Eating Disorders Treatment Program

Eating Disorders Treatment Program

Eating Disorder Treatment Program

Partial Outpatient Program and Life Coaching

A Transitional Living Program

What is an Eating Disorder, including Anorexia Nervosa or Bulimia?

An eating disorder is any collection of thoughts, feelings, or behaviors around food or weight management that has become extreme or unmanageable and potentially destructive to health, self, and relationships.  There are different types of eating disorders and individuals often cycle between diagnoses, yet professionals agree that those afflicted share a dysfunctional relationship with food and often (but not always) one’s body.  Frequently, clients who struggle with eating disorders have comorbid psychiatric disorders, such as mood disorders, anxiety, impulse-control problems, and substance-abuse disorders.  Eating disorders cause serious emotional and physical problems for both males and females of all races, in all age groups, and are life threatening.  In the course of a ten-year period, one in ten individuals who struggle with an eating disorder will die.


Anorexia Nervosa is a clinical term, describing the suppression or refusal of the appetite and typically involves excessive weight loss. This psychiatric disorder is characterized by an unrealistic fear of weight gain, which includes self-starvation and a distortion of body image.  The individual is obsessed with weight control and restricts intake to the point where physical and mental health are compromised.  Individuals demonstrate inappropriate or highly specific and disciplined eating habits and rituals and irrational fear of weight gain.  Restriction is maintained through various cognitive biases that alter how the affected individual evaluates and thinks about their body, food, and eating.

While the majority of those with anorexia continue to feel hunger, they deny themselves all but very small quantities of food, usually limited to very few foods as well. The caloric intake of people with anorexia can vary significantly between individuals and over time, depending on whether they engage in binging and/or purging. Extreme cases of utter self-starvation and a refusal to eat at all are known. Anorexia is a serious health risk with a high incidence of comorbidity and equally high mortality rate as compared to other serious psychiatric disorders.


Bulimia Nervosa is characterized by the consumption of an unusually large amount of food in a short period of time, then using compensatory behaviors to rid one’s self of calories and avoid weight gain.  Those who struggle with this disorder may vomit, use diuretics or laxatives, or exercise excessively in order to make up for calories consumed.  People with bulimia report feeling out of control during binging episodes and are often overly concerned with appearance.

Binge Eating Disorder

Binge Eating Disorder is the most common eating disorder in the United States, characterized by recurrent episodes wherein large quantities of food are consumed, often quickly and to the point of physical discomfort.  Binge eating can involve preexisting periods of restriction and rigidity with food or periodic dieting and/or fasting. Individuals report feeling out of control during binges, along with a sense of profound shame and guilt following bingeing episodes.

Suffering from Both Forms of These Eating Disorders

Some suffering from bulimia maybe also suffer or have suffered from anorexia. Bulimia can also be accompanied with fasting over an extended period of time, which precedes the binge. These are dangerous, habit-forming practices that occur with the sufferer focused on trying to keep their weight under a self-imposed maximum. These habits can lead to a loss of potassium, a deterioration in physical and emotional health, with depressive symptoms that are often escalating and that can lead to a high risk of suicide. Bulimia is thought to be less life-threatening than anorexia; however, the occurrence of bulimia is higher but less easy to spot, as oftentimes bulimics are not overly thin as would be an anorexic.

What is Unique about our Eating Disorders Program?

At Harmony Place Monterey, we focus on helping clients gain control of behaviors such as restriction, binging, purging, and obsessional thinking about food, weight, and appearance.
The transition from residential care to an outpatient program is often difficult and individuals are frequently prone to relapse.  Our treatment team anticipates probable lapses as we work to help clients both recognize and achieve a level of support conducive to continuing to recover at a lower level of care.  For those who are being seen on an outpatient basis and need more support around eating behaviors, we are able to provide a structured, day treatment program that helps them achieve their goals.
Our experienced team of eating disorder therapists works both individually and in group therapy, to help our clients unmask key issues underlying eating disorder symptoms and coach our clients to practice new life skills while in treatment. Clients learn about what might be holding them back, what they are afraid of, and slowly confront fears through exposure and self-evaluation.  We teach clients how to practice and master new patterns of thinking, feeling, and behaving on a daily basis.  Clients obtain tools and practice “real life” situations in order to gain a sense of competency and self-efficacy that provides the foundation to recovery from an eating disorder.

The Transition? Why Is It So Hard?

Sometimes the transition back to the home environment and the accompanying triggers found there are too great. Sometimes there isn’t enough stepdown transition to allow for the unmasking of the fears that were once dealt with by the addiction’s numbing, so the client feels terrified. Often the eating disorder serves many functions and residential treatment is unable to create the exact trigger in order to then create healthy replacements for these functions.

The Goals of the Harmony Place Eating Disorders Program

The goals of this program is to help the client unmask the key issues, during individual psychotherapy, and then not avoid fearful opportunities to confront those real issues in the real world. We use “coaching” to help the client recognize what they fear, to then “show-up” for life’s obligations, and we guide the client to slowly confront their fears through exposure to them, and thoughtful support. We help teach, master, practice and rehearse new patters of thinking, feeling, and behaving on a daily basis. Clients learn new “tools” to gain feelings of competency, effectiveness, and pride as they deal with previously overwhelming and unwanted emotions.

The Harmony Place Setting

The Monterey Peninsula, including beautiful Carmel, California and Pebble Beach and then up to the Redwood Forests of Big Sur provide some of the most stunningly beautiful geography on the continental U.S. Hiking, golfing, dining, kayaking, bicycling, shopping or quiet solitude in nature are all readily accessible. Natural beauty alone doesn’t cure relational problems —but it certainly provides an inspiring backdrop.

Individuals who come to Harmony Place stay in a comfortable, beautiful house near the ocean and are surrounded by support from other clients and our Harmony Place staff. Planning meals and grocery shopping are also facilitated.

Eating Disorders and How They Operate as Addictions

Though eating disorders fall in to a distinctive diagnostic category, they have elements in common with other addictive disorders. Specifically, the behaviors of bingeing, purging, and restricting typically escalate overtime (tolerance), such that, more is necessary to achieve the temporary “relief” originally attained by less. Likewise, secrecy, minimization, and denial routinely accompany the disorder, as eating disorders behavior escalates. The purging that occurs with bulimia may take multiple forms that include extensive, even dangerous levels of laxative and diuretic use, exercise that grows increasingly compulsive, and vomiting that can become habitual and anytime food is consumed.

To break patterns that have become severe and chronic requires higher levels of care, including a period of inpatient or residential care. For some clients, day treatment (PHP) or intensive outpatient (IOP) may provide the containment necessary. Where there is the possibility of a strong support system that the client will allow to provide needed help, outpatient treatment alone may be sufficient.

I. Binge-eating Disorder

Since the DSM-V has included the diagnosis of Binge Eating Disorders, an increasing number of clients are seeking treatment for this long-neglected struggle with food. The critical component of intervention is creating an individualized, balanced, non-restrictive meal plan concentrated on re-establishing hunger and fullness cues and addressing cravings. This step is achieved with the assistance of a dietitian. The emotional component of bingeing requires attention to the particular contributing factors for each individual. Issues of loneliness, social isolation, and relationship challenges may require attention and intervention. For others, complex trauma or PTSD can be the causative agent. Other factors may include long-standing patterns or double binds related to perfectionism, anger, social anxiety, impulsive or obsessive traits, shame or self-loathing. The goal of treatment is to develop and implement alternative coping responses to binge-related triggers, leading to the decrease of cravings and urges. Additional work may be important around originating, maintaining, or addressing concomitant issues in order to achieve lasting symptoms remission.

II. Anorexia and Bulimia

With anorexia and bulimia, the sooner the intervention, the better the yield for prognosis. This is due in part to the debilitating effects of malnutrition. Descent into an eating disorder can create the precise circumstances that make it increasingly difficult for a person to accurately register the level of debilitation or danger their continuing behaviors pose to both physical and mental health. Part of the complexity is that greater symptom stabilization may need to precede insight, yet insight is required for the person to accurately assess the realities and derive adequate motivation from that realistic assessment.

In order to optimize the client’s ability to acquire control over the addictive process, initial phases of treatment are typically coordinated with a dietitian and psychiatrist. Once the symptoms are initially stabilized, the client often experiences the more intense emotions that the eating disorder was being used, in part, to suppress. At this point, dialectical behavioral therapy (DBT) and mindfulness work can be useful for what we call establishing “affect tolerance” and fostering the “emotional intelligence” requisite for creative problem-solving. Once the eating disorder symptoms, while ultimately life-threatening, provided, temporarily, the ability to push through certain life challenges or put aside persistent fears.

Work with a life coach to master the experiences that were previously overwhelming can often be of benefit. Where past trauma or overwhelming developmental experiences have contributed to the development of the eating disorder or to an underlying depressive or anxiety disorder, trauma resolution and grief and loss work are often useful.


Intensive Outpatient Therapy is three hours each day. Partial Hospitalization is six hours each day.

Clients can enroll in either program and go to school or have a part-time job. Individual therapy is included in each of the programs.

The Harmony Place Transitional Living Outpatient Staff

We have an experienced staff including a psychiatrist, a dietitian, a life coach and experienced therapists. Clients are seen once or twice a week as well as participate in several ongoing groups with other clients who have attained differing degrees of recovery.

Confidential Consultation

Contact us for a confidential consultation. We welcome your questions and inquiries. Let us assist you in taking whatever necessary next steps are available to you as well as to your partner, family member, or loved one.