Body Movement and Body Image Work

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Body Movement and Body Image Work

• Amy Kayda, MA, DTR, LPC
• Deanna James, MA, DTR, LPC

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MAJOR CONCEPTS

• Connection is essential to the recovery process.
• The body can be used as a resource for deepening
  the therapy, self-expression, and emotional
  regulation.
• Body centered therapies can be used to deepen the
  IFS process, including connection to self energy.
• Trauma is held in the body and thus the body, and
  its memories / sensations must be addressed and
  expressed for healing to take place.
• Negative body image is not really about our
  culture and media. Our culture reinforces
  negative body image and disembodiment, it does
  not create it.

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Why is Body Movement Body Image work essential?

• Due to painful or traumatic experiences it is
  difficult for clients to connect to the body in a
  safe and effective way.
• Eating disorder symptoms further serve to
  disconnect one from their bodily felt sensations
  and emotions.
• In eating disorder recovery, it is essential that
  there is a mind/body connection.
• Many clients struggle with distorted body image
  which causes anxiety, exacerbation of the ED, and
  disruption of self image and thus relationships.
• In order to achieve full acceptance of self,
  clients must learn to accept their body and the
  emotions that are held in the body.

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Why is Body Work Essential?

• In eating disorders clients view the body as a
  billboard HELP! See how much pain I am in!
• Our goal is to help clients view the body as
  their home.
• Client often view their body as a condemned home,
  one that is not safe for habitation.

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Philosophy of Treatment

• At Castlewood, we encourage an exploration of the
  mind/body connection in order to assist those
  struggling with eating disorders to begin to
  forge a new relationship with their bodies, one
  that is compassionate, accepting and kind.

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Philosophy of Treatment

• One of the core concepts of the Internal Family
  Systems model is that parts are held in and
  around the body. It is our belief that in order
  to understand parts and their functions with
  compassion and acceptance, clients must learn to
  connect to the body that is the container for
  these parts.

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Philosophy of Treatment

• In order for clients to truly engage in the
  recovery process, it is essential to incorporate
  healthy and safe ways to connect to the body.
• An essential component of the healing process is
  to integrate cognitive and somatic insights.
• We use body work to deepen the cognitive process,
  as well as to express feelings and sensations
  trapped in the body as a result of trauma.

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What is Body Movement Therapy?

• Based on the assumption that the body and mind
  are interrelated, body movement therapy is
  defined as the psychotherapeutic use of movement
  to further the emotional, cognitive, physical,
  and social integration of the individual. The
  dance/movement therapist focuses on movement
  behavior as it emerges in the therapeutic
  relationship. Expressive, communicative, and
  adaptive behaviors are all considered for both
  group and individual treatment. Body movement as
  the core component of dance simultaneously
  provides the means of assessment and the mode of
  intervention for dance/movement therapy. American
  Dance Therapy Association

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What is Body Image?

• Body image is comprised of how one sees their
  body, lives in and experiences their body and
  perceives how others see their body.
• Negative body image can serve a protective
  function to distract clients from painful
  feelings or emotions held in the body.

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Goals of Body Movement and Body Image Work

• Connection to the body in a safe manner.
• Increased ability to be present in the hear and
  now. (Mindfulness)
• Safe and healthy expression through the body
• Increased ability to utilize self soothing and
  affect regulation skills
• Connection to and acceptance of all parts
• Connection to sense of Self

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Connection to the Body in a Safe Manner

• Why connect?
• We experience feelings in our bodies. Part of
  recovery is being able to distinguish and label
  whats going on inside so that we can respond
  appropriately.
• We cannot like or appreciate something we are not
  connected to.
• Many clients experience extreme body image
  distortion. Through connection and exploration of
  the body a more accurate perception can unfold.
• Many clients experience psychosomatic symptoms.
  Connection can help alleviate some of these
  symptoms.

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Connection to the Body in a Safe Manner

• Why connect?
• As a result of trauma, many clients disconnect
  from internal emotional cues, as well as internal
  body sensations. Clients often re-enact trauma
  and feelings associated with trauma onto the body
  through their ED, self-injury, critical
  self-talk, etc.
• Clients may ignore or dissociate from their
  natural early warning signs of danger. This
  disconnection can result in clients putting
  themselves in dangerous situations, or seeking
  out danger/perpetrators.
• It is essential to re-connect clients with their
  bodys emotional cues and warning signs of
  danger, not only to help them make safe choices
  but also to help them gain insight into trauma
  re-enactment dynamics.

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Increased Ability to be Present in the Here and
Now.

• The here and now focus provides not only an
  invaluable source of information for each
  patient, but also a safe arena in which patients
  may experiment with new types of behavior. Irvin
  D. Yallom, Inpatient Group Psychotherapy pg 175.

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Safe and Healthy Expression Through the Body

• Clients often view the body as something they
  have to carry around with them. A number on a
  scale, the thing that keeps them from being
  happy, the thing that makes them different, etc.
• Helping clients to see their body as a vehicle
  for healthy expression can change their
  perception of their body.

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Safe and Healthy Expression Through the Body

• Often in trauma, clients view the body as another
  thing that betrayed them. By using the body to
  express feelings, clients may begin to see it as
  an ally.
• Through the use of ED and other self-harm
  behaviors the body becomes an object. The goal is
  to help clients see their body as part of
  themselves.
• The eating disorder functions as a way to express
  to others the pain and overwhelming feelings held
  in the body. Clients can learn to express these
  feelings in a healthy way.

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Increased ability to utilize self soothing and
affect regulation skills

• The eating disorder functions as a self
  regulatory mechanism. As part of the recovery
  process clients must learn to manage internal
  distress in safe and healthy ways.

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Connection to and acceptance of all parts
Connection to sense of Self

• The non-extreme intention of each part is
  something positive for the individual. There are
  no bad parts and the goal of therapy is not to
  eliminate parts but instead to help them find
  their non-extreme role.
• Self is the core, or center of the person. When
  differentiated it acts as the active
  compassionate leader.

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Possible Interventions

• Write or create artwork about your relationship
  with your body (past and present). Include
  significant life events, messages you received
  about your body, (positive and negative),
  memories, feelings about femininity/masculinity,
  sexuality, etc. You can also include actual
  photos of yourself.

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Possible Interventions

• Use the following prompts to create images When
  I look in the mirror I see When my eating
  disorder looks in the mirror it wants my body to
  beWhen I nourish and take care of my body
  appropriately it naturally appearsI think others
  sees my body

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Possible Interventions

• Nature walks that incorporate the following
  reflection on surroundings, pausing to take deep
  breaths or simply notice the movement of the
  breath in the body, moving the body in any way
  that feels refreshing and releases tension,
  silent mindful walking mediation alone or in
  groups/pairs, choosing an object in nature that
  represents how a client feels currently about
  their body and how they would like to feel in the
  future.

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Possible Interventions

• Write a letter to your body and have your body
  write back. You may also write a letter of
  apology to your body for hurting it in the ways
  that others have hurt you.
• -Make a list of all the functions of your body.
  What does your body do for you? (Example my
  eyes allow me see beautiful sunsets, my arms
  allow me to hold my nephew, my ears allow me to
  hear my favorite band on the radio, etc)

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Possible Interventions

• Guided imagery and mindfulness activity (5-10
  minutes) focused on what a client is experiencing
  in the moment internally with focus on body
  sensations, here and now, mental noting of
  thought and feelings with a non-judgmental
  stance, counting breaths (1-5) or labeling the
  inhale and exhale. Client can keep eyes open or
  closed based on comfort. You can expand on this
  by having client draw an image of the experience
  and then bring the image to life in movement or
  gesture.

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Possible Interventions

• Movement timeline Ask the client to express in
  movement her journey through eating disorder
  recovery. Identify, embody and move through
  stuck points.
• -Spontaneous, creative play, (clapping game/hands
  on floor), popular group dances, piling pillows
  and jumping into the them, punching pillows,
  adding sound, asking clients to bring in their
  favorite music, all can help clients feel more at
  ease and joyful in their bodies.

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Possible Interventions

• Body tracing
• Speak to the client about the objective of the
  tracing. The goal is to help her understand the
  underlying Feelings, Associations and Thoughts
  (F. A.T.) that contribute to body-image and
  self-image. Inform her that the tracing is
  going to be imperfect because there is human
  error. Clothing, crinkles in the paper, etc.
  influence the outcome. Bodies are three
  dimensional and this is a two dimensional image,
  so it has inherent limitations. Be sure that the
  client feels safe and is grounded before you
  attempt the tracing.
• Get a large roll of paper. Tracings can be done
  either lying down or standing against the wall,
  with the paper taped to the wall.
• Trace the client. Be sure to check-in throughout
  to see if the client feels safe and is
  comfortable. Remind her that she can stop at any
  point whatsoever.

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Possible Interventions

• Process the tracing in the following way
• Ask the client to write a response to the tracing
  using stream of consciousness.
• Ask the client to use artwork, photos, colors,
  shapes and words to fill in the tracing using the
  Feelings, Associations and Thoughts (F.A.T.)
  guidelines. Include memories, experiences,
  trauma, messages received and/or internalized
  about the body or body parts. Encourage
  authenticity and honesty.
• Ask the client to share the image in session
  and/or group.
• Ask the client to create either an additional
  image either on another piece of paper or on the
  back of the first image or one can add things
  directly on the first image. The theme of this
  image is What does this body (the initial
  tracing) need now? Encourage the client to
  reflect on the 8 Cs of IFS therapy.
• Ask the client to process the entire experience.
  Be sure to include current bodily-felt sensations
  as you process the imagery.

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Possible Interventions

• Group Unburdening- Create a fire in the middle
  of the room. Have clients put feelings, memories
  represented by pillows or other objects in the
  middle of the room. Have clients share what they
  are placing in the fire. Put the fire out by
  placing blanket over the pile of pillows. Have
  clients then take positive qualities out of
  water to replace what they just gave up.
• Group Sculptures/exploration of qualities of
  self- Have clients explore the various qualities
  of self through movement, group sculptures,
  postures.
• Moving in self and various parts(separating from
  parts)- Have clients move from pillow to pillow
  or chair to chair exploring what various parts
  (feeling states) feel like in their body. Have
  one pillow or chair represent the qualities of
  self. Explore how the body feels different
  between self and parts.

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How do we invite our body and the clients body
into the therapeutic process?

• Maintain an awareness of your own body in
  sessions and groups. Attend to what you are
  experiencing in your body. Examples
  (tightness, heaviness or warmth in the chest,
  sleepiness, butterflies in the stomach,
  headaches, tingling, numbness or pain in body
  parts, dizziness, excitement, agitation,
  calmness, etc). Somatic counter-transference
  provides valuable information and assists with
  interventions.

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How do we invite our body and the clients body
into the therapeutic process?

• In order to be more fully embodied, carefully
  attend to non-verbal communication (body posture,
  breathing, tone of voice, facial expression, skin
  tone changes, gestures and overall physical
  presence in the room). If a client shifts her
  posture or takes a deep breath, gently mirror the
  behavior yourself, and/or simply verbalize what
  you notice. Mirroring is one of the most
  fundamental and powerful therapeutic
  interventions. Non-verbal mirroring techniques
  are simple and effective incorporating them can
  greatly deepen the therapeutic process and
  invites the body into the space.

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How do we invite our body and the clients body
into the therapeutic process?

• Ask regularly about what clients are experiencing
  in their body during therapy. This integrates
  mind/body and dismantles the familiar talking
  head syndrome, in which clients are cognitively
  and intellectually insightful but completely
  disconnected from their body. The eating
  disorder lives in the body. The only way out is
  through the body.

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How do we invite our body and the clients body
into the therapeutic process?

• Encourage simple and mindful ways to be embodied
  such as connection with nature, balanced and fun
  movement, yoga, dance, martial arts, connecting
  to the senses by lighting a candle, applying
  lotion, listening to music, receiving a massage
  or manicure/pedicure, relaxing in the hammock.
  Ask regularly if your clients are engaged in some
  activity that connects their mind and body in a
  gentle, kind way.