An eating disorder like anorexia nervosa or bulimia nervosa is a traumatic experience; in addition to the negative physical consequences they bring, people who suffer from one of these disorders often refuse to seek out help or even admit there is an issue. This is often due to the self-propagating nature of eating disorders, but uncertainty about what treatment entails is often part of it.
Every individual has a unique case, and so each needs a unique treatment plan. With certain techniques such as CBT almost always being part of an eating disorder treatment plan, most individuals can count on the mainstays of therapy. However, since treatment can encompass so many different types of therapy, it’s better to come prepared for many possibilities.
It is common for those entering residential eating disorder treatment centers to be unsure of what to expect and to feel anxiety about what kinds of treatment they’ll receive. Here, you can check out several types of therapy that can be part of eating disorder recovery, and hopefully assuage some of the nervousness you or a loved one might feel about going into recovery.
Body Image Therapy
One of the common underlying factors that contribute to the onset of eating disorders is a negative and/or distorted body image. Because it factors into almost every case of an eating disorder, body image therapy is an integral part of eating disorder treatment. Useful in both individual and group milieus, body image therapy can help clients understand connections between the negative body image of others and their own personal outlook during group therapy in eating disorder facilities, or it can serve to help the client understand their distorted thought processes.
Cognitive Behavioral Therapy
Almost every eating disorder treatment center makes use of cognitive behavioral therapy for eating disorder treatment. This form of therapy centers around identifying disordered thoughts and then systematically and rationally debunking them. Cognitive behavioral therapy can be done individually or with a group – during group sessions, individuals get to learn from one another, and during individual sessions, the client and therapist can build on prior progress in a more intimate way. During this process, a “dialectic” or a dialogue between the participants commences. They discuss their feelings and thoughts, especially those that center around disordered eating behaviors. Over time the therapist will ask questions that help the client recognize that these thoughts are distorted – that they’re not objectively true but instead a reflection of their eating disorder. Eventually, CBT can help individuals recognize and experience these disordered thoughts without acting on them.
Acceptance and Commitment Therapy
Acceptance and commitment therapy (ACT), highlighted in this article from Psychology Today, is a type of psychotherapy that helps encourage greater well-being by fostering coping and acceptance skills. Very often, eating disorders result at least in part from a failure to deal with emotional challenges in a productive way. Through acceptance and commitment therapy with a group, these individuals learn how to utilize interpersonal relationships and communication to accept challenges and commit to a healthier solution than disordered eating patterns.
This form of therapy is essential in preparing people recovering from an eating disorder for returning to the “real world” after they finish inpatient or intensive outpatient treatment. In exposure therapy sessions, individuals are literally exposed to the things they fear or are anxious about in small doses. This serves to reduce the anxiety surrounding those situations. An example of this might be an individual with anorexia nervosa eating a little bit more during each session until their inclination to restrict calories becomes manageable enough to eat a balanced meal in full.
This form of group therapy may be the most important of all from a support-system point of view. In these sessions, the individual and their immediate family and caregivers work with the therapist to learn more about eating disorders and how they affect the psyches of the patient as well as those around them. They help to avoid codependent and enabling actions on the part of the family, while also helping the subject become more comfortable expressing their emotions to their loved ones and asking for support. In some cases, the family may engage in training sessions without their loved one present, as well.
Eating disorder behaviors are not always centered around food. In many cases, as a replacement or in combination with restrictive or purging behaviors, an individual might compulsively and excessively exercise to lose weight. This means exercising when they don’t feel like it, working out through a serious injury, or canceling social engagements to work out. Like with other disordered behaviors, there are special techniques used to modify these compulsions. Among the most prominent are mindfulness training and mindful movement. Mindfulness is the state of experiencing a moment without acting upon it. It’s often part of a mediation regimen and can also be implemented in movement classes. A prime example is yoga, which includes both gentle movement and meditative practice into a single experience. It’s standard at most eating disorder treatment facilities and can help replace punishing or compulsive exercise with a mindful movement routine.
Eating disorders are complex psychiatric disorders on their own, but normally specific medications are not prescribed for individual disorders such as anorexia nervosa or bulimia nervosa. However, since co-occurring psychiatric disorders are exceedingly common with eating disorders, incoming clients should expect significant psychiatric support. Ideally, a psychiatrist will be on staff and available for regular consults. Depression and anxiety disorders are the most frequent co-occurring disorders, both of which can be treated with a combination of medication and therapy. Psychiatric staff can also treat more serious psychiatric disorders such as OCD or schizophrenia, working in conjunction with the eating disorder specialists and other therapeutic staff.
Advanced cases of eating disorders can often cause severe medical problems that require intensive medical care. While the most severe symptoms will require hospitalization, ongoing care should be expected at a comprehensive eating disorder treatment center. Different disorders bring different medical needs. A person with advanced anorexia nervosa might be suffering from malnutrition, anemia, and other complications of low body weight. A person with bulimia nervosa might exhibit gastrointestinal problems, swollen glands, and dental problems. Or a person with binge eating disorder might be struggling with type 2 diabetes, heart conditions, or other difficulties related to obesity. No matter the medical issue, the treatment center should be equipped to manage it.
To put it simply, true recovery begins when you leave the treatment center. Of course, the progress you make in treatment is essential to a full recovery. Therapeutic techniques like CBT and exposure therapy lay the groundwork for your return to “daily life.” However, recovery is an ongoing process and most graduates from an eating disorder treatment program need continued care as they reintegrate into their old routines. Before you discharge, you should expect the treatment team to build an aftercare plan with you. That might include step-down to day treatment following residential, organizing virtual sessions with a therapist, or even an online alumni group that meets regularly to provide support. Family members should also receive education and training on how to support you in the weeks and months to come. Relapses do happen, but a quality aftercare program can help prevent them and make the rebound much faster and safer.
Don’t Let Uncertainty About Treatment Stop You From Getting the Help You Need
The decision to seek treatment for an eating disorder is a tough one to make; you or your loved one will be making fundamental changes to the way they live, feel, and relate to themselves and their bodies. However, eating disorders can be deadly if they aren’t addressed. Fear of change and anxiety about treatment methods, while sometimes powerful dissuaders for people getting help, can be overcome by calmly explaining what will be involved. Armed with knowledge about what to expect, the road to recovery is that much easier to navigate.