Everyone has a story. And each story is unique, complex, and interwoven with others. You cannot fully understand someone unless you know their story, and sharing your story takes time, vulnerability, and courage.
When someone enters addiction treatment, we want to hear their story. How did they get here? How are their relationships affecting their disease? Are there other problems or unhealthy patterns present? What is the root issue?
Drug and alcohol addiction almost always functions as a solution to a deeper internal problem and an inability to cope with emotions in a healthy way. These root issues often lead to other problems as well, including anxiety, depression, low self-esteem, and disordered eating.
Especially in women, there is a significant overlap in drug and alcohol addiction and disordered eating. It does also occur in men, but not nearly as often. With co-occurring disorders, holistic healing is absolutely crucial to lasting recovery. If only one issue is addressed in treatment, the other may emerge as the primary coping mechanism, and clients often end up going back and forth between disordered eating programs and substance abuse programs, which is obviously frustrating and discouraging.
Lack of Understanding
“Up to 50 percent of individuals with an eating disorder abuse alcohol or illicit drugs compared to approximately nine percent in the general population. Up to 35 percent of alcohol or illicit drug abusers have an eating disorder compared to up to three percent in the general population.”1
With numbers like these, why is there such a lack in co-occurring treatment? Addiction and disordered eating are both complicated issues that are challenging to treat individually. When combined, they become increasingly complex and dangerous. The comorbidity of these disorders is significant, but because of the complexities, very little research has been done on co-occurring treatment.3 For starters, we need to talk about the common roots.
We have to start with defining and understanding the underlying issues that characterize both of these disorders. Both are often related to difficulties with coping and regulating emotions. In other words, using drugs and alcohol allows someone to temporarily escape or minimize an emotion; restrictive eating, binging, and purging have the same effect. In neurological research, we also see that these two behaviors activate similar neurotransmitter activity in the brain.2
Shame and low self-esteem are also common in these women, and these can quickly feed a vicious cycle of negative and self-defeating behaviors. Depression, anxiety, and personality disorders are also seen as important links between disordered eating and substance abuse. Society’s loud message of thinness as an ideal and the overwhelming number of diet fads are perpetuating these issues. The world is constantly screaming “You are not good enough.” We have to boldly fight against that message.
Treatment at MARR
At MARR, we use holistic, gender-specific treatment to create an environment where clients can feel fully accepted and capable. Each woman gets a personal individualized treatment plan that fits her unique story. The Therapeutic Community provides support and accountability throughout treatment. Women get to be in community with people who understand them and relate to their struggles, which is invaluable.
Our Disordered Eating Program is fully integrated with the rest of treatment so clients can work on dual diagnoses simultaneously. Clients who are eligible will work with a Registered Dietician who is specifically trained in Disordered Eating. They will also attend special process groups and meal groups as well as receiving Mindful Eating education.
We also teach Dialectical Behavioral Therapy (DBT) Skills. DBT aims to teach new, more effective strategies to deal with emotions. We help women develop coping skills that will help them learn how to react mindfully to intense emotions.
We believe in whole-person recovery. It is only when we address the core issues underlying these conditions that true recovery begins. Healing happens from the inside out, and it has the potential to create a powerful chain of events that can turn someone’s life around.
The good thing about stories is that there is always room for change. With the right tools and support, men and women can move from a place of shame and pain to a place of hope and emotional health.
February 26-March 4 is National Eating Disorder Awareness Week. For more information and resources, visit https://www.nationaleatingdisorders.org/.
1 “Food for Thought: Substance Abuse and Eating Disorders.” The National Center on Addiction and Substance Abuse at Columbia University. December 2003.
For additional resources and research on DBT, visit https://behavioraltech.org/research/evidence/efficacy-trials/