If you have an eating disorder, you are not alone. You may also be among the many men and women with eating disorders that have a history of trauma. Consider these numbers: about 30% of women with eating disorders have been sexually abused. If you think that those numbers are high, think again: this is likely an underestimate because trauma is associated with secrecy, guilt, and embarrassment.
There’s good news though. With treatment, recovery is possible. joltleft.com recently had a chance to interview local Cherry Hill, N.J., expert, Shari Botwin, LCSW. An active clinician who provides therapy, runs groups, and speaks about eating disorders, Shari was candid in sharing her own experiences of recovery, as well as what she sees from men and women with a dual history of trauma and eating disorders.
Examiner: Shari, thanks for taking the time to talk with us. Could you tell me about your own experience with an eating disorder?
Shari: I still remember the first time I used food. I was about 7 years old and went to the snack bar at my swim club and bought candy to comfort myself. For the next 5 years, I fantasized about food and sometimes ate until I felt physically sick. During my early teens, symptoms of anorexia began to surface. I went on my first “diet” at age 14, and was praised by family members for losing weight. For the next 4 years I went back and forth: restricting, overexercising and obsessing about food, then bingeing to comfort myself. When I left for college, I developed anorexia and struggled with the disorder until my early 20’s.
Examiner: Wow, that sounds like a challenging time? When did you seek help?
Shari: I did not even know I had an eating disorder until I started counseling other women with eating disorders in my early 20’s. Within 6 months of starting work at a treatment center, I got myself into intensive outpatient treatment. My eating disorder symptoms went into remission two years into therapy, when I began talking in therapy about my past. Having had an eating disorder and being in recovery has helped me be a better therapist, because I can understand the shame and fear that comes along with letting go of the very thing that kept me alive for most of my childhood ¾my eating disorder. I can empathize with my patients without enabling them or letting them off the hook. I did not start disclosing my own eating disorder until nearly 10 years had elapsed. I have learned that it is important to fully digest our own experience before putting it out there, whether that be in my sessions with patients, my writing, or workshops that I have led.
Examiner: What, then, do you see as the most common reasons that men and women with trauma histories develop eating disorders?
Shari: For most trauma survivors, eating disorders serve a purpose. It is a distraction from dealing with feelings associated with trauma. For some, the disorder keeps them in the “not knowing.” For example, many trauma survivors with eating disorders repress memories from their conscious awareness. If someone is thinking about food all day long, or so starved that they cannot think straight, memories of things like abuse will stay unconscious. I also think trauma survivors hold onto their eating disorder to manage the feelings of shame and guilt that come with being a trauma survivor. These are often feelings of responsibility or blame for experiences that really had nothing to do with them. When a trauma survivor gets stuck in the shame, she cannot grieve and accept what has been lost. Trauma survivors would rather blame themselves, than hold other people accountable. Self blame leads to destructive coping strategies.
Examiner: Given these self-destructive coping strategies, what kinds of interventions are needed?
Shari: The most important intervention for a trauma survivor is finding a safe place where she can begin to digest and process her experiences. Before that, however, it is important to get the eating disorder to a place where it is not life threatening. Some women need to be hospitalized so they can stabilize their mood and eating. Trauma survivors go through their experiences feeling alone, so I think being able to develop a support system and finding a witness, which in some cases is her therapist, are crucial to recovery. Feeling heard can heal the parts of them that felt the most abandoned betrayed.
Examiner: Is this witness always a therapist or could it be someone else?
Shari: For some women, getting involved in a therapy group can be helpful. Group members can support each other in finding ways to set limits and hold boundaries. It is also important to remember that the process of recovery is slow and at times frustrating. It is not so much how often someone goes to therapy that makes the difference, but more her ability to take the therapy in and filter out the shame or negative thinking. Learning how to trust in a therapy relationship can lead to much healthier relationships and also the ability to trust oneself to make good choices.
Examiner: Wow, Shari, that is great information. Do you have any other advice would you give those who would like to recover?
My advice is to get a good therapist, someone who understands the role of trauma in developing an eating disorder. I cannot even count how many times I wanted to quit treatment. Whenever the memories became too painful to process, I would go into shame and transfer some of those feelings onto my therapist. I would lose trust in myself and everyone around me. The best thing I did was doing the opposite of what the memory or feeling was telling me. For example, when I felt like I should not have spoken about my past I would imagine all of my supports with me nodding in approval and telling me it was going to be okay. It is normal to want to give up. I always held onto the idea that someday I would be free and feel heard. That is something I still need to remind myself when I am being confronted with strong feelings or when I am digesting another part of my experience.
Examiner: Are there any other life experiences that helped you in your own recovery?
Becoming a mom 4 months ago has made me have to look things in such a direct way. I could choose to run away when the pain feels like too much, or I could choose to restrict and focus on losing my baby weight, or I could choose to love myself. Facing my fears and feelings has allowed me to be fully present with my newborn and prove to myself I am so much more than a trauma survivor or an eating disorder survivor. I am also a mom, a therapist, a friend, a student and at times a patient. Most importantly, my recovery has shown me that nothing can take away my ability to love and be loved!
For more information:
Shari is currently accepting new members for her ongoing therapy group on Tuesday evenings from 545-7:00pm. Perspective members should contact her at 856-424-4004 to set up a consultation. Feel free to visit her website at www.sharibotwin.com.
Save the Date: December 7, 2011 at 7pm Healing from an Eating Disorder with Shari Botwin, LCSW, Dr. Jane Shure and Dr. Beth Weinstock, at Kaiserman JCC, 45 Haverford Road, Wynnewood, Pa.. For family members, patients and professionals! At the workshop Shari will be talking about her recovery. Check back later this summer for registration details at www.sharibotwin.com.