Healing the Trauma of Residential Treatment for Eating Disorders

People in recovery from eating disorders often need to address the trauma of being in treatment programs in order to fully get well.

Hospital stays and residential treatment are often, but certainly not always, a necessary part of recovery. Critical medical issues need attention and sometimes a hospital stay is necessary. When people experience prolonged, severe eating disorder symptoms, residential treatment may be the only way to normalize eating enough to continue down the path of recovery.

Patients who understand their illness usually agree when it’s time to go into treatment as well, even if they are reluctant.

The trauma of being in treatment can stem from being forced into the program, especially if the patient is young, but often trauma occurs even when the patient decides to seek help themselves.

Treatment programs render the patient powerless and helpless. They have to stay on the physical premises and are only allowed out on arranged outings. They must eat what is in front of them, no matter how frightening or overwhelming the experience, five to six times daily. They need to tolerate any changes in their bodies, no matter how sudden. For the first few weeks, they cannot even go to the bathroom themselves for fear they may engage in eating disorder behaviors.

In addition, patients need to adhere to these rules while attending individual and group therapy sessions where they are expected to talk about deeply personal and sensitive topics. It’s hard enough to broach those topics in the best of circumstances, let alone when the person is locked away without any rights, independence or agency.

Weeks or months of being trapped without any say and forced to do the terrifying act of eating many times per day while one’s body changes, often very quickly, is frequently traumatizing.

The expectation after treatment is that patients will continue their meal plan, ignore the emotional fallout of weeks or months in treatment and recover swiftly.

Clearly there is something missing in this plan for eating disorder recovery.

After discharge from treatment, patients need to start to talk about their experience immediately. Not only is it harder to eat without being forced to do so, but a common response to being so powerless is to assume power back with eating disorder symptoms. Paradoxically, the traumatic experiences reinforce the eating disorder itself. Patients need to talk through their experience and feelings immediately in order to not fall into the most common pitfall after discharge.

In addition, discharge plans from treatment need to focus on the food in a compassionate and supportive way. The draconian methods used in programs will backfire in the world. Force does not create an path to recovery.

Last, patients need to know they will be in charge once they are out in the world. The experience of being trapped and overwhelmed renders people scared and alone. Retreating to the eating disorder feels like the only way to regain any sense of safety and security.

This topic is even more important with the growth of treatment programs in recent years. Therapists need to be ready and capable of ensuring patients get compassionate care after discharge from programs.