The ingestive disorders
The ingestive disorders include alcoholism, addictions to legal and illicit drugs, nicotine dependency, and the eating disorders. Each of these disorders is characterized by abuse of a substance: alcohol, drugs, nicotine, or food. The abused substance facilitates the three R's: regulation, reenactment, and reexperiencing (Omaha, 1998; Omaha, 2001).
Regulation The abused substance enables the individual to regulate current disturbing emotion that would otherwise be overwhelming.
Reenactment The abuse substance facilitates reenactment of unresolved, archaic trauma.
Reexperiencing The abused substance facilitates a vicarious reexperiencing in a more or less dissociated state of unprocessed emotions assembled with the trauma(s) at the time(s) of occurrence.

A syncretic theory and therapy
"Syncretic" means the process of growth of a system through accretion of tenets and propositions from a variety of sources. The theory upon which ACT is founded brings together concepts and ideas from genetics, developmental neurobiology, developmental psychology, dynamic systems theory, attachment theory, object relations, information processing, dissociation theory, trauma theory, and ego state theory. ACT unites therapeutic concepts from Eye Movement Desensitization and Reprocessing (EMDR), attachment therapy, Gestalt therapy, ego state therapy, and relapse prevention.

ACT Theory for the Ingestive Disorders
ACT is a psychodynamic model for the ingestive disorders. It traces the causes of present behaviors and dysfunctions to events in infancy, childhood, and preadolescence. The primary causes of the ingestive disorders are deficit experience and trauma or adversity. Deficit experiences occur when the dyadic, attuned, mutually responsive relationship between infant and the primary maternal caregiver fails for whatever reason. Sometimes the primary maternal caregiver has to return to work, and the day care provider cannot adequately attend to all of the infant's needs. Sometimes the relationship is adversely impacted by maternal substance abuse. ACT Theory states that deficit experiences during the period from birth through the third year result in an impaired attachment. Failures of the attachment stage of development produce deficiencies in emotional regulation. The greater the failures in attachment, the more severe the deficiencies in emotion regulation. By the onset of adolescence, individuals whose childhoods are characterized by failed attachment have difficulty recognizing, tolerating, or regulating negative as well as positive emotions.
Adversity or trauma is a second cause of adolescent and adult onset ingestive disorders. Trauma occurs on a range from less severe, called adverse experience, to more severe, termed trauma. At the less severe end of the spectrum are neglect, abandonment, and physical or emotional unavailability. Severity increases with verbal, emotional, and psychological abuse. This can include double binding, shaming, devaluating, and denigrating. Physical abuse and sexual abuse are at the most severe end of the scale. Childhood trauma is known to prevent consolidation of identity. In object relations terms, trauma prevents separation and individuation of the self from inner representations of the parents or primary caregivers. The images, sensations, and emotions associated with traumatic events are stored in a state-specific, excitatory form in which they are more likely to be triggered by internal or external stimuli than is more adaptive material (Shaprio, 1995). Trauma theory proposes that the trauma(s) will be reenacted in a disguised form. ACT Theory hypothesizes that addictions, alcoholism, eating disorders, and nicotine dependency are forms of trauma reenactment.

The genetic basis for the ingestive disorders
Humans inherit an emotion processing system. The objective of this system is to resolve disturbing emotions adaptively. The robustness of this emotional processing system is inherited. Alcoholics, for example, are believed to have inherited deficiencies in the endorphinergic neurotransmitter system. This deficiency reflects the genetic impairment of one aspect of the emotional regulatory system. Alcoholism is not a disease, nor are nicotine dependency, addictions, or the eating disorders. They are not inherited. They are disorders with a heritable component, the robustness of the emotional regulatory system.