We take a transdiagnostic approach to eating disorders, meaning that we don’t focus on specific diagnoses (eg. Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder) but instead focus on your relationship with food and your body.
In addition to working on your relationship with food and your body, we believe that lasting change usually means also working on what sits underneath. We believe that eating disorders are not about food, weight, and shape, but that deep down they are really about pain and discomfort.
In this way the food and body image difficulties act like a mirror, reflecting a deeper, more complicated pain.
Some common examples of what can sit underneath, and may be worth working on, include:
- Perfectionism
- Self-doubt
- Guilt that doesn’t fit the situation, and self-blame
- An unclear sense of self (not being sure who you are)
- Trauma experiences
- Relationship difficulties (this can include family, friendships, and romantic relationships)
- Feelings of helplessness, hopelessness, or emptiness
- Feelings of unworthiness or inadequacy
- Ongoing pressure from others or yourself to achieve academically, in sports, or in other areas
- Finding it hard to cope with and/or communicate feelings
- A strong need to be in control
Through working on these, you can work towards not only a positive relationship with food and your body, but a meaningful life that includes joy, pleasure, flexibility, freedom, and spontaneity.
What causes eating disorders?
To look for a single cause is to misunderstand the nature of eating disorders. Eating disorders are often a way of coping that develops out of multiple circumstantial pressures as well as a genetic predisposition.
Most clinicians understand eating disorders through the biopsychosocial model, which looks at biological, psychological and social factors together.
Biological risk factors may include:
- Family history of eating disorders
- Family history of anxiety
- Family history of mental health conditions
Psychological/personality risk factors may include:
- An overcontrolled style of coping (strong need for control)
- Perfectionistic tendencies
- Being academically or athletically gifted from a young age (reinforcing very high standards and entangling achievement with identity and worth)
- Low self-esteem
- Discomfort with sexual maturation
Social/environmental risk factors:
- Having a parent with an eating disorder
- Parent/carers or family members that engage in diet culture (either through discussion or behaviours)
- Emphasis on success or achievement in the family home
- Unclear boundaries in the family home
- Having a family member living with a physical or mental health condition
- Trauma or attachment trauma
- Early or late onset of puberty
- Experiencing starvation syndrome
- Food allergies leading to a distrust in food
- Anecdotally, we have observed that many of our clients with eating disorders participated in dance, gymnastics, swimming, or running during childhood
Eating Disorder Support Options
At Exhale Psychology Centre, we aim to develop a plan that fits you, as we believe there is no one-size-fits-all approach. At your first appointment you can discuss with your psychologist which approach may be best for you. We offer:
A note on Cognitive Behaviour Therapy - Enhanced (CBT-E). While some of our clinicians are trained to deliver CBT-E, we typically do not offer CBT-E for the following reasons:
1. Research suggests CBT-E may be less effective for some people with complex co-occurring conditions, who are also often excluded from research studies.
2. People who feel unsure about whether they are ready for change often don’t respond as well to CBT-E.
3. It is a heavily manualised therapy, which makes it hard to tailor to each person
4. The structured nature of the therapy makes it difficult to deliver it in a way that is neuroaffirming
5. It is a weight-focused therapy and we strongly believe in offering eating disorder support that is not weight focused
If you are looking for CBT-E therapy, we recommend finding a psychologist or practice that specialises in delivering CBT-E.
Eating Disorder Resources
- The RAVES Model by Shane Jeffrey (Download PDF)
- The Effects of Starvation Behaviour (Download PDF)
- Set Point Theory (Download PDF)
- Fact Sheet for General ED Carers (Download PDF)
- Common questions about eating disorders
In our clients’ words
When I was in the midst of my eating disorder, I often wondered whether it was worth pushing through the challenges associated with the recovery journey, because it was hard to believe that I could actually get past it, and I wasn't sure that life would actually be any different - would the preoccupation ever subside? Being somewhat on the other side of it now, I can whole heartedly say that it was worth it! I was lucky enough to have a very patient and persistent circle of support around me, and it was absolutely worth pushing through the discomfort. My recovery journey felt long, and it had lots of ups and downs, but the preoccupation has gone, and I have never felt so comfortable
- C, Brisbane
People I have met and respect are recovered and if they can do it, so can I! I know I have a distorted body image and I do not see myself as others do. It does not matter if I have a slightly rounded stomach or my thighs touch, other people are not going to notice or care and are not going to judge me as a person based on my body shape. I have compiled a list of "healthy self-statements" books and articles I have read, that I keep on my phone which I refer to for inspiration
- J, Brisbane
