Sexual Violence and Eating Disorders: Making Connections to Promote Holistic Healing

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Sexual Violence and Eating Disorders: Making Connections to Promote Holistic Healing

sexual violence and eating disorders

Introduction by Molly Boeder Harris

In my experience working within the field of sexual violence, I have often noticed that issues of food, appetite and body image arise at some point in my conversations with survivors. These topics or concerns will emerge with both recent survivors and also with those that may be months, years or even decades removed from their experience(s) of violence. While the connections between sexual violence and disordered eating may seem apparent to those who witness how it impacts survivors’ lives, many of us lack in-depth education or training specifically around eating disorders to compassionately understand the connection. I believe our community of healing arts practitioners, advocates and survivors themselves will benefit from learning more about this relationship from those with expertise in the areas of eating disorders, trauma and embodiment. By increasing our knowledge about this connection, we can enhance our referrals, resources and responses to individuals who are navigating eating disorder recovery, along with the journey to heal after sexual trauma.

In this interview, “Sexual Violence and Eating Disorders: Making Connections to Promote Holistic Healing” I spoke with Ellen Boeder, a psychotherapist with a Master’s Degree in Transpersonal Counseling Psychology from Naropa University, a yoga practitioner and teacher, and someone who has specialized in working with individuals in eating disorder recovery for over a decade, and now her practice is increasingly shifting towards working with couples. In her blog, she writes about eating disorders, body image, the media’s objectification of (pregnant) women’s bodies, the ongoing journey of motherhood, and embodied parenting. Ellen’s empowering approach to working with her clients offers a beautiful model for understanding the rich transformation that is possible through a psycho-therapeutic practice that is intentionally inclusive of the body, mind and spirit of each unique person.

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The Breathe Network: Can you tell me about your understanding of the connections or relationship between surviving sexual violence and developing an eating disorder or perhaps disorder eating behaviors?

Ellen Boeder: A large percentage of those who struggle with eating disorders report that they are survivors of sexual (and/or physical abuse), as much as 50%, which is about 20% higher than the “average” woman. In my experience as a clinician in the field, I would say that statistic is closer to 80%, when I consider the clients that I have personally treated. How much this abuse has played a role in the development of an eating disorder (ED) is difficult to say exactly, but it makes complete sense when we consider the general function of an ED.

A simplified explanation of the function of an eating disorder is that it is an internal regulating mechanism for emotional experience. Through the process of over regulating food, weight, and exercise (in the short term) one is able to regulate their internal experience: this means their physical sensations and emotions, as well as what their mind focuses on. In a certain light, an ED is a brilliant way of coping with trauma, as the intense focus on food and body image temporarily narrows awareness enough to block out the overwhelming thoughts, feelings, and emotions that are part of surviving a traumatic event. I think that particularly when the trauma is sexual abuse or assault, the ED helps the survivor by screening out the excruciating body and mental memories and impact of the trauma. However, an ED creates a whole other set of problems and issues to overcome eventually. Ideally, if a survivor receives immediate and adequately skilled support, they would not need to develop a strategy like an eating disorder to cope with the traumatic event(s).

TBN: The sexual violence advocacy community is beginning to explore more and more the embodied effects of sexual violence, and I hope we will eventually see more collaboration between those in the sexual violence movement and professionals working with eating disorders. Has the community of professionals and educators around eating disorders identified the prevalence of sexual violence or trauma among this population?

EB: Many clinicians who specialize in working with ED’s also have training in working with trauma. Trauma is not always part of the development of an eating disorder, but for a lot of people who struggle with them, it is a component. Having specific training in both areas is helpful for successful treatment much of the time. With Post Traumatic Stress Disorder and eating disorders, dissociation from the body and the felt sense underlies the struggle. So, helping clients reconnect with the body, and all that their body experiences in terms of pain and resource, is a central part of the healing process. 

TBN: In the sexual violence advocacy community we often talk about providing “survivor centered services/care” which essentially means that we empower survivors to trust their intuition around their healing journey as they navigate systems, options, and tools for healing. Does this approach make sense for individuals with eating disorders?

EB: I love the movement towards survivor-centered care. It is in alignment with more current thinking and awareness that our clients have wisdom and knowing within them to support their own healing, and the art of therapy is to bring that knowing to the surface. Practitioners are less and less “the expert” and increasingly, the facilitators of growth and healing by providing the space and the tools for transformation and insight. 

I see a similar trend in psychotherapy in general, and in the treatment of eating disorders. Centers and providers are working to individualize treatment and empower clients to engage as fully as possible in their recovery. Challenges to this empowered client involvement are in the form of insurance companies mandating certain levels of care and time frames for treatment. Additionally, when it comes to recovering from an eating disorder, at times the client has lost so much cognitive capacity due to the ongoing depletion of suffering from an ED that they are not able to make well informed decisions about their care. So, how to include and empower someone who is very destabilized looks different than how it would if someone had all of their resources in place. 

Regardless of the state our clients are in, it seems imperative that we work to build trust between ourselves and our clients, teach and empower them to build inner and outer resources that support healing, and utilize a range of modalities to allow recovery to unfold for the mind, body, and spirit of each individual.

TBN: Thank you Ellen for sharing your insights into the connections between sexual trauma and disordered eating and your commitment to empowering people along their journey of healing and self-discovery.

Learn more about Ellen’s private practice and approach to psychotherapy, yoga instruction, as well as more information about eating disorders on her website. You can also visit her practitioner page with The Breathe Network to learn specifically about her work with survivors of sexual violence, why she is interested in working with this population, how her approach addresses survivors holistically and the modifications she offers to increase comfort and accessibility for survivors.

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