The Connection Between Eating Disorders and Dissociation

By: Megan Samuels, MSW, LCSW-C, Trauma and Eating Disorder Therapist

Dissociation is a word that gets thrown around a lot in social media and in popular culture.  I hear a lot of people tell me that they think that everyone who experiences dissociation has dissociative identity disorder, which is not true.  Dissociation is a spectrum and can be part of a normal human experience.  In this blog, I’ll discuss what dissociation is, how it can show up, and the connection between dissociation and eating disorders.

What is Dissociation?

The definition of dissociation is to disconnect or separate.  The disconnection or separation can be from self, from others, or from the world around us.  We can feel distant from others and not hear what they are saying or recognize familiar faces.  We can feel disconnected from ourselves and not feel like our body belongs to us.  And lastly we can feel disconnected from the world around us.  I’ve had clients describe this as feeling as though they exist in a video game or simulation where their thoughts and actions feel like they are being controlled by someone or something else.

Dissociation is an unconscious defense mechanism that allows us to disconnect in order to protect ourselves from something that is scary or dysregulating to our nervous system.  When we dissociate to protect ourselves, it is adaptive, meaning that it is helping us to survive in the world.  If the dissociation continues happening past the adaptive function or threshold, it may become maladaptive, which is typically when it begins to interfere with functioning (such as work or relationships).  

How Does Dissociation Show Up?

Dissociation can be part of a normal human experience and it's not always something that we want to make go away as it could still be serving us in adaptive ways.  

Some ways that dissociation may show up in our everyday lives include feeling like the world looks “foggy” or “unclear,” not hearing part of or all of what another person has said, not remembering past important life events, or not feeling connected to body or mind.

Dissociation is a spectrum and ranges from normal, everyday, adaptive functions, to more clinical and significant dissociation that may include more maladaptive functions that can lead to dissociative disorders, including dissociative identity disorder.  

Dissociation and Eating Disorders:

A skilled trauma and eating disorder therapist will know about dissociation and be able to assess and work with the dissociation, as well as understand how the dissociation relates to the eating disorder.

Oftentimes clients with eating disorders report experiencing a disconnect from their body.  This dissociation that occurs can lead to eating disorder behaviors as dissociation can include a decrease in ability to recognize hunger and fullness cues which can contribute to behaviors like restriction or binge eating.  Additionally, often individuals with eating disorders score higher than the general adult population on the Dissociative Experiences Scale, which is a tool that I use with clients to assess levels of dissociation.

In addition, I’ve seen a lot of folks experience dissociation during episodes of binge eating.  Clients may report not remembering how much or what they ate during a binge eating episode.  That loss of memory is a part of dissociation, known as dissociative amnesia.  

Also, I mentioned earlier that dissociation is an unconscious defense mechanism that allows us to disconnect in order to protect ourselves from something that is dysregulating to our nervous system. Similarly, eating disorder behaviors can sometimes be (in part) ways that individuals are trying to regulate their nervous system in the aftermath of trauma or otherwise.

Next Steps:

If you are experiencing dissociation and an eating disorder, it's crucial to see someone who specializes in the intersection of both.  I provide trauma and eating disorder therapy in Rockville, MD and virtually throughout Maryland for teens and adults. I offer EMDR therapy which is highly effective for the treatment of both trauma and an eating disorder, alongside DBT therapy.  I offer a free 15-minute consultation to see if we would be a good fit for working together.

Journal Prompts for Dissociation and an Eating Disorder:

1. In what ways do you find feeling disconnected from yourself, others, or the world around you?
2. Do you notice any patterns with this disconnection/dissociation (for example only experiencing it in the mornings or at work)?
3. In what ways is dissociation contributing to your eating disorder?
4. When you are experiencing this disconnection/dissociation, are you able to notice it in the moment?  Do you allow yourself to stay with it or do you try to do things to decrease the disconnection/dissociation?

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