For years and years, eating disorder treatment centers used only medical and psychiatric methods to provide eating disorder treatment for sufferers of anorexia nervosa, bulimia nervosa, and other common disorders. While in keeping with the scientific and medical philosophy of the times, this approach to eating disorder treatment could have the unfortunate effect of ignoring or even harming the client’s spiritual side, and her connection with the world around her. While medical and psychiatric components are key to any program, true healing of mind, body, and soul requires a mindfulness portion as well.

Holistic Healing in Eating Disorder Recovery

“Holistic” is a term that gets bandied about quite a bit these days, but the term’s meaning in an eating disorder recovery setting is not widely understood. Too often it’s associated with New Age or “hippie” trends of the 1970s and perceived as less serious than traditional eating disorder treatment centers’ methodologies. This perspective may be passed on by more traditionalist care providers or through badly-researched portrayals of holism and mindfulness in the media.

However, holistic treatment using mindfulness techniques is a cornerstone of the best modern mental health treatment models, including specialized eating disorder treatment.

In the mental health treatment sense, holistic treatment doesn’t necessarily imply crystals, incense, or other stereotypical activities (they may be included but in an evidence-based implementation rather than random occurrences). Instead, it means that it respects the intersection of a person’s physical health, mental wellbeing, and spirituality or soul. In other words, holistic treatment treats the whole person, not just the component parts or their symptoms.

An example of this with relation to eating disorder treatment could be a person with bulimia nervosa who has corroding teeth due to repeated vomiting. A traditional treatment program might employ dentistry to fix the specific symptom, combined with medication or talk therapy to address the mental portion. However, this would set aside the underlying sense of dissatisfaction with the individual’s body or their sense of distress when around food. In essence, by only treating the body and aspects of the mind, there remains a possibility for disordered eating behaviors to come up once again.

It’s simply not treating the whole person.

In light of the now-understood necessity of helping people in eating disorder recovery, or even staying in an eating disorder treatment center, treat not only the surface symptoms but the underlying issues, holistic treatment gains even more importance. And key to every great program which treats the whole person is mindfulness.

What Is Mindfulness?

Simply put, mindfulness is being aware of yourself and your surroundings. It’s living in the moment, not getting stuck in regrets or nostalgia for the past and not being paralyzed by fears (or even hopes) about the future. It could even be called “living within the experience.”

When employing mindfulness techniques, a person can truly make the most of each moment. With a sense of what you are doing and why you are doing it, it common to gain a sense of clarity. While this certainly allows many people to truly appreciate the people, things, and experiences around them, it can also allow people to highlight problem thoughts and behaviors and begin to correct them. Mindfulness is at the core of most “whole person,” or holistic eating disorder treatment program.

How Does Mindfulness Assist in Eating Disorder Recovery?

Before getting into particular mindfulness techniques which are so central to modern eating disorder treatment, we should take a moment to look at the specific symptoms of various eating disorders that can be relieved through mindfulness training. Professionals in medicine and at specialized eating disorder treatment centers have determined certain symptoms and behaviors which are common to most DSM-V listed eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, orthorexia, and others. Some of these symptoms and behaviors include:

Body dysmorphia or distorted body image

While not present in every type of eating disorder, body dysmorphia is central to many of the most dangerous ones, particularly anorexia nervosa and bulimia nervosa. Also known as negative or distorted body image, body dysmorphia is a sense of constant dissatisfaction with one’s body. This can manifest as a person thinking she is fat or overweight despite medical or even visual evidence to the contrary (that is, a person with anorexia nervosa stemming from body image issues will look in the mirror and see herself as overweight even though she is emaciated), or by perceiving flaws in her body that no one else sees. This kind of disordered self-image is a leading causative factor in most eating disorders and can be a standalone mental health issue in its own right.

Repetitive and compulsive behaviors

Well-known among these behaviors in the eating disorder treatment community is the binge eating and subsequent purging cycle which defines bulimia nervosa. Even without the purging acts, repeated binge eating episodes are endemic to people with binge eating disorder. These behaviors often induce a feeling that the individual has lost control over their actions, which then cause the person to feel pronounced guilt, shame, and self-loathing. These feelings, in turn, cause the person to engage in the disordered behavior again as a coping device, starting the cycle anew. It can be like a negative feedback loop, where the negative feelings sparked by the episodes of binge eating and/or purging are amplified each time the behaviors take place.

Anxiety surrounding food and eating

A major component of virtually every eating disorder is a sense of discomfort or unease surrounding food and mealtimes, particularly when around other people or in public. This kind of anxiety can show up in various ways. People with binge eating disorder will often eat sparingly during public meals but hoard junk foods away in their room, where they can be consumed in private. Many people with anorexia nervosa will just have a glass of water and a tiny appetizer for their entire meal, and oftentimes will leave that food largely untouched. Even something as seemingly innocuous as making sure foods on the same plate don’t touch each other, or listlessly moving food around on the plate, can be indicators that a person has a stress response to eating in public. These rituals can work in a similar fashion to the aforementioned compulsive behaviors in that they can become the start to a tricky spiral.

So what do these behaviors and negative feelings have in common? They result in guilt, shame, and poor self-esteem, and they lead to a loss of control. That’s where mindfulness comes into play.

Taking Back Control

As discussed a bit earlier, mindfulness is a way to live in the moment and be aware of your thoughts, emotions, actions, and surroundings. This means that a person emphasizing mindfulness, through evidence-based therapies like cognitive behavioral therapy or more traditional method such as mindful meditation or yoga, in their eating disorder recovery can achieve moments of clarity when engaging in disordered behaviors. They can see clearly what they are doing, outside of the clouded thoughts and feelings that have triggered these behaviors.

A sense of self-and situational awareness is key starting blocks for people in recovery to begin to make conscious changes in the way they feel and act on those feelings.

Consider, as a metaphor, that you’ve just bought a new album by your favorite band. You fire up your music app, put in the headphones and start listening. Just when you start to really enjoy the music, you hear an ambulance’s siren. And you notice the laundry machine is making a lot of noise. And your calendar notification goes off, remind you that you need to call your mother and go get a birthday gift for her. Then you look at your gift shopping list, and wonder if you should get the slippers she liked or a nice book… And so on.

Next thing you notice, a half-hour has passed, and you didn’t even really pay any attention to the music you were looking to enjoy. This is what a mind without mindfulness training can be like – full of distractions which keep you from living in the moment and being truly aware of what you’re doing.

For people with eating disorders, the thoughts and feelings of anxiety, stress, low self-esteem and negative or distorted self-image we went over earlier take the place of the laundry machine and the calendar notification. These distracting, and often distressing, thoughts prevent the individual from actually appreciating the eating experience – how it tastes, the mouthfeel, how it smells and how full they are getting.

Mindfulness training allows people in treatment to wipe away these distracting thoughts and emotions and learn to simply experience the moment. These feelings, which trigger behaviors that cause a sense and guilt, can be pushed away. This allows for a “blank slate” of mindfulness where the individual can control what they are thinking and feeling – and begin to take control of her relationships with food, eating, and her body.

Mindfulness Techniques Used in Eating Disorder Recovery

Mindfulness therapy in eating disorder treatment centers normally focuses on isolating harmful or distorted thoughts and behaviors and gradually replacing them with a self-aware, positive alternative. These methodologies often revolve around sensing and acknowledging feelings of hunger and fullness.

For example, someone with anorexia nervosa that’s advanced to the point where eating disorder treatment is needed is normally experienced in suppressing feelings of hunger, so as to avoid taking in any calories (due to the distorted self-image of being “fat”). This individual will benefit from mindful meditation that allows her to be aware of hunger pangs and acknowledge them. From there, the person can begin to accept that her body is telling her that it needs nutrition, and hopefully from there begin to regulate regular meals and a better relationship with food in general.

Another example might be a person with binge eating disorder (which is characterized by repeated episodes of consuming large amounts of food in a short period of time without purging). A person with this condition normally eats well beyond the point of being full or satiated during one of these binges. While a distorted body image isn’t normally connected with binge eating disorder, the episodes do normally come as a stress response and provoke feelings of guilt or self-disgust. In these cases, a course of mindfulness training aimed around being aware of her feelings of fullness can help to reduce the amount of food eaten during these binge eating episodes, and then finally only eating when they are actually hungry.

Moving from a Blank Slate to a Better Life

By incorporating evidence-based therapeutic techniques like cognitive behavioral therapy (CBT), which is a talk therapy that strives to gradually replace disordered thoughts and perceptions (like the body image distortions that accompany anorexia nervosa) with more realistic thoughts, into eating disorder treatment, patients can start to recapture a more positive relationship with their bodies, food, and eating. CBT is methodical in nature; it identifies disordered thoughts and behaviors, and then over time and many sessions, replace them with more rational ideas. Mindfulness training is a catalyst for CBT, in that it provides the clarity and awareness of the moment which allows people to realize that their thoughts and behaviors are disordered and even harmful. Once the mind is cleared and reality sets in, true recovery can begin.

If your adolescent daughter is suffering from an eating disorder or has received an eating disorder diagnosis, consider calling Clementine at 855-900-2221 today. Our focus on mindful recovery can not only promote a full recovery from the eating disorder but provide the tools for a happier, healthier life at the crucial junction of childhood and adulthood.

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Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.

Making the Most of the Moment: Mindfulness Matters in Eating Disorder Recovery