Body Movement and Body Image Work

1. Body Movement and Body Image Work Amy Kayda, MA, DTR, LPC Deanna James, MA, DTR, LPC

2. MAJOR CONCEPTS • Connection is essential to the recovery process. • The body can be used as a resource for deepening the therapy, self-expression, and emotional regulation. • Body centered therapies can be used to deepen the IFS process, including connection to self energy. • Trauma is held in the body and thus the body, and its memories / sensations must be addressed and expressed for healing to take place. • Negative body image is not really about our culture and media. Our culture reinforces negative body image and disembodiment, it does not create it.

3. Why is Body Movement &Body Image work essential? • Due to painful or traumatic experiences it is difficult for clients to connect to the body in a safe and effective way. • Eating disorder symptoms further serve to disconnect one from their bodily felt sensations and emotions. • In eating disorder recovery, it is essential that there is a mind/body connection. • Many clients struggle with distorted body image which causes anxiety, exacerbation of the ED, and disruption of self image and thus relationships. • In order to achieve full acceptance of self, clients must learn to accept their body and the emotions that are held in the body.

4. Why is Body Work Essential? • In eating disorders clients view the body as a billboard: “HELP! See how much pain I am in!” • Our goal is to help clients view the body as their home. • Client often view their body as a condemned home, one that is not safe for habitation.

5. Philosophy of Treatment • At Castlewood, we encourage an exploration of the mind/body connection in order to assist those struggling with eating disorders to begin to forge a new relationship with their bodies, one that is compassionate, accepting and kind.

6. Philosophy of Treatment • One of the core concepts of the Internal Family Systems model is that parts are held in and around the body. It is our belief that in order to understand parts and their functions with compassion and acceptance, clients must learn to connect to the body that is the container for these parts.

7. Philosophy of Treatment • In order for clients to truly engage in the recovery process, it is essential to incorporate healthy and safe ways to connect to the body. • An essential component of the healing process is to integrate cognitive and somatic insights. • We use body work to deepen the cognitive process, as well as to express feelings and sensations trapped in the body as a result of trauma.

8. What is Body Movement Therapy? • Based on the assumption that the body and mind are interrelated, body movement therapy is defined as the psychotherapeutic use of movement to further the emotional, cognitive, physical, and social integration of the individual. The dance/movement therapist focuses on movement behavior as it emerges in the therapeutic relationship. Expressive, communicative, and adaptive behaviors are all considered for both group and individual treatment. Body movement as the core component of dance simultaneously provides the means of assessment and the mode of intervention for dance/movement therapy. American Dance Therapy Association

9. What is Body Image? • Body image is comprised of how one sees their body, lives in and experiences their body and perceives how others see their body. • Negative body image can serve a protective function to distract clients from painful feelings or emotions held in the body.

10. Goals of Body Movement and Body Image Work • Connection to the body in a safe manner. • Increased ability to be present in the hear and now. (Mindfulness) • Safe and healthy expression through the body • Increased ability to utilize self soothing and affect regulation skills • Connection to and acceptance of all parts • Connection to sense of Self

11. Connection to the Body in a Safe Manner • Why connect? • We experience feelings in our bodies. Part of recovery is being able to distinguish and label what’s going on inside so that we can respond appropriately. • We cannot like or appreciate something we are not connected to. • Many clients experience extreme body image distortion. Through connection and exploration of the body a more accurate perception can unfold. • Many clients experience psychosomatic symptoms. Connection can help alleviate some of these symptoms.

12. Connection to the Body in a Safe Manner • Why connect? • As a result of trauma, many clients disconnect from internal emotional cues, as well as internal body sensations. Clients often re-enact trauma and feelings associated with trauma onto the body through their ED, self-injury, critical self-talk, etc. • Clients may ignore or dissociate from their natural early warning signs of danger. This disconnection can result in clients putting themselves in dangerous situations, or seeking out danger/perpetrators. • It is essential to re-connect clients with their body’s emotional cues and warning signs of danger, not only to help them make safe choices but also to help them gain insight into trauma re-enactment dynamics.

13. Increased Ability to be Present in the Here and Now. • “The here and now focus provides not only an invaluable source of information for each patient, but also a safe arena in which patients may experiment with new types of behavior.” Irvin D. Yallom, Inpatient Group Psychotherapy pg 175.

14. Safe and Healthy Expression Through the Body • Clients often view the body as something they have to carry around with them. A number on a scale, the thing that keeps them from being happy, the thing that makes them different, etc. • Helping clients to see their body as a vehicle for healthy expression can change their perception of their body.

15. Safe and Healthy Expression Through the Body • Often in trauma, clients view the body as another thing that betrayed them. By using the body to express feelings, clients may begin to see it as an ally. • Through the use of ED and other self-harm behaviors the body becomes an object. The goal is to help clients see their body as part of themselves. • The eating disorder functions as a way to express to others the pain and overwhelming feelings held in the body. Clients can learn to express these feelings in a healthy way.

16. Increased ability to utilize self soothing and affect regulation skills • The eating disorder functions as a self regulatory mechanism. As part of the recovery process clients must learn to manage internal distress in safe and healthy ways.

17. Connection to and acceptance of all parts Connection to sense of Self • The non-extreme intention of each part is something positive for the individual. There are no “bad” parts and the goal of therapy is not to eliminate parts but instead to help them find their non-extreme role. • Self is the core, or center of the person. When differentiated it acts as the active compassionate leader.

18. Possible Interventions: • Write or create artwork about your relationship with your body (past and present). Include significant life events, messages you received about your body, (positive and negative), memories, feelings about femininity/masculinity, sexuality, etc. You can also include actual photos of yourself.

19. Possible Interventions: • Use the following prompts to create images: When I look in the mirror I see… When my eating disorder looks in the mirror it wants my body to be…When I nourish and take care of my body appropriately it naturally appears…I think others sees my body…

20. Possible Interventions: • Nature walks that incorporate the following: reflection on surroundings, pausing to take deep breaths or simply notice the movement of the breath in the body, moving the body in any way that feels refreshing and releases tension, silent mindful walking mediation alone or in groups/pairs, choosing an object in nature that represents how a client feels currently about their body and how they would like to feel in the future.

21. Possible Interventions: • Write a letter to your body and have your body write back. You may also write a letter of apology to your body for hurting it in the ways that others have hurt you. • -Make a list of all the functions of your body. What does your body do for you? (Example: my eyes allow me see beautiful sunsets, my arms allow me to hold my nephew, my ears allow me to hear my favorite band on the radio, etc)

22. Possible Interventions: • Guided imagery and mindfulness activity (5-10 minutes) focused on what a client is experiencing in the moment internally with focus on body sensations, here and now, mental noting of thought and feelings with a non-judgmental stance, counting breaths (1-5) or labeling the inhale and exhale. Client can keep eyes open or closed based on comfort. You can expand on this by having client draw an image of the experience and then bring the image to life in movement or gesture.

23. Possible Interventions: • Movement timeline: Ask the client to express in movement her journey through eating disorder recovery. Identify, embody and move through stuck points. • -Spontaneous, creative play, (clapping game/hands on floor), popular group dances, piling pillows and jumping into the them, punching pillows, adding sound, asking clients to bring in their favorite music, all can help clients feel more at ease and joyful in their bodies.

24. Possible Interventions: • Body tracing: • Speak to the client about the objective of the tracing. The goal is to help her understand the underlying Feelings, Associations and Thoughts (F. A.T.) that contribute to body-image and self-image. Inform her that the tracing is going to be imperfect because there is human error. Clothing, crinkles in the paper, etc. influence the outcome. Bodies are three dimensional and this is a two dimensional image, so it has inherent limitations. Be sure that the client feels safe and is grounded before you attempt the tracing. • Get a large roll of paper. Tracings can be done either lying down or standing against the wall, with the paper taped to the wall. • Trace the client. Be sure to check-in throughout to see if the client feels safe and is comfortable. Remind her that she can stop at any point whatsoever.

25. Possible Interventions: • Process the tracing in the following way: • Ask the client to write a response to the tracing using stream of consciousness. • Ask the client to use artwork, photos, colors, shapes and words to fill in the tracing using the Feelings, Associations and Thoughts (F.A.T.) guidelines. Include memories, experiences, trauma, messages received and/or internalized about the body or body parts. Encourage authenticity and honesty. • Ask the client to share the image in session and/or group. • Ask the client to create either an additional image either on another piece of paper or on the back of the first image or one can add things directly on the first image. The theme of this image is “What does this body (the initial tracing) need now? “ Encourage the client to reflect on the 8 C’s of IFS therapy. • Ask the client to process the entire experience. Be sure to include current bodily-felt sensations as you process the imagery.

26. Possible Interventions: Group Unburdening- Create a “fire” in the middle of the room. Have clients put feelings, memories represented by pillows or other objects in the middle of the room. Have clients share what they are placing in the “fire.” Put the “fire” out by placing blanket over the pile of pillows. Have clients then take positive qualities out of “water” to replace what they just gave up. Group Sculptures/exploration of qualities of self- Have clients explore the various qualities of self through movement, group sculptures, postures. Moving in self and various parts(separating from parts)- Have clients move from pillow to pillow or chair to chair exploring what various parts (feeling states) feel like in their body. Have one pillow or chair represent the qualities of self. Explore how the body feels different between self and parts.

27. How do we invite our body and the client’s body into the therapeutic process? • Maintain an awareness of your own body in sessions and groups. Attend to what you are experiencing in your body. Examples: (tightness, heaviness or warmth in the chest, sleepiness, butterflies in the stomach, headaches, tingling, numbness or pain in body parts, dizziness, excitement, agitation, calmness, etc). Somatic counter-transference provides valuable information and assists with interventions.

28. How do we invite our body and the client’s body into the therapeutic process? • In order to be more fully embodied, carefully attend to non-verbal communication (body posture, breathing, tone of voice, facial expression, skin tone changes, gestures and overall physical presence in the room). If a client shifts her posture or takes a deep breath, gently mirror the behavior yourself, and/or simply verbalize what you notice. Mirroring is one of the most fundamental and powerful therapeutic interventions. Non-verbal mirroring techniques are simple and effective; incorporating them can greatly deepen the therapeutic process and invites the body into the space.

29. How do we invite our body and the client’s body into the therapeutic process? • Ask regularly about what clients are experiencing in their body during therapy. This integrates mind/body and dismantles the familiar “talking head” syndrome, in which client’s are cognitively and intellectually insightful but completely disconnected from their body. The eating disorder lives in the body. The only way out is through the body.

30. How do we invite our body and the client’s body into the therapeutic process? • Encourage simple and mindful ways to be embodied such as connection with nature, balanced and fun movement, yoga, dance, martial arts, connecting to the senses by lighting a candle, applying lotion, listening to music, receiving a massage or manicure/pedicure, relaxing in the hammock. Ask regularly if your clients are engaged in some activity that connects their mind and body in a gentle, kind way.