Eating Disorder Recovery and Trauma: Nervous System Dysregulation

By Jennifer Rollin, LCSW-C, Therapist & Founder of The Eating Disorder Center

Eating disorders and a history of trauma often overlap in clinical practice. In fact, one study found that 43.8% of individuals diagnosed with an eating disorder reported experiencing more than one traumatic event in their lives (Converino et al., 2022).

As an eating disorder therapist and founder of The Eating Disorder Center, based in Rockville, Maryland, but serving across multiple states, I believe it’s crucial to discuss the intersection of eating disorders and trauma. 


The Window of Tolerance

The Window of Tolerance is a concept developed by Dr. Dan Siegel which describes a “zone of optimal” nervous system arousal, where individuals are best able to function (Fritscher et al., 2023).

Trauma can push an individual outside their window of tolerance, dysregulating their nervous system (Fritscher et al., 2023).

Above the window of tolerance is a state known as hyperarousal, in which many people experience symptoms such as hypervigalence, increased anxiety, flashbacks, nightmares, heightened startle response, and trouble sleeping (Fritscher et al., 2023).

Below the window of tolerance is a state known as hypoarousal, which is associated with a shutdown response. In this state, individuals may experience symptoms such as depression, numbness, dissociation, and a sense of disconnection from others and the world around them (Fritscher et al., 2023).

Experiences of trauma can serve to narrow your window of tolerance. EMDR therapy for trauma can help with vast improvement of symptoms associated with the experience of trauma. EMDR therapy is a powerful therapy that helps people to reprocess traumatic memories and find healing after trauma.


Eating Disorders and Trauma

While eating disorders are mental illnesses and NOT choices, for some individuals, eating disorder behaviors may serve (in part) a coping mechanism, providing a false sense of control when trauma symptoms make them feel unstable or out of control.

When the world and their body feel unsafe, eating disorder behaviors may be a resilient, though maladaptive, attempt to seek safety.

Sometimes, eating disorder behaviors are unconscious attempts to manage trauma-related symptoms, where temporary relief can be achieved by restricting, binging, purging, or compulsively exercising. However, we know that in the long run, these behaviors typically lead to more misery and a sense of being “trapped” by them.


Eating Disorders and Nervous System Dysregulation

Trauma is broadly defined as any experience that dysregulates the nervous system. It’s important to note that all experiences of trauma are valid and that symptoms may manifest differently across individuals.

Eating disorder behaviors can (in part) be an unconscious attempt to cope with nervous system dysregulation.

In Healing The Fragmented Selves of Trauma Survivors, author Janina Fisher talks about eating disorder behaviors as attempts to regulate the nervous system.

Fisher says, “In anorexia, restricting food intake results in (temporary) numbing of emotion and sensation. Overeating also results in numbing accompanied by relaxation, increased parasympathetic hypoarousal, disconnection from the body, spaciness or drowsiness” (Fisher, 2017, p. 131).

Fisher continues, “Bulimia, in both the binging and purging phases, causes a reduction in hyperarousal and decreased pain sensitivity via activation of the dorsal vagal system” (Fisher, 2017, p. 131).
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Healing From Trauma and an Eating Disorder

EMDR therapy, alongside other modalities (we frequently use DBT and ACT in our practice), can be a powerful healing modality for both trauma and eating disorders. We offer EMDR therapy for trauma and an eating disorder in Rockville, Maryland, and virtually throughout Maryland. 

People with eating disorders may carry distressing memories related to food and body image. EMDR therapy can address these specific memories, offering relief and promoting resilience in recovery. For individuals dealing with both trauma and an eating disorder, EMDR therapy can help reprocess trauma-based memories, supporting the overall recovery process and emotional healing related to body and food issues. Somatic practices to promote healing can also be used alongside EMDR therapy.

All of our therapists at The Eating Disorder Center are trauma-informed, and we believe this is a crucial element of treating eating disorders.

Through therapy, you can work on learning more values-aligned coping skills, reprocess traumatic memories, and find more adaptive ways to help regulate your nervous system (other than relying on eating disorder behaviors).

You deserve to feel free from the grip of an eating disorder and trauma-related symptoms.

Take the first step towards healing. You don’t have to continue to feel so trapped and alone.

Schedule a free 15 minute consult for eating disorder therapy in MD, VA, DC, NY, FL, PA, or recovery coaching worldwide.​​

​Click here.

The Eating Disorder Center is a premier outpatient eating disorder therapy center founded by Jennifer Rollin. We specialize in helping teens and adults struggling with anorexia, binge eating disorder, bulimia, OSFED, and body image issues. We provide eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney, Silver Spring, Germantown, and Washington D.C. We also provide eating disorder therapy in Arlington, Virginia and virtually throughout Virginia. Additionally, we offer eating disorder therapy virtually in New York (NYC), Florida, Pennsylvania, and California. We provide eating disorder and EMDR trauma therapy in Rockville, Maryland and virtually throughout Maryland. We provide eating disorder recovery coaching via Zoom to people worldwide. Connect with us through our website at www.theeatingdisordercenter.com

References:

• Convertino, A. D., Morland, L. A.; Blashill, A. J. (2022). Trauma exposure and eating disorders: Results from a United States nationally representative sample. International Journal of Eating Disorders, 55(8), 1079–1089. https://doi.org/10.1002/eat.23757
• Fisher, J. (2017). Healing the fragmented selves of trauma survivors: Overcoming internal self-alienation. Routledge/Taylor & Francis Group.
• Fritscher, L. (2023, October 23). What Is the Window of Tolerance? Verywell Mind. https://www.verywellmind.com/window-of-tolerance-7553021