Binge Eating Disorder: Clinical Interventions to Treat Underlying Trauma, Body Shame, and the Diet/Binge Cycle

CPD

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Speaker

Amy Pershing, LMSW, ACSW, CCTP-II Related seminars and products

Center for Eating Disorders

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Amy Pershing, LMSW, ACSW, is the Founder of Bodywise, the first binge eating disorder (BED)-specific treatment program in the United States, founded in 1995.  She is the Director of Pershing Consulting, which offers training to clinicians treating BED around the world.  Amy is also the creator of "Hungerwise™," a 9-week program for ending chronic dieting and weight cycling using the Attuned Eating And Movement approach, offered nationally online.  Based on over 30 years of clinical experience, Amy has pioneered a treatment approach for BED that is strengths-based, incorporating Internal Family Systems, somatic trauma techniques, Attuned Eating and Movement, and a Health at Every Size philosophy.  Amy lectures internationally and writes extensively on the treatment of BED and her own recovery journey for both professional and lay communities.  She has been featured on radio, podcast, and television speaking about BED treatment and recovery, relapse prevention, weight stigma, and attuned eating and movement.  She is a founding member and Past Chair of the Binge Eating Disorder Association (BEDA), and is the winner of BEDA's Pioneer in Clinical Advocacy award.  She is the author of the book Binge Eating Disorder: The Journey to Recovery and Beyond as well as many articles and chapters about BED treatment and advocacy.

Speaker Disclosures:

Financial: Amy Pershing is the founding director of Bodywise and the Vice President of The Center for Eating Disorders. She is an author with Routledge Publishing and Receives royalties. Ms. Pershing receives a speaking honorarium, book royalties, and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.

Non-financial: Amy Pershing is a member of the National Association of Social Workers, the Academy for Eating Disorders, and the Academy of Certified Social Workers. She is a founding board member of the Eating Disorders Action Network and is the membership chair for the Eating Disorders Professional League of Michigan.

Objectives

1. Articulate the critical role of traumatic experiences in the development of Binge Eating Disorder (BED).
2. Teach clients about the neurological impact of binge eating on “fight/flight/freeze” activation.
3. Catalog the critical steps and strategies of “Attuned Eating and Movement” in BED recovery.
4. Provide psychoeducation to help clients understand the role of binge eating from a strengths-based perspective.
5. Implement strategies to help clients identify and challenge internalized weight stigma and challenge external body shaming cultural milieu using advocacy and community building.
6. Implement clinical strategies for processing entrenched body shame narratives in clients, family systems and in the cultural milieu.

Outline

Get to Know Binge Eating Disorder (BED)

• 5 damaging myths about BED and the recovery process
• What makes treatment of BED unique from other eating disorders
• Why treatment often fails
• Current research: Gains, limitations, risks
• Why weight has nothing to do with it
• Is BED an addiction?
• Key tenets of weight-neutral recovery

Complex Trauma and Binge Eating

• The neurobiological legacy of trauma in binge eating
• Fragmentation of the self: the role of dissociation in BED
• How trauma activates the binge/diet cycle
• Saving “Self”: the role of binge eating in managing danger
• Attachment ruptures, social anxiety and the binge cycle
• A body-shaming culture’s impact on trauma narratives

Assessment & Treatment Planning

• 5 must-ask intake questions
• What to look/listen for to identify BED
• DSM-5® criteria
• How to gather food history information
• Ruling out co-occurring medical issues
• Common co-morbidities: depression, anxiety, personality disorders
• Screening for trauma 100% of the time
• Why the initial goal is not to stop bingeing

Clinical Strategies for Processing Trauma and Stopping the Binge Cycle

• Why a “do-no-harm, strengths-based” approach is critical with BED clients
• Psychoeducation – initially and throughout treatment
• P.O.W.R. process for trauma activation, finding the “window of tolerance”
• The nuanced parallel process of each treatment piece

IFS-Informed Recovery Strategies

• Stepping into Self
• Identify fragmented “parts”
• Develop compassionate curiosity toward the “parts”
• Build affect tolerance

Attuned Eating and Movement: Stepping into the Body

• What the data tells us about behavioural weight loss/dieting
• 5 steps of attuned eating to teach your clients
• The body as a wise ally, not broken or wrong
• Using the body as the best source of information
• Teaching clients to know when the trauma narrative has been triggered
• Attuned movement v. “exercise”

Reinventing Body Image: Help Clients Feel at Home in their Bodies

• The truth about weight and health
• Cultural narrative about weight and worthiness
• The healing power of Health at Every Size (HAES)
• Help clients shift from “body as billboard” to “body as home”
• How the clinician’s body image impacts treatment

Building Resiliency to Relapse

• 4 A’s: Awareness, analysis, action, accountability
• Finding community that aligns with your recovery
• Resources for weight-neutral medical/nutritional care
• Collaborative care with prescribers

Clinical Considerations

• Doing your own work: Modeling body acceptance
• Navigating countertransference/bias
• Multicultural considerations – Gender, race/ethnicity, sexual orientation

Target Audience

• Counselors
• Social Workers
• Psychiatrists
• Marriage & Family Therapists
• Psychologists
• Addiction Counselors
• Case Managers
• Registered Dietitians & Dietetic Technicians
• Nurses
• Mental Health Professionals

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