A couple of weeks ago in this space, we talked about eating disorders. The response from our readers was notable. Within hours of being posted at the Salem News web site there were 1,210 hits to our article about National Eating Disorders Week, which prompted us to share more about the subject.
Researchers are active, seeking deeper understanding of eating disorders, their causes and the best means of treating them. They have found that there are related issues to eating disorders: they do not occur in isolation. In an early study of 20 individuals with bulimia, 20 with panic disorder and 20 with social phobia, it was learned that 75 percent of those suffering bulimia also had an anxiety disorder.
A national survey advised that 80.6 percent of individuals had an anxiety disorder at some time in their lives, even childhood, well before the onset of an eating disorder. Bulimia (binge eating, then purging or using diuretics, enemas or laxatives, and over-exercising to avoid weight gain) and mood disorders-particularly depression-are common. Anorexia has been associated with anxiety and depression. Obsessive-compulsive disorder (OCD) also is related.
Because of the co-occurrence of disorders, "We have developed a transdiagnostic unified treatment protocol," write David Barlow, Ph.D. and Christina Boisseau, Ph.D. in the Winter 2011 Perspectives, a professional journal of The Renfrew Center Foundation in Philadelphia. In this protocol, emphasis is "on the way that individuals with emotional disorders experience and respond to their emotions." Five of the eight modules are:
1.) Emotional awareness training.
Emotional awareness training works on 'increase awareness within the immediate context in which emotions occur.' What negative self-talk is going on? Why do you think negatively about yourself or your reactions in social situations? How can you make positive statements out of those things and build your self-esteem?
2.) Cognitive reappraisal.
You learn to understand how you interpret the situations in which you find yourself and how those judgments trigger your negative responses. Undertake the challenges of debunking the negative beliefs. Learn to be flexible.
3.) Emotion driven behaviors and emotional avoidance.
Remember fight-flight responses to life-threatening situations? Sometimes people use those responses incorrectly when they fear social interaction and work at avoiding the situations that trigger their negative thinking. You become able to recognize those emotion-driven behaviors and learn better responses.
For someone with an eating disorder, you learn to remain in the anxiety-provoking situation or sit with your emotions rather than purging. Establish regular eating patterns and learn to keep eye contact during social interaction so you will begin to feel comfortable and not avoid the times and incidents that might involve emotional reactions.
4.) Awareness and tolerance of physical sensations.
The fourth module uses particular exercises that are similar to exercises related to intense emotions, like running in place to raise the heart rate and cause the face to flush, reactions similar to social anxiety.
"Working with patients to increase tolerance of anxiety-related physical symptoms may also become important in treatment of eating disorders," say doctors Barlow and Boisseau, particularly because of the research being done on the connection between anxiety disorders and eating disorders.
5.) Emotion exposure.
The final module works on the emotions, not situations. It's about feeling emotions and not avoiding them. When you numb yourself to pain, you also are numb to other emotions, like joy and happiness.
"Theadvantages of a unified transdiagnostic approach include the provision of a single set of therapeutic principles in one treatment protocol applicable to all anxiety, mood and related disorders, rather than numerous diverse protocols for each disorder," Boisseau and Barker say.
For more information about eating disorders and how to get on the road to recovery, contact Family Recovery Center, 964 N. Market St., Lisbon; phone, 330-424-1468; or e-mail at firstname.lastname@example.org.