Sprouting Yoga

In every eating disorder, be it anorexia, bulemia, binge eating or anything else not otherwise categorized, there is an element of body dysmorphia. Body dysmorphia is literally not seeing what you are when you look at yourself whether its in the mirror or simply looking down at your thighs.

There are those that have Body Dysmorphic Disorder (“BDD”) related to an eating disorder (“ED”) realm, but different. Related in that both disorders have an element of anxiety – with anxiety being significantly correlated and/or comorbidly related to ED. In ED, the anxiety causes and triggers the disorder. In BDD, the anxiety IS the disorder. BDD is characterized by being excessively concerned or preoccupied with body image. In essence, when related to weight, BDD is an obsession and intolerance of the body and the perceived flaw of being fat.  Some psychologists classify BDD as a form of obsessive complusive disorder.  Keep in mind though, those same psychologists classify bulemia and anorexia as anxiety disorders. So how is BDD different from the general public’s malaise with their body?

“Many people are somewhat critical of their appearance, and some people will go to great lengths in attempt to change what they consider to be flawed. Plastic surgery is increasing in popularity, and more people are willing to take the risk of “going under the knife.” A specific aspect of appearance can be surgically altered or “corrected” through procedures such as rhinoplasty (or a “nose-job”). Many people who have had this procedure are happy with the results and can move on with their life. When, however, BDD is a factor, the nose will never be perfect — or if they are satisfied with the nose, another obsessive fixation on a different body part will take over.”

BDD occurs when the individual is so preoccupied with their perceived flaws that it impairs occupational and/or social functioning, sometimes to the point of severe depression and anxiety and development of other anxiety disorders. BDD, like ED, can be caused by biological, psychological or environmental factors, with many researchers linking BDD to abuse or neglect. Sue Jones, of yogaHOPE -www.yogahope.org – once summarized BDD as doing what most abuse survivors do – turning their feelings of being bad or unworthy – into concrete form. Instead of thinking  ”I am bad or unworthy inside” as many who suffer from addictions do, they those with BDD think ”My body is bad or unworthy.”

In clinical terms, “body dysmorphic disorder (BDD) and anorexia nervosa are severe psychiatric illnesses involving perception of appearance. While there are differences and are treated as distinct disorders, they have many similarities including obsessive scrutiny of appearance features, possible perceptual distortions, and anxiety,” says Jamie Feusner, M.D.

The suicide rate for those with BDD is double that for those with depression, and some researchers state that suicidal thoughts are as common as occurring in 80% of those with BDD.

BDD is treated through therapy and medication – most likely cognitive behavioral therapy and selective serotonin inhibitors. Its interesting that there is little written about Yoga as a treatment for BDD. When asked about the relationship between the two, noted psychologist Kelly McGonigal stated “yoga helps by cultivating a healthy body image based on internal sensation and awareness, not one based on cognitive distortions.”

Articles like this http://www.observer.com/node/51695 in the New York Observer detail how many with BDD seek out yoga for the spiritual relief from the disorder and from related eating disorders. More scholarly articles note that

Modern psychological studies have shown that even slight facial expressions can cause changes in the involuntary nervous system; yoga utilizes the mind/body connection. That is, yoga practice contains the central ideas that physical posture and alignment can influence a person’s mood and self-esteem, and also that the mind can be used to shape and heal the body. Yoga practitioners claim that the strengthening of mind/body awareness can bring eventual improvements in all facets of a person’s life.

Author Info: Douglas Dupler, Rebecca J. Frey PhD, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Alternative Medicine, 2005,  available at: http://organizedwisdom.com/helpbar/index.html?return=http://organizedwisdom.com/Body_Dysmorphic_Disorder&url=www.healthline.com/galecontent/yoga

Others state that: “there are excellent treatments for BDD. One of them is cognitive-behavioral therapy (CBT) with uses exposure and response prevention. Also the addition of mindful awareness training, cognitive restructuring….” Eda Gorbis, PhD, MFCC Assistant Clinical Professor, UCLA School of Medicine.

Yoga is a form of mindful awareness training – a way to experience the body while in an anxiety free zone (or anxiety reduced zone) due to the deep breathing and conscious awareness fostered by the practice. Yoga and CBT are closely linked.  CBT’s goals are to restructure the thinking patterns of the patient towards tolerance of anxiety provoking triggers. Yoga’s goal is to reduce the whirlpools of the mind, by changing behavior, perceptions and reducing automatic instant response cues (pratyahara).

Unlike the times where I normally say, “Yoga is so much more than the postures, its benefit to eating disorders comes from the sutras and other resources,” in treating BDD, it is the postures that assist in treatment. By providing a controlled environment where students can experience being present in their bodies, even for short periods of time yoga takes on many of the characteristics of CBT work. Classes are also beneficial to those with BDD because cues are given to breathe deeply, and to stay “on the mat”, giving students tools for handling the intolerance of certain feelings in the body – fullness in the stomach, width of thighs, etc.

In that way, yoga can be seen as a form of CBT and mindful awareness training at the same time. Given that BDD is chronic and worsens without treatment, it makes sense to advocate for any method of treatment that would be beneficial.

I sat down to write a post about some of the debate in the body diversity and eating disorder advocacy world going on over Miss Universe’s decision to pose nude in an Australian magazine without photoshop. Its lovely, no? Info about it here: http://www.beautifulyoubyjulie.com/

Here’s the thing though – over the last month or so, several advocates such as Voice in Recovery – http://www.facebook.com/#/AVoiceinRecovery?ref=ts – have noticed a trend to discuss body types as “real women.” As in, Miss Universe is not a real woman because she fits within the runway model physique. The term “real women” has been used to refer to women with larger hips, breasts and in general stature or shape. In referring to some models as not “real women” they essentially state that one shape is better than another.

I think this hurts women, and hurts those in recovery from an eating disorder or disordered eating. Why? Because by saying one shape is better than another, or truer than another, or more “womanly” than another, the same paradigm of appropriate, acceptable, laudable still exists. You are “womanly” from your ability to give birth and/or nurture children and things. You are “womanly” by your ability to create and conceive, be it children or campaigns or clothes or constitutions.  You are not womanly from your shape. I love many women who are terrific mothers and shaped like pencils, some like rulers, others like chalk erasers. Not all women are shaped like hourglasses, some are closer to clocks, others like the hands on clocks. Nor are you more of an eating disorder advocate based on one shape over another.

I’m particularly fired up about this issue because I think referring to one shape or another as “real” is incredibly harmful to those in recovery from eating disorders or disordered eating. When I was at my smallest point, not even acknowledging that I was restricting, only referring to it as entirely losing my appetite and not eating, where friends would call to make sure I’d eaten something like three meals (me: “coffee, yogurt, bagel” them: “that’s one meal, not three”), I could shop in the children’s section. I’m 5′8″. I remember saying this to the law student running the eating disorder awareness week at my law school. She agreed – it was the only section where tops would fit, she said. I couldn’t believe that her round frame had ever been as small, as flat chested as I had been. And here’s what sucks – I didn’t want to look like her, so I put off facing my food issues for a long time. I put off fully totally surrendering the weird crap I do with food to both a higher power and a nutritionist because if recovery looked like her, I wasn’t going to be able to tolerate it.

Recovery from eating disorders or disordered eating (what I went through), doesn’t look like anything. It isn’t big or small or constantly cheery or mad all the time. It isn’t turning into a poet and sticking your middle finger up at the world. Its being healthy. Eating to fuel your body and your mind and your spirit. Thats what being real is. Its getting real with yourself and your own individual needs. Its flaunting your awesome perfect body, whether you have beautiful muscles, or long lines. Curves or angles. Its being real with who you are and what you bring to the table. And pencils and rulers and chalk erasers and clocks and hourglasses can all do that. Because they are all real.

And for you yogis who think that there is only one shape or size of a yoga teacher – you are wrong. In America, in gyms maybe there is one acceptable size of yoga teacher. But true teachers come in all forms, sizes, shapes and teach in all manners. Check out Christina Sell’s wonderful book, Yoga from the Inside Out, which discusses her own battles with bulemia and addiction and yoga and the anusara yoga tradition/lineage’s approach to shape.

I recently re-read this wonderful article by Dr. Lynn Somerstein, a wonderful therapist and yoga teacher. Lynn is also on the advisory board of Sprout Yoga (thank goodness!).  My plan through this post and others is to encourage readers to build an library of ideas of how to survive the holidays. As I’ve written before, yoga is more than just a series of movements, it includes philosophies and disciplines too. Below is Lynn’s article on staying true to yourself during the holidays and avoiding food binges, I think her experience as a yoga teacher is woven through it. I know I’ll be using her tricks below to stay centered and calm, and as I’ve written before – Yoga Chitti Vritti Nirodha – Yoga Is the Stilling of the Whirlpools of the Mind. So even if you can’t whip out a warrior pose in the middle of Christmas dinner you can still breathe and still the whirlpools.

Namaste, Maggie

By Lynn Somerstein, PhD, RYT

The hardware store on Third Avenue has a sign in the window that says, “Sharpen your knives for the holidays.”

Many of us are lucky enough to have joyful holiday celebrations, with loving family, friends, people who are positive, and that’s wonderful—but unfortunately not the universal experience; there’s a down side to many celebrations—not everyone is your friend, and some of those unfriendly people sharpening their knives for the holidays want you to be their turkey.

For example, food is love, right? Well, sometimes it is, when your friend cooks you something special and you are free to eat as much or as little as you want, and give a big thank you. But some friends and relatives aren’t satisfied with a compliment- they want to you to eat it ALL UP. Like the Clean Plate Club Kid I wrote about last month. He comes from a family of overeaters and controllers- they’re only happy if he eats so much he gets sick—that’s how he proves he loves them.

Or how about meat eaters who insist you really aren’t a vegetarian, or vegetarians who rank you out because you eat meat, or drinkers who push alcohol on someone who is in recovery.

And what happens if you’re on a diet, or you’re allergic, or you simply can’t stand sitting next to Aunt Rose, or anyone, but you have no choice, and you get really mad, so you stuff yourself, or you starve yourself, or you just go in the bathroom and throw up.

What about that mean cousin who always gives you the business about your love life, or your job, or your kids, or your bank account?

Walls closing in. Push back and find space.

Object Relations theorist DW Winnicott talked about the play space- an imaginary state where everyone is equally free, holding of self and other, and able to pretend and have fun.

Here are some playful ideas to help you strategize, survive Thanksgiving, and not feel like a turkey. Write me if you think of a few more.

1. Don’t come with expectations. Just show up and be with people as they are, not how they should be or where you would like them to be.

2. Your imagination was your first toy, and it still can be.

3. Make believe you’re an anthropologist observing a strange tribe. Take notes!-

4. Had enough to eat? Say no thanks and stand firm. Hide your plate. Or give a very detailed description about what happened the last time you ate too much Thanksgiving dinner. Gross.

5. Pretend you’re a hostage waiting for your release. How much money for your ransom? Who should pay? Maybe you’ll manufacture a wild escape. How should your jailers be punished? Let your imagination run wild.

6. Okay, so Aunt Rose never stops talking and has no manners. You’re not going to change her- you’re stuck. You can sit and steam and ruin things even more for yourself, or you can find ways to dampen your burning fuse. Maybe Aunt Rose wants to be interviewed. Maybe you’re a TV host. Maybe one of you is Oprah in disguise. Take turns, even if Aunt Rose can’t.

7. Try deep breathing. Breathe out and make the room bigger.

8. Tell jokes to yourself, and to anyone else who might have a sense of humor. Keep the mean remarks private though.

9. Remember– all the spiteful things your nasty cousin says tell you lots more about HIM than about you, and you don’t have to answer if you don’t want to. He’s pushy? You’re kung fu master. Let the negative energy flow right past you and back at him. BAM!

10. Try not to leave your body, if you can. Ground yourself by feeling your feet on the floor, your hands in your lap or on the table. Breathe. Focus you attention on something beautiful.

11. If that doesn’t work, how about an out of body experience? How do things look when you’re floating up on the ceiling? Wave to the folks down below. Can anyone see you?

12. Pretend you’re an invisible star or king or Buddha or angel. Knives, sticks, stones, not even nasty words can hurt you.

13. Act like you’re surrounded by Buddhas in disguise, and honor everyone. Remember- therapy gives you tools you can use for self-defense as well as self-understanding.

This is our first guest post, and I’m thrilled to have it. Sprout Yoga is an organization dedicated to inspiring, supporting and training yoga teachers that want to work with people overcoming eating disorders and/or trauma. We can help match people in recovery with teachers, as well, but we are focused on getting those teachers trained. Here’s an anonymous post on a key issue for teachers and ahimsa, the body, and the relationship between the two.

please enjoy! ————————————————————————————————————-

One of the first things yoga teachers in training learn is that it is important to offer modifications to your students.  Allowing students to do Vasisthasana with the lower leg down on the mat is reminding them to find a practice that fits their bodies.  Use of straps can allow less flexible students to reach places that otherwise would be inaccessible.  Yoga teachers should encourage students to take a break in Balasana when they are tired because they need to take care of themselves.  In addition, yoga teachers need to follow these same practices on their own mat to show their students that such modifications are acceptable and good. Ahimsa, the principle of non-violence extends to ourselves and as yogis we need to remember to put our bodies over our minds on the mat.  Our teachers should be the first people to show new and old students how to apply this principle in their practices, because they are yoga role models for those in the class.

I was reminded of these things the other night when I went to a workshop at a locally well known yoga studio by a “famous” yoga teacher.  This studio often holds workshops in eating disorder management and incorporates healthy eating in their teacher trainings.  I assumed that the environment there would thus be evocative of wellness and a supportive lifestyle.  To say this was the opposite is an understatement.  Both the teachers and many of the students appeared to be extremely thin, almost dangerously so.  The conversation during the talk was largely focused on appearances and addictions.  True the visiting yogi speaking was emphasizing not to feed these obsessions, but the audience clearly had not heard this before, or at least had not listened.

What struck me about the attitude at this studio was that the teachers in particular did not appear healthy.  Yet, as yoga students/teachers we participate in a lifestyle that encourages the opposite.  Yoga for all its spiritual history and basis still remains an activity with a strong physical aspect.  Yoga teachers have an obligation to remind their students not only to modify their practices on the mat, but off as well.  Students should be encouraged to eat well, to sleep and to not participate in behavior that causes violence to them.  Ahimsa in the form of self-care and not self-violence should be paramount in a yoga class.  Any teacher who presents things otherwise should be avoided because their words are decidedly un-yogic.

My home studio (which has also been around for nine years) could be called “Ahimsa yoga” because the teachers there constantly are reminding students to make the practice on and off the mat safe.  We are reminded to take it easy on ourselves even in vigorous power classes.   Props are readily available and teachers often use them when they practice as well.  But the most amazingly wonderful aspect of this studio is that all the teachers look like regular people.  They look healthy, and happy and well.  They practice in life what they teach in class and so their words are meaningful to their students.  The studio mentioned above would be wise to look at my studio to learn about how best to teach their students about a healthy lifestyle.  Having teachers that appear to be suffering from an eating or other disorder does not encourage the students to eat well.  Let’s face it, many students look up to their yoga teachers as models of what we aspire to be whether that is with strong arms in Vrschikasana or balance in Garudasana or even as merely a body type worth attaining. It is imperative for them to be healthy to spread such a message to their classes.

Ahimsa is a principle that should be present in everyone’s practice in life and on the mat.  For a teacher to preach of its benefits they too must prescribe to its practice.  Yoga teachers as leaders in a healthy lifestyle industry have an obligation to their students to tackle their own issues before stepping onto a mat in the front of a room.  To do otherwise is to jeopardize the health and well-being of their students, and to make the practice of yoga harmful.

I am overjoyed that the tri-delts are at it again. Fat Talk Free Week is a fantastic program that generated from the sororiety Delta Delta Delta as a way of addressing body image and disordered eating. And its freaking fantastic. To see how its spreading across the country, see their webpage here:  http://endfattalk.org/  follow them on twitter at @endfattalk and sign up for more info here: http://endfattalk.org/getinvolved.html.

Why am I so overjoyed? and what on earth does this have to do with Yoga? I’ll tell you straight and simple. Last month, the International Association of Yoga Therapists published an article I wrote about how images of overly slim women doing yoga keeps people who could benefit from yoga as a therapy (such as those with Eating Disorders/Disordered Eating and trauma survivors) from attending class. http://www.iayt.org/site_Vx2/publications/journal/2009/IJYT-2009%20(contents).pdf  But there is more to it than that.

I’ve described the concept of ahimsa before – the idea that nonviolence (or avoiding of violence)  is the first and primary duty or goal of a yogi.  For those that follow yoga as an eight fold path, ahimsa is the first step – before the asana or postures, before the pranayama or breathing, before even meditation.  Ahimsa is part of the yamas – or ways of being that assist a yogi in calming the whirlpools of the mind so that the benefits of breathing, movement and mediation can take hold. In fact, some sources say that Ahimsa is THE yama, and the rest (truthfulness, non-stealing, divine conduct,  patience, steadfastness, compassion, honesty, moderate appetite,  and avoidance of impurity in body) merely support the practice of nonviolence.

As yogis, our primary goal is to quiet our own minds first, and to create peace in our own selves, so that we can then find our unique way of creating and spreading peace in our communities.  “Your ultimate goal is to be happy. Where is that happiness? Within you. If you want to have permanent happiness, it will never come from outside,” said Sri Satchidananda, founder of Integral Yoga and all around great yogi. 

My favorite yoga teacher, Sandi Angotti (http://www.sandibeachyoga.com/) once described ahimsa as more than nonviolence, but as nonpushing.  The idea of nonpushing being that you refrain from using force, mental, physical or spiritual, to make some thing happen or create some sort of result.  If you couple the idea that ahimsa is nonpushing and nonviolence, with the idea that your first job or ultimate goal is to be happy or content, then doing nonviolence to yourself becomes a primary goal. 

So how do you practice this ahimsa to the self? It should seem easy, right? First do not harm yourself. But we aren’t trained to love ourselves any more. In fact, 81% of 10 year olds are afraid of being fat. 51% of 9 and 10 year old girls feel better about themselves if they are on a diet. We are trained to be on a diet, to be constantly evaluating ourselves and others to see if we are “OK.” The most extreme form of this is body dismorphia, where a person has anxiety (near panic levels of it) about the size or shape of their body so much so that they are unable to accurately gauge how they look. When we constantly evaluate how we look or what shape we are in and more importantly, when we constantly judge ourselves and berate ourselves for the results of that evaluation not measuring up, then we are constantly pushing ourselves towards a result. We are disturbing the peace of our minds to attain a goal our bodies can’t quite get to. In other words, we are doing violence to ourselves through these thoughts. But at the same time, how do you conquer these thoughts and judgements when everyone around you engages in them?

This is why I so love and support Fat Talk Free Week and the work of End Fat Talk. Their mission, as they explain it: 

Fat Talk describes all of the statements made in everyday conversation that reinforce the thin ideal and contribute to women’s dissatisfaction with their bodies. Examples of Fat Talk include: “I’m so fat,” “Do I look fat in this?”, “I need to lose 10 pounds” and “She’s too fat to be wearing that swimsuit.” Statements that are considered Fat Talk don’t necessarily have to be negative; they can seem positive yet reinforce the need to be thin — “You look great! Have you lost weight?”

We believe that by eliminating Fat Talk, we can begin to change the way women think about their bodies.

So by signing their pledge, and forwarding it to a friend, you commit to engaging in ahimsa towards yourself. And you act compassionately towards your friend by saying that they too deserve to have a little more peace in their minds, a little less pushing of themselves.

Ahimsa is the very root of yoga, and stilling the chatter of the mind is the heart of yoga. By turning that ahimsa to the chatter of the mind ABOUT the body, you can achieve so much more in yoga than if you constantly push yourself to be the ideal, be the body you are supposed to have.  Still the chatter, sign the pledge.

People have been asking me lately why I started Sprout Yoga. Why I focus on yoga for people with eating disorders or post traumatic stress (such as rape or domestic abuse survivors). Everything I have done up to now has led me to this place. Everything I have been has led me to this work. I believe this is my dharma, my work, my spiritual purpose. The word dharma has a variety of different meanings based on the religious/philosophical tradition that you view the word through. In yoga, we define dharma very loosely as your purpose, your job, your work. In doing that work, you align with the higher principles. Broken down it goes like this: There is a “way” or order to the universe and to life on earth. Your conduct here can be in conformity with that way if you figure out what your specific individual duty is here. That specific individual duty is your essential nature, your true self. Yoga is often used in this quest for the true self, in this journey to the part of you that remains constant and beautiful no matter what changes occur around you or what happens to you.

I believe everyone has a dharma. I also believe that everyone should be able to get to practice their dharma. I had a fantastic conversation with Waller of Create Radiance last week. She’s doing amazing work in eating disorder clinics and with women recovering from prostitution, among others. Through this work I’ve met countless people volunteering to work in battered women’s shelters and with many other beautiful souls. Each of these people do this work from the heart. They feel called to bring the ease that yoga brings, the transformational healing that can occur to people who deserve this practice, this discipline.

Sometimes I look back on my time as a corporate attorney and think “What was I thinking?” No wonder I felt so out of sorts, so blocked and confined. But the skills I used as a corporate bankruptcy attorney allowed me to start a nonprofit that grew into Sprout Yoga. So did all my time up late in the library running a law journal. That time also allowed me to learn how to manage people, ideas, and work collaboratively with other journals and organizations. Sure I threw my great GPA out the window when I took on the law journal, but I learned more about working with people than I would have without that journal. I learned maybe the most important thing I’ve come to know in my 34 years: that it feels really really good to give people the space, support and resources they need to allow them to do a good job at the task they’ve been given.

I used to call my twenties my wasted youth. But I know now all the time I spent struggling to figure out what I wanted to be when I grew up, and the place of utter disrespect for myself that led to thinking I had to go to the best law school, and be the best student in order to show the world that I was worthy of respect even if I didn’t believe it, all that time was valuable because it gives me a tiny window into the thinking that my special students have – those yoga students who come to me because I offer free individual yoga lessons for rape survivors. It lets me get it just a little bit, and in getting it, I can create some small space for that person to open up to their dharma. I allow just a little bit of light through the yoga I teach for that person to do their spiritual job. I create ease and spread love, and that is my dharma.

I do all of this because I’ve been led here – through years of working in nonprofits, in law firms, in law school – all of my twisted winding road to this amazing place where I get to inspire others to volunteer to teach yoga, to support those doing this work and to create a body of research on this amazing practice. I’ve been led to this place to create a space for others to heal. And when I sit with this space, sit with this work, I feel inspired and moved and energized because its my dharma, its my job.

I do this work because I know that the struggle, and pain, and feeling of falling down and not being able to get back up again that goes along with an eating disorder, or body hate, or body dysmorphia robs you of your chance to practice your dharma. I know that the obsession with not eating, with growing smaller, with taking up just a little less space, can act like a film covering your eyes from seeing what’s happening around you, from learning from what is going on in your life, and from moving towards your purpose. So I do this work, I started this nonprofit, so that I could help in some way to clear out the film. To create space for healing and to allow a way that the healing and the recovery can effect more than the body, but also allow you to use that information. Use the information in a way that lets you learn from it spiritually, lets you absorb and digest it mentally and move you towards your purpose.

I do this work because I know that the flashbacks, the hyperviligence, the constant surveying of the environment that accompanies Post Traumatic Stress Disorder is a heavy load. I know that when you are raped or beaten or harmed that you had your ability to choose taken away in that moment. And I also know that you were given this fear and anger like a smelly old coat that weighs on you and that you would really rather put down and walk away from. I know that all the time that you spend trying to take that smelly old coat off, you are distracted from your heart, your soul and your purpose.

So I do this work because it is my work. It is the work I’ve been called to do, the work I’ve been led to do. I do this work so that the millions of people with eating disorders and the millions of women and men who’ve survived sexual or domestic abuse can do their work.

Sometimes I hear from yoga teachers that they are hesitant to volunteer to work with people with eating disorders or PTSD because they feel like they don’t have adequate training. I respect that and Sprout Yoga is working on training programs to address that, so that more yoga teachers can provide more yoga to more people. However, at the same time, a part of me thinks, its a lot more simple than that.

I get a manicure when I am feeling like poop about myself or my body. Why? Because ages ago, maybe even lifetimes ago, I read an article about the simple things you can do to improve your body image. One of them was to find one spot on your body that you liked a lot, and treat it really well. Say, for example, you have pretty feet. Get a pedicure, buy some fancy pants lotion for your feet and really love on that part of your body. Then see if week by week you can expand that part that you like by an inch or more. Sticking with your feet, try moving up to your ankles, then your calves, pretty soon you have your entire lower body and why not throw your hips in too? While you are at it, the belly is right there near the hips, and its pretty good… you get the idea. So a manicure is a way for me to see that I like my hands, and that I’ve done something to appreciate my self. Body image is incredibly complicated and healing from disordered eating and body hate is complex. But there are some things that can be simple and can add up.

I think yoga is one of those things that can be simple; maybe not for everyone recovering from an eating disorder/body hate, but for many people. No one person can do all yoga poses (asanas) perfectly: its an incredible anotomical anomoly to be able to do that. And, each day that you approach a yoga class or session, you never know what parts of you will be tighter than the day before, so on some days a pose will be easy and you can do it with grace, on others, well, not so much. A practicing yoga requires that you remember these things each time you do it. In fact, the poses themselves will remind you of the changes in your body on a regular basis. In that way, you discover and connect with your body each time you do yoga. Just yoga. Not even yoga for special needs, or a yoga class targeted to people with ED or body hate. Just a plain old vanilla yoga class will remind you that your body is uniquely your own, and some poses will be easier for you than your neighbor on the mat next to you, just as your legs are longer or shorter than that neighbor next to you.

There are many things yoga teachers should be aware of when teaching people with ED, including body posturing, language and even specific asanas that should be avoided (for example, strenuous twists might not be advisable for people in recovery from bulemia). But the prevalence of eating disorders in the population means that at any given time in any yoga class there may be people in recovery attending the class. In other words, yoga teachers are already teaching people with or in recovery from ED.

Studies have also shown that yoga can reduce anxiety and separate studies have shown that the ED population has a significantly higher rate of anxiety disorders than the general population. That’s another reason that yoga can be beneficial for those in recovery. However, people with more type A personality traits should avoid yoga that is only based on stillness meditation, as studies have also shown that type A personalities have increased heart rates when told to sit quietly. So what type of yoga should they do? A flowing vinyasa class might feel delicious. A vigorous class of harder balancing poses might focus the mind off of a constant stream of negative anxiety producing thoughts and allow for a brief respite from the anxiety. Trust me, its really hard to have anxious thoughts and balance in a headstand at the same time.

So if yoga is helpful for people with ED/in recovery from ED, why don’t more people do it? Well, cost is definitely a factor. That’s why Sprout Yoga exists – to bring yoga to people who can benefit from it, for free. That’s why Sprout Yoga needs yoga teachers and yoga studios as partners and volunteers. Visit the Sprout Yoga web to sign up  – www.sproutyoga.org or to find a volunteer teacher in your area.

I know a lot of other people who don’t do yoga because they feel so self conscious in their bodies that they don’t want to go to a yoga class where they will do poses that might make them feel or look fat. This I can sympathesize with. I held back from training to be certified to teach yoga because I thought I didn’t “look like a yoga teacher.” You know what I mean, long lean lines of a body. Instead, I look like me: one part amazon, one part fertility goddess. But in my certification program I found a yoga teacher who embodied the strength and grace I’d wanted to have in my own yoga practice, but not in that traditional look (she teaches here: http://asktheyogateacher.com/about/ and is at the bottom of the page). Strong, loving, dynamic and able to move with grace and ease into a scorpion (pinchasana) she taught a killer class that had everyone no matter what size sweating and beaming. Yoga is for everyone. Yoga can be done by everyone. Some classes in some studios even accomodate women with larger bodies. http://community.nytimes.com/article/comments/2009/05/14/health/nutrition/14fitness.html

So how can yoga be of benefit to women who struggle with feeling as though they will be exposed in a yoga class? One on one teaching is an option – I teach individuals in recovery from ED alone or in classes. Then its just me with my long monkey arms who reminds you that we all look differently and can do different things. But even just attending a yoga class can help with the feeling of exposure. When you see people you think who look ideal but who for example can’t touch their toes, yet you easily do this, you are instantly presented with an opportunity to receive information about your body. That is, you know that the ideal you are seeking is a myth – there is no perfect body that can do everything. And that won’t heal an eating disorder, but it is one more simple thing that can add up.

Sprout Yoga’s mission is to create and support a national network of yoga teachers and licensed counselors who understand how yoga can play a role in healing from eating disorders. As a part of this mission, Sprout Yoga seeks to train, advocate, inspire and coordinate yoga teachers across the country on community yoga and the vital need for non-fee based yoga classes. Sprout Yoga believes that this kind of karma yoga benefits not only the community, but the teachers themselves. Sprout Yoga also seeks to work with the mental health community to create greater understanding about what role yoga can play in healing disorders with dissociative aspects, such as eating disorders and post traumatic stress disorder. Sprout Yoga’s mission is also to create a bridge between the valuable research and education already in existence in the mental health community and yoga teachers.

We achieve this mission, as my young friend Faith says, “the same way you eat an elephant, one bite at a time.” We have several outreach projects currently underway, but hampered by the costs of printing and mailing. You can help Sprout Yoga by showing your support and donating to our cause through our homepage at www.sproutyoga.org.

In their article in the Qualitative Health Research journal, authors Jill Anne Matusek and Roger M. Knudson propose a radical new approach to what constitutes recovery from an eating disorder. They urge that recovery should be considered (and measured or studied) not by cessation of physical symptoms, but relief from the pyschological and psychosocial factors accompanying anorexia, bulemia and complusive overeating. Rethinking Recovery From Eating Disorders: Spiritual and Political Dimensions, Qual. Health Res. 19:5, p. 697.  The authors begin by noting “Overall, the ‘best’ evidence-based therapy interventions are hardly producing good clinical outcomes, with only 30% to 50% experiencing relief from their symptoms and/or recovery.” (Citations omitted). The authors also note two strains of outcomes from eating disorders in the mainstream media  – either full recovery with hope for the future, or containment of symptoms and management of chronic disordered eating.

Interestingly, the authors note that recovery from an eating disorder can be seen solely by weight restoration and cessation of disordered eating, but they caution that this approach is not enough and provides only a superficial level of the experience of recovery. Because they were not satisfied with the more short sighted view of recovery, the authors undertook a study “through a narrative approach aiming to capture and present the women’s recovery experience through storytelling and performance-based texts.” Id. (Citations omitted). They note that there have been realistically only three studies aimed at capturing the spiritual aspects of recovery from ED; by Garrett in 1998, Reindl in 2001, and Redenbach and Lawler in 2003.

The three studies reviewed in the article provide a clear link to yoga, noting that eating disorders “are an extreme form of desire: a spiritual craving expressed through the body…” where recovery includes “an abandonment of food/weight obsessions, a firm resolve to never again starve, binge, and purge, and no longer feeling cut off from oneself and others.” Id. at 698. “…Overcoming bulemia involved coming to terms with the core sense of shame associated with needing and wanting, experiencing a sense of “enoughness,” recognizing and listening to bodily sensations, and learning to tolerate emotional distress.” Id.  Interestingly, several of the women interviewed for the research study conducted by the authors practiced yoga. Id. at 699.

The Yoga Sutras of Patanjali comprise the underlying principles of yoga. As I’ve blogged on before, these sutras provide in concise pithy statements, the foundations of yoga. The sort of “why are we doing this” background. In those Sutras, we find “The art of Yoga is the repeated practice of restraining the fivefold movements so one can detach from desires and achieve ultimate freedom.” Sutra 1.7. This Sutra refers to the movements of the mind, which are described in Sutra 1.5 as “The mind modifications are composed of fivefold movements that are either afflicting or unafflicting, distressing or undistressing, pleasing or painful, troubling or untroubling, disturbing or undisturbing.” So in Yoga we are seeking to calm the mind (See Blog Post on Yoga for PTSD and Sutra 1.2), and reduce our desires. We do this to access that part of ourselves that is real. That part we talk about when we say we “feel like ourselves again.”  This is a basic principle of yoga, that Pain comes from the inability to separate true self from the illusory self. Sutra 2:17. In this way, doing yoga, with a firm emphasis on the foundations of yoga, such as the sutras, appears to be more useful in recovery from eating disorders than merely just focusing on stopping the disordered eating behavior. But there’s more to yoga than just reducing desires and calming the mind.

The aim of yoga is to connect, both with the body and mind, then with the self to all other selves, all other people, and finally to the higher power/higher self, god, universe or whatever you choose to call it. See Sutra 1.19 (“What arises is a state of awareness where the seer is merged with nature.”) When we practice yoga regularly in a studio or other environment, we sometimes feel connected to the other people in our class. That’s one reason we say Namaste at the end of class. To salute that element of universal light that exists in all of us, all around us. Some yoga teachers end class by chanting “Jai Sri Satguru Maharaj Ki” to which the students respond “Jai!” Its meaning? “May the Light of Truth overcome all darkness” to which the students respond “Victory to that light!”

The article goes on to mention that recent research has found that women who recover from eating disorders believe that spirituality was an important factor in their healing and recovery. (citations omitted). In concluding about the many studies they cite, the authors state “These findings support the broader empirical evidence that spiritual practices promote physical and emotional healing beyond the realm of eating disorders.” Id.

The authors report that “What emerged from these accounts is an understanding that overcoming an eating disorder requires attention to the whole human being in all its mental, emotional, physical, social and spiritual richness.”  Id. at 703. They summarize their findings as “Recovery from an eating disorder appeared to be experienced by recovering/recovered women as a spiritual (re)connection of the self to body, nature, and society.” Id. at 705 (citations omitted). ”The results of this study argue that treating eating disorders and their recovery requires a reconceptualization of treatment and recovery to include a focus on the whole person, with particular attention to spiritual and political dimensions.” Id.  The authors also note that recovery is an ongoing process of restoration and discovery. Id.

My cat does yoga. Or maybe better said, my cat IS yoga. 

In December of 2006, I found myself at the SPCA. Totally unclear on why I was there, I walked in thinking I needed to add some volunteering to my boring lawyerly life. I waited patiently in line until the woman in front of me asked if I was ahead of her. “No, you go ahead, I’m not sure why I’m here, ” I told her. “I’m just here to surrender these kittens.” She said. “I think I’m here for your kitten.”

She was tiny, no where near the size she should have been if the woman giving her up was right – a three month old Maine Coon kitten that wasn’t even a pound? And she was shaking, from the cold I thought, but as soon as I tried to set her down to fill out the paperwork to take her home she promptly fell over. Not shaking from the cold, and not just clumsy, little kitten had some serious neurological problems.

“Are you sure you still want her?” the SPCA volunteer asked me. “Of course, she’s my kitten.” I answered. Because I have the best vet in the entire world (The Cat Hospital of Media, PA), I have had an opportunity to learn what exactly is wrong with Hannah the kitten: she has a disorder that robbed her of balance, coordination, depth perception, control over her back legs, and left her shaking everytime she focuses on something. I learned how to teach her to walk, and by watching and thinking and trying a variety of games and activities, I learned some of what was going on in little Hannah’s brain.

In her world, the ground is constantly moving up and down, things that seem close could be as far away as 5 feet, like say, the ceiling fan, which was not, in fact, trying to attack her, or the stripes on the rug, which weren’t moving for the rest of us. Hannah’s determination to get where she wanted to go, to learn to walk, to figure out what the heck water was, inspired me to teach yoga to others who have chaotic inner worlds.

So how is it that Hannah does yoga? First, she applies one of the basic underlying principles of yoga: that direct experience is the most valuable knowledge. (Sutra 1.7 “The elements of sound intellection are: direct observation, inductive reason, and trustworthy testimony.”) The underlying principles of yoga can be found in the Yoga Sutras of Patanjali and at first seem to be a brief, concise list of ideas. In reality, a yogi can study the sutras for lifetimes and still have much to learn. Hannah’s understanding that what she sees might not be “real” is a basic principle: what we see we filter through our preconceptions, our assumptions, that information that isn’t real, but attached to prejudices, negative thoughts and judgments. In yoga we seek nonattachment from assumptions, judgment and prejudices. Just as we learn in an asana class that achievement of a pose isn’t the goal of yoga, but that being present in the moment in a pose is the goal, to achieve a “seat” in a particular pose, a place of comfort, understanding, precision in mental clarity.

For Hannah to move from her seat on the couch to her dinner, she must negotiate what might seem to be a huge chasm of a drop from the couch to the floor (its really only 2 feet), negotiate around the moving wall, and topsy-turvey floor, through the dining room chairs and find her way to the bowls of food. Once she’s there, she has to figure out how far or close the food actually is, which she does by taking several attempts at it, from banging her face into the food to missing it entirely. All of this on back legs that don’t consistently respond to what she’s telling them to do, and losing her balance at least twice in the the 10 foot walk from couch to food. To say that this maneouver is exhausting is an understatement. It requires great concentration and faith. Just as holding a balancing pose requires great concentration and faith in oneself. It requires that you remove or detach your assumptions about yourself, the pose, the class, your teacher, the other students. It requires that you quiet the mind, so that you can concentrate on feeling your way into the pose.

This quieting of the mind is the heart of yoga. Sutra 1.2 states “Yoga chitta vritti nirodha” or Yoga is the Quieting of the Whirlpools of the Mind. Stilling the mind waves, quieting the monkey brain which swings from a limb of a thought to another limb of a thought, like monkeys do from tree to tree, is the premise of yoga. Those things that still the mind waves are yoga. The practice and disciplines of yoga curl inward around this goal like the petals of a lotus – each individually useful and beautiful but combine into an awe inspiring event.

Hannah’s most frequent mission is to land, somehow, often feet over head, into my lap. She’s my meditation partner and for good reason. I start by mindfully watching her make her way over to me. Whether I’m seated on her couch or on the floor, she will focus her attention on a single purpose: “LAP.” I dig deep and draw on love and compassion to prevent myself from scooping her up and just placing her in my lap, just as a yoga teacher draws deep on patience, love and compassion to provide an atmosphere where her students can learn ease of mind, ease of pose on their own. Once she has achieved her goal of landing in my lap, she melts into a warm, ridiculously furry ball of contentment. Many people, even not particularly cat people, love when she sits on them. She brings a sense of relaxation, of peace, to people when she sits on them because she completely and utterly lets go of all the crazy information bombarding her small cat brain. In this way, she stills the mindwaves, quiets the chaos and is able to be at once present and at the same time relaxed.

Yoga chitta vritti nirodha. Yoga is the stilling of the mind waves or the whirlpools of the mind. If my cat can do it, surely anyone can, right? If concentration on movement, with a one pointed mind, can quiet the unreal and false information flowing into her small, furry cat brain, then logically, it would work for humans who are bombarded with unreal and false information either about their bodies (those with eating disorders/disordered eating/body hate) or about events in time (those with Post Traumatic Stress Disorder “PTSD”). Research has shown that Mindfulness Based Stress Reduction has a significant effect on reducing symptoms in those with PTSD. I’ve blogged before about PTSD, but a brief synopsis of the disorder goes something like this: some people who experience a traumatic event are unable to attach a place and time to that event, and thus it reoccurs into their daily lives, bouncing in like a puppy at inopportune times, times that recall something of that event, like a sound or a phrase, or even just the physical sensations of the traumatic event – elevated heart rate, sweating, restricted breathing, etc. I know of one woman who was held down and had her throat restricted when she was attacked. Any cardiovascular exercise brought back memories and fears and sensations from when she was attacked because once again, her breathing felt restricted. People with PTSD also must contend with hypervigilence, a state where they pay attention to every small sound, every small movement. Some books and scholars classify this as a high startle response. There are a host of other physical symptoms to survive when living with PTSD, but I think these seem like plenty, don’t you?

Relief from PTSD involves stilling these mind waves, learning not to detach completely from the material world to the inner world (that can be called dissociation, and is another symptom of PTSD), but rather, learning and acquiring the power to view the chaos of information about the material world as potentially unreal. Just as a friend who suffers from panic attacks learned to tell herself “This isn’t a real danger. This is just a test. Like a test of the emergency system on TV. This is just a test.” From repeating this to herself, she was able to quiet the mind and managed to move from several panic attacks a day to less than one a week. Yoga Chitta Vritti Nirodha. Yoga is the quieting of the whirlpools of the mind. Understanding that information coming in might seem to place you right back in the war zone, right back in the apartment of the attacker, but might also not be real, is a vital step in healing from PTSD. Yoga can provide this understanding. By working through asanas, those with PTSD learn how to constantly redirect the mind away from the constant flow of information (recall the hyperviligence) and sort through what information is actually vital. Staying in a pose where one can feel the muscles working, the ground under you, allows someone with PTSD to remain anchored in the present world. Focusing on breathing in each pose trains the mind to continue to breathe fully when uncomfortable, scared or tired. This can help short circuit panic attacks or other somatic responses to fear/flashbacks.

Yoga chitta vritti nirodha. Yoga is the quieting of the whirlpools of the mind. It is estimated that approximately 8% of the United States population has or will experience PTSD. Many of these individuals lack access to yoga, a possible treatment modality of great value, because of either access to a studio/gym or because of the cost. Yoga teachers can rectify this situation by providing free community based classes or by volunteering to teach people with PTSD individually. If y0u’d like to volunteer, contact Sprout Yoga by its Director at maggie@sproutyoga.org. If you’d like to assist in this vital work, but don’t have the time to volunteer, please donate to Sprout Yoga by its webpage www.sproutyoga.org. For those living with PTSD or eating disorders who want yoga but are priced out of this possibility, please contact Sprout Yoga who may be able to connect you with a teacher in your area.