craving connection: how science and faith converge when ... · the polyvagal theory: “love...
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Craving Connection: How science and faith converge when
treating eating disordersKari Anderson, DBH, LPC, CEDS-S
myeatingdoctor.com
FoodBodyAndLove.com
The Powerpoint for this session is available at the above webpage, look for AACC “Craving Connection”. I also invite you to download a “sneak
peek” of my book coming out in early 2020 on this topic.
Designed for Relationship
• God designed us for deep and trusting relationships. Genesis 2:18 Even in a perfect world and perfect connection to God, Adam needed another human to connect with.
• God’s prescription is this: internalize God’s love-which transforms the entire being-so that you love both God and people, for whoever loves God will also love others. 1 John 4:21 The Remedy
• In love there is no fear.
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Our Health is Influenced by Love
“There are tens of thousands of studies showing that people who feel lonely, depressed and isolated are three to ten times more likely to get sick and die prematurely from virtually all causes, compared to those who have strong feelings of love, connection and community”Dean Ornish, Love and Survival
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Wonderfully Made
• The heart in a fetus begins beating before the brain is formed. Science is not sure how this works, but it has to do with the electrical impulses and neurons around and in the heart.
• There are at least forty thousand neurons in the heart that signal the emotional structures in the brain. Core feelings of love, appreciation and care can immediately shift our heart rhythms and a cascade of neural and biochemical events begin to affect virtually every organ in the body.
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The Polyvagal Theory: “Love Code”
-Porges, Stephen (2011) The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication and Self Regulation. Norton-Mammalian brain structures depend on social interactions to stabilize physiological arousal by means of facial expressions and vocal tones.
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Connectedness: A Biological Imperative
Survival of the fittest is what organisms need to perpetuate their existence. In mammals, the fittest may also be the gentlest, because survival often requires mutual help and cooperation.T. Dobzhansky (1962)
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Does the evolutionary doctrine clash with religious faith?
“I am a creationist and an evolutionist. Evolution is God’s, or Nature’s method of creation. Creation is not an event that happened in 4004 BC; it is a process that began some 10 billion years ago and is still under way” Dobzhansky (1973) Nothing in Biology Makes Sense Except in the Light of Evolution. The American Biology Teacher.
“ The more I study science, the more I believe in God” Albert Einstein
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Love Bonds in Animal Kingdom
Neuroception: Subconscious system for detecting safety and danger
• Detects Safety, allows for spontaneous social engagement with others using eye contact, facial expression, vocalizations and gestures to support co-regulation of autonomic nervous system. The “gazing effect” or face-heart connection takes place when love is present (no fear) using parasympathetic (ventral vagal)
• Detects Danger, ignites defensive strategies using the sympathetic nervous system to activate fight/flight into mobilization
• Detects Life Threat, ignites defensive strategies that feign death, into complete shutdown and immobilization through the parasympathetic (dorsal vagal)
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Royal Images of Love and Safety
The Social Engagement Systemcopyright Kate White ppncenter.com
The Vagus Nerve
Pure Terror
Polyvagal Theory and Eating Disorders
Eating behaviors are like social behaviors in that they use the same neural pathways to regulate our autonomic state. The social engagement system includes facial expressions, vocalizations and gestures where eating behaviors include chewing, sucking and swallowing. Both regulate the autonomic nervous system.
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Polyvagal Theory and Eating Disorders
Eating disorders are an attempt to regulate autonomic states due to an underdeveloped social engagement system. They may supplement or replace social behavior as a strategy to regulate state and are viewed as a dependence on eating (and not social) behaviors to regulate state.
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Porges Prescription for Eating Disorders“The single most important thing for someone with an eating disorder is to come out of isolation and begin eating with other people. Eating across from one another, eye to eye, changes the dynamic with food as co- regulator”
The Polyvagal Theory and Trauma
• Traumatic experiences interrupt opportunities to exercise the neural circuitry of connection
• Trauma replaces patterns of connection with patterns of defense
• Adaptive survival responses replace social engagement
• Co-regulation is unavailable/dangerous
• Self-regulation is ineffective/inadequatemyeatingdoctor.com
Trauma and the Vagus Nerve
• Immobilization with Fear, not all stressors result in Fight/Flight, not all Vagal (parasympathetic) responses are restorative.
• Centers for Disease Control and Prevention (CDC) report 20% of all women and 3% of men in USA suffered sexual violence involving physical contact at one point in their lives.
• Most mental and physical effects of sexual abuse involve the disruption of the neural regulation of the ANS.
• Sexual Abuse linked to IBS, Fibromyalgia, mental health disorders.
• Depresses HRV (modulation of vagal tone)myeatingdoctor.com
Eating Disorders and Sexual Trauma
Victims of childhood sexual abuse differed from controls on measures of eating disorder behavior and individuals who had experienced both childhood sexual abuse and rape in adulthood were most likely to display eating disorder‐related psychopathology. Victims of childhood sexual abuse also distinguished themselves with high levels of eating disorder behavior plus multiple forms of impulsive self‐destructive behavior.
Wonderlich et al.
An Eating Disorder Metaphor: The Log
Adapted from Anita Johnson
Four D’s of Trauma
Dissociation
Developmental Attachment Failure
Dysregulation
Disembodiment
Peter Levine
Problems associated with Eating Disorders and useful Treatment Modalities
Difficulty with Self-Regulation (DBT, ACT, Polyvagal Informed TX, EFT, Animal Assisted Therapy)
Impulsivity, ADD, Eating “Addiction” (Exposure w/ RP, ACT, DBT, Behavioral, Environmental)
Lack Interoceptive Body Awareness ( Sensory Motor, DBT, ACT, Mind-Body, TRM)
Lack Social Skills/Trust, Isolation, Interpersonal Conflicts (DBT, IPT, IFS, EFFT)
Lack Mental Flexibility, Stuck, Perfectionism (RO DBT, DBT, IFS, ACT)
Trauma, PTSD, Dissociation (EMDR, SM, TRM, IFS) myeatingdoctor.com
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Interpersonal Psychotherapy (IPT)
• A form of psychotherapy in which the focus is on a patient's relationships with peers and family members and the way they see themselves. Interpersonal psychotherapy (IPT) is based on exploring issues in relationships with other people
• Interpersonal Psychotherapy Model (IPT) developed by Gerald Klerman and colleagues in late 1960s.
• Effective treatment for BED and BN. Binge based disorders.
• Grounded in attachment theory (Bowlby).
• Research links poor interpersonal functioning to ED. (Wilfley, Stein & Welch, 2005).
• Interpersonal Deficits: Patients who are socially isolated and/or involved in unsatisfying relationships with minimal social supports.
• Interpersonal Role Disputes: Conflicts with significant other (partner, co-worker, family member, friend) emerging from differences in expectations.
• Role Transitions: Difficulties associated with change in life circumstances (divorce, retirement, leaving a job etc.).
• Grief: Patient’s symptoms are associated with recent or past loss of person or relationship.
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IPT FOR EATING DISORDERS
Internal Family Systems (IFS)
• Schwartz began this work with eating disorder treatment using a family systems orientation.
• Our authentic self (spirit led self-cook&miller) is value lead represented by the heart or center.
• Each of us have parts of ourselves that represent • our past that holds on to painful memories and feelings of shame, fear,
loneliness, hurt, sadness called Exiles.
• Protectors, including “managers” that work to keep you from pain including worry, control, perfectionism, self critical or people pleasing OR “firefighters” that work to extinguish pain. Binging, purging, starving or other addictions.
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ACT (Acceptance and Commitment Therapy)
• Third Wave Cognitive Behavioral Therapy
• Acceptance is taught as an alternative to experiential avoidance
• Cognitive Defusion
• Being Present
• Self as Context (Watch and examine yourself)
• Value Driven
• Committed Actionmyeatingdoctor.com
Born to be in Relationship
We were born to be in relationship. In primitive times we needed our clan to survive, to watch out for one another. We have a fear of being kicked out of the clan! This would mean sure death for us being left out in the wild to be eaten. We crave acceptance and connection out of our own survival! We compare ourselves to others, try to fit in, and will do most anything not to be left out in the cold.
- Russ Harris of ACT
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Why Polyvagal Theory in Therapy?
The autonomic nervous system is the foundation
upon which all lived experience sits.
The autonomic nervous system acts in service of
survival.
Polyvagal Theory explains how and why our clients
mobilize, disconnect, and engage with the world.
Understanding the science reduces blame and shame
and makes room for curiosity and compassion.
copyright Deb Dana, LCSW 2017
An autonomic system that is
missing the regulating influence
of the ventral vagus brings
health challenges, creates
distress in relationships, and
shapes a daily experience of
suffering.
copyright Deb Dana, LCSW 2017
Mapping the Polyvagal Pathway with the Autonomic Ladder by debdanalcsw.com
Parasympathetic Ventral Vagal, SAFEConnected and socialCoregulating and self regulating
Sympathetic, DANGERMobilized, fight-flight, narrow focus, vigilantReady for action
Parasympathetic Dorsal Vagal, LIFE THREATImmobilized, collapsed, trapped, shut downDisconnected, dissociation, despair
The Power of a Sigh/Exhale
• A “re-setter of the system”
• Notice spontaneous sighs
• Use intentional sighs
• Slow exhalation is “abdominal breathing” which decreases heart rate and “brakes” via vagusnerve
• Inhalation turns off the brake and increases heart rate through Sympathetic Afferent Nerve
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Quick Coherence TechniqueHeartMath
• Focus your attention to area of your heart
• Begin to breath slowly and deeply in a smooth easy rhythm as if you are breathing through the heart
• At the same time, begin to capture a genuine feeling of love, care and appreciation as if it’s radiating from your heart
• This technique aligns your heart rhythms into a more coherent pattern which accesses your ventral vagal system- a state of clarity and connection
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Meditating on God’s Love
• Meditating on God’s love in our heart activates emotional circuits and calms the brain’s fear circuits. Changes brain pathways in as little as thirty days.
• Nuerocommunication from the heart to the brain connected by the VagusNerve (parasympathetic) and the Sympathetic Afferent Nerve through the spine.
• So a man thinketh in his heart, so is he. Proverbs 23:7
• Coherence or peaceful rhythms of our heart (Heart Rate Variance) calms the body; incoherence is an erratic HRV driven by fear and agitation. Heartmath Research Center studies heart intelligence.
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Pure Love
Hearts Aligned
• Purina video that shows how the love bonds between humans and dogs have been tracked by measuring heart rate variance rhythms.
• When owner and dogs are apart they are largely incoherent and have faster heart rates, within minutes of being together, their heart rate coherence begin to align in the same rhythm.
• This is co-regulation at it’s finest. This occurs through the heart - face connection network in the body.
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Relationship as Healer
• APA’s Society of Clinical Psychology set out to identify empirically supported treatments, they found that the “therapy relationship makes substantial and consistent contributions to psychotherapy outcome independent of the specific type of treatment,” and that “the therapy relationship accounts for why clients improve (or fail to improve) at least as much as the particular treatment method.”
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Therapist as Co-regulator
Our vocal tones, soft gaze, breathing and heart rate act as an
anchor for our clients, soon they will calm and begin to feel
safe. We are models of regulatory processes and interpersonal
connectedness.
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Mind Body Healing
• Yoga programs help people who are chronically stressed by learning to calm themselves down through breath management and engage in poses that put them in touch with their dissociated bodies
• Breath with rhythmical activities such as drumming or body movements such as tai chi can shift people out of disorganized and fearful brain states and heal processes related to ADHD, anxiety and trauma
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TRM: Therapeutic Rhythm and Mindfulness
• Involves group drumming and percussion, relaxation exercises, mindfulness techniques, and visualization to promote health, wellness, present-moment awareness and authentic expression while deepening connections with one’s own self, intuition and others.
• Two empirically validated techniques, HealthRHYTHMS and Mindfulness Based Stress Reduction (MBSR) combined with a third element of a positive and supportive group environment.
Geller, S. 2010
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PLAY: A Neural Exercise
Enables co-regulation of physiological state to
promote neurophysiological states the support mental
and physical health. It involves:
Reciprocity
Movement and inhibition
Face to face interactions
Prosodic vocalizations
Proximity
Touch
Music and rhythm
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Loneliness and Isolation in ED
• Loneliness is perceived social isolation (Heinrich & Gullone, 2006)
• Eating disorder theme “something is wrong with me”
• Emotional isolation is when one keeps their feeling to themselves, do not allow themselves to receive emotional support or lack willingness to share feelings and experiences with another.
• Disconnection allows for continued focus on food and weight
• Dysregulated eating behaviors reinforce shame and self hate, choosing to be alone serves to validate worthlessness
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Weight Bias and Isolation
Obese individuals are frequently stigmatized because of their weight in many domains of daily life. Research spanning several decades has documented consistent weight bias and stigmatization in employment, health care, schools, the media, and interpersonal relationships. For overweight and obese youth, weight stigmatization translates into pervasive victimization, teasing, and bullying.
Multiple adverse outcomes are associated with exposure to weight stigmatization, including depression, anxiety, low self-esteem, body dissatisfaction, suicidal ideation, poor academic performance, lower physical activity, maladaptive eating behaviors, and avoidance of health care.
R. Puhl myeatingdoctor.com
Rat Park
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Isolation vs socializationBruce Alexander studies in the 1970’s
Choosing connection over drugs or other substances
How are you going to create your Rat Park?
