Eating Disorders

New Book! Jade Miller’s “Attachment and Dissociation: A Survivor’s Analysis” in e-book form. About intergenerational dysfunctional attachments and Jade’s healing process. (Jade is the author of “Dear Little Ones.”)


Now for eating disorders. This is a huge subject and I will break it up with posts on a couple of other topics. (Like, say, Mothers’ Day, which doesn’t bother me a bit. Yeah.) Think of this post as the introduction; there is nothing about alters, ritual abuse, or healing in this section, so be patient. And there won’t be lots of statistics in the other sections.

I was at the International Society for the Study of Trauma and Dissociation (ISSTD) conference the beginning of April this year and went to two very good workshops on eating disorders. One was “The Body Remembers: The Brain Reacts: Clinical Applications of Current Research on the Underlying Connections between Eating Disorders and Trauma” by Norman H. Kim, National Director of the Center for Change and Director of Reasons Eating Disorder Center. The other was “Trauma, Dissociation, and Eating Disorders: When No Body is Home” by Debbie Cohen, who is on the Faculty of ISSTD. Much of the material in this post comes from those workshops.

Let’s start with some definitions. Anorexia is limiting the intake of food to the point of significantly low body weight, along with the fear of becoming fat and the distortion of body image to seem heavier than one is in actuality. Bulimia is the periodic out-of-control eating of large amounts of food followed by attempts to prevent weight gain by vomiting, using laxatives, or excessive exercising. Anorexia can be followed by periods of binge eating, or bulimia may occur alone. Binge Eating Disorder is the periodic out-of-control eating of large amounts of food, but without attempts to prevent weight gain. It is accompanied by shame, embarrassment, and attempts to hide episodes from other people. Steadily eating large amounts of food isn’t currently labelled an eating disorder, even though it probably should be.

There are a lot of misconceptions about eating disorders. A big one is that they are caused by society and the media, with all the hype about weight, dieting, and the desirability of thinness. The emphasis on weight makes people dissatisfied with their bodies: 42% of girls in first to third grades want to be thinner; 81% of ten-year-old girls are afraid of being fat; and half of ten-year-old girls have dieted. But the rate of eating disorders has not changed. We are more miserable and pour billions of dollars into the diet industry but the prevalence of eating disorders has not changed.

Another misconception is that it’s an illness of rich white girls. However, that’s who gets studied and therefore that’s who gets the attention. The rates are the same for Afro-American and Latina girls.

Men, too, suffer from eating disorders. Of all people with eating disorders, about 25% of anorexics  and 36% of bulimics are male. Men tend to get overlooked because eating disorders, like depression, are seen as a women’s problem. There now are some in-patient and out-patient treatment programs specifically for men and hopefully there will be more resources in the future.

Family and twin studies suggest a genetic component to anorexia and bulimia. Anorexia is seen in 0.3% to 0.7% and bulimia in 1.7% to 2.5% of women in the general population. Yet they are 7 to 12 times more likely in relatives of those with eating disorders, even if relatives do not share a common environment. Twin studies show that genetic factors seem to “kick in” at adolescence and that there seems to be something in the environment that triggers the onset of eating disorders.

So if you have an eating disorder, and lots of your blood relatives do, too, it may be genetic. Not your fault, just plain bad luck. Of course, if it wasn’t genetic, it still wouldn’t be your fault.

Eating disorders, especially anorexia, are very, very serious. In females 15 – 24 years old, the mortality rate from eating disorders is 12 times higher than the mortality rates from all other causes of death combined. And, if you have an eating disorder, it is reported that your chances of dying from this illness at some point in your life range from 5% to 20%, depending on the study.

The environmental trigger typically seems to be a trauma, such as sexual abuse or bullying. A study described in “Anorexia Nervosa and Bulimic Disorders: Current Perspectives,” edited by G.I. Szmukler, P. D. Slade, and P. Harris, pp. 357-61 showed that almost two-thirds of women patients who entered a London eating disorders clinic between 1982 and 1984 reported sexual trauma in childhood or adolescence. This did not, of course, include anybody who had amnesia for the abuse.

One last bit of information: there have been two surveys (that I know of) looking at the prevalence of eating disorders in survivors of ritual abuse and other forms of extreme childhood trauma. Both were self-reporting and open to any survivor who wished to participate. One was conducted by Survivorship and the other by the Extreme Abuse Survey. 60% to 65% percent of survivors said that they had an eating disorder, while less than 20% reported that they were alcoholic and/or drug-addicted.

I’d like to end this post by pointing out that eating disorders are hard to treat, the effects of sexual abuse are hard to treat, and the two together are even harder to treat. Or to live with, for that matter!!! Add in amnesia, dissociation, ritual abuse, and/or mind control … well, nobody said it was going to be easy.

Kinder, Gentler Language

Somebody sent me an entry from a blog by Isabel Foxen Duke, who is a coach who “helps women stop feeling crazy around food.” You can find it at

Here it is —

“I have never “binged,” but only eaten a lot of food… (and why this is an important technical distinction).

I used to call myself a “binge-eater.”  I would diet, diet, diet and then when I would “fall of the wagon” – bam, I “binged.”  Binge, binge, binge.  Just the use of this word, I truly believe kept me in a mental cycle of  “success” and “failure” or “good” and “bad.”

The linguistic distinction of calling any act with food a “binge,” keeps us in a state of mind where we are judging ourselves.  Every time we say we “binged,” we are essentially saying, “we failed,” we are “wrong,” or generally suck.

In order to live in a world of food and body freedom, we have to let go of all language that is judgmental, hateful, or disapproving of ourselves.  I contend that just the use of the word “binge” falls into this category, and should thus be stricken from our lips.

New Linguistic Model:  Last night I went out to dinner with my family and ate a lot of food.  I got really full.  And today is Tuesday, and the sky is blue.

I did not “binge,” I did not MURDER ANYONE.  I just ate a lot of food.  Big fucking deal.

(Isabel blogs at )

I think she is right on about language. When we use negative language, we keep ourselves in a negative frame of mind and locked into negative behavior patterns.

Using Isabel’s New Linguistic Model, it would make good sense to make the language we use gentler. We can replace negative words with positive or neutral ones. Now, I don’t mean replacing “I am ugly” with “I am the most beautiful person in the world.” That’s a down right lie and you will just feel foolish saying it. Nor am I suggesting replacing “pain” with “slight discomfort” because euphemisms are a form of deception, too. I am suggesting replacing a denigrating or frightening word with one that is accurate but does not have a negative charge attached to it.

Take the word “trigger.” It has always given me the willies. I see a gun in my mind’s eye, and I react to the word itself with fear because it brings up thoughts and memories of violence or death. Why would I want to do this to myself?

Well, I don’t. I already have enough of those thoughts swirling around in my brain. I’d much rather use “reminder.” The smell of beer reminds me of somebody, reeking of beer, hurting me. I have to deal with that memory, but I don’t have all the extra feelings, thoughts, and memories that the word “trigger” stirs up.

I have similar negative feelings toward the word “programming.” It suggests that I am a machine and that I must obey any instructions that have been entered into my mind. Now I use “taught,” which implies that I do not have to do what I was taught to do and that I can learn other things. I was taught to ride a bicycle, to make my bed every morning, to speak French. Do I do any of those things now? No. Nor do I do what my abusers taught me to do.  I don’t deny that I was taught those things, or that I was forced to do them.  But I don’t do them any more.

Cleaning up my language makes life easier. It strips the negative words of their magic power and gives me one less thing to struggle with. It helps me see things for what they really are, not what I was supposed to believe they were. What a gift!

Healthy Eating for an RA Survivor (HA!)

Healthy eating for anybody in America these days is not easy. Tons of cheap junk food. Sodas and juices laced with high fructose corn syrup. Cheeseburgers with lots of fat. And fruits and vegetables? They are available only in supermarkets and ethnic markets, not in every corner store and gas station. And they are expensive!!!! Especially organic produce.

Plus which, Americans have been trained to think of donuts, candy, potato chips as treats. Who thinks of a banana as a reward for a job well done? Or a grapefruit? Not too many people, I bet.  In the first days of television, an ad showed Chiquita Banana dancing and singing about developing flavor by never putting bananas in the refrigerator. You’d never see that in prime time today.

So our whole culture encourages eating poorly, simply because it makes big money for the big corporations. Junk food is easy to package, easy to ship, and doesn’t rot like fresh veggies.

It’s hard for the average American but it’s thousands of time harder for survivors of ritual abuse. We have been starved, deprived of water, and made to eat and drink things that never were intended to be put in a human mouth, both in rituals and as punishment. And sometimes, rarely, we have been rewarded with edible food, usually junk food.

I remember being unable to eat tomatoes as a child. I finally figured out why: they are red. Their color triggered the feelings I had about blood. There are a huge number of potential triggers that make it very difficult for survivors to eat a whole range of things. Triggers are different for everybody, but I bet everybody responds to at least some food triggers.

And to make it more complicated, alters respond differently. One alter will try really hard to avoid a certain food, while another alter wants to gorge on it. Imagine the internal battle!

Avoiding lots of triggers can lead to anorexia. There’s another more general cause of anorexia; the absurd amount of attention put on being model-thin in our society. When Chiquita was happily dancing, models were of normal weight — now they look like stick figures. At the same time, the percentage of overweight and obese adults and children is increasing. The gap between actuality and so-called ideal is increasing every year.

Then there is the issue of control. Our perpetrators made all the decisions for us and then taught us that whatever happened was our fault. No matter what we did, no matter how hard we tried, we could never get it right. We had zero control as kids, although we didn’t necessarily know it.

Fighting our perpetrators with food can go either way, anorexia or over-eating. One thing we can control as adults is our eating. We can refuse food — “You can’t make me eat.” Or we can gain tremendous amounts of weight in an attempt to become unattractive to our perpetrators and thus gain some control over their behavior. Sometimes it works, sometimes it doesn’t.

Many people, not only survivors, use food as a source of comfort. Sugar and carbohydrates work because they increase the feel-good chemicals in our brains, just like hard drugs. Comfort eating often is accompanied with purging so that the spike of pleasure is offset by getting rid of the food before it can be digested. Many people who are of average weight have this double problem.

So that is what we are up against.

What can we do?

1. Recognize that we have a problem.
2. Recognize, deep down, that it isn’t our fault. It’s a legacy of ritual abuse and having been abused was NOT our fault in any way.
3. Make a commitment to working on handling the problem. Not solving it, especially overnight, but handling it differently.
4. Learn the basics of nutrition.
5. Start slowly. Seriously, slow is better, much better than fast.

Here is what I did. I didn’t give up all comfort foods at once. I didn’t give up any of them! I experiment with eating less of them, eating them less often, or even eating them at a different time of day. I played around and saw what happened when I did something different. I didn’t journal, but by keeping an eating journal you can find out what different parts of you think about this strange new way of being in control.

Along with working with the foods that were bad for me, I experimented with foods that were good for me. I simply added them to my meals. First once a week, then a couple of times a week, then I switched to another healthy food to see if I liked it or not. I was not making a life-time commitment, I was just seeing what happened when I tried different things.

Over time, I saw big positive changes. It was very gratifying and remains so today.

If you have a 12-Step background, Overeaters Anonymous can be very helpful.  It’s for people with all kinds of eating disorders, not just over-eating. You will get lots of support, and companionship, to boot. It also helps with self-acceptance, as nobody is going to consider you a freak.

Some people are comfortable with commercial weight loss programs. They provide a structure if you are having trouble doing it yourself. I personally don’t want to give over that much control, but I have seen people have great success with them.

You might want to try each of these approaches and see what feels most useful and comfortable. Remember — you are in control now, and there is nothing wrong with changing your mind!

I thought of including some recipes in this article, but decided the comments section would be a better home for them. Share your favorite new dishes and give some tips on making this process a little easier!