Typically, eating disorders (EDs) come with other mental health struggles and addictions. Mood disorders and emotional distress are often the underlying issues that fuel and motivate the ED behaviors as a method of coping. An ED may also be a way of attempting to manage symptoms of trauma and psychological distress. Other addictions such as substance use and process addictions are also very common co-occurring issues.
Understanding the relationship between multiple addictions is critical in the recovery process. Addictions may have a swapping effect in which one addiction decreases in frequency or intensity, then another one increases. Or, addictions may compound where one starts or increases and then others also increase.
Knowing the patterns of addictive behaviors helps to improve effectiveness in ED recovery. If someone is decreasing ED behaviors and self-harm behaviors increase as a result, then the transfer of behaviors will delay the process of developing healthy and effective coping skills.
Holistic treatment is necessary as a way of addressing underlying issues and developing lasting recovery skills. If someone is holding onto one addiction, it will be very difficult to achieve and maintain recovery. This can be challenging because addictive behaviors work well to manage emotional distress. Often people want to hold on to one part of their addiction to still provide emotional relief.
For EDs, it is particularly common for people to want to continue restricting behaviors. They may enter treatment or therapy willing to surrender bingeing, purging, self-harm, and alcohol, but want to still maintain control or emotional numbness through restricting. This is a slippery slope and a dangerous position because recovery does not work this way. This is where pattern identification is helpful because most people with EDs will not be able to only maintain slight restriction. Restricting behaviors will often increase in intensity or lead to other ED behaviors, which may also then result in additional addictions surfacing.
This can be extremely challenging for those working toward recovery because it feels like such a huge loss to have all forms of coping removed. It leaves people feeling very raw, vulnerable, and fearful of emotional experiences. It is during this vulnerable time that one can begin to explore support and healthy ways of coping to build tolerance to distressing feelings. If someone is still holding on to an addictive behavior, then they do not get the exposure and experience of managing emotions healthily because they still have one destructive way of coping in their back pocket.
Overall, recovery requires willingness to completely surrender. This process may take time and it may be easier to start with letting go of certain behaviors and slowly letting go of others along the way. Continual awareness of addictive habits and patterns will aid in long lasting recovery. Accountability is key as well with having a support system that can notice new or increasing behaviors as these can often appear subtly. Although it is challenging, holistic recovery that addresses and manages all addictive behaviors is the most effective approach for long-term recovery.
TK Contributor: As the Timberline Knolls Eating Disorder Program Coordinator, Camille Williams MA, NCC, LCPC, supports the development of curriculum, supervises the eating disorder specialists, and provides group therapy. She also educates and trains all staff on campus and advocates for eating disorder awareness through publications. Timberline Knolls serves as an iaedp™Presidents Council Member.
*The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders and not intended as endorsement by iaedp Foundation, Inc. or its Board of Directors.*