Art Therapy in the Treatment of Addiction and Trauma by Patricia Quinn

Author:Patricia Quinn
Language: eng
Format: epub
Publisher: Jessica Kingsley Publishers
Published: 2020-12-21T00:00:00+00:00

Eating disorders and substance use

Among the most common psychiatric comorbidities with eating disorders are mood disorders, anxiety disorders, and SUDs. In a study of more than 2400 individuals hospitalized for an eating disorder, Blinder, Cumella, and Sanathara (2006) found that 97 percent had one or more co-occurring conditions:

• 94 percent had co-occurring mood disorders, mostly major depression

• 56 percent were diagnosed with anxiety disorders

• 22 percent had an alcohol or substance use disorder.

Immediately, given what we know about trauma and how it affects the nervous system and regulatory functions, we can see why these symptoms might go hand in hand. Van der Kolk (2014) points out a circular relationship between PTSD and substance use, saying, “While drugs and alcohol may provide temporary relief from trauma symptoms, withdrawing from them increases hyperarousal, thereby intensifying nightmares, flashbacks and irritability” (p.329).

Paula Scatoloni (2019, p.278) states succinctly, “ED behaviors serve as a creative strategy to help the individual return to a state of regulation.” Both eating disorder and substance use behaviors can be used as a means of emotional expression and self-regulation. Both help the individual to dissociate and manage more extreme states that feel intolerable. As mentioned previously, each of these disorders can be quite functional in nature, so that an eating disorder or SUD works, until it doesn’t any longer. An alcoholic may hold a job for years before their drinking gets to a point where it disables their functioning. Similarly, someone with bulimia may get through college without anyone ever knowing about the behavior, and it may be years before they develop any health issues related to the behaviors. These disorders can remain hidden and are often mired in secrecy and shame. The individual using the symptoms may fear being found out—even if they know they need help, they are aware that seeking help could mean having these defensive strategies “taken away.” This perpetuates the cycle of symptoms, and long-term use of those symptoms wreaks havoc on the nervous system, making recovery more complicated on several levels. The body and mind are resilient and will adapt, so many can maintain a level of functioning for some time with the external structure of their symptoms in place. While the symptoms provide a scaffold—a temporary sense of stability—the person may be operating at a sub-optimal level.

One way I like to illustrate this is by using Maslow’s (1943) hierarchy of needs:

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