapist help the client explore different movements that start activating the muscles in a new way, which can bring up psychological issues to be explored and healed. This makes body centered therapy different from more traditional cognitive therapies.
Some of the symptoms Dr. Butterworth’s adult clients suffer from BED are:
- Taking on too much responsibility
- Can’t set limits with others
- Lets others dominate them
- Not okay to be angry
- People pleasers
- Hard time focusing (ADD/ADHD)
- Hard time making decisions
- Hard time with logistics
- Hard time planning ahead
- Don’t know what they’re feeling
- Hard time balancing self and other
- Can’t tell when they are hungry
- Are triggered by large, unstructured blocks of times
- Don’t know what they need
- Fears being abandoned
- Distrustful of others
- Poor boundaries
These symptoms, she believes, are linked back to developmental traumatic events with their caregivers. What she has found for treatment is that the client needs to recognize these underlying traumas as the cause of their distress. As the trauma begins to resolve the client’s relationship to food will begin to change and become more positive. She used developmental movements to activate a certain muscle to help the client feel the connection to the trauma they experienced. These movements are very subtle and very powerful in activating the client.
Dr. Butterworth did not mention the application of EMDR, but I think bringing EMDR therapy into working with the developmental trauma would also help the client resolve the past. As the past resolves, the client feels more present with what was driving the symptoms and causing distress. EMDR could help the person could develop a healthier relationship with food.
If you are interested in learning more about EMDR Therapy and how it can be applied to BED and other eating disorders, I would recommend reading Robin Shapiro’s, “EMDR Solutions II: For Depression, Eating Disorders, Performance, and More.”