ABSTRACT. Numerous investigators have noted a correlation between compulsive eating patterns and dissociative symptoms, but there is no systematic explanation for how these two phenomena interact. It is not uncommon for patients with compulsive eating patterns to experience previously dissociated memories of abuse and trauma, but there are no generally accepted interventions that address both the eating disorder and the traumatic experience. Furthermore, there are no commonly accepted guidelines for assessing trauma and dissociative symptoms in the many patients with intractable compulsive eating symptoms who may initially present with no traumatic history. This article presents theoretical formulations, a review of relevant research, and a model that suggests a causal relationship between dissociation and compulsive eating. Guidelines for assessment and intervention are proposed. The theoretical constructs in this paper are based on hunger-based symptom assessment and a feminist interpretation of object relations theory as it applies to compulsive eating and body shame.
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