At Harmony Place Monterey, we offer comprehensive treatment for Eating Disorders (ED). Unlike traditional ED treatment, our approach is aimed not simply at alleviating symptoms, but adressing the underlying issues, enabling clients to live fully. The intent of this document is to give an overview of the principles that guide our understanding and treatment of EDs and outline the components and requirements of the program.
At HPM, we treat all forms of eating disorders, with the primary diagnoses being Anorexia (characterized by restricting food intake), Bulimia (characterized by binging and purging behaviors), and Binge Eating Disorder (characterized by episodes of out-of-control eating).
While someone may present with a specific set of symptoms at a given time, most people struggling with EDs tend to have latent features of multiple disorders. As a result, EDs often shift from one category to another over time. For example, someone may begin with anorexia, which later transitions into bulimia. They might then focus on stopping the binge-purge cycle, considering this “recovery,” while in reality, they have simply switched to relying on different symptoms. Similarly, a person who frequently binges at night may not recognize their daytime restriction as equally disordered.
On the surface, eating disorders (EDs) may seem to be primarily about food (often viewed as a diet gone awry), but when examined more deeply, it becomes clear they are about much more. While food and body image issues may be the presenting problem, many people have underlying diagnoses, commonly anxiety, depression, OCD, or a combination of these. Often, the ED serves as a way to alleviate these deeper, foundational symptoms. As individuals gain control over binging, purging, and restricting behaviors, they frequently
The development of an eating disorder (ED) is often an attempt to cope with trauma by diverting focus away from overwhelming emotions associated with traumatic events. EDs can also serve as a symbolic or physical attempt to gain control over what was previously uncontrollable. For survivors of sexual trauma, significant weight loss or gain can be used as a way to insulate oneself from perceived danger. In cases where trauma is present, addressing ED symptoms is necessary but usually insufficient for meaningful recovery. To achieve true healing, the underlying trauma must also be addressed.
People with EDs often struggle with intimacy and relationships. At the core of many EDs is an intimacy disorder, characterized by avoidance. At some point in their lives, individuals may have learned that turning to food felt safer than turning to people. An obsession with food and body image can unconsciously become a person’s primary relationship, serving as a substitute for genuine intimacy with others. Similarly, individuals with EDs often exhibit certain personality traits, such as perfectionism, rigidity, and obsessiveness (typically seen in restrictive behaviors) or chaos and lack of control (often linked to binging or purging behaviors). People may swing between these extremes not only in their relationship with food but also in their relationships with others.
EDs have a strong addictive quality. Similar to other addictions, individuals with EDs often find that they need increasingly more of the same behavior to alleviate unpleasant emotions. For example, those with anorexia frequently require more extreme starvation to ease anxiety about weight gain. It’s common for people with anorexia to express the desire to “just lose 5 more pounds,” but after achieving that goal, they find it’s still not enough and set an even lower target weight. It’s also not unusual for another addictive behavior, such as alcohol, drugs, excessive exercise, or tanning, to emerge during ED recovery. Therefore, it is crucial that all addictive elements are treated simultaneously.
Prior to or upon admission, clients undergo a thorough screening process that includes a nutritional assessment, medical review, psychiatric evaluation, and an admissions assessment. Biopsychosocial assessments are conducted to explore the individual and family dynamics contributing to the development of the ED and associated symptoms. Clients are provided with a specialized treatment plan and may receive any additional diagnostic assessments as needed. Evidence-based treatments offered include Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), Acceptance and Commitment Therapy (ACT), Exposure Therapy, Eye Movement Desensitization and Reprocessing (EMDR), and Internal Family Systems (IFS).
Harmony Place Monterey (HPM) offers treatment at the Partial Hospitalization Program (PHP) and Intensive Outpatient Program (IOP) levels. Participation in the Eating Disorder (ED) Track at these levels requires medical stability and the ability to engage in recovery without the support of a residential setting. To determine if our program is the right fit, we consider two key factors:
Requirements for Participation:
For those needing more support than we can provide at the PHP or IOP levels, we will facilitate referrals to higher levels of care, such as residential treatment, where additional structure and support are available.
