Eating Disorders and our Nervous System

A relatively new direction in psychotherapy is the discussion of our nervous system. Words such as activation and dysregulation of our nervous system describe increased anxiety or the experience of shutting down in response to external or internal emotional triggers.

Discussing our nervous system incorporates the idea that some responses to our lives are driven by ingrained reactions, not emotions or fear.

The referenced nervous system is the autonomic nervous system, an automatic and unconscious part of how our body functions. The autonomic nervous system regulates brain and body activity in response to threat and safety and changes how our body reacts to these different scenarios.

The key is that these nervous system reactions are automatic. Although we may create a logical explanation as to why we react the way we do, the story matches but does not explain the physiological and emotional response. Our bodies instead are programmed to respond to stress or safety in specific ways, but not the same ways for everyone.

Focus on the connection between the autonomic nervous system and mental health revolves primarily around the treatment for trauma. The underlying point is that the ways our bodies react to trauma are protective: we activate our fight-or-flight response or shut down in order to avoid as much harm as possible during the traumatic experience. The new theory helps people understand why their body reacted to trauma the way it did, how this response is protective and the cause of their current symptoms.

My question is how does the autonomic nervous system relate to eating disorders?

First, most eating disorder symptoms replicate the experience of shutting down. Restricting food, binging and purging all induce the feeling of shutting down our vigilance and cognitive abilities thereby numbing emotions and connections in the world. Eating disorders trigger a part of the autonomic nervous system that protects us by shutting down. When emotions or agitation are too strong, the quick fix of eating disorder symptoms can powerfully access shutting down.

Recovery and treatment demand being present, as I have written about extensively in the blog, and also emotional attunement with others, another core part of the autonomic nervous system. The vulnerability of the heightened awareness of being alive and connected to others often overwhelms people in recovery. The temptation of shutting down can be so powerful and lead to slips or relapse.

Even this simple framework opens up many questions. Is there a component of attunement and alertness that is overwhelming for people who get eating disorders in first place? Is there a predilection to seek the numb feeling of shutting down? Does the pull to shutting down reflect a reaction to prior trauma or to a life experience? Are people with specific types of autonomic nervous system more prone to eating disorders?

This new theory about mental health is applicable and useful for eating disorders. New conceptualizations of eating disorders are necessary. The current clinical approaches are often punitive and not helpful. Perhaps theories about the autonomic nervous system will open new doors to eating disorder treatment and care.