Transcription
The hardest thing to treat. It's a comorbidity between trauma, anorexia, and addiction. And these three things go together. This is the unholy triad of psychiatric illness.
So, when I take someone in my rehab and we remove substances from the equation, they can no longer use opioids or marijuana or cocaine or whatever to regulate their emotions. As the emotions rise, how do they gain control of them? They become more anorexic.
Literally, some of the hardest patients to treat when I've worked in rehabs have been with comorbid addictions and substance use disorders. So, cuz if you kind of think about it, how do they deal with these feelings of loathsomeness, right? How do they suppress their appetite? Cocaine. I have low energy, I feel fatigued, I'm irritable, I feel hungry, I hate feeling hungry, let me use cocaine.
So, it almost becomes a game of whack-a-mole, where as I start treating the trauma, their emotional experience rises to the surface. Now they're grappling with trauma, substance use increases, eating disorders increase. So, it becomes this game of whack-a-mole, where progress in one dimension makes it hard to progress in other dimensions.
So, what is the most common thing that is rampant in eating disorder treatment centers? Substance use, right? So, it's really, really difficult.