|
Mindful & Intuitive Eating |
|
A conversation with Wendy Oliver-Pyatt, MD |
|
What is Mindful and Intuitive Eating and why do you use it at Oliver-Pyatt Centers? |
Clients with eating disorders are not just afraid of food, they are afraid of their desire for food. In anorexia nervosa, the eating disorder protects the client from experiencing this conflict by leading the person to not eat at all. In bulimia nervosa, the eating disorder leads the client to starve, denying food, but the body backfires in an effort to survive, by binging. There is evidence that all of this is based on a mixture of biological, genetic, psychological and social forces.
The skill and capacity to utilize Mindful/Intuitive Eating must be developed before the eating disorder client can feel safe enough to let go of the only voice that they hear- the harsh and rigid mindset of the eating disorder. The eating disorder voice has convinced the client that it the only thing they can trust.
Individuals with eating disorders may have good intentions about recovery, but they are not able to eat meals without support. The "voice" of the eating disorder is far too overwhelming. For the client to become capable of eating independently, they must learn how to respond normally to their body's normal "hunger" signals. Because of their faulty alarm system, the client will be afraid of these signals -the sensation of starvation may trigger nothing, yet the mere presence of food in the client"s body may set off a terrifying surge of fear- leading to future restriction and/or other ways of compensation.
Mindful Eating teaches the important and vital skill of internally regulated, hunger-driven eating. Mindfulness allows even the person entrenched in the eating disorder to use knowledge, thought, and reality to determine the biological needs of her body. This requires time, a learning process, risk, hard work and trial and error. Eventually, the process becomes more natural and spontaneous and Intuitive Eating emerges.
Intuitive Eating allows us to step back into our true selves. It is the restoration of an essential mind/body connection. As it emerges, it"s a clear sign that our client is rediscovering how to listen to her body.
Most individuals in recovery from eating disorders will learn to use a combination of mindfulness/intuitiveness to regulate their intake of food. Mindfulness is always available to us and comes from within. It allows us to make personal choices using wisdom, perspective and reason, even when we"re experiencing anxiety and fear.
We incorporate Mindful and Intuitive Eating at Oliver-Pyatt Centers because this approach leads the eating disordered client to trust in herself and her body and freedom from food preoccupation. |
|
But how do you teach individuals who do not have hunger cues to eat intuitively? |
All clients, upon admission, are put on a caloric intake level that is consistent with their medical needs and psychological state. All clients are monitored closely for re-feeding syndrome and other complications caused by the eating disorder. Because Mindful Eating skills take time to learn and because the voice of the eating disorder can be far too overwhelming, we initially portion food for our clients. But no matter where any client is at in the recovery process, all are taught about Mindful/Intuitive Eating as a long term goal.
Once a client begins to respond to inner cues, and is able to distinguish between the eating disorder voice and the voice of perspective and wisdom, will they become more able to eat mindfully and responsibly? This is a gradual and challenging process. When the client is medically and psychologically ready, they are given the opportunity to begin portioning some of the meals themselves. They are encouraged to observe, write about and respond to cues of hunger, satiety and the many emotions they experience when they have food in their body. As they progress in recovery, they are given more opportunities to portion food themselves allowing them to "work out" under our care, and with our support, their internal conflict about eating.
All clients are reminded that they will not be able to experience satiety unless they eat satiating foods. Clients with eating disorders doubt their ability to experience satiety. Because they have been eating a restricted diet for so long, they forget what satiety is, and fear they can"t stop eating. But all human beings (with the exception of those with certain rare medical conditions) are capable of learning the skill of Mindful/Intuitive Eating. |
|
What does Intuitive/Mindful Eating represent in terms of my internal recovery process? |
True recovery is more than a medical amelioration. I approach my clients as both a medical doctor and a therapist. It is vital that each person work through the issues that cause her to doubt herself, and deny her physical and emotional needs. Clients can learn that by taking their need to eat seriously, this will not lead to self-destruction or "being fat." Clients will learn that their needs, whether physical or emotional, are worthy, important and make sense. It is the denial of and/or aversion to needs of their own humanness, that leads to self-destruction, dependency and the underlying eating disorder process.
It is through acceptance of needs, the development of trust, and integration of the body, mind and soul, that the individual is lifted out of their eating disorder. Their true and wise self, which has perspective and vision, can emerge, take form and build strength, guiding the recovering client through her life.
How we do one thing, may be how we do everything. We explore how eating is reflected in the way we are living our life. We teach each client to hear the voice of her "wise self" which guides her mindfully through all life experiences, including eating. |
