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Eating Disorder Treatment

Though eating disorders fall into a distinctive diagnostic category, they have elements in common with other addictive disorders. Harmony Place Monterey specializes in Eating Disorder Treatment.

Specifically, bingeing, purging and restricting typically escalate over time (as the person builds a tolerance to the behavior), so more is necessary to achieve the temporary “relief” that was originally pleasurable. Secrecy, minimization, and denial routinely increase as eating disorder 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 anytime food is consumed. Yet despite the dangers, the behavior continues, similar to an addict’s compulsive need to satisfy his addiction, despite loss of health, job, family and possibly death.

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.

    • Finding the “why”
    • Inpatient Program
    • General Education
    • Anorexia
    • Bulimia
    • Binge Eating Disorder
The Lone Cypress

Eating Disorder Treatment Resources

At Harmony Place Monterey, we help clients gain control of behaviors such as restriction, binging, purging, and obsessional thinking about food, weight, and appearance.

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 what might be holding them back, what they are afraid of, and slowly confront those 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 life skills and practice “real life” situations to gain a sense of competency and self-efficacy that provides the foundation to recovery.

Anorexia

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 bingeing and/or purging. Extreme cases of utter self-starvation and refusal to eat at all are known. Anorexia is a serious health risk with a high incidence or comorbidity and equally high mortality rate as compared to other serious psychiatric disorders.

Anorexia Nervosa is a complicated illness. Each client tends to be more different than similar, and the development trajectory for each client is complex. Many clients with anorexia nervosa will move into bulimia, while many bulimics who get under control will attempt to restrict; therefore, one common feature of the illness is that over-control eventually leads to out of control. Our experience is that many clients with anorexia nervosa have a history of childhood trauma or neglect leading to the fragmentation of their sense of self; however, there are many subtypes and contributing factors and treatment for each client needs to be radically different.

Bulimia

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 consume. People with bulimia report feeling out of control during bingeing 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 felling out of control during binges, along with a sense of profound shame and guilt following bingeing episodes. Typically, binge eating is difficult to get under control by attempting self-control and requires a restricting of one’s life decisions.
Garrapata Beach

Eating Disorders and How They Operate as Addictions

Though eating disorders fall into a distinctive diagnostic category, they have elements in common with other addictive disorders. Specifically, the behaviors of bingeing, purging, and restricting typically escalate over time (tolerance), such that, more is necessary to achieve the temporary “relief” originally attained by less. Likewise, secrecy, minimalization, and denial routinely accompany the disorder, as eating disorders behavior escalates. The purging that occurs with bulimia ay 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, 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.

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 to achieve lasting symptoms remission.

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 during our Eating Disorder Treatment. 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.

Sexuality and Intimacy

The vast majority of anorexics and bulimics, likewise, manifests sexual over control and out of control difficulties. In their disease, they are unaware of cues for appetite or satiations. In a similar manner, the cues for sexual appetite are confused. Once they are eating and re-fed, often they will experience sexual arousal, but the ability to use those cues to make sexual decisions is blurred. These primary interactions with others are geared to avoid disappointment, as well as to please. It is as if they do not have a core sense of self to know or determine what they deserve, so they make decisions regarding their wants in relation to not displeasing others. Unfortunately, sex, for the sake of the other can be disastrous, since it typically feels like an assault to the body when there is little desire combined with intense fear. The result of these juxtaposition and disconnections is a pattern of sexual behavior that is out of control, many patterns in a short span of time, while simultaneously experiencing low desire as even sexual aversion. When they do find a partner who is desirable, after their body is too traumatized, by prior objectification and bypassing, they are unable to respond.

What is Unique about our Eating Disorders Program?

At Harmony Place Monterey, we focus on helping clients gain control of behaviors such as restriction, bingeing, 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 are 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 patterns 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 for our Eating Disorder Treatment Center. 

As an option, individuals who come to Harmony Place can 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.

IOP/PHP

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.

Transitional Living is:

Learning to be in the world

Having directed a residential treatment center for eating disorders for many years, we are aware that recovery is about establishing and then following some control over symptoms. However, few individuals are provided anticipatory guidance of what’s to come, which includes understanding the fear that arises with social interactions, dating, sexuality, establishing a career, preparing meals, showing up and not avoiding activities that are fearful or overwhelming.

Recovery Cannot Be Done Alone

At Harmony House Monterey, we know that recovery can’t be done alone. It cannot be done without support, guidance, and coaching. We provide a living environment with supervision, guidance, structure and encouragement.

Learning How to Live Without Addiction

Traditional living support allows the opportunity to return to school, find a job, or learn simple tasks and guidance. At Harmony Place, we provide psychotherapists, life coaches, dietitians, and therapists experienced in working with difficult challenges and with individuals who have already been through many treatment programs that might not have led to long-term success.

Give yourself and/or your loved ones the transitional support you need.

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.

Eating Disorder Treatment Resources

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2020, 2019, 2018 & 2017 Monterey Award Program "Best Eating Disorder Treatment Center"Award-winning Care

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Best of 2020 Monterey Award Eating Disorders Clinic