[An audio version of this blog post can be found HERE]
"Where did your eating disorder come from?" is one of the most frequent questions I receive from and through this blog. Sometimes, it's followed up with the well-intentioned but damning, "Well, you look healthy now." This is damning because health cannot be determined by how someone looks. Health, especially mental health, is never, ever visible. People at "normal" weights with "normal" BMI's have eating disorders. People who are clinically defined as "overweight" or "obese" have eating disorders. People who seem happy and overall well from the outside could be battling some serious mental demon. Nobody can see that shit.
Plus, by the time someone has starved themselves well enough or long enough to become visibly skeletal, the eating disorder has likely lived in them for a very long time, far before anyone could see it.
Nobody really knows where eating disorders, or any mental disorder for that matter, come from (read a previous blog about the origin of eating disorders HERE ). But what has been found, over and over again, is that traumatic events or traumatic childhoods are often precursors to mental illnesses. Children especially don't have the tools to cope with traumatic events. The correlation between trauma and poor mental health is as obvious as it is overlooked.
The Office of Woman's Health states, "Abuse, whether physical, emotional, verbal, or sexual, can have long-term effects on your mental health. Trauma can affect how you feel about yourself and how you relate to others.Abuse may have happened during childhood or as an adult. It can be emotional, verbal, physical, or sexual.Trauma can have long-term effects such as: severe anxiety, stress, abuse of alcohol or drugs, depression, eating disorders, self-injury, or suicide." Traumatic events can include (but are not limited to): violence or prolonged abuse, natural disasters, serious illnesses, death of a loved one, or neglect. Trauma can occur all at once, like in the case of a natural disaster, or it can be chronic, like being repeatedly abused or chronically neglected.
The SAMHSA-HRSA Center for Integrated Health Solutions states that in the United States, 61 percent of men and 51 percent of women report exposure to at least one lifetime traumatic event, and 90 percent of clients in public behavioral health care settings have experienced trauma. Unaddressed trauma results in poor physical, mental, emotional, and social health outcomes. Unaddressed trauma does not only affect the person who carries that trauma either; it bleeds out of their lives and into the lives of those they interact with. It's incredibly important to note that the person victimized in these scenarios is never at fault but unfairly burdened with the task of either resolving their trauma or existing within it.
The Adverse Childhood Experience Study (ACES) found that survivors of childhood trauma are up to 5,000 percent more likely to attempt suicide, have eating disorders, or become IV drug users. The ACE Survey measured 10 types childhood trauma, five of which are personal — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect; and five that are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment.
Speaking from experience here: those who struggle with mental health issues have a tendency to blame themselves. We think there is something inherently wrong with us, when really, we've just learned how to survive in environments that aren't altogether healthy or good for us. And environments that cause some people to thrive may not be good for others. "Trauma," too, doesn't have to be an enormous, life-altering event, especially for children. Living in uncertain environments where food, emotional stability, financial security, etc, may be conditional is enough to deeply impact a child. And if a caretaker is living with unresolved trauma and handling it poorly, you can bet they will pass it on to their child.
At the heart of many eating disorders is a deep need to control something. For children with chaotic home lives, food is an easy thing to control. Doubling damning is that many young people are taught to associate their inherent worth with the shape and size of their bodies. This thought process may not make sense to the outside world, but for someone with an eating disorder, it can be lifesaving.
The thought process looks something like this: "I don't feel safe or loved in this environment, but I also don't have the skills or power to change my current environment. I don't necessarily feel loved, but I do know that smaller, thinner, more attractive people seem to receive attention, and that seems similar to love. I can control my body by controlling my food and then maybe I'll receive the love that my current environment or situation isn't providing me." In this scenario, the eating disorder isn't an enemy, it's an ally, and sometimes, the disorder is an individuals closest ally. We cling to it when we have nothing else to cling to or depend upon. Often, people feel this way because of an unresolved trauma that really has nothing to do with them.
The most important thing to note about trauma and about eating disorders, is that we can make the difficult choice to *attempt* to resolve our traumas. That work is ongoing and may never be done. We can also make the difficult and seemingly impossible choice to recover from our eating disorders. The trauma inflicted upon us is never our fault, and we don't have to live with it.
P.S. Watch a short video about trauma and eating disorders HERE.
P.P.S. If you or someone you love is struggling with an eating disorder, contact the NEDA helpline at (800) 931-2237, find a treatment center or therapist near you HERE, or find an Eating Disorders Anonymous (EDA) meeting near you HERE.