April 21, 2015 Andréa Copeland

Treating Eating Disorders with Co-Occurring Trauma and PTSD

In this video interview, Executive Director Diane Ryan and Trauma Therapist Ann Twilley describe how and why Mirasol Eating Disorder Treatment Centers developed its specialization in treatment of eating disorders with co-occurring complex trauma and PTSD.

"Years ago most eating disorder treatment centers — Mirasol included — did not include trauma as part of their treatment programs. In fact, people were turned away if they reported significant trauma before we admitted them," says Ryan.

"So it became evident that that was not going to work, we were not going to be able to take care of people if we weren't willing to address the traumatic issues in their lives because it was too closely tied in with the eating disorder."

Ann Twilley, trauma therapist and prior director of Mirasol's aftercare program, observed the same phenomenon.

"When we were trying to work on the eating disorders, we kept bumping into the trauma, so we absolutely had to do something different," says Twilley, "and we knew that treating the symptoms wasn't working, so we had to treat the underlying issues, and a lot of that was about trauma."

Most treatment centers use a variety of narrative therapies for trauma treatment, but Mirasol clinicians do not believe that this is the most effective strategy.

"We found that people telling their story in a group or even in an individual setting was really re-traumatizing," says Ryan, "so we needed to find another approach."

Twilley notes that many Mirasol clients had already experimented with cognitive behavioral therapy or cognitive behavioral therapy, but it hadn't worked for them. "It wasn't sufficient, it wasn't deep enough work for them, and so that's how we started going where we went."

"The gold standard for trauma treatment has always been EMDR (Eye Movement Desensitization and Reprocessing), so that was the first training that we pursued," says Ryan, "and since we at Mirasol have always emphasized experiential therapy and believed in healing through the body, we then pursued training in some somatic therapies as well."

"There are a lot of ways you can address trauma through wilderness therapy and similar experiential interventions such as psychodrama, so we began putting more emphasis on training in those areas."

Over the next several years, Mirasol clinicians obtained training in not only EMDR, but also EFT (Emotional Freedom Techniques) and TRE (Tension and Trauma Release Exercise).

"EFT is something that can be really self-empowering for the client because we can teach the skill," says Twilley, "and we offer a monthly online alumni group that has been very supportive for clients years after they complete treatment at Mirasol."

The additional trauma modalities complemented Mirasol's already comprehensive integrative eating disorder treatment program including polarity therapy, Reiki, cranial sacral therapy, dance-movement therapy, yoga, adventure therapy and neurofeedback.

And tying it altogether, according to Twilley, is Mirasol's pioneering work in neurofeedback.

"Neurofeedback is the science that supports a lot of the work that we do. Neurofeedback shows us that the client's brain is changing. That's really exciting for them to see, and really exciting for us to see." Neurofeedback can be used in conjunction with other treatment modalities to measure their effectiveness and determine what types of treatment are most effective for the client.

"We've developed a strategy that really works for just about any client in terms of teaching them how to master the reactions of their own nervous systems," according to Ryan.

She notes that Mirasol has recently expanded its adventure therapy program to include backpacking.

"A lot of research has been done about wilderness and what happens in the wilderness to people who have been traumatized, so this creates yet another way to address trauma in a way that is safe and supported and that helps them heal."