Trauma can come in all forms; from witnessing a brutal murder or having experienced physical abuse firsthand, being involved in a war, a natural disaster, traumatic medical complication or a being the victim in an emotionally and psychologically abusive relationship. Some trauma is related to the lack of secure attachments in childhood with caregivers or parental figures. These traumatic experiences can create a sense of turmoil and isolation in individuals, affecting them in many ways. Traumatic experiences lead to isolation, automatic recoil, blocking and dissociation, meaning individuals will learn to avoid triggers, block out negative thoughts, seek solitude and break away from their relationships and potentially engage in self-destructive behaviors as unhealthy defense mechanisms as a result of their traumatic experience. Individuals who experience any form of trauma have a higher likelihood of developing an eating disorder compared to those who did not suffer a traumatic event. The earlier age at which the traumatic event occurs, the greater the outcome can be due to the state of the individual’s brain organization and development, hence why children and teenagers to experience a traumatic event have a higher likelihood of being affected by this trauma in adulthood.

Disorders eating as unhealthy coping skills as a response to trauma

Avoiding meals, extreme overeating, purging or vomiting after meals, all are coping behaviors intended to control overwhelming emotions that are developing due to past traumatic events. Eating disorders are not just about food but also about using food as a way to manage and hide feelings. The trauma behind the disorder must be addressed before the nutritional or behavioral practices will be effective. Often, this trauma is kept alive by self-criticism that develops at a very young age. This voice can lead to guilt and shame, and to silence it, one leans on the controllable factors in emotional life, such as the relationship with food. When the eating disorder takes center stage, feelings of hopelessness ensue. As a result, one’s self-identity becomes synonymous with the eating disorder. These individuals may bury their emotions through their eating habits to the point they may completely forget why their eating disorder began in the first place. Recognizing the underlying trauma, identifying the unhealthy patterns and developing coping strategies to deal with the unwanted thoughts associated with the traumatic events must be introduced during eating disorder treatment to treat the eating disorder. As a result, many eating disorder treatment centers offer a trauma track where eating disorder treatment specialists who are specialized in treating trauma play an integral role in the individual’s treatment plan.

Loneliness, dissociation and eating disorders

A typical adaptive response to experiencing trauma is splitting off from the self, which is known as dissociation. The function of dissociation concerning trauma is to separate oneself from any thoughts or emotions associated with the pain caused by the traumatic event. Individuals with eating disorders often will have “out of body” experiences in the context of a traumatic event in such a way that the traumatic act is happening, but the individual is observing the act being done to some other body rather than their own; the ability to split off and dissociate with oneself even when the trauma is ongoing. This can affect how they view their physical appearances in terms of body image and weight. They may see themselves different compared to how someone else views them. They may not notice how underweight they are, that their dental enamel is eroding from their teeth, that their hair is falling out or that they have scabs on the back of their knuckles. Loneliness is a universal symptom that nearly everyone struggling with eating disorders experience. Loneliness is also strongly connected with past traumatic experiences. Loneliness occurs regardless if individuals live alone and have little interaction with others, or are surrounded by loved ones such as friends, family, a spouse, and children. Loneliness takes place regardless if others surround the individual. Often this loneliness has been present for as long as the individual can remember, and their eating disorder has been one way they have learned to cope with the pain that comes from it. The eating disorder is a way to attempt to escape the pain of an individual’s trauma. Eating disorders are a disease of disconnection. To engage in eating disorder behaviors, whether it’s through restricting, purging, or binging, one has to disconnect from oneself, disconnect from what the body wants and needs. In addition to helping the self-disconnect from the part of the individual that is carrying the pain, the eating disorder unintentionally perpetuates the loneliness and eventually becomes the individual’s companion.