Eating Disorders & Underlying Personality/Mood Disorders (BPD and others) | Chat w/ an Expert

Eating Disorders are not about vanity o can I change that misconception they are about survival but they do often I will not I'm not going to challenge you on that I agree with you that timately it is but like they do you know I would argue that mine began as a motivation to be thinner and look better okay I don't know if that's even vanity I think it's okay to want to look better I don't think you have to be vain to want to look better what's under wanting to look better acceptance well is aren't you allowed to want to look better and still accept who you are in the moment depends on how far it goes in my opinion right if it goes as far as changing what I eat or adopting unhealthy compensatory behaviors then I think it's more about acceptance or the risk of feeling excluded and let's go back to a borderline pathology the first diagnostic criteria is behaviors aimed at thwarting real or imagined abandonment you know go back to uh billions of years ago living in groups was protective if I did something that made the chieftain angry and I got put out of the fort or wherever we lived when the tiger comes I'm not going to have too many people to to help me survive I I think that's really important right so but now let me add when I um I would argue recovered from the eating disorder right it was just no longer a thing and I thought everything would be fine that was when the borderline stuff really surfaced for me and it was like cuz I never understood why I had the eating disorder like I never understood what it did I understood its function in the context of the work I had done in the program how it allowed me to step away from Life instead of putting myself out there and face the discomfort of challenges and the uncertainty that they presented and that I might fail and all those things so it allow it kind of removed me from that opportunity safety yeah yes yes so it took me away from that so I knew that but when you really no longer have the behavior for a long stretch of time yeah you're being given a tremendous amount of space or a tremendous amount of space opens up that had here to for you know just not existed cuz it had been co-opted by the eating disorder and all of the craziness quote unquote mhm that you have to engage to maintain it um that was when the borderline stuff surfaced and so and there was no skill that I could use to fix that problem because there the eating was no longer a problem so I was like but eating is everything else is a problem but the eating isn't a problem um but but yeah what happens like how how many people that do you think have um a crossover with something that once the eating disorder does truly resolve and they are recovered there is another personality disorder Psychopathology beneath that needs addressing most most most whether it's depression or anxiety interesting um I think meds need to be managed um during the early stages of recovery because if you have a restricting eating disorder and you're malnourished your body's compensating in all sorts of ways and you're probably not metabolizing medication as effectively as possible so medications are they don't have an anorexia or a bulimia pill you you might medicate symptoms around it the early stages of recovery are the most susceptible to a low a lapse a relapse because people ask themselves remind me again why I did this because it seemed a whole lot easier to just Purge and get rid of it get the Endorphin rushed and feel kind of calm than this being anxious all day or you know I thought my life was going to be perfect no so early stage of recovery is a lot of work protecting the fragile your recovery at that point I'd like to give it a metaphor of sort of a fine piece of Crystal it's fragile but let's say so or rather are you saying that the co-occurring diagnoses that probably exist with most people who have an eating disorder don't Bubble Up Until the symptoms remit because the symptoms have been essentially protecting you from having to manage this other deeper right you know thing I think or not that psychiatrists will be able to observe it more I think these symptoms become more prominent to the person based on discomfort and family people surround in your orbit it's not really that they weren't there before I think they were there but the eating disorder was kind of like sitting on them absolutely if that makes sense yeah so they become more prominent to be observed and addressed right so do you think is someone who is an eating disorder therapist the best equipped at that point to do it or do you think like would they be better served working with someone who specializes in that area it's so interesting because I believe that eating disorder therapists are schooled in depression and anxiety and those are going to be some of the biggest ones you'll see you will also see some obsessive compulsive traits so it's important that the clinician understand screening methods for different underlying ones and that the person is uh aligned with a psychiatrist um maybe even some testing that's done if it's helpful but I do believe that even sort therapists understand enough about the mood disorders because they are prevalent in the Eating Disorders because if you look at what was going on right before the behavior H I don't know depression anxiety feelings of being overwhelmed oh I would call that anxiety what are your skills for anxiety it's so interesting I I think in answer your question I would retain and of course I'm biased here because I'm eating sort of therapist but I would retain the eating disorder therapist for a while because there's so much symptom substitution so consider the person who is a restrictor initially let's say say we have an adolescent who's a restrictor the eating disorder has been identified they are in treatment and let's say family based treatment and the parents are in charge of the food and there's all sorts of conflict around meals and the patient or the client is encouraged to eat larger amounts that's the treatment when he or she starts eating a higher volume there is at least a 50% chance that he or she will engage in some compensatory measure because not only do I have to eat more all of a sudden my family is on me like Hawks MH and they're watching me so I have to eat more and up being watch 247 and now I'm really uncomfortable so I I want to validate again my understanding it makes sense to me that people would want to shift to a compensatory behavior orthorexia is very common it was labeled I think in the mid 90s by Steve Bratman I think it falls under the Arid diagnosis avoidant restrictive feeding intake disorder which is kind of a new one too we're trying to figure out where to put all of these behaviors I know if you read pop psych or social media there are things such as bride orexia uh that's somebody who wants to lose a large amount of weight for their wedding right and and they actually have some tube systems that yeah it's that scary Yep mm where food is extracted from their body so they can fit in the wedding dress that they chose that was several sizes too small

Channel: BorderlinerNotes

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Id: KOGK0duy6Kw

Length: 9min 2sec (542 seconds)

Published: Tue Dec 19 2023