Background: Individuals with eating disorders often use food and eating behaviors to numb feelings and disconnect from unpleasant somatic sensations including fullness and anxiety. As a result, eating disorders result in an antagonistic view of the body and a distrust in the body to know what it needs. Over the past decade, research has suggested that improving interoceptive awareness and body responsiveness can help facilitate intuitive eating, decrease self-objectification, improve body image, and increase effective communication of emotions. This presentation explores ways of helping individuals with eating disorders improve interoceptive awareness/responsiveness and overall presence in and acceptance of the body.
Objectives: Following this presentation, participants will be able to: 1. Define interoceptive awareness/responsiveness and explain its role in eating disorder recovery. 2. Identify three common attunement disrupters. 3. Utilize three techniques for improving interoceptive awareness.
Content Outline
I. Introductions
II. Review of Interoception
A. Define
1. Biology – anatomical studies and brain mapping
2. Cognition and emotion
3. Three-dimensional model
a) interoceptive accuracy
b) interoceptive sensibility
c) interoceptive awareness
4. Assessing interoception
a) Genetic differences
b) Environmental factors
(1) Role of self-care
(2) Impact of restriction
c) Heartbeat detection tests
B. Interceptive deficits in eating disorders
1. Patients’ relationship with:
a) Feelings – maladaptive emotion regulation
b) Food – self-soothing, numbing
c) Body
(1) Body image
(2) Somatic sensations
C. Interoceptive responsiveness
III. Interoception and eating
A. Interoceptive states of hunger, fullness, and thirst
1. Nature
2. Individual differences
B. Mindfulness and mindful eating
C. Intuitive eating (IE)
1. Principles
2. Relationship between BMI, IE, and interoceptive sensitivity
D. Other approaches to eating based in attunement
IV. Interoception and emotions
A. Somatically sensing emotions
1. Pleasant, unpleasant, aroused, calm
a) Experiential activity of tuning in
2. Primary and secondary emotions
3. Emotional exposure
B. Emotional acceptance and non-acceptance
C. Mindfulness-based therapy approaches
1. Mindfulness and emotion regulation
V. Interoception and body image
A. Acceptance of somatic sensations
B. Self-objectification
1. Objectification theory
2. Body consciousness
C. Role of body appreciation in interoceptive awareness and IE
D. Application of body work
1. Mindful meditation
2. Yoga and movement
VI. Experiential activity
Abstract
Individuals with eating disorders often use food and eating behaviors to numb feelings and disconnect from unpleasant somatic sensations including fullness and anxiety. As a result, eating disorders result in an antagonistic view of the body and a distrust in the body to know what it needs. Over the past decade, research has suggested that improving interoceptive awareness (IA) and body responsiveness can help facilitate intuitive eating, decrease self-objectification, improve body image, and increase effective communication of emotions.
In recent years, studies have shown that interoceptive deficits are associated with symptoms of Anorexia and Bulimia. Specifically, those with body image distortions have been shown to have a reduced ability to perceive and recognize bodily signals and interoceptive cues. Research in the field of neuroscience has revealed that brain regions related to interoceptive signals overlap with areas representing body image and found that the function of these areas are altered in those with significant body image disturbances.
Another study found that self-objectification was predicted by public body-consciousness and IA when considered together. It was hypothesized that those with high self-objectification placed more attention on external stimuli (perceived judgement from others) than on internal cues. This ignoring of information stemming from within the body could result in a further disconnect between body and mind and an over-emphasis on external validation and societal messages about food, weight, size and shape.
IA also appears to play a significant role in shaping one’s emotional experiences and in one study, non-acceptance of emotional experiences mediated the relationship between mindfulness, drive for thinness and symptoms of bulimia (even more significantly than impulsivity or impulse dysregulation). Taken as a whole, these findings suggest that eating disorder professionals need to be able to help clients improve both IA and their ability to respond appropriately to internal cues. This presentation aims to address the application of these findings to eating disorder treatment and recovery, and provide practical tools for improving IA, body responsiveness, and mind-body integration.
Genevieve Camp, MA, ATR-BC, LMHC, RYT is the clinical program coordinator for the UF Health Eating Disorders Clinic in Gainesville, FL. She received her master’s degree in art therapy from The George Washington University and specializes in integrative treatment of eating disorders that combines art therapy, counseling, yoga and meditation.
Kelly Ulmer graduated with a master's degree in counselor education and a specialist's degree in mental health counseling from the University of Florida. She is a registered mental health counseling intern in the state of Florida, specializing in eating disorders, anxiety disorders, mood disorders, and obsessive compulsive and related disorders. She is currently a therapist and program co-coordinator for the UF Health Eating Disorders Clinic.
