Getting Unstuck Using Neuroplasticity When Recovering From An Eating Disorder
By Laura Cipullo RD, CEDRD-S, RYT
Many individuals who have been diagnosed with an eating disorder are considered to have experienced trauma and or have been diagnosed with PTSD, similar to a veteran of war or survivor of abuse. “Trauma is stored in somatic memory and expressed as changes in the biological stress response, creating undischarged energy in the nervous system (specifically in the amygdala, thalamus, hippocampus, hypothalamus, and brain stem) not accessible” to the understanding, thinking, reasoning part of your brain known as the frontal cortex. Individuals may have been traumatized and possibly not even recognize or recall the experience. On the other hand, Post- Traumatic Stress Disorder is characterized by a persistent re-experiencing of the traumatic event (intrusions), regular avoidance of anything associated with the trauma, an effort to numb oneself to all feelings and thoughts, and finally, a constant state of arousal known as fight, flight or freeze by way of being “stuck” in the autonomic nervous system’s sympathetic response.(1). Keep in mind, many individuals can be traumatized by more than one event or experience. Meal times and body image can both be experienced as traumatic for clients with eating disorders, especially those who have already experienced trauma earlier in their life.
Eating disorders are considered disorders of the brain involving neurological, physical, emotional, cognitive and social processes. Therefore, when creating a care plan and team for someone with an eating disorder, one must consider a holistic treatment plan to address all of these systems. Through Functional MRIs and PET Scans, it is apparent that individuals with eating disorders are wired differently than individuals without eating disorders. This means there are greater and or lesser levels of activity in parts of the brain. As healthcare practitioners, parents or individuals with eating disorders, it is wise to consider neuroplasticity to help the individual with an eating disorder stuck in the sympathetic response of flight fight or freeze. Neuroplasticity is defined as the brain’s ability to reorganize itself by forming new neural connections throughout life, especially in response to learning or experience. This means individuals can use their brain to unwire old patterns associated with traumatic experiences, and then reconnect the mind, brain and body when in a state of calm, to stimulate new, healthy neuropathways. Studies have demonstrated the benefits of neuroplastic changes (rewiring the brain) in the ED brain through exposure to specific movement interventions such as the Feldenkrais Method (see Part 4 for more information) and or trauma-informed yoga. (2,3)
Dr. Moshe Feldenkrais observed that in order for there to be real long-term behavior change, one must change the way they sense and move in their body. (2)
Dr. Norman Doidge, author of The Brain That Changes Itself, explains that neuroplasticity allows for the development of resourcefulness and flexibility, yet is also capable of producing rigid habits and behaviors. He says “Just as there is a path into an eating disorder, there is a path to recovery, with both pathways stemming from the brain’s ability to be altered by thoughts and behavior.” (3) As eating disorder specialists, parents and or individuals suffering with an eating disorder, we need to explore using both the top-down approach of talk therapy and cognitive therapies with and the bottom up approach through movement and sensory motor modalities. In other words, “a healthy self is an embodied experience, learned through body sensations and proprioception which create new neuropathways.” This means we need to help clients identify their body sensations in a new way to create a healing and or positive experience of themselves, their meals and their body (body image). (2) The common saying is “Where attention goes, neural firing occurs, and where neurons fire, new connections can be made.” This means when one is internally aware, present and without judgement, they can connect previously isolated segments of their brain. This will help to release the fight, flight or freeze response and engage the parasympathetic nervous system to access a state of calm to wire new healthy neuropathways associated with positive feelings and thoughts around food and body. (2,3)
Whether post COVID, or just a normal day, most clients with eating disorders operate in the PTSD state of fight, flight or freeze and or experience meal time as traumatic. This makes treatment feel uncomfortable and sometimes seemingly counterproductive for both the provider and the client. Neuroplasticity offers a new perspective and a more holistic treatment model. As RD’s and eating disorder specialists, we can help our clients by using other adjunct modalities to create new neuropathways and or refer to other practitioners employing a “bottom up” approach. To create these new pathways and remove the stuck quality resulting from trauma, we need to first or simultaneously help clients engage their parasympathetic nervous system. Self Exercises to engage the PNS include breathing, mindfulness meditation and yoga and mindful meals. Include specialists in Feldenkrais, Rolfing, Cranial Sacral Therapy, Reiki, Somatic Experiencing, EMDR, Acupuncture and Trauma Informed Yoga to create brain-changing electrical pathways. Research shares “by increasing brain circuitry through bodily movement with attention and self-awareness, somatosensory education…in connecting body with mind, and brain with body… fosters the neurophysiological reintegration of the core self that is embodied,” (2) which can provide the opportunity to move forward on the journey of recovery from an eating disorder.
- Ramirez, M.A., RYT-200, G. M. (2019).Single Yoga Session Effect on Anxiety and Body Image in Eating Disorders [Doctoral dissertation, Xavier University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1566813967139149
- Natenshon, Abigail. “Clinical Application of Neuroplastic Brain Research in Eating Disorder Treatment.”The Open Access Journal of Science and Technology, vol. 4, 2016, https://doi.org/10.11131/2016/101219.
- The National Institute for the Clinical Application of Behavioral Medicine, Ruth Buczynski, PhD How to work with clients who are stuck (Educational video modules) including but not limited to…How to Engage the Parts of the Brain that Get Stuck After Trauma, Part 1: Bessel van der Kolk, MD How the Unconscious Brain Creates a Holding Pattern of Fear; How to Engage the Parts of the Brain that Get Stuck After Trauma, Part 2: Rick Hanson, PhD; Why Implicit Memories May Be Keeping Your Client Hostage (And How to Release Them), Part 1: Peter Levine, PhD accessed 11.23.2021
