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enables you to rewire the internal communication loop of brain, nervous system, and body so that it stops recycling outdated, harmful, self-limiting messages about you and your possibilities in life.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/.

Every day, every minute we’re bombarded with messages from the culture about how women, young and old, are supposed to look. When it comes to weight, there’s just one right size: thin.  Movies, TV, magazines, the news, advertising, music, dance…all promote “thin,” not merely as the ideal, but as the only way to look.  Because these cultural messages are everywhere, they have the feel of universal truth instead of the fashion of the moment, as they actually are. Women who fit the ideal are rewarded with admiration and more. Women who don’t fit the ideal are often subjected to shaming and discrimination.

Part of being a woman in this culture is that we talk to one another about the issues of our daily lives: relationships, family issues, tastes and trends in entertainment, fashion, problems in school or work, and so forth. Sharing our ideas on these matters with one another is an important part of how we work out personal guidelines for living. These conversations are a crucial interface where individual women size up their own ideas and values with those of the larger culture.

The subject of weight—size, shape, dieting, exercise—is almost inevitable when women talk to each other. Each of us brings to these conversations our own version of desires to be socially acceptable, included, admired and loved. So what we say to one another has a big impact on all of us. The way we talk can either powerfully reinforce harmful cultural messages about weight—or confront them.

I invite you to begin thinking about the conversations you have with your friends, family, school mates, work colleagues and others about weight. When you talk with other women, do you:

• Fret over small personal weight gains?
• Report weight losses or smaller clothing size?
• Talk about others, including celebrities, who’ve  gained or lost weight?
• Treat as a given that “thin” is the only acceptable look?
• Refer to anyone, including yourself, who’s even a little above the culturally–ideal weight as “fat”?
• Make moral or psychological assumptions about fat people?
• Discuss weight loss methods?
• Discuss the calorie content of various foods?
• Focus on the calorie–burning effectiveness of exercise or other activities?
• Talk about being “good” or  “bad” when it comes to what you’ve eaten?

Most importantly, notice how these conversations affect you. Do they make you feel better or worse about yourself? How do they affect your mood? Do they make it more or less likely for you to go on a diet or exercise compulsively? Do they trigger eating disorder symptoms or support recovery?

If women can affect other women by reinforcing the code of “thin,” then we’re equally capable of helping each other challenge it! Weight ideals are socially constructed and change over time, just like fashions in clothing. Just being more aware of powerful cultural effects and speaking openly about them is a start.

The way you talk to your friends won’t turn the culture on its head overnight. But remember: a few women talking to a few women eventually led to female suffrage, a place for women in the work world and more equality at home. You have the choice to be “part of the problem or part of the solution,” to talk with others in ways that hurt or help your recovery.

So here is a challenge for you (should you choose to accept it!): Spend one month staying away from “thin” “fat” or “diet” talk. Instead, talk about the impact of cultural dictates when it comes to size, shape and weight on you and other women. At the end of month, notice how you feel and how this shift in focus affects your recovery efforts. Good luck!