Body-Based Conceptualization of Eating Disorders

Physique-Based mostly Conceptualization of Consuming Problems


Our autonomic nervous system (ANS) is finest described as our “private surveillance system.” It’s all the time figuring out and responding to the query, Am I protected?

The polyvagal concept, coined the “science of feeling protected,” was developed by Stephen Porges, an internationally-renowned trauma researcher, and neuroscientist. The vagus nerve is an info superhighway in our physique, connecting our face, coronary heart, and respiration to our intestine. It informs our ANS when there’s a hazard to mobilize protecting measures and places on the brakes once we are protected, and all techniques are “clear to go.”

It may well additionally sign the ANS to close the system down within the case of a brilliant risk, which is smart contemplating the behavioral expressions of hyperarousal and hypoarousal in response to concern. This concept has knowledgeable many therapists to see their shopper symptom behaviors by means of a lens of risk and security, responding with body-based interventions as major to the therapeutic course of.

As a licensed consuming dysfunction specialist who makes use of polyvagal-informed therapies, I now see consuming dysfunction signs extra clearly and compassionately. I perceive my purchasers are merely trying to really feel higher, discover security, or keep away from hazard.

In truth, conceptualizing many behaviors as a physique choice relatively than a cognitive course of permits for extra compassion and fewer “blame the sufferer” countertransference. Sadly, most of us both miss the signs or see the signs as a willful act. I did for years till I used to be skilled to look extra intently.

Let’s look at some frequent consuming dysfunction signs and see how they could be defined by means of the lens of concern and security.

Avoidant Restrictive Meals Consumption Dysfunction (ARFID)

The mind interprets sure tastes, smells, and textures as harmful. Bitter and bitter tastes, as an illustration, are supposed to warn the mind that one thing could also be rotten, spoiled, or toxic. Many of those aversive tastes are acquired by cultures and usually are not pure, such because the style of bitter espresso or bitter kimchi. In any other case often called “choosy consuming,” ARFID could also be the obvious instance.

Some people have a heightened alert system (ANS) and easily don’t really feel protected consuming sure meals. Some have an exaggerated gag reflex and are afraid they are going to unintentionally vomit. One class of ARFID relies fully on the concern of hostile penalties. All these responses interrupt a standard consuming course of and, over time, create bodily and social penalties.

Heightened Interoception

Some consuming dysfunction signs revolve round a heightened interoception, particularly as associated to the intestine or enteric nervous system. Interoception is mostly known as “the notion of inside physique states.” These people might really feel nauseated or bloated or might discover the act of digestion insupportable. Coupled with a dorsal vagal (beneath the diaphragm) concern response, they could really feel full and lack starvation although they’re ravenous.

One concept is that these with anorexia might, in reality, be instinctively afraid to eat as a result of their physique is telling them it’s too harmful. This messaging could also be a throwback to the searching and gathering days when staying within the cave is a safer possibility than in search of meals when predators are lurking.

Dulled Interoception

Different people have a dulled sense of interoception, which means they will’t learn inside indicators, reminiscent of starvation or fullness, ache, and even the felt expertise of emotion. These are people whose consuming problems contribute to a extra dissociative course of, reminiscent of binge consuming and purging. Dissociation is a protecting response to concern and trauma.

Tactile Sensitivities

Moreover, some physique perceptions are aggravated by tactile sensitivities, reminiscent of sure materials, tight waistbands, or tags inside clothes. The whole lot feels tight, main them to consider that they’re fats or massive, along with emotions of feeling bloated. This results in additional restriction when mixed with distorted physique picture.

Consuming Problems Important Reads

Social Anxiousness

Auditory and light-weight sensitivities, together with misophonia, sign the ANS to hazard, which prompts a response to isolate and defend. Changing into overwhelmed can result in “meltdowns” and tantrums. When people are requested too many questions and assist suppliers attempt to assist, it might additional agitate them, and social connections start to interrupt down. Signs of social anxiousness and issues with interpersonal relationships are frequent themes in these with consuming problems.

Common Anxiousness

Anxiousness is a trademark symptom of consuming problems. In truth, anxiousness typically precedes the consuming dysfunction signs, particularly within the case of obsessive-compulsive dysfunction (OCD) or post-traumatic stress dysfunction (PTSD). Anxiousness is a concern response of the physique. Our mind typically creates weird narratives to make sense of the physique’s defensive responses. That’s why anxiousness and consuming problems appear so irrational.

However it didn’t begin as a cognitive course of; it began with the physique. The physique’s concern responses are expressed in inattention, impulsivity, and pushing others away. The usage of meals (restriction or bingeing) are methods to calm the physique, put the brakes on the concern, and sign security within the physique. In different phrases, they activate the vagal response (the vagus nerve indicators the guts to decelerate). Some our bodies don’t have good brakes, and their vagus nerve is gradual to reply. They’re born that means, or a trauma response has rewired their system (“Idiot me as soon as, not going to be fooled once more”).

It begins and stops with the vagus nerve.

It doesn’t imply we don’t should take care of the cognitive distortions or revisit the interpersonal injury; it simply means we should begin with the physique. If the physique doesn’t really feel protected, our purchasers aren’t going to have the cognitive capability to soak up the cognitive methods or really feel protected sufficient to attach interpersonally. So, we’d like methods to tone the vagus nerve to be extra responsive. Fairly actually, we’d like neural workout routines.

There are a number of “portals” to the vagus nerve that may assist. The ear is one such portal.

The Protected and Sound Protocol (SSP) is a listening remedy that acts as an acoustic vagal nerve stimulator.

It teaches our nervous system to really feel protected and calm by means of a bottom-up course of of coaching the vagus nerve. Porges has developed this remedy primarily based on the polyvagal concept and has confirmed its effectiveness with many years of analysis. Not surprisingly, the primary inhabitants researched utilizing this remedy was the neurodivergent. It has unfold to these with PTSD, ADHD, and continual ache and has demonstrated effectiveness with these needing assist with anxiousness discount and emotional regulation.

I’ve began growing case research for these with consuming problems. The SSP is a five-hour auditory intervention designed to cut back stress whereas selling calm and resilience by means of a extra regulated nervous system. It’s a non-invasive intervention that may complement or speed up different types of remedy. Suppliers who use this remedy have discovered accelerated outcomes when added to their different therapeutic processes.

Different nervous techniques regulate actions by means of sensory mindfulness, vocalizations, breath work, and focused actions utilizing stress and different sensations on the neck, joints, and pores and skin.

My e-book, Meals, Physique and Love, however the best of those is love, explains the connection between the vagus nerve and consuming problems. It gives therapeutic and lifestyle-based interventions for serving to people dwell with much less concern and shift their vagal responses towards an expertise of security and connection.

To discover a therapist close to you, go to the Psychology Immediately Remedy Listing.


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