RISE Therapy for Eating Disorders
Recruiting in Palo Alto (17 mi)
Age: Any Age
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Auburn University
Disqualifiers: Under age 10
No Placebo Group
Trial Summary
What is the purpose of this trial?Interoception is the process of perceiving one's bodily sensations. Interoception is critical for survival and maintaining homeostasis, as it motivates sensation- and need-specific autonomic reflexes and adaptive behaviors (e.g., eating when hungry, terminating eating upon fullness, drinking when thirsty). Not all individuals have accurate interoceptive abilities. Individuals with eating disorders often have low perception of gastrointestinal, pain, and emotion sensations. Interoceptive dysfunction is believed to influence the development and maintenance of many forms of psychopathology. Identifying effective ways to restore accurate interoceptive processing is an important aim for clinical researchers. The goal of the present study is to continue to test the effectiveness of a training for interoceptive dysfunction that aims to reconnect individuals with eating disorders with their internal sensations, which is called, Reconnecting to Internal Sensations.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment Reconnecting to Internal Sensations and Experiences (RISE) for eating disorders?
The research highlights the importance of understanding and treating eating disorders by focusing on bodily and narrative identity, which aligns with the goals of RISE therapy. Additionally, treatments that enhance emotional processing and symbolic thinking, like ILET, have shown promise in addressing eating disorders, suggesting that RISE's focus on internal sensations may be beneficial.
12345How is the RISE treatment for eating disorders different from other treatments?
RISE Therapy for Eating Disorders is unique because it focuses on reconnecting individuals with their internal sensations and experiences, addressing the disconnection between bodily and narrative identity often seen in eating disorders. This approach emphasizes understanding and integrating bodily interactions and sensorimotor patterns, which is different from traditional treatments that may not focus as deeply on the embodied self-concept.
12678Eligibility Criteria
This trial is for individuals over the age of 10 who have been clinically diagnosed with an eating disorder and are patients at the Louisville Center for Eating Disorders. The study aims to include those who may struggle with recognizing internal bodily sensations.Inclusion Criteria
I have been diagnosed with an eating disorder.
Be a patient at the Louisville Center for Eating Disorders
I am older than 10 years.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Intervention
Participants undergo interoceptive training consisting of four 25-30 minute modules delivered weekly, focusing on body awareness, body sensations and movement, eating, health and self-care, emotional awareness, and understanding the self in relation to others.
4 weeks
4 sessions (online)
Follow-up
Participants are monitored for changes in eating disorder symptoms and interoceptive awareness using self-report assessments.
1 week
Participant Groups
The study is testing a training called 'Reconnecting to Internal Sensations and Experiences' (RISE), which is designed to help participants with eating disorders improve their ability to perceive bodily sensations like hunger, fullness, and thirst.
1Treatment groups
Experimental Treatment
Group I: Reconnecting to Internal Sensations and ExperiencesExperimental Treatment1 Intervention
The interoceptive training consists of four 25-30 minute modules (plus 15-minutes worth of optional weekly practice) that focus on multiple aspects of interoception including: body awareness, body sensations and movement, eating, health and selfcare, emotional awareness, and understanding the self in relation to others. These modules are delivered weekly.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Louisville Center For Eating DisordersLouisville, KY
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Who Is Running the Clinical Trial?
Auburn UniversityLead Sponsor
References
Narrative and Bodily Identity in Eating Disorders: Toward an Integrated Theoretical-Clinical Approach. [2022]Eating disorders (EDs) can be viewed as "embodied acts" that help to cope with internal and external demands that are perceived as overwhelming. The maintenance of EDs affects the entire identity of the person; the lack of a defined; or valid sense of self is expressed in terms of both physical body and personal identity. According to attachment theory, primary relationships characterized by insecurity, traumatic experiences, poor mirroring, and emotional attunement lead to the development of dysfunctional regulatory strategies. Although the literature shows an association between attachment style or states of mind, trauma, behavioral strategies, and various EDs, the debate is still ongoing and the results are still conflicting. Therefore, we believe it is important to examine and treat EDs by understanding which narrative trajectory intercepts distress in relation to narrative and embodied self-concept. Drawing on clinical observation and a narrative review of the literature, we focus on the construction and organization of bodily and narrative identity. Because bodily representations are the primary tools for generating meaning, organizing experience, and shaping social identity from the earliest stages of life, we focus on the role that bodily interactions and sensorimotor and proprioceptive patterns have played in the development of EDs. We consider the role that lack of attunement, insecure attachment, and relational trauma play in mentalizing, affecting self-representation and emotion regulation strategies. The paper also considers a semantic mode of trauma in EDs that involves a top-down pathway through beliefs and narratives about oneself based on lack of amiability, on devaluation, and on humiliation memories. Finally, we would like to highlight the proposal of an integrated model with multiple access model to psychotherapy that takes into account the complexity of ED patients in whom aspects related to dysregulation, body image disintegration, and post-traumatic symptoms are associated with a suffering sense of self and a retraumatizing narrative.
From red vegetables to sexuality: Resymbolizing the meaning of concrete thought in eating disorders. [2020]This paper introduces and describes the theory and practice of a novel treatment approach to eating disorders-internal language enhancement therapy (ILET)-illustrated with a case study. This treatment approach is informed by the neurobiology of emotional processing integrated with elements of psychoanalytic theory and practice, early maternal preoccupation, development of the self, early right hemisphere language development, and techniques from cognitive behavioral therapy. ILET is based on the Discontinuous Model of Neural Emotional Processing, which means that emotions are processed in the brain either symbolically or concretely. The aim of ILET is to open up and reinforce the underused brain pathway to the symbolic functions by forensically working back to and accurately identifying the emotional material that triggers the concrete state. When the emotional trigger is identified it is explored using symbolic and metaphoric language that reconnects the patient to the symbolic state. ILET posits that eating disorders only appear in the concrete state.
Recovery from eating disorder 1 year after start of treatment is related to better mentalization and strong reduction of sensitivity to others. [2019]To investigate whether recovery from an eating disorder is related to pre-treatment attachment and mentalization and/or to improvement of attachment and mentalization during treatment.
[Schematherapy in Eating Disorders - An Integrative Approach to Improve the Outcome]. [2018]Despite evidence-based psychotherapeutic treatment approaches such as cognitive behavioral therapy and psychodynamic therapy eating disorders still pose a challenge to therapists and patients alike. Eating disorders are associated with a high comorbid prevalence of personality disorders and other psychological axis-I-disorders, show highdrop-out rates and relapse rates and anorexia nervosa has the highest mortality rate compared to all psychiatric disorders. Even self-motivated patients frequently fail to achieve the treatment goals like developing a normal eating behavior, gaining weight, and changing the underlying dysfunctional behavioral patterns and cognitions. We will present a schematherapeutic approach with experiential methods, integrated in evidence-based CBT, with the intention to improve motivation and therapeutic outcome.
Eating disorders and attachment: a contemporary psychodynamic perspective. [2016]A contemporary psychodynamic framework can add much to our understanding of eating disorders. Eating disorders are associated with complex comorbidities, high levels of mortality, and therapist countertransferences that can complicate psychological treatments. Mainstream models currently focus on cognitive, biological, or cultural factors to the near exclusion of attachment functioning, and the individual's dynamics. As such, standard models appear to exclude person-centred and developmental considerations when providing treatments. In this article, we describe a contemporary psychodynamic model that understands eating disorder symptoms as a consequence of vulnerability to social pressures to be thin and biological predispositions to body weight. Individual vulnerabilities are rooted in unmet attachment needs causing negative affect, and subsequent maladaptive defenses and eating disorder symptoms as a means of coping. We describe how this model can inform transdiagnostic eating disorder treatment that focuses on symptoms as well as specific attachment functions including: interpersonal style, affect regulation, reflective functioning, and coherence of mind. Two clinical examples are presented to illustrate case formulations and psychological treatments informed by these conceptualizations.
Histories of childhood trauma and complex post-traumatic sequelae in women with eating disorders. [2019]The profound self-destructiveness and tenacity of eating disorders found among women abused and neglected in childhood become comprehensible when understood within a complex posttraumatic conceptualization as desperate attempts to regulate overwhelming affective states and construct a coherent sense of self and system of meaning. Trauma leads to the predictable consequences of dysregulation of the arousal system, avoidance, and constriction of affect; coherence of self and world are shattered. Abused patients' childhood experiences teach them that to need is to expose oneself to the pain of abandonment and betrayal at the hands of individuals responsible for their care. Consequently, needs-psychological, physical, and spiritual-come to be perceived as dangerous, and human relationships are simultaneously yearned for and feared. Robbed of the opportunity to develop a cohesive self and a coherent system of meaning and faith to sustain from within, the traumatized eating-disorder patient turns to the culture to tell her who to be and how to live; she learns that to conquer rather than satisfy needs and to be "in control" (an internal state of equanimity manifested externally in a thin body) will bring meaning and purpose. Binge eating, purging, and starving become apt metaphors for the boundless hunger, the wish to fulfill needs together with the wish to rid oneself forever of need, the desire to "purify" the damaged psychic and physical self, and the hope of restoring meaning. The treatment of the traumatized eating disorder patient is complex. Individual therapy provides the opportunity for intensive relational work that begins to restore faith in human connection and that provides a "safe base" from which to examine the trauma and separate past from present. Therapy groups for eating-disordered women and trauma survivors provide relief from isolation, valuable perspectives from others who have "been there," and the opportunity to contribute to others' healing as one heals. Ultimately, these patients must be willing to leave the world of obsession with food and weight, which guarantees safety from interpersonal hurt while it simultaneously guarantees that hope will not be restored. Though reconnecting with humanity carries the risk of further pain, it opens up the opportunity for connection, healing, and growth.
"Bringing and Removing Self from the Table": Therapists' use and management of eating disorder lived experience in the treatment of clients with eating disorders. [2023]Therapists report significant countertransference reactions when treating clients with eating disorders (EDs). Countertransference may be pronounced among therapists with eating disorder lived experience (EDLE). Minimal research examines how therapists with EDLE negotiate their experiences while treating ED clients. Informed by the person-of-the-therapist philosophy, this study sought to understand how therapists use and manage their EDLE when working with ED clients. Using constructivist grounded theory methodology, semistructured interviews (Mtime  = 89 min) were conducted with 22 therapists with EDLE. Results revealed that therapists engaged in two interconnected systems. The Central System helps therapists transform their lived experiences into clinical guidance. The Checks and Balances System allows therapists to find a balance between connecting with the client and allowing for differences in experiences to emerge. Lastly, three personal processes existing outside of these systems were found to impact therapists' use of self. Findings provide novel ways that therapists can use their EDLE.
Integrating cognitive processing therapy for posttraumatic stress disorder with cognitive behavioral therapy for eating disorders in PROJECT RECOVER. [2021]Posttraumatic stress disorder (PTSD) frequently co-occurs with eating disorders (ED) and is likely to be a powerful ED maintaining factor for a significant subgroup of individuals. The goal of PROJECT RECOVER is to develop and evaluate concurrent integrated treatment approaches for ED-PTSD to enable these individuals to recover from both their ED and PTSD. To date, we have trialed two approaches to concurrent/integrated treatment in PROJECT RECOVER: (1) concurrent delivery of Cognitive Processing Therapy (CPT) for PTSD to individuals receiving intensive ED treatment, and (2) delivery of a manualized individual cognitive-behavioral therapy (CBT) addressing both ED and PTSD (Integrated CBT for ED-PTSD) following a period of initial ED treatment. Interventions from both CBT for ED, and CPT for PTSD can be utilized and adapted to address the functional relationship between ED and PTSD, and promote full recovery from both disorders. Examples include integrating PTSD symptoms into the cognitive-behavioral individualized formulation of ED maintenance; integrating the ED into psychoeducation about PTSD maintenance; and identifying maladaptive beliefs that connect the ED to the trauma and/or PTSD. Emerging evidence suggests that CPT can be successfully integrated with CBT for ED.