The Missing Element in the Treatment of Eating Disorders

Our current treatment for all eating disorders, anorexia, binge, and bulimia still primarily centers around behavioral and mind-based interventions, such as CBT and DBT treatment. Where these interventions are very effective for some, as we know they are not effective for all. As a somatic psychotherapist, what I find is a key missing component in all ED treatment is a form of somatic intervention.

Somatic interventions in the treatment of eating disorders tends to be poorly understood. Often when hearing the word “somatic” the mind tends to wrap around the things we associate our body with the most, movement. Therefore, a somatic intervention currently used the most in eating disorder recovery is yoga asana. Often, the integration of yoga as a gentle, yet active form of movement is used to help aide in one’s body awareness and present moment focus. I am a huge fan of the integration of yoga as one, and I stress, one form of somatic intervention. However, I am now here to tell you about another form of somatic intervention that is just as, if not more important than yoga, yet is less known and infrequently used.

A lesser known area of somatic intervention is Interoceptive Awareness and it has to do with the deeper, more inner-experience of the body. The way we perceive our bodies from the inside out, by way of attending to sensations and fluctuations in the sensory experience of the body. Do you ever stop to attend to the varying temperature of different parts of your body? What about the way your breath feels in your belly or in your chest or throat? It is awareness such as this that lights up areas of our brain and helps us to know ourselves better. Interoceptive Awareness is one of the most important skills one can learn when in recovery from an eating disorder. Why? Because with all eating disorders there is a lack of this embodied connection. Areas of the brain are firing and mis-firing and these internal signals get shut-down and crossed to the point that people end up misperceiving what they feel and see! When we begin to teach these important somatic skills they begin to re-connect with this important knowledge needed for full and lasting recovery. Many of these skills can be taught without movement and instead by teaching our clients self-touch and sensory awareness exercises that they will be able to carry with them throughout a day, not just when on a mat.

The Befriending Your Body (BFYB) Program takes people through a journey of interoceptive awareness on many levels. We begin with a basic understanding and simple questions to a deeper understanding by starting to register the way emotions and thoughts feel in the body as well as just physical sensations. Over time people come to know their bodies and themselves in a different way. They carry themselves around with new knowledge and awareness that they can actually feel and not just think about. This leaves them feeling more in control and in charge of their lives, which is a feeling all clinicians understand is a necessary and needed step in moving forward along the path to lasting recovery.

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Self-Compassion As A Protective Factor in Eating Disorder Recovery

Throughout my years of clinical practice I have witnessed a strong connection between self-compassion and healing from eating disorders and body-image struggles. So when I had a chance to engage in my own research interest during my doctoral studies I chose to research self-compassion in the recovery process. That was five years ago, but no surprise, there is now more and more in the literature that supports what I found through my own research study and have anecdotally known throughout the years.

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Staying Amidst Changing

August 30th welcomed in the Black Moon. I’m the first to admit that I don’t know much about this. Instead I rely on my fellow moon-following yogi’s to teach me. One of the things I learned was that it is a great time to make changes and set goals. My first reaction to this was resistance. What if I just don’t want any more change, any more effort? What if I just want things to remain steady for a while? It reminded me of many years ago when I first started my yoga practice in a more serious way.

I had just given birth to my twin boys, 21 years ago. After their birth I became pretty ill with Grave’s disease an auto-immune disease that really does a number on you, especially with two preemie newborns! Long story short because yoga had always calmed me in the past, I found my way into a yoga class where the teacher happened to teach the same sequence over and over again. There was no variation, no change to the poses, class after class. As boring as this may sound, I found great solace in that silly sequence. I felt I could rest into the moment. I felt capable in my body. I felt strong again. I felt grounded. I also recognized that it was a break from the reality of life, which isconstant change. Not having to think about what my body was doing or not doing, I was able to rest and soften around all the changes happening around me and to me. After some time I noticed I focused less on my body’s struggles and more on its capabilities. I also started to care more about what was happening in my mind. I noticed the distractions. I noticed the fear. I noticed the obsessive thoughts. I also noticed something spectacular when I left. Where my body’s struggles were still there, my mind was in a different place.

I still had all the same medical struggles but my mind was no longer obsessed on them. I learned that underneath what seemed to be the same and unchanging, was actually where the greatest change was taking place. So now when I feel that resistance to more goal-setting, more change, I remind myself that it’s really okay to stay for a while. It’s okay to go back to some of my routines that provide me with this sense of sameness and safety. It’s all okay as I know that it’s just a little cushion of cover for the constant change that is still taking place underneath. I have learned to trust that change will happen when we are least focused on it.

I tell my clients this often when it comes to the biggest challenges in recovery. After all, recovery work takes effort and change. Change to habits, change to your body and most importantly, change to your mind-set. It also requires a fine balance of effort and staying at the same time to be aware of this mind-set. I invite you to explore the following embodied practice next time you need a break from the change and to feel as if things are just staying for a while.

Compassionately Closing In And Staying

1) Sit on the ground, close your eyes and take a few release breaths

2) Call to mind an image when you hear the words comfort, soothing and calming. Now notice where you feel the words in your body? What does it feel like? What is the felt sense of these words?

3) Allow yourself to gently move to these words and create some kind of posture or gesture that represents the feeling of comfort, soothing and calming. Maybe that’s a hand to your heart; maybe it’s folding over in a child’s pose; maybe it’s curling up on the ground. Whatever feels like you could stay and rest in.

4) Allow yourself to stay for a while. Repeat this embodied reminder of “staying and sameness” whenever you feel the constant change gets too much. Trust that as you give yourself time to stay that change will unfold.

Read more in Befriending Your Body: A Self-Compassionate Approach to Freeing Yourself From Disordered Eating. Now available on Audio Book!

Sometimes Compassion Is Fierce!

A few weeks ago I found myself in a “Facebook argument.” You know one of those instigating social media conversations that hook you? You may be wondering, she gets hooked? Yes, I get hooked. Thank goodness it is not often but when I do, I do. Rather than bore you with the details of the whole conversation I will just say that I was shocked by a post that was very judgmental, racist and critical toward others. I felt the need to comment first stir in my body and then in my mind. That led to a whole string of comments back, one by someone who does not know me but must have looked up what I do and stated, “Oh I see you teach compassion but you still stepped in the mud.” She said it as a criticism however, it was in that moment that I felt such a sense of relief in my body and mind as, little did she know, she gave me a compliment not a criticism! It was in that moment that I was reminded, once again, what the practice of compassion has done in my life.

The purpose of self-compassion practice is so you CAN engage in and sit in the mud when you need to! Self-compassion knows there is mud and that’s why we practice. Kristen Neff, co-founder of the MSC program states, “we practice self-compassion because we are suffering, not to get rid of suffering.” It is not about getting rid of the mud or avoiding it, nor is it about becoming soft and weak in any area of your life. Rather it is about getting stronger, facing what you need to when you need to, and easing the fear of doing that. It makes you have a louder yet more grounded voice and the ability to use it when you wish because it puts you in touch with your needs. Self-compassion practice allows you to find, have and express your needs and values and stick to them no matter what. Hence my willingness to engage in the mud. When I read something that struck me as inhumane and against my values I was able to express my voice in a grounded and compassionate way. The whole incident was another reminder to me of how much self-compassion helps us to stay true to what we need and believe in. That is the internal protection of self and the external protection of others. Self-compassion is fierce and over time it will lead you to become more self-protective and protective of others.

The following practice will help you to explore your relationship to your needs, voice, and your expression of what’s important to you.

1) Close your eyes and call to mind what is most important to you. Ask yourself: What is most important to me? See what comes into mind first. It is from this discovery that you can now ask the question:
What need arises from what is most important to me?

2) Take notice of what calling this need to mind feels like in your body. What sensations do you notice from just calling this need to mind?

3) Take a little movement into that area. Check back in to see what it feels like now.

4) What is it like for you to have this need now? Is it the same as when you first called it to mind? Different?

5) Start to imagine yourself expressing this need in some way. Imagine writing it out or saying it out loud. Check-in now to see what you notice in your body as you imagine expressing this. Where can you feel it the most? What are the sensations you notice now?

6) Take a little movement into that area now. Check back in to see what it feels like now.

7) Imagine what action expressing this need could lead to in your life?

8) Take a hand to your heart and a few release breaths (in through your nose, out through your mouth) and acknowledge your strength and power in both allowing and expressing a need. Acknowledge how challenging this can be but doing it despite.

Practice this anytime you feel you have something to say but are holding back and shutting down and away. Remembering that self-compassion allows you to openly express in a fierce but grounded way as well as builds up your internal strength to sit in the mud when you need to.

My Relationship with Fear

“How can I take a leap when I don’t know what waits on the other side?” So many of my clients wrestle with this question. It has been a question I have wrestled with my whole life as well. Although, by the looks of the many things I have done in my life, especially the last several years, one would not know that without asking. But yes, this fear-based question has lived within me since I can remember. As a matter of fact, fear has lived within me since I can remember. The fear of the unknown; the fear to take a leap to what is next when you don’t know what’s next and the fear to take a chance when there are no guarantees. A client of mine recently asked, “did you know what would be next each time you made a decision to do the things you did?” The answer is a big NO!

Not only did I not know, but I was also filled with fear. I still am. Every time I speak to an audience and teach what I love to teach I get butterflies in my stomach, my heart races, my mind goes a little blank. In all these years I have not learned how to get rid of fear, rather I have learned how to soften it and live with it. I have learned to feel my feet on the ground, turn my presence to my breath, and most importantly, to remind myself of my faith and belief in what is important to me. The big realization that I came to many years ago was that, fear may be present, but so am I! This self-acceptance and self-compassionate understanding about myself and my relationship with fear did not happen overnight. It took time and patience and more importantly, practice!

It took lots of practice of soothing the fear, both on a physical level, such as grounding my body and slowing down my breath, and on a mind level, such as working with thoughts of self-doubt and criticism through self-compassionate words. Hard work, over and over again. Why? Because I was a child raised in fear. Fear was believed to be something that would protect me. Rather, it stifled me. Not only did it shut down my voice, and my needs, but it also led me to shut down and hide away all hopes and dreams and chances. It hid ME away. Behind every eating disorder is great fear. Fear of change; fear of a body changing; fear of a life changing. Many of your current behaviors are familiar and believed to be a security to you. However, the truth is it is not just a false security but an entrapment. Fear is the primary reason people get stuck in moving forward and leaving behaviors behind as they are too afraid of not knowing what will be without them. You know exactly what I mean. The fear of what’s next can and will be stifling and hold you in patterns that are no longer serving you. You can find a way to soothe and live with fear. If handled in a compassionate way we can actually use fear as part of the soothing and healing process!

In Chapter 6 of my book we explore how to use self-compassion as the skill base needed during these fearful moments. The following meditation practice is called Compassion for What Is Next:

Contemplate the question, “What is next for me?” Feel what that question does in your body. Can you feel the emotion that builds? Where do you feel it? Keep asking the question and notice how you feel. What does your body and your nervous system feel?

1. Take a release breath, inhale through your nose, and exhale through your mouth. Ground in your body. Feel the points of connection your body makes with the earth. Breathe from here.

2. Take a few more release breaths. Allow your body to soften and simply hold your head in your hands. Check in with how your body feels now, right in this moment. Maybe it has calmed down just a bit. Can you accept that you are just trying to understand? Just as a child is curious and wants to know what will happen next, you, too, wish for the same knowing, the same peace of mind. Can you hold compassion for the part of you that wants to know? Can you hold compassion for the fact that it can be scary to not know? Can you hold compassion for how hard it is to let go and let be with what you know right now? Allow yourself to fold over a little in your seat to rest into any emotion or sensation you feel. Use your breath to soften and release. Feel the softening and release.

Practice this embodied meditation whenever fear arises. For fear to take a back seat and allow YOU to come forward it must be softened and soothed. You cannot expect it to disappear without responding to it compassionately first.

Read more at: Befriending Your Body: A Self-Compassionate Approach to Freeing Yourself From Disordered Eating, Shambhala Publications

This Is How It Is

Sometimes all we need is a few simple words to calm a moment. In the midst of the typical hectic life of balancing work, family, training programs, book events, and presentations, I took the time, as I do each morning, to stop, slow down and practice. Some mornings it is my meditative yoga practice, others it is a formal sitting meditation and then there are times I simply listen to a Dharma talk. The talk I chose to listen to was all about, no surprise, slowing down! Something we all could use, especially at this time of the year entering into summer. I find nature is the perfect invitation into this teaching. During the talk the teacher stated these simple words that stood out and resonated with me the most: This is how it is; It is like this.”

Simple yet profound what these words can do in a moment. If you are like most busy humans, you may notice that even when you do slow down your mind still wanders. It may still wander to what needs to be done, what’s next, and what is bothering you. Just because your body has slowed down it does not mean your mind will. If you haven’t already noticed, your mind has a mind of it’s own! Therefore, it is not enough to just take a break, a weekend off or a vacation. Because often we are still living somewhere else. Instead, we have to engage in the mind work of inviting and resting into a moment to really take in the slowing down, the break and the rest. When I heard the simple words of This is how it is; It is like this, I immediately felt an internal shift. My mind and nervous system released. Just through repeating these simple words I was able to let go of what was racing around in my mind, of what I was to do next, of what was distressing and instead be. It does not mean that all those things won’t be there afterwards. I’ll still need to return to the busy and the hectic as This Is How Life Is Right Now; It Is Like This! But somehow I am returning to it in a calmer, more centered, less reactive way. There is a shift within that allows me to go forward in a different way.

The practice below is from chapter 2 of my book. It’s called Finding and Feeling Containment. I am adapting it here, integrating these words into the practice.

Sit comfortably and touch your fingertips together so your hands make the shape of a diamond: thumbs touching thumbs, pointer fingers touching each other, and so on. Close your eyes and envision placing inside your hands anything in this moment that feels overwhelming. Say, “This is how it is; It is like this.” No matter what IT is. Keep repeating the words. Repeat this statement several times and notice what happens in your body, in your mind. See if you are able to feel a softening around it, a settling, a gentleness, a soothing.

I’d like you to see what it is like to practice this each time a difficult emotion, ruminating or worrisome thought comes your way to see what happens. From there, return to your life as IT is, but in a new way.

Read more at: Befriending Your Body: A Self-Compassionate Approach to Freeing Yourself From Disordered Eating, Shambhala Publications

The Perfect Riverboat Ride in Paris

My daughter and I just spent a week together in Paris. The trip was one of those momentous vacations celebrating her 16th birthday, even though delayed almost a year. Nonetheless, a great time together in mother-daughter bonding. I am grateful for the ability and privilege to take a trip like this and I am grateful as I reflect on our joyous times together along with the silly, spontaneous, unplanned, and imperfect moments. As it was those imperfect moments that have taught me the most.

We had lots of things planned in Paris, tours, visits to famous sites and churches and palaces. The one thing we fantasized about the most and had stuck in our heads the whole week was the romantic idea of taking a riverboat ride on the Saine. It seemed like the perfect thing to do and we had each built up our own vision of what it would be like. The first time we tried, I had lost the tickets, something I usually never do. The second time we tried it was too late at night. The third time was our last day. We decided we must try again. This time we built up the idea of a beautiful sunny day and a picnic lunch on the boat! What could be a better way to end the trip? Well, the sun became covered over by dark clouds, the wind picked up, and we couldn’t find the boat. We were hungry, tired, and frustrated. Our perfect moment lost again. Instead, we sat on an old wooden bench filled with pigeon droppings, shivered in the cold and ate our lunch (mine fell to the ground), barely looking at the Saine. We were disappointed and annoyed. The point is (as you may have guessed), things don’t always work out as planned nor should they as the messiest and most imperfect times are often the ones we learn from the most. They are also the ones that remind us of every emotion, along with teaching us what the moment is really about.

I am glad the riverboat ride did not work out as it gave me the opportunity to reflect and understand what about this ride was so important to me. Why was I trying so hard to make it happen? What was all the longing for it to be so perfect all about? In the end I realized it wasn’t about the boat ride. Rather, it was about my wish to hang on to another memory and moment with my girl, my youngest, who has one more year before heading off to college. I know these precious moments will shift and change. My mind wanted me to believe that somehow we could make this perfect and that making it perfect may somehow ease the changes to come. This compassionate understanding allowed me to release the expectation of the perfect moment and instead to just have a moment. It was only when I released the perfect that my heart was able to be felt. It is not perfection that helps us feel and grow, rather, it is the acknowledgement and acceptance of our imperfect selves, moments and lives that does.

To work with releasing the “perfect and feeling the heart” try this simple practice:
The next time you are caught up in the grasp of perfection close your eyes and place one hand on your heart. Repeat the following words:
1) It’s really okay that I wish to get it right and keep things as they are
2) It’s really okay if I don’t get it right and things change
3) It’s really okay to let this moment be exactly as it needs to be
4) It’s really okay to just be
5) It’s really okay to just feel

Read more at: Befriending Your Body: A Self-Compassionate Approach to Freeing Yourself From Disordered Eating, Shambhala Publications

The Meaning of Safety and Protection

What words come to mind when you read the question, what makes you feel safe and protected? Try to answer quickly. You may have found that you went to thinking about the larger picture of your life first, such as your surroundings, relationships, and maybe even the state of our world. These are very important things to consider without a doubt, as to feel safe and protected we need to feel this in our relationships and community first and foremost. However, today I am focusing on a smaller, less observed sense of safety. That less observed sense of safety is the sense of safety and protection that stems from what you hold in mind day in and day out.

A teaching from the Buddhist text translates as: “What the enemy can do to you the ill-directed mind can do to you even worse.” Pretty powerful statement if we really understand it. It’s a statement that defines safety and protection as what we hold within. What we focus on, what we attend to, or fail to attend to, and what we say to ourselves. The internal messages and dialogue we entertain and give to ourselves day in and day out about who we are, what we look like, what we do or don’t do, are the basis of how safe we will feel inside. Beginning to pay attention to what we hold in mind is the first step in starting to shift around an internal sense of safety. From there, we can begin to build what really makes us feel safe and protected.

These are a few questions from Chapter 2 in my book Befriending Your Body that can assist you in beginning to attend to when, where and how you feel most safe and protected in mind and body.

1) Where do I feel most alive and free?
2) What or who helps me to feel safe and protected?
3) Where do I feel most safe? What do I do that makes me feel safe?

Once you find the answers, make sure at least one of these is in your life each and every day. Remember, safety is also in what you hold in mind. It is not enough to just have a place or action that makes you feel protected. You must also attend to what you say to yourself once there!

Read more at: Befriending Your Body: A Self-Compassionate Approach to Freeing Yourself From Disordered Eating, Shambhala Publications

Life’s Attachments: This and That

I cannot believe that a year ago I was on my Buddhist pilgrimage trip in India. I often think back to it wondering what was the biggest lesson I learned? Our guide told me at the end that my self-work going forward was to work on attachments. Hum, like attachments to the relationships in my life? Attachments to things? It left me wondering what exactly he meant by that. In the meantime, I still have on the string bracelet he tied around our wrists upon leaving. The bracelet that was a reminder of impermanence and how nothing lasts forever is still on my wrist a year later and I must say I have become quite attached to it!

What am I supposed to make of that I wonder? Is the bracelet now telling me some bigger lesson about attachment now? I have found its “permanence” to be quite humorous and it wasn’t until a recent meditation practice that I came to recognize perhaps what attachments I really needed to look at.

As I sat and simply felt my breath and watched my thoughts move in and out, I noticed the less obvious form of attachment, the more subtle form, such as what I wish, want and desire things to be, rather than what they are. I realize, as I am sure you do as well, that when life brings something challenging my way I wish and often expect for it to be different than as it is. It is human nature to want this to be. To wish the suffering wasn’t there anymore. The constant wish, left unchecked in the mind, can easily turn into the expectation that sounds something like, “it’s not supposed to be this way,” “Why is this happening?” And there settles in the attached mind. The mind that focuses on the way it should be different rather than the way it is. The mind that creates more suffering around what we are already suffering with. The non-stop cycle. After that meditation, I listened to a Dharma talk by Jack Kornfield (one of my favorites), on the attached mind. He said a few simple words which resonated with me throughout the day: Sometimes we have to go through this to get to that. Simply put, the understanding that what we really need is the love and willingness to show up for this life that will constantly bring a this and a that. The question is not in stopping the this and that’s or controlling them in some way, but rather, simply how do we show up for and with them.

For a little help in releasing the mind’s attachment, this month’s practice from my book is a simplistic one called Breath Inside the Body. A simple practice to invite you into releasing the attached mind.

This practice can be done while sitting or lying down. It is a great one to do in the morning or at the end of your day to help ease your thoughts and either awaken or go to sleep with a clearer mind.

1. Close your eyes and notice your natural breath moving in and
out through your nose.

2. Lengthen your inhalation to the count of 3 and slow down your
exhalation to the count of 6. Inhale 1, 2, and 3. Exhale 1, 2,
3, 4, 5, and 6.

3. With your next inhalation, notice where the breath begins in
your body. Does it begin in the lower half or the upper half?
Does it feel like it starts in your front body or back body?
Maybe you can get more specific and feel if it begins in one
particular space or another.

4. Now do the same for your exhalation. When you exhale, take
notice of where the breath ends. Is it in your chest? In your
stomach? Can you feel it in your back body or your front
body? Try to get more specific with each breath.

Watch how the simple focus on breath and body release the attached mind.

For more embodied practices and developing a deeper connection to your body read more in my book Befriending Your Body!

Also this month I’m proud to be included in Shambhala publications Inspiring Women’s month!
To celebrate the publisher is offering 30 % off through March 30th with the code March30

And big news! Stay tuned an audio book version of Befriending Your Body will be released soon!

What Does Overwhelm Feel Like?

I’m glad the month of January is over. The New Year started off quite intense with loved ones in transition and health issues with those I love. As a teacher and trainer of all things embodied and stress-relieving it is not always easy for me to realize when I am overwhelmed! I am the one always counseling and teaching others how to release and often I can bypass when I need it the most until I stop and pay attention to my body and mind.

The thing I noticed first was tension in my body. Not surprising as this is where we will find the overwhelm of life land first. In our body through stuck points, discomfort and if ongoing, pain. The next thing I noticed was what was happening in my mind. I was scattered and forgetting things I don’t normally forget. Perhaps the biggest sign was feeling blocked. I did not even sit to write this newsletter until a few days ago as I was blocked on what to write! Once I recognized this truth, I was able to relax into it. When we are overwhelmed, the first thing we have to do to create a shift is to recognize and admit that we are overwhelmed! From there we can go to our body to investigate where and how we can feel this and then we can move toward release.

The practice I turn toward the most when anxious and overwhelmed is restorative yoga. Restorative yoga is a gentle, passive practice that allows your body to rest and release and restores your body and mind back into balance. While there are many postures to use, one of my favorites is Chair Pose. I offer this in my book as a pose of choice when we need to feel some ease in our body, mind and life.

For this pose you will need a mat to lie down on or a towel, a chair and two blankets or two pillows.

1. Lie down on a blanket or mat with a chair placed at one end.
Place a pillow or folded blanket (about 2 inches) under your low back and your legs over the chair, so that you are in an L-shape, with knees bent and calves resting on the chair. Place a pillow for support under
your head and rest here for 10 to 15 minutes.

2. You may play soothing music during this time or rest in silence,
concentrating and searching for sensations of ease, neutrality,
and release in your body.

3. When you are ready to release, simply draw your knees into
your chest and roll to one side. Stay a few minutes and return
to sitting when ready.

4. Notice how your body feels after this deep rest. See if sensations
that were unpleasant or tense have shifted in any way. Notice if the overwhelm in your mind has shifted in any way.

For more embodied practices and developing a deeper connection to your body read more in my book Befriending Your Body!

And big news! Stay tuned an audio book version of Befriending Your Body will be released soon!