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Your brain and your body, closely linked by the nervous system, are partners in a constant stream of two-way communication. For every thought, emotion, impulse, action or perception there is a corresponding response in your body. For instance, your jaw may tense when you’re angry, your chest may swell at the sight of a beautiful sunset, you may experience an overall sense of lightness in moments of relaxation, or there may be pressure in your throat and chest when you have an urge to binge.

What’s more, body sensations influence the thoughts and feelings in your brain and vice versa. When the influence goes from brain to body, we call it “top-down” influence. When the influence goes the other way, with body states affecting brain processes, we call it “bottom-up” influence. While top–down and bottom–up influences occur automatically all the time, each can be engaged consciously to make changes in your experience. Thus, both can be useful in recovering from an eating disorder.

Traditional therapy methods, such as psychodynamic therapy and cognitive behavioral therapy (CBT), work from the top down. You rely on your thinking, logical brain to be the agent of change and to create some law and order among unruly internal processes. This is what you’re doing when you develop insights about yourself, focus on changing disordered thinking, or learn about nutrition.

Bottom-up approaches, in contrast, rely on the opposite direction of influence. You learn to change the way you think, feel, and act by contacting and modifying internal processes such as “gut” sensations, impulses, or your “felt sense.” You may have seen such treatments referred to as mind-body, body-based, energy, or somatic therapies.

The key to the effectiveness of these therapies is the development of body awareness, both as a way to know yourself more accurately and deeply and as a resource for creating lasting change. Body awareness enables you to rewire the internal communication loop of brain, nervous system, and body so that it stops recycling outdated, harmful, self-limiting messages about you and your possibilities in life.

Some bottom-up treatments focus almost exclusively on body-based interventions. (“Body-based,” by the way, does not imply or require physical touch by the therapist.) Thought-field therapy (TFT) and the Feldenkrais Method are examples of treatments that are primarily body-based. Other approaches, such as EMDR (Eye Movement Desensitization and Reprocessing), Somatic Experiencing, and Sensorimotor Psychotherapy, combine top-down and bottom-up techniques.

Body-based treatment approaches can make a significant contribution to eating disorder recovery. Here are some examples of common eating disorder problems, along with ideas about how a body-based, bottom-up approach may help.

Unruly Emotions

You already know that you turn to food—or restricting or purging—when uncomfortable feelings arise. So you’ve probably also figured out that developing more effective ways to handle your emotions will be essential if you are to truly leave your eating disorder behind.

Working from the bottom up means learning to calm and quiet the body sensations of negative emotions. When you are experiencing an emotion, slip down into your body and you will notice a corresponding body sensation: the racing heart or shallow breath that goes with fear, the tingle in your chest when you’re excited, or the flushed face that accompanies embarrassment or shame. You will discover that when you calm down your body—for example through deep breathing exercises or other relaxation techniques—your mind and emotions calm down right along with it!

Limiting Learnings

Limiting learnings are deeply engrained, often unconscious beliefs or habits that squelch your sense of personal possibility. Most likely the “limiting” resulted from childhood family patterns in which certain behaviors were discouraged, or not sufficiently encouraged. You may have learned, for example, that nice girls never get angry. Or you might have lacked models for healthy self–assertion. Limiting learnings may show up in the present primarily when you feel threatened—such as becoming defensive when you feel criticized—or may have generalized into a more basic orientation to life. For example, you may always be on the defensive, or you may lack of any sense of inner spark or capacity to change yourself or your circumstances.

When you work on these habitual patterns from the bottom up, your therapist may suggest you try movements or gestures that will eventually support new ways of experiencing yourself or new patterns of interacting with others. For example, your therapist may invite you to make the motion of pushing away that means “no.” This can be the start of defining personal boundaries.

Your therapist may also notice and encourage movements that develop spontaneously during your treatment. For instance, a gesture of reaching out can be the starting point for developing deeper connections to others. Or, awareness and support for subtle muscle sensations that signal an impulse to act can be a first step toward expressing personal agency and initiative. When physical options you didn’t learn in childhood come online, they change your experience of yourself. You start on a path toward becoming more flexible and adaptive in the way you respond to what life brings you.

Binge Urges

If you binge, the binge urges probably feel outside your control. Top-down approaches to bingeing wisely engage your observing mind to identify binge triggers and make mindful choices about how to respond. Complementary bottom-up approaches can significantly enhance your efforts.

Binge urges, like any urges, are fundamentally body sensations. When you learn to contact these sensations and identify them, you begin to experience them in a new way. With practice, you can learn to stretch your capacity to tolerate these sensations without acting on them, much as you stretch your muscle capacity through incremental workouts. A body sensation you simply observe and track will often fizzle on its own (or uncover experiences fueling the urge that you can then work to resolve). When body sensations related to a binge urge don’t resolve, you can learn how to quiet them much as you’d quiet the sensations of uncomfortable emotions. For example, you might imagine yourself in a calming, soothing environment or with the arm of a comforting person around your shoulder. Or you might talk to yourself in a quieting way, saying things like “You’re alright.” or “It’ll be okay.” Your body will tell you when you’ve hit on the right thing: it will feel a little more relaxed and the sensations of the binge urge will be less intense.

Trauma

If you have an eating disorder, the chances are high that you also have a history of trauma. By trauma I mean any experience that overwhelmed your capacity to cope at the time it occurred. Trauma may include experiences such as physical, sexual, or emotional abuse as well as neglect or catastrophic loss. Many people with eating disorders have experienced attachment trauma. Attachment trauma results from ongoing disruption in the quality of early caregiving that prevented you from developing basic security within yourself or in relation to others. Eating disorders frequently represent a desperate attempt to cope with the enduring effects of trauma on daily living.

Many body-based treatments, such as EMDR, Somatic Experiencing and Sensorimotor Psychotherapy, began as trauma treatments. Trauma therapists have long recognized that the tenacious effects of trauma reside in the body and nervous system, exerting disruptive effects upward onto thought, perception, and emotion. When you observe and track your body sensations, you have direct access to your nervous system while it is responding to trauma triggers. This opens the possibility of changing the response and calming it down. In trauma treatment, staying connected to sensations tells you how much stimulation your nervous system is experiencing. This allows you to adjust your response so that you neither become flooded nor preempt flooding by shutting down or dissociating. Body experiences that represent the trauma can be digested in manageable bits and resolved.

Final thoughts…

Body-based, bottom-up methods can help resolve common eating disorder problems such as these and help build resiliency essential for recovery. They do so by exploiting the two-way street of influence between body and mind, as well as the nervous system’s built-in capacity to learn to regulate itself. It’s nice to know that your body, which has often been such a source of distress and despair, can become a potent source of hope and healing.

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This post first appeared as an article in the Summer, 2009 issue of Eating Disorders Recovery Today, a newsletter published by Gürze Books. The article is reprinted here with permission of the publisher. If you are interested in learning more about Eating Disorders Recovery Today, reading some great sample articles, and finding out how you can subscribe, go to www.bulimia.com/.

Most of you are working on learning better ways to handle distress than turning to your eating disorder. This is an excellent project! Your success with it will go far to help you build a solid recovery.

Many people—with or without eating disorders—turn first to distraction as a way to manage difficult feelings. By distraction I mean diverting your focus from the upsetting thing to something unrelated, to get your mind off the upset. You’ve probably figured out that your eating disorder has been an unhealthy version of distraction. But maybe you’ve also found that listening to music, gardening, going to the movies or laughing with a friend can be healthy distractions.

I personally like distraction as a coping mechanism. I wouldn’t want to face life without it as an option. I find it can be a helpful choice when:

• I need to quiet down so I can consider a problem or upset more calmly and clearly
• I’ve worn out the usefulness of thinking about a problem for the time being
• There’s nothing I can do about a problem or upset

Several potential drawbacks go hand–in–hand with using even healthy distractions to cope, however. Most of these have to do with misuse or overuse.

The most common misuse of distraction comes from confusing it with an actual solution. Distraction at its best is only intended to provide a temporary resting place when you need a break from focusing on resolving your distress. When your distress is too intense or you’ve focused too long, a break is a good idea. Bur when you use distraction as a substitute for working out a problem or coming to terms with distress, you run into trouble. It’s the “ostrich with its head in the sand.” You not only fail to resolve anything, you build a reputation with yourself as someone who can’t handle difficult experiences. The next time something hard comes up, you haven’t developed any confidence in yourself. So you’ll be more likely to turn to distraction as a substitute. It’s a vicious cycle.

Overuse of distraction is likely to occur when you don’t have sufficient alternatives for coping with your distress. When you turn to another focus, you don’t come back. You may tend to get lost in your distraction activities. You start to play video games, surf the net or read a novel and suddenly the whole day is gone. Many addictive activities start out in exactly this way.

There are two coping challenges for which you need more and better coping tools than distraction. The first is problem solving. The second is managing difficult emotions.
Let’s consider some alternatives to distraction for times when either challenge is threatening to overwhelm you.

Problem Solving

Everybody runs into problems that seem overwhelming from the start or bog us down and frustrate us as we try to find resolution. You might try one or more of the following techniques which successful problem solvers use to see themselves through to the end:

• “Talking yourself through” confusion, uncertainty and frustration; for example, offering yourself reassurance or a steadying voice: You can do this or You’ll be okay or Just stay with it.

• Reminding yourself of times when you successfully handled other difficulties that at first seemed overwhelming

• Breaking the problem down into small, more manageable pieces

• Asking for help

Managing Difficult Emotions

There are many approaches to managing difficult emotions. All of them have something to offer as you work on developing this basic life skill. The important thing is that you find approaches that suit you—and that you use them! Here are a few examples:

• Dealing with only small doses of feelings at any given time

• Thinking of soothing, comforting responses

• Imagining yourself in a peaceful place or with a comforting person while you feel the feelings

• Learning to sort out and correct distorted thoughts that are making you feel even worse, such as Nothing ever goes my way; I’m such a loser; Nobody will ever love me, and so forth
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• Engaging in mindfulness meditation in which you learn to observe your feelings rather than be totally in them

• Praying (if this fits with your beliefs)

• Walking, exercising or practicing yoga while experiencing the feelings

• Sharing your feelings with people who are sympathetic and calming

Remember that none of these techniques is likely to provide instant relief. But your effectiveness in using them will get better with practice. And as you get better, you’ll have more confidence in yourself. You’ll be able and willing to take on more in life.