Reversing Eating Disorder Relapse
August 7th, 2009 |
By Joanna Poppink, LMFT
Click here to contact Joanna and/or see her GoodTherapy.org Profile
I’m in the middle of attending a great conference at UCLA this week end. It’s “Adult Attachment in Clinical Context: Applications of the Adult Attachment Interview.” Superb and gifted researchers and clinicians are gathered to discuss and share information on the latest neuroscience findings, the reasons why humans bond or do not bond well with each other, how human relationships can harm and heal, and the powerful healing force of human love, compassion, stability, flexibility and reliability. As I participate in this conference, surrounded by clinicians dedicated to learning and fostering healing, I feel richly held. I am free to let my mind relate what I’m hearing and learning to people who, in some way, live with the experience of eating disorders. Here’s what I’ve come up with after two days of the conference:
Changing Our Brains: The joyous or painful or frustrating reality is that we humans can destroy, create, and change neural functioning in our brains. In other words, we can improve. We can deteriorate. We can change – for better or worse. The research coming out of neuroscience provides evidence that particular circumstances over time can alter brain activity and even brain structure. See Dan Siegel’s work and Allan Schore’s writings.
Power of Love and Kindness: The good news is that a durable, kind and informed relationship with a trustworthy and stable person over a considerable period of time will actually create conditions where a person’s brain can change for the better. This is one of the great and wonderful powers of long term, in depth psychotherapy with a trustworthy and focused psychotherapist. This is also why loving, trustworthy, stable, reliable and empathic parents produce secure, loving and self confident children. This is also why a loving, trustworthy, stable, reliable and empathic aunt or uncle or grandparent or teacher or neighbor can contribute to building a secure base in a child who has problematic parents. Love and kindness as well as focused attention and knowledge creates an environment in which new ways of seeing the world can become permanent. The developing child or the adult patient not only develops trust for the parents or the therapist. She actually develops the capacity to trust, to be more optimistic, to recognize good opportunities and act on them.
Power of Negative Influence: We can also put ourselves in circumstances that destroy trust, not only in a relationships but in the brain’s ability to trust at all. One of the tenets of 12 step programs is: stay away from lower companions. The people around us affect our sense of ourselves and our brain functioning.
Stress and Relapse: In a stressful environment where fear, pain, ridicule, shame and unpleasant surprise are continual, we will adapt in ways to care for ourselves. If you are a person with a history of an eating disorder or an active eating disorder this can mean going back to old coping mechanisms like binging, purging, “spacing out” and hiding. You can also reinforce this negative condition yourself by pummeling your mind with negative critical judgments about yourself. This too affects neural pathways, synaptic connections and your view of the world. This can reinforce eating disorder thinking and behaviors.
Difficulty in Getting Relapse Recovery Help: In such a state you will find great difficulty in recognizing opportunities for help. Even if you do recognize such opportunities you may lack the trust and self esteem to reach out and ask for help. The longer this situation lasts the more ingrained your eating disorder style of living will become.
Meaning of Relapse: The return of eating disorder behaviors or feelings or both signal that either new growth is necessary or achieved progress is undermined. This is a time for you to look for relationships, behaviors and circumstances around you which are negative, isolating, critical, demanding, frightening or composed of unrelenting stress. The return of the eating disorder is an attempt to cope with these circumstances. Noticing them is the beginning of restoring your recovery path.
Effect of Short Term Negativity: If you experiences harsh negative circumstances momentarily genuine recovery will stand. If you experiences such circumstances for a longer period, you will be stressed but can most likely rely on your newly internalized strengths and self confidence powered by your more developed neural mechanisms.
Effect of Long Term Routine Negativity: But, if you experiences such circumstances as part of a new normal routine in your life, regular and unrelenting, your brain can adapt to the situation and create entrenched patterns. What begins as a temporary state can become a permanent trait. Here we have the relapse stretching out into what seems an intractable way of living and being.
Relapse Recovery: However, even if this happens you can still take action to put yourself in a loving, kind, healing environment where you can once again allow your heart, mind and brain circuitry to heal and develop along the pathway to health. Yes, a relapse, even a long relapse, can be reversed. It’s truly amazing and wonderful to learn how putting ourselves in relationships filled with love, compassion, empathy and focused attention will not only allow us to build good feelings but actually change ingrained patterns of negative feelings thoughts and action. We can help each other evolve, even at the neural level, toward health. Who would have thought neuroscience would bring such a message, backed by scientific evidence, of hope and loving direction? (In addition to Siegel and Schore’s work, I recommend, for those who are up for some heavy reading, The Development of the Person. When Drs June and Alan Sroufe discuss their research following individuals from before birth to their 30’s I’m always inspired and find myself filled with teary heart felt appreciation for them and their work.
©Copyright 2009 by Joanna Poppink, LMFT. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Joanna and/or see her GoodTherapy.org Profile



















5 comments so far
Hi Joanna,
Thanks so much for taking the time to share your notes on the conference and to good therapy for publishing this. It’s almost as if I attended the conference, for free nonetheless… I love how the wisdom of psychotherapy and the research of brain science is merging to reveal the hope for change…
Joanna I want to add my thank you too. So generous of you and good therapy to share your notes with us like this! I’ve always believed that showing love and kindness consistently can overcome almost anything. It’s wonderful to see scientific evidence.
I am so happy to see that there is now more attention being paid to this issue, but for very personal reasons I only wish that more had been known sooner. I lost my sister Julie to anorexia and related complications from the disease more than 20 years ago. Then no one even knew about the disease much less did anything to prevent relapse. I am glad to know that there are people now who care and see this as a serious enough issue to address and hopefully prevent for other families.
Sad to see anyone relapse with anything they struggle with. Good news in the making when there is ever any forward progress in this area
thanks for a great article!