Using Breathwork to Improve Self-Regulation Skills in Individuals with Eating Disorders
7-minute read
Using Breathwork to Help Treat Eating Disorders
This article discusses how somatic (body) therapies such as breathwork can help to improve the mind-body connection and improve self-regulation abilities of individuals with eating disorders. It will discuss the evidence behind body therapies and their link to improving outcomes in individuals with eating disorders. Finally, it will provide you with 3 easy breathwork techniques you can start using and experiencing the benefits of today!
Have you ever experienced an emotion that feels unbearable? Like it might swallow you up.
When you’ve experienced these emotions, what do you usually do to cope?
Do you have effective tools and strategies to express your emotions or does it go a little bit like this……
You’re sitting at home scrolling on your phone, you see an Instagram post of a friend or maybe even an ex. He’s sitting there shirtless, his perfectly sculpted abs popping as he sends a dazzling smile towards his new girl. You wince, as you feel a pang of jealousy and feel your jaw start to clench. You look down at yourself, you haven’t showered in 3 days, your stomach slightly bulging over your pants and you start feeling a mix of self-loathing and hopelessness. So you roll over, reach for the chocolate. “I’ll just have one or two pieces” you promise yourself. “I’ll get back in shape tomorrow.” Before you know it you’ve eaten the whole block whilst binge watching your favourite TV shows.
Now you’re not only feeling lonely but also completely stuffed, guilty and ashamed. How did this happen again?!
Instead of effectively identifying and expressing your emotions, you’ve fallen into the old pattern of suppressing and avoiding your emotions through food. Evidence suggests that individuals with disordered eating and eating disorders usually experience a low tolerance for self-regulation.
What if there was a way to learn how to identify, tolerate and express these emotions without being consumed by them? Tools and strategies that actually left you feeling more connected to yourself and emotionally stronger.
Breathwork, a body based therapy, when used in conjunction with mindset and cognitive based therapies, is one of those tools.
What are body-based therapies and how are they helpful with treatment of eating disorders?
Body based therapies such as breathing help an individual identify and safely experience what is happening within the body. They do this by helping individuals learn to effectively link their bodily state to their emotional state. An individual with an eating disorder generally has difficulty connecting their mind and body. They use food and body obsessions to disconnect from uncomfortable sensations within the body and avoid emotions which feel too distressing to sit with.
“Eating disorders are a means of voicing oneself and their unmet needs without speaking. Food and body issues become the vehicle for what otherwise cannot be expressed.”
Learning to identify and tolerate emotions is one of the first steps to creating and maintaining a healthy relationship with food and your body. It can also assist with regulating mood more effectively, start to reverse mind-body disconnection and numbness and help with the integration of emotions.
Research indicates that individuals with eating disorders lack a relationship between their cognitive and embodied sense of self (head and heart). This means that only addressing your cognition mind or just the body can reduce the chance for long-term improvements. Body psychotherapists recommend that healing should be done through the body, therefore programs which don’t include a body or somatic element may fall short. For example, using only cognitive behavioral therapies ( i.e. Psychology alone ) can lead to an intellectualisation of the eating disorder. Meaning, you can understand the problem but can’t identify how to improve it.
For a more effective holistic treatment approach both aspects of mind and body need to be addressed. This treatment strategy may look like a mixture of cognitive behavioral therapy tools and strategies, addressing bodily awareness, movement, breathwork and touch.
The role of breathwork in self-regulation
Breathwork in simple terms is about bringing intentional awareness to your breath. There are a range of different types of breathwork such as the famous Wim Hof style breathing which is fast paced and requires quite a bit of physical effort. On the other end of the spectrum, techniques such as heart coherence, one of the most researched and evidenced based techniques, is a slower more relaxing technique.
Breathwork can facilitate an empowered sense of self
Breathwork can enable an individual to learn to take control of a situation and their emotional state. Seligman 1991, discusses the idea that being repeatedly exposed to stressful stimuli (such as a binge) without appropriate tools or strategies can lead to a learned sense of helplessness. If you feel like you have no control over a situation, you can start to become a victim to that situation or behaviour. Breathwork can help empower you to change that narrative. It can help you to create a new story, that you always have the ability to take control of a situation as you can always choose to breathe (Paivi Lehtinen et al, 2014).
Breathing has been shown to have an immediate (within minutes) and direct impact on your physiology. For example, it can help to soften the intensity of the urge to binge or purge. This can give you a chance to pause instead of acting on impulse and empower you to make a decision on your actions, rather than be a victim to your physiology.
How does breathwork alter your physiology?
Breathwork can help to alter your physiology
It does this by shifting the nervous system from a sympathetic state (fight and flight) to a parasympathetic state (rest and digest) calm state. Generally, when someone is in a stress state their breathing rate increases and less oxygen is released into the body due to the reduction of carbon dioxide. This can result in shortness of breath, fatigue, faintness and dizziness, symptoms which have been linked to an increased likelihood of engaging in binge eating behaviours (Kelly A. et al, 2020).
The good news here is you can take control, instead of allowing your physiology or emotions to control your breath and lead to unwanted physiological and psychological consequences. You can actively practice breathwork to help you learn to transform your physical and emotional state (Bloch S et al, 1991; Sageman S, 2002).
Not only can breathwork change your physiology, it can help you to improve awareness of your physical and emotional state to create a stronger mind-body connection.
Breathwork can help improve self-awareness and strengthen the mind-body connection
How does it strengthen the mind-body connection?
By focusing your attention on your breath, you can start to notice and identify bodily sensations as they arise. If you allow yourself to experience them without judgment, you can start to become more aware of what your body is experiencing. Quite often, individuals who binge, struggle to tolerate or identify their bodily sensations. Binge episodes frequently occur in a dissociated (disconnected) or trancelike state where an individual may not even remember the episode.
“By focusing on your body and breath without judgment it will help you move towards an attitude of acceptance of your inner experience instead of resistance and suppression (Dowling 2000; Minett 2004). This can empower you to change your relationship with your thoughts, feelings and sensations and choose how you decide to respond to them rather than act on impulse (Baer 2003; Bishop et al. 2004; Hayes and Feldman 2004; Shapiro et al. 2006).”
Why would you need to improve your relationship with your thoughts, feelings and sensations?
If you can identify what your body is feeling or experiencing you can start to identify your needs. When you are able to identify your needs, you can learn to fulfill them, instead of using food or body obsession as a maladaptive behaviour to meet your needs.
Did you know that the ability to tolerate emotions and improve mood has been reported to be one of the most obvious benefits of mind-body interventions (Stromberg et al., 2015). Breathwork interventions have been shown to help reduce the impact of stress and emotions on the body (Jerath et al., 2015). One study showed that a 6-week breathing course was long enough to significantly decrease levels of anxiety in healthy adults (Chandla et al., 2013). Evidence from brain imaging studies support this hypothesis and suggest that long and regular breathing can help to deactivate the limbic system (Kalyani et al., 2011). This means, it can help to reduce the intensity of emotions and sensations within the body.
Along with emotional disturbances, tension and body discomfort is a common feature in individuals with eating disorders. It can be a trigger for eating disorder behaviours. Breathwork has been shown to be an effective tool to reduce muscle tension. Let’s explore this further.
Breathwork can help reduce muscle tension
Have you ever experienced a stomach ache that doesn’t go away no matter how much pain medication you take?
Did you know emotions can be stored in the body. Often, individuals with eating disorders present with muscle tension which can impact posture and disrupt circulation within the body. Releasing muscle tension in areas of the body such as the jaw, neck, shoulders, hips and other major joints in the can help to release emotions such as vulnerability and openness. This can help lay the foundations for you to start expressing some of the emotions food has been repressing such as anger, frustration, hate, envy or desire.
Breathwork techniques can help to regulate tension in the mind and body and in turn help improve awareness, self-compassion and relaxation (Paivi Lehtinen et al, 2014).
What does this all mean?
In summary, breathwork techniques can be an effective tool to help facilitate treatment in eating disorders, helping to improve self-regulation, awareness and strengthen the mind-body connection (Lloyd Lalande et al, 2011).
Ready to try a few techniques?
Checkout the 3 breathwork techniques below which focus on downregulating the nervous system, creating a sense of calmness and clarity within the body. They’re simple and the best news is you can do them anywhere, anytime without anyone knowing you’re doing them.
See website for a range of programs available to support you.
References
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143.
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., et al. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11, 230–241.
Bloch S, Lemeignan M, Aguilera N. Specific respiratory patterns distinguish among human basic emotions. Int J Psychophysiol. 1991;11:141–54. [PubMed] [Google Scholar]
Chandla S. S., Sood S., Dogra R., Das S., Shukla S. K., Gupta S. (2013). Effect of short-term practice of pranayamic breathing exercises on cognition, anxiety, general wellbeing and heart rate variability. J. Indian Med. Assoc. 111 662–665. [PubMed] [Google Scholar]
Frances A.Carter, Cynthia M.Bulik (1994). Exposure treatments for bulimia nervosa: Procedure, efficacy, and mechanisms. Advances in Behaviour Research and Therapy, 77-129. https://doi.org/10.1016/0146-6402(94)90003-5
Gail A.Williams-KerverabJanis H.Crowthera (2020). Emotion differentiation and disordered eating behaviors: The role of appearance schemas. Eating Behaviors 37. https://doi.org/10.1016/j.eatbeh.2020.101369
Hayes, A. M., & Feldman, G. (2004). Clarifying the construct of mindfulness in the context of emotion regulation and the process of change in therapy. Clinical Psychology: Science and Practice, 11, 255–262.
James C.Rosen, HaroldLeitenberg (1982) Bulimia nervosa: Treatment with exposure and response prevention. Behavior Therapy 13 117-124. https://doi.org/10.1016/S0005-7894(82)80055-5
Jerath R., Crawford M. W., Barnes V. A., Harden K. (2015). Self-regulation of breathing as a primary treatment for anxiety. Appl. Psychophysiol. Biofeedback 40 107–115. 10.1007/s10484-015-9279-8
Kalyani B. G., Venkatasubramanian G., Arasappa R., Rao N. P., Kalmady S. V., Behere R. V., et al. (2011). Neurohemodynamic correlates of ’OM’ chanting: a pilot functional magnetic resonance imaging study. Int. J. Yoga 4 3–6. 10.4103/0973-6131.78171 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Kelly A. Romano, Kristin E. Heron, Kathryn E. Smith, Ross D. Crosby, Scott G. Engel, Stephen A. Wonderlich, Raina D. Pang, Tyler B. Mason (2020), Somatic Symptoms and Binge Eating in Women's Daily Lives, Journal of Psychosomatic Research, Volume 135,110161, ISSN 0022-3999, https://doi.org/10.1016/j.jpsychores.2020.110161.
Lloyd Lalande, Matthew Bambling, Robert King, Roger Lowe (2011) Breathwork: An Additional Treatment Option for Depression and Anxiety? Journal of Contemporary Psychotherapy DOI 10.1007/s10879-011-9180-6. An-additional-treatment-option-for-depression-and-anxiety.pdf (bjarnesand.se)
Ma, X., Yue, Z-Q., Zhang, H., Duan, N-Y., Shi, Y-T., Wei, G-X., & Li, Y-F. (2017, June). The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Frontiers in Psychology, 8: 874. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455070/
Paivi Lehtinen, Minna Martin, Maila Seppa, Tina Toro (2014). Breathing as a Tool for Self-Regulation and Self-Reflection. Finland, Mediapinta Oy
Sageman S, How SK. International Symposium on Sudarshan Kriya, Pranayam and Consciousness. New Delhi: All India Institute of Medical Sciences; 2002. Can treat the cognitive, psychodynamic, and neuropsychiatric problems of post traumatic stress disorder. Proceedings: Science of Breath; pp. 28–31. [Google Scholar]
Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62, 373–386.
Stromberg S. E., Russell M. E., Carlson C. R. (2015). Diaphragmatic breathing and its effectiveness for the management of motion sickness. Aerosp. Med. Hum. Perform. 86 452–457. 10.3357/AMHP.4152.2015
Victoria M.Lingswiler, Janis H.Crowther, Mary Ann Parris Stephens (1989). Emotional and somatic consequences of binge episodes. Addictive Behaviors 14 503-511. https://doi.org/10.1016/0306-4603(89)90070-1
