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Can focusing on emotions when talking with your therapist improve symptoms of Binge-Eating Disorder (BED)?

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Binge-eating disorder, although not formally recognized until added to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the most common eating disorder in the United States.   Having experienced the suffering from this diagnosis myself in the past, I used to refer to it as an emotional eating disorder.  Simply put, I used food to soothe and comfort myself.  I had not learned any healthy coping strategies when I experienced emotions, so I did my best to stuff them down with food.  It wasn’t until I took the journey of befriending my emotions and honoring their intelligence that I even became aware of my unhealthy relationship with food and eating behaviors.

Once I was able to accept my emotional beingness as a human, so many more things began to make more sense to me.  With the support of a good therapist, I came to learn that what I had experienced as a child was traumatizing and I disconnected from my emotions to survive.  However, living life from only the logical intelligence perspective was so limited.  And, even though I disconnected – or dissociated – from my emotions, it didn’t mean they went away.  They wanted to come out and be heard, so they knocked on the door loudly, sometimes bursting in when I least expected or wanted them.  So I used food to try to quiet them down, like you feed a baby when they are crying.

When I learned how to recognize my emotions and allowed them to have some air time, I was able to engage in a dialogue with them so they could inform me what I needed in the moment.  I then needed to learn how to give myself what I needed.  My personal journey towards valuing my superpower – my emotional intelligence – is the reason that my psychotherapy services include emotion-focused therapy (EFT).  Prior to EFT being researched to the point of becoming an evidenced-based practice, most research and treatment for BED aligned with cognitive behavioral therapies (CBTs).  Unfortunately, these approaches could not address efficacy, failure to abstain from such unhealthy eating, and high drop-out rates from treatment, because powerful emotions are among the most accurate predictors of BED.

This realization led researchers to consider exploring other psychological treatments with a focus on emotions.  A recent research study looked at EFT as an alternative treatment approach for BED other than CBT.  The results validate my own personal journey.  The findings provided additional evidence that individual EFT might be beneficial in the treatment of BED, as it supports clients in processing uncomfortable emotions instead of relying on food as an emotional coping mechanism.

To read the full article, click the link below:

Emotionally-focused Therapy for BED

Do emotions have a role in healing childhood trauma?

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I sense that most of us are aware that our brain, especially the rational part (i.e., prefrontal cortex) does not reach full development until age 25 or so, which implies, by default that until that age, we tend to operate more from the emotional parts, such as the amygdala.  And, as our brains develop, the connections between the two (emotional and rational) centers are still developing as well.  What we may not be so aware of is the impact of childhood trauma on such connections.  We also may not be fully aware of many of the situations that are now understood to be traumatizing to children.

Let me start with the latter.  Extensive research has been ongoing since the original group of participants were recruited for the Adverse Childhood Experiences Study between 1995 and 1997 in California.  Although the study ended in 1997, most states continue to collect such information through the Behavioral Risk Factor Surveillance System.  The information collected focuses on child abuse and neglect and other household challenges, including intimate partner violence, substance abuse and mental illness in the household, parental separation or divorce, and if a household member was incarcerated. This research has resulted in the inclusion of a new diagnosis of Complex posttraumatic stress disorder, also referred to as developmental PTSD, within the International Classification of Diseases, 11th Edition, recently officially endorsed by WHO’s World Health Assembly and set for implementation outside of the US in 2022.

This is a HUGE step forward in identifying the underlying cause of most challenging symptoms to mental health, including anxiety and depression, and how these symptoms link to most chronic physical diseases, such as heart disease and cancer!  I have been known to say we don’t need a Diagnostic and Statistical Manual (DSM) of Mental Disorders, we simply need The Book of Trauma.  When we all can embrace the idea that there is nothing wrong with us and instead can understand it is what happened to us when we were little that makes it so difficult to live a life full of joy and meaning today, there will no longer be any stigma to seeking support and we can begin the process of healing by shedding the shame and suffering we have been carrying.

Now to expand on the awareness of the impact such developmental PTSD has on the growing connections between the emotional and rational parts of a child’s brain.  When we are little and presented with trauma (as defined above), the emotional input to the brain is overwhelming to the point where we only ‘feel’ and are unable to ‘think’ because the developing rational part of the brain is hijacked by the emotional part, cutting off the connections that encourage a more balanced perspective.  The most familiar and natural fear responses of ‘fight or flight’ in many cases may not be an option for children.  Therefore, the ‘freeze’ response may be the most accessible, especially in young children.  The freeze response is used when the presenting danger cannot be escaped or beaten down, and if either were to be attempted, might actually increase the risk of harm.  The freeze response is a survival response that encourages stillness and silence to avoid being seen and offering a mental escape instead.  What this normal response to danger also does is narrow the range of emotional awareness to flavors of fear and shuts down the development of a more diverse range of emotions, including engagement, joy, comfort, confidence, empowerment and enthusiasm.  When the freeze response helped us to survive the traumas of our childhood, it also stunted our emotional intelligence (aka alexithymia), locking us in a world where danger lurks around every corner, even as adults.

So what can we do to unlock the door to the fear chamber and open it up to a safer, more peaceful existence?  In order to facilitate improvements in trauma-specific symptoms, such as anxiety, depression, dissociation, impulsivity, and interpersonal problems, emotions need to be welcome to express themselves.  Working with a therapist that embraces the intelligence of emotions, through perhaps using Emotionally-focused therapy, can address the emotional challenges associated with alexithymia and thus, begin to resolve issues of childhood trauma.

To read a little more of the research on how working with emotions heals childhood trauma, click on the link below:

Healing childhood trauma through emotions