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Embodying Mindfulness In Recovery - An Eating Disorder Awareness Week Message

In this piece I further explore and break down the idea of mindfulness and embodiment in recovery as an exploration of ‘Embodiment and Treatment of Eating Disorders’ by Catherine Cook-Cottone. Embodiment is a way of being in which we experience all dimensions of life. It is the internal, external, and existential experience from the body perspective. Eating disorders often eliminate the innate appreciation of experience and self that we are born with. Personal value becomes based on societal standards and expectations. We find ourselves working against our bodies instead of collaboratively. And we end up in a place of stuckness. Alternatively, engaging in practices of mindfulness encourages the return to embodiment and allows for an increased awareness and appreciation for self. Acknowledgement of all that our bodies do for and with us. And development of an internal drive to continue personal growth and development.


Embodied mindfulness in eating disorder recovery. This topic expands far beyond the idea of incorporating yoga, meditation, and gentle movement into recovery practices. Eating disorders are complex; with those experiencing them doing two seemingly contrary things. Psychologically, patients are working extremely hard to distance themselves from their lived experience in order to avoid their bodies, thoughts, and feelings. While at the same time, the eating disorder develops a relentless, cognitive, emotional, and pathological engagement with their bodies (Cook-Cottone, 2015). To encourage sustainability in recovery, this body acuity can be utilized by changing the focus from degradation of self to the mindful embodiment of self.


Embodying Mindfulness

Eliminating disordered behaviors alone is unlikely to lead to long term resilience and recovery. Instead, we can help build resiliency by regularly practicing mindful self care and living with ‘a sense of mission and purpose in life, firmly anchored in a felt sense of personal values’ (Cook-Cottone, 2020). This practice of mindfulness and positive embodiment is dynamic and allows for flexibility in recovery through the development of structure and predictability, while also building competence for managing challenges that arise. Allowing for the ability to honor previous efforts, setbacks, and struggles, to keep moving forward, and to learn from the past mistakes. Leading to the development of self compassion, gratitude, and body appreciation. (Cook-Cottone, 2020).


Positive embodiment of the self is an overlap of insight, mindfulness, and the ability to embrace emotions and cognition as the sensing and feeling body. Aka embodiment is mindfulness. In eating disorders, positive embodiment is abandoned for engagement in external aspects that appear to offer long term satiety. Eating is no longer determined by the needs and desires of the body and the body is being judged and ignored rather than being seen and felt (Cook-Cottone, 2020).



Finding the Mindful Why

If eating disorder symptoms provide a sense of purpose through structure, consistency, and identity (Marco, Canabate, & Perez, 2019); one can assume that finding an internal sense of being or why would be effective in combating the eating disorder. Getting to know the ‘Recovery Why’ requires mindfulness, awareness and groundedness in order to engage in intentional recovery focused thoughts and actions and when the present moment becomes difficult it is important to remember two things (a) the reason for being and/or mission-the why; and (b) that the person and the why are worth the effort of making the recovery focused decision. (Cook-Cottone, 2020).


The Morita table assists in identifying the ‘Recovery Why’ when triggers are present in order to make choices in the present moment about what to be with and what to work with. This table was modified by Cook-Cottone (2020) for use during triggering moments to assist in identifying what can or cannot be controlled, encouraging acceptance, and allowing the situation to be as is.




Utilizing Tools for Embodiment

Once an eating disorder is established, these patterns and behaviors become the comfort zone. The goal of acknowledging arousal level in particular is to push individuals to become uncomfortable enough to move into the growth stage; without immediately moving to distress, overwhelm, and reaction [in the form of eating disorder behaviors] to return to the comfort zone. This distress occurs when an individual is outside of their Window of Tolerance. In this distressed state, there is the risk of activating the Sympathetic Nervous System (SNS) and moving into fight or flight; or Parasympathetic Nervous System (PNS) and moving into shutdown mode. (Cook-Cottone, 2020). The sweet spot for eating disorder recovery is in the growth zone; where there is the experience of being highly engaged, learning new things, and tolerating new ranges without being overwhelmed. (Cook-Cottone, 2015; Cook-Cottone et al., 2017). It is the state in which one is safe, yet uncomfortable.


Reconnecting and re-engaging the mind and body, recognizing arousal, and utilizing breathework and grounding are key practices. When utilizing the arousal scale, first identify a baseline of being with the understanding that most individuals perform most optimally when they are within their Window of Tolerance-the state in which individuals perform optimally and most effectively; not too aroused and not too shut down. Within the window of tolerance are the growth zone and the comfort zone. The growth zone is the state within which we can engage in optimal psychological and interpersonal growth (Cook-Cottone et al., 2017; Ogden & Fisher, 2015; Siegel 2019). In the comfort zone there is 100% mastery and functioning is familiar and predictable.




Embodied & Mindful Movement

Within physical movement, being embodied and remaining within the Window of Tolerance requires adjusting through aging and development with a lifelong attunement to and loving kindness for the body (Cook-Cottone, 2020). This requires movement in a way that there is balance between effort and rest. There is flexibility in exercise type, duration, and intensity (Reel et al. 2016) and there is emphasis on how the body feels or what the body needs rather than external factors (ie: time spent moving, calories burned, etc) (Greenleaf & Hauff,2019). Positive embodiment and mindful movement require one to practice being with and for their bodies physically.



Positive embodiment and mindfulness extended far beyond individuals and into the communities within which we reside. To sustainably recover requires engagement within communities that reduce the isolation and withdrawal that often precede the spiraling of eating disorder symptomatology. This requires both individuals and communities to have a caring focus on body awareness and connection, attunement to the internal self, language based on positive embodiment, and a model of compassion for all emotions and experiences.


 

References

Astrachan-Fletcher, E., & Maslar, M. (2009). The dialectic behavior therapy skills workbook for bulimia: Using DBT to break the cycle and regain control of your life, Oakland, CA: New Harbinger.


Calogero, R., Tylka, T.L., McGilly, B.H., and Pedrotty-Stump, K.N. (2019) Attuned with exercise (AWE). In T. Tylka andN. Piran (Eds.), Handbook of positive body image and embodiment: Construct, protective factors, and interventions (pp. 80-90). New York, NY: Oxford University Press.


Cook-Cottone, CP. (2015). Embodied self-regulation and mindful self-care in the prevention of eating disorders, Eating Disorders, 24:1, 98-105


Cook-Cottone, C.P. (2015b). Mindfulness and Yoga for self-regulation: A primer for mental health professionals. New York, NY: Springer.


Cook-Cottone, C.P., & Douglass, L.L. (2017). Yoga communities and eating disorders: Creating a safe space for positive embodiment. International Journal of Yoga Therapy, 27.


Cook-Cottone, C. (2020) Embodiment and the treatment of eating disorders. New York, NY: Norton.


Greenleaf, C., & Hauff, C. (2019) Environments that cultivate positive embodiment through mindful movement. In T. Tylka & N. Piran (Eds.), Handbook of positive body image and embodiment: Construct, protective factors, and interventions (pp. 119-128). New York, NY: Oxford University Press.


Marco, J.H., Canabate, M., & Perez, S. (2019, January 20). Meaning in life is associated with the psychopathology of eating disorders: Differences depending on the diagnosis. Eating Disorders. http://doi.org/10.1080/10640266.2018.1560852


Ogden, P., & Fisher, J. (2015). Sensorimotor psychotherapy: Interventions for trauma and attachment. New York, NY: Norton.


Reel, J.J., Galli, N., Miyairi, M., Voelker, D., and Greenleaf, C. (2016) Development and validation of the intuitive exercise scale. Eating Behaviors, 22, 129-132.


Scritchfield, R. (2016). Body Kindness: Transform your health from the inside out-And never say diet again. New York, NY: Workman.


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