How Eating Disorders Affect Interoception and Keep You Trapped in Trauma Responses

Current trauma theories are recognizing the role of disordered eating as misdirected attempts at self-calming intolerable emotion.

I couldn’t be happier.  Seeing disordered eating as a self-calming strategy that has become additive gives trauma survivors and therapists a chance to address these issues with more compassion and effectiveness.

Disordered eating harms the body, and it has some unique “add-ons” in terms of sensory processing problems.

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Disordered eating damages the ability to be connected to your body through interoceptive processing.  This is not a good thing.  If your therapist has asked you to use quiet meditative visualization, and all you can feel is the quart of ice cream you ate 30 minutes ago in your gut….If your therapist has ever told you that you needed to ground yourself and you couldn’t feel your body, or asked you how your sadness or anger felt in your body, and you had no answer to give….

You were most likely experiencing a lack of interoceptive registration or discrimination.

We know a considerable amount about how disordered eating affects interoception.  Here are some of the highlights:

  • Chronic starving decreases the sensation of hunger, and to some degree, thirst.  Anorexics don’t mind.  They generally don’t want to be hungry.  But without those signals, the body and the mind are now less connected via interoception.  This is a loss of sensory registration, and no brain can process information it DOESN’T RECEIVE.
  • When food is consumed, the sensory experience is now very intense in comparison, and awareness of the body is sudden and often unwelcome.  Like a foot that was numb from being sat on for a while, the normal actions of digestion can be incredibly strong.  When the digestive system is deprived, processes get more difficult to tolerate for many sensitive people.  Now interoception is a poorly regulated/modulated sense.
  • Binges increase interceptive awareness.  Filling a stomach or intestine too full too fast will massively increase interoceptive awareness, because the largest number of receptors for interoception are, wait for it, in the tissues of the abdomen.  All that distention and digestion will bring someone in a numb or depersonalized state back into their window of tolerance briefly.  The reason it won’t last is because it will soon become too stimulating.  But at the beginning, it will return them from that ‘checked out” state.
  • So does purging.  The effect of rapidly emptying the stomach or colon is intensely interoceptive in nature.  The strong sensory input will stimulate that vagus response and allow depersonalization and derealization to abate.  But this isn’t a promotion of purging.  It is an explanation of why it is so addictive.  Again, it is rapid and effective way to not feel so numb.  The cost of purging to your body is severe and progressive.  It might be one of the most difficult disordered eating behaviors to let go because of its strong effects on interoception.

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As an occupational therapist, I have been trained in physical treatment methods to increase a client’s interoception that are based in neurology and physiology.  They don’t require clients to talk about their past or their current struggles to use effectively, and clients can be taught how to use them outside of a clinic setting.  For trauma survivors, thoughts and emotions related to the past can come up when sensory processing treatment improves their connection to their body.  Psychotherapy with a skilled trauma therapist will help trauma survivors with disordered eating to take their improved interoceptive skills into their counselor’s session and make progress in healing the past and the present.

For more information on interoception, read Why Interoception Should Matter to Adults With DID  .

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Published by Cathy Collyer

I am a licensed occupational therapist and a licensed massage therapist, in private practice in the NYC area. I have over 25 years of professional experience in adult and pediatric treatment, with a focus on sensory processing issues and treating the consequences of complex trauma. I am the author of four books, including "Staying In The Room: Managing Medical And Dental Care When You Have DID" and "The Practical Guide To Toilet Training Your Child With Low Muscle Tone". Over the years I have lectured about trauma treatment and pediatric development.

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