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June 24, 2020 by Samantha Willy-Gravley

Trauma-Informed Care, the Body and Eating Disorders

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"We are all just walking each other home."

Ram Dass

A beloved yoga teacher once said to me "the body is just trying to help," referring to its beautifully adaptive nature. He was explaining this as a way of introducing a sense of radical trust and compassion for how to understand ourselves. In my work as both a yoga teacher and a psychotherapist, I find this wisdom to be inherently true. Just take the example of sitting at your desk while typing on the computer: after several minutes or even hours, your spine will contract, your shoulders will internally rotate and your chest will tighten — all in an attempt to keep you in a hunched, rounded position conducive to typing at the computer; exactly what you are asking the body to do! How remarkable!

If we have been perpetually unsafe or in situations where we were not loved or cared for like we needed, the body adapts to keep on alert for danger and pain, hoping to avoid it and protect us. Neuroscience indicates that trauma results from an overwhelming activation of the threat response in the body. In short, this could be: fight, flight, attach cry, freeze or submit/collapse. Often, these responses get "stuck," resulting in nervous system dysregulation and an overall sense in the body and brain of not being safe. This comes at a cost with symptoms like: hyper-arousal, tension, hypo-arousal, sleep disturbance, flashbacks, body memories, dissociation, and avoidance of past reminders. As those experiences are unaddressed, they stick with us, leaving a lasting impression and also leaving us to believe that this adaptation is who we are.

When working with eating disorders, it is important to remember that behaviors, such as disordered eating, are a result of the body's attempt to regulate or self-medicate nervous system dysregulation and attachment wounds. Unfortunately, traditional behavioral models often look solely at the behavior itself and fail to address the purpose of disordered eating for the nervous system. This disregards the principal of the body as a protector and helper. However, it is vital that we learn to get curious and ask the "why" of behaviors. What is it that the body is trying to protect? Where do you hurt? How did disordered eating help you survive? After all, food intake restriction can have a numbing or energizing effect, binge/purge cycles can often affect serotonin levels and release endorphins and over-exercise works similarly to create the endorphin high needed to regulate. Again, the body is just trying to help.

What if we did believe that our body was just trying to help? That it is HAS helped us? AND, that it is the way through healing? How would that change how we saw one another and saw ourselves? In the past decade, trauma-informed care has emerged as a guiding principal for practitioners working with clients. At its core, trauma-informed care is deep respect and love for the ways in which we have survived. It is the understanding that each person is just doing the best that they can. This belief and value system centers around connection and joining with someone, rather than away from them. It is the belief that while we may need support, we are still complete, intelligent, worthy beings with our own innate wisdom. Trauma-informed care is taking a slow, calm breath, lengthening the spine, relaxing the shoulders and walking with someone (not in front of or behind!) on their journey. Trauma-informed care is learning to make peace with the body.

So what does that look like in practice? Trauma-informed care might look a little more like being with a client, rather than doing something with them. It looks like asking questions and expressing curiosity about behaviors and shying away from assumptions. It is acknowledging that trust and safety are absolutely essential for healing and take priority over our own agenda. Trauma-informed care means being very interested in how we do things, and not just what we do. At meal times, it might look like releasing "calling-out" of behaviors and instead, observing, playing a game, asking questions or being silly. It might look like taking the time to explain the neurobiology of disordered eating, as a means of reducing the shame that clients feel about how their systems have adapted and survived. It might look like using a first session to get to know the client, instead of asking for a full disordered eating history. It might look like taking a few minutes before a session to close the eyes, place a hand on the heart and take a few deep breaths. Trauma-informed care is educating ourselves about the histories and legacies of systemic oppression and violence including: racism, sexism, fat phobia, ableism, white supremacy, colonization and homophobia and learning how they have shaped clients experiences. Above all, trauma informed care is a felt sense in the body of loving-kindness and acceptance. It is teaching and modeling how to be in the body in a safe way. It means doing our own somatic healing work and breaking free from the fears, worries, judgments and "triggers" that get in the way of being the calm, present guide that our clients need. Using the words of Ram Dass, we could say that in trauma-informed care, "we are all just walking each other home." Trauma-informed care is connecting mind, body and spirit so that we can remind one another of who we really are.

Samantha Willy-GravleySamantha Willy-Gravley, Primary Therapist
Mirasol Recovery Centers
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