Foreign Bodies: Eating Disorders, Childhood Sexual Abuse, and Trauma-Informed Treatment addresses the association between eating disorders and childhood sexual abuse, proposing a new way of treating those suffering from eating disorders who were sexually abused as children. Based on testimonies of survivors of abuse who subsequently developed eating disorders, it offers a new form of diagnosis and treatment, arguing that the eating-disorder field often ignores the traumatic sources of eating disorders, leading to some treatment programs not being commensurate, and at times conflicting, with the principles of childhood sexual abuse treatment.
The case studies used to highlight the link between childhood sexual abuse and eating disorders are presented from the perspective of the women involved, in their own words. Their voices are supplemented by Gur’s own stance as a clinician specializing in the treatment of sexual abuse and CPTSD. The book is divided into three parts: the first deals with eating disorders, childhood sexual abuse, and the association between them; the second examines the treatment of eating disorders and childhood sexual abuse; and the third offers a new form of diagnosis and treatment for eating disorders.
This book will be of great interest to researchers and postgraduate students in the eating disorder field of psychotherapy, psychology, or psychiatry, plus those studying the treatment of trauma. It will also be of interest to clinical dieticians, psychologists, social workers, doctors, nurses, eating disorder specialists, and policymakers in the mental health field, as well as eating disorders sufferers and those who care for them.
Table of Contents
Introduction PART ONE: EATING DISORDERS, CHILDHOOD SEXUAL ABUSE, AND THE LINK BETWEEN THEM Chapter 1: Eating disorders Chapter 2: Childhood sexual abuse—From witchcraft and hysteria to CPTSD Chapter 3: The relation between childhood sexual abuse and eating disorders: A meta-view of the professional literature Chapter 4: Women speak of the association between childhood sexual abuse and eating disorders Chapter 5: Eating disorders in the service of dissociation Chapter 6: The betrayed/betraying body: Eating disorders as ways of coping with the feminine body, sex, and sexuality in the wake of childhood sexual abuse PART TWO: TREATMENT OF EATING DISORDERS AND CHILDHOOD SEXUAL ABUSE Chapter 7: Treating eating disorders Chapter 8: Specialist sexual-abuse treatment PART THREE: A NEW DIAGNOSIS AND TREATMENT PROPOSAL Chapter 9: Women, "madness," and a new diagnosis Chapter 10: Treating CPTSD Chapter 11: Eating disorders, CPTSD, and appropriate treatment Epilogue Appendix: Dawn's story
Anat Gur, MSW, PhD, is a social worker and psychotherapist specializing in the treatment of women and survivors of sexual abuse and complex PTSD. She is the professional director of the Women’s Therapy Centre: Women’s Wisdom in Israel, head of the two-year programme for treating sexual abuse at Bar-Ilan University.
"This long-awaited book addresses the needs of traumatized patients who struggle with dysregulated eating. Often in my practice as teacher and clinician I found myself in need for an authoritative text that will clarify why some patients do not respond well to best practice protocols for the treatment of eating disorders.
Foreign Bodies is the book I have needed. It will guide clinicians through the distinctive drives and needs of traumatized individuals with eating disorders. Anat Gur eloquently argues her case in a clear but scientifically-based text laced with illuminating case studies. Her book is an important contribution to the improvement of care offered to many survivors of childhood adversity."
Eli Somer, PhD, Clinical professor of psychology, University of Haifa. Past president, European Society for Trauma and Dissociation, International Society for the Study of Trauma and Dissociation.
"FOREIGN BODIES is a persuasive and comprehensive book about eating disorders, sexual abuse, and trauma-informed treatment—which constitutes her sub-title. Complex and painful material is beautifully, gravelly, calmly, "maternally" described. Dr. Gur issues a clarion call for mental health professionals to streamline their understanding, diagnoses, and therapeutic plans for the at-risk victims of childhood sexual violence—the anorexics, bingers, drug addicts, prisoners, suicide artists, and prostituted girls and women. They are the survivors, often the mute witnesses of a long-denied plague, one which causes life-long devastation.
Based on her own clinical work and on studies, Dr. Gur argues, persuasively, that an eating disorder is merely a symptom, not an underlying cause, and that anorexia, bulimia, and bingeing, as well as diagnoses such as dissociative disorder or borderline personality, are all part of a single but complex, post-traumatic stress disorder that itself is a normal, human response to early childhood violation and betrayal. The author, and her very moving interviewees, insist that denial on the part of parents, teachers, social workers, and mental health professionals, is as traumatizing as the sexual violence itself.
I strongly and passionately recommend this book for scholars and clinicians, as well as civilians, who are all caught in the cross-fires of gender warfare."
Phyllis Chesler Ph.D, Author of WOMEN AND MADNESS and WOMAN’S INHUMANITY TO WOMAN.
"With the publication of Foreign Bodies, Dr. Anat Gur makes a significant contribution to the field of eating disorders. Her work further informs providers, patients and their families about the central role that childhood sexual abuse, arguably one of the most damaging forms of child maltreatment, may play in the development of eating disorders. Such a crucial piece of the history is all too often missed or minimized and not integrated into a comprehensive treatment approach. This often leads to higher dropout, inadequate response, and/or early relapse. Dr. Gur amplifies that feminist voice against not only the original maltreatment of these young women who developed EDs but also of the mal-treatment that unknowing professionals inadvertently perpetrate on these women by their avoidance and minimization. Foreign Bodies is unique because it takes the reader through the painful, lived experiences of survivors who have endured such horrific experiences, which is often marked by extreme shame and guilt. Foreign Bodies further adds to the growing database demanding integrated Trauma-informed care and practice for this complex and often treatment-resistant subgroup of patients."
Timothy D. Brewerton, MD, DLFAPA, FAED, DFAACAP, HCEDS.