Obesity & Trauma Disorders Introduction
There are a lot of similarities and crossover criteria between depression, anxiety and trauma disorders. Similarities include poor health habits, lack of physical activity, unhealthy eating, stress-related problems, addiction disorders, and sleep issues. In particular, trauma is often associated with elevated and even severe stress responses. For various reasons, some individuals have a greater predisposition for negative responses to traumatic stressors than others.
Trauma disorders range across a spectrum of severity and include reactive attachment disorder, adjustment disorder, acute stress disorder, and PTSD. Diagnostic criterion for PTSD that follows witnessing or experiencing a single or repeated traumatic event includes:
- Recurrent, involuntary, and intrusive distressing memories of the event
- Reactions or flashbacks in which it feels as though the event was recurring
- Prolonged distress at exposure to cues that remind one of the event
- Physiological reactions to reminder cues
- Avoidance or suppression of memories, thoughts, or feelings related to the event
- Avoidance of external reminders such as people or places that arouse memories, thoughts, or feelings associated with the event
- Persistent negative beliefs or expectations about oneself or others as a result of the event
- Distorted thoughts about the event that lead to blaming oneself
- Persistent negative feelings such as fear, horror, guilt, and shame
- Feelings of detachment from others
- Inability to experience positive emotions such as happiness, love, joy, or satisfaction
- Less interest or participation in significant activities
- Irritable behavior and angry outbursts
- Reckless or self-destructive behavior
- Hypervigilance and exaggerated startle response
- Difficulty with concentration
- Sleep disturbance – staying or falling asleep
- Recurrent distressing dreams related to the event
When we look at this criteria it’s clear that the majority of these symptoms can affect physical health and contribute to emotional eating and the development of obesity. Five clustering attributes relevant to obesity are impaired sleep, negative self-view, cognitive & emotional impairment, and pervasive (dis) stress. These five factors stimulate appetite, particularly for foods and beverages that quickly upregulate mood and energy.
The Path to Recovery
For patients suffering with trauma learning to down-regulate stress is key to recovery from eating and substance disorders. While there are great stress reduction courses, when trauma is a factor there may be the need for cognitive reprocessing. In the BreakThrough! program this recovery starts with working on the thought patterns underlying depression and anxiety before working through trauma history. This approach allows for a progressive exploration and insights before plunging into trauma work. So why explore depression first? If we can help a client shift from a negative view of self, to one of strengths, then it’s much easier to explore their anxiety on the way to working through trauma history. When we work through anxiety with clients we’re initially focused on three thought processes that sequentially influence emotions and behavior. These are:
- Thought &
Perception is presented as the filter through which our client sees themselves, people, relationships as well as their world-view. If the perception is flawed from the outset, which is common to mental health disorders, then the sequence of thought looks as follows:
Perception: “I’m such a loser”
Additional negative thought: “I never get anything right”
Projection: “I’ll never succeed…f…it!”
Once a client is at the “f…it!” stage, dysregulated eating or substance use is common and easily understood. This is underscores the importance of counseling in recovery from obesity. Our clients are taught that if they don’t take charge of their thoughts (brain), they’re along for the ride. Our brain doesn’t distinguish between what we perceive (or imagine) and what may be real or accurate. The brain’s always going to default to perceptions until it’s trained for success.
BreakThrough! and Resistant Thinking
To reduce anxiety, clients are invited to challenge their narrative in order to release themselves from a miserable cycle of self-defeating fear-based beliefs. The following example is directly from the BreakThrough! course. By completing over 500 similar in our online learning management system, clients develop insight and resistance to impulsive emotional responses.
Resistance: We can start anytime by answering the following questions:
- How am I looking at this situation? – Perception
- How am I judging it? – Thoughts from the past?
- Why do I think things won’t turn out well? – Projection of past experience?
- What am I adding to what’s actually being said or indicated?
- What fears surface? Rejection? Failure? Abandonment? Loss?
- What’s actually happening or needs to be done? Present thinking
- Am I simply being asked to consider new information or try a different technique?
- Is my character being challenged or I am internalizing or awfulizing needlessly?
When we start exploring a client’s trauma history they begin the work with an improved self-view, and an understanding of distorted cognitive processes that lead to emotional dysregulation. This allows us to develop healthy resistance skills and new narratives such as “I may want it; but I don’t need it!” or “That was then; I’m safe now!”
There’s no doubt that stress is significant to PTSD and weight gain. Furthermore, there’s no need to debate causality if we simply take the bi-directional features of these disorders. We hope this has been an informative article on behavioral change and the BreakThrough! program. If we can be of assistance in helping your clients work through mental health challenges affecting their health please reach out to us!
Heather Hamilton PhD