Eating Disorders and Sexual Trauma

Eating Disorders and Sexual Trauma

There is a connection between sexual trauma and eating disorders.  As a survivor of sexual trauma, there are many aspects of your experience that put you at risk for developing an eating disorder. Many survivors of sexual trauma perceive their bodies as a risk and may unconsciously attempt to make their bodies as least appealing as possible to ward off additional sexual trauma. Coupled with the messages they receive from society, survivors may mistakenly believe that if they do not dress or look like what is considered sexy or desirable, that they will be less likely to be a victim of sexual violence. For instance, some survivors may mistakenly think that if they are “too fat” or “too thin” they will be safe from sexual violence. This may cause survivors to develop an eating disorder as they unconsciously try to make their body safe by becoming overweight or underweight.  Another factor that puts survivors of sexual trauma at risk for eating disorders is the experience of dissociation.  In the moment of sexual trauma, many survivors must disconnect from their body. The ability to disconnect from one's body or dissociate is a common survival mechanism and it helps survivors block out part of the trauma. After the trauma, your body may default to using dissociation as a coping mechanism when you are under stress. This pattern of dissociation trains survivors to ignore or not even be aware of their bodily sensations. The ability to disconnect from one's body and ignore sensations such as hunger or satiety puts survivors more at risk for developing an eating disorder.  Does either of these examples ring true for you? The questions below will help you understand the connection between your past sexual trauma and your relationship to food and your body image.

Questions About the Sexual Trauma - eating disorders and sexual trauma in Philadelphia: It is important to recognize the coping mechanisms you used to survive your sexual trauma. Once you can identify the behaviors you developed to survive the trauma and its aftermath, you can see how these behaviors have played out in your life. Often behaviors that were useful to help you survive the sexual trauma may no longer be useful to you anymore. Some of these behaviors may even be putting you at a higher risk for developing an eating disorder. These questions will help you explore the sexual trauma and how you survived the sexual trauma. Answer the following questions:

• When did the abuse begin?  How long did it last?
• How were you coaxed into silence?  Were you given rewards?  Were they food-based?
• During the actual trauma, was food used?  Sometimes, especially in ritualistic abuse cases, food is incorporated into the abuse.
• What was appealing about the sexual trauma? Consider whether you were rewarded materially or were treated specially.
• How did you deal with your emotions during the sexual trauma?
• How did you manage your emotions related to the trauma afterward?
• How did you cope with your physical sensations or pain during the sexual trauma? Consider both painful, pleasurable, and mixed sensations.
• How did you handle physical sensations or pain related to the trauma afterward?
• How did you view your body before the trauma? After the trauma?
• What fears or concerns did you have about your body after your sexual trauma?
• How did your relationship with your body change after the trauma? Five years later? Ten years later? Twenty years later?
• If your sexual trauma occurred during childhood, how did puberty impact the way you viewed your body? What about childbirth? Parenthood? Menopause?
• How do you think the trauma continues to influence your relationship with your body?
• What did you do to protect yourself from the sexual trauma? Consider whether you used food, style of dress, poor hygiene, etc.
• How did sexual trauma impact self-care?
• After your sexual trauma, how important was it to feel in control or your body? How would you exert this control over your body?
• Who do you know has also experienced sexual trauma?
• When, if ever, did you disclose your sexual trauma and why?
• Who knows about your sexual trauma?
• What has influenced your decision about disclosure?
• What do you imagine would have happened if you had told people right after your sexual trauma? If you had told people now?

Questions and Thoughts about Your Relationship with Food and Your Body - eating disorders and sexual trauma treatment in Philadelphia:  The following questions ask about eating disorder behaviors and body image. It is possible that you are presenting with an eating disorder but that the root of your problem lies in sexual trauma that you have never healed from. Think about the following questions:

• Describe your relationship with food. Which aspects are healthy? Which are unhealthy?
• What else are you denying yourself besides food? What else are you indulging in too much besides food?
• What other reasons besides feeling hungry do you eat?
• What other reasons do you stop eating besides feeling full?
• What emotions or feelings do you experience when overeating? What about starving?
• About an hour or so after overeating, what emotions or feelings do you experience?
• Are you most likely to eat when you feel....frustrated, lonely, anxious, angry, irritated, uncomfortable, bored, distracted, tired, stressed, embarrassed, guilty, jealous? What about when you feel...happy, excited, calm, playful, energized?
• Are you most likely NOT to eat when you feel...frustrated, lonely, anxious, angry, irritated, uncomfortable, bored, distracted, tired, stressed, embarrassed, guilty, jealous? What about when you feel...happy, excited, calm, playful, energized?
• When are you most likely to purge? Describe your emotional state.
• How do you determine when you are hungry? What about when you are full? Describe the physical sensation of each.
• Describe your body image.
• Look in the mirror. What do you see? What do others see?
• What do you believe is the impact body image has on sexual safety?
• How safe do you feel in your body?
• How does purging make you feel about being in control of your body? What about restricting your caloric intake?
• How does being able to determine what you eat and do not eat play into your sense of power and control?
• When do you feel out of control of your body?
• When do you feel in control of your body?
• How do you know you are in control of your body?

Reflecting on Your Responses: eating disorders and sexual trauma treatment in Philadelphia It may take you several attempts to answer the questions. If you find yourself stumped, emotionally overwhelmed with feelings of anger, sadness, shame, guilt, etc. put the questions away and revisit them in two days. If you find yourself stumped again or emotionally overwhelmed, revisit them in another week. Your responses may not make sense to you and this is okay. It is more important that you be honest in your responses rather than withholding a response because you feel as though it does not make sense. If you have a trusted friend or partner share your responses with them. Your friend or partner may be able to identify your patterns. Write your responses to the following questions to reflect on your responses:

• Which questions brought up the strongest emotional reactions?
• What were your emotional reactions to these questions?
• What is similar about the way you answered these questions?
• Which sets of questions are similar or different from each other?
• What is most concerning about your responses?
• What patterns or themes do you notice in your responses?
• What makes more sense to you now?
• What still does not make sense to you?
• What questions do you still have or what new questions do you now have?

Reaching Out.  After reflecting on your responses, share the above information with a trusted friend, partner or family member.  Although there are many benefits to reaching out to others like increasing your social support and experiencing validation about how you're feeling and what you went through, reaching out might not feel right to you.  Perhaps you do not have someone to share with or you feel too embarrassed.  Maybe you feel the trauma was too recent or still too scary to talk about.  If this is the case you should consider if you would feel comfortable reaching out to a therapist.  In addition, even if you do not understand the connection between your sexual trauma and your eating disorder, if you have an eating disorder you are putting your body at risk for many serious health conditions and need to seek help. Understanding how your eating disorder and sexual trauma are related is an important step, but is only one step in the recovery process. Therapy can provide you with the support and skills to address both your eating disorder and your sexual trauma.