Embodiment and the Treatment of Eating Disorders: The Body as a Resource in Recovery
“The fact that the book is about so many other aspects of life beyond eating underscores the author’s premise that EDs are about so much more than food and size.”
Embodiment and the Treatment of Eating Disorders is clearly a labor of love that largely succeeds in sharing the author’s considerable wealth of wisdom and experience in her field. In addition to being an eight-book published author, psychologist, yoga instructor, and professor/researcher at the University at Buffalo, SUNY, Cook-Cottone has also recovered from an eating disorder which began, like the majority of them do, with thinking she was too fat, starting a diet, and then badly disordering her relationship with food and her body in pursuit of thinness. Her passion to prevent others from suffering her fate and to heal those with disordered eating comes through loud and clear on every page.
This scholarly book aims to provide a new paradigm for professionals who treat clients with eating disorders (EDs) such as Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge-eating Disorder (BED). AN is “traditionally characterized by a drive for thinness and a corresponding fear of gaining weight, within the context of a significantly low body weight, that does not shift in intensity as weight decreases.” BN “is characterized by recurrent episodes of binge eating combined with extreme compensatory behaviors to prevent the ingested food from affecting weight or shape.” The core feature of BED is “the occurrence of eating binges” which are defined as “the consumption of an objectively large amount of food in a discrete period of time along with the sense of being out of control.”
Cook-Cottone uses an “embodied approach to treating eating disorders,” calling it EAT-ED. Its premise is that eating disorders are not merely about food or even solely about the body, but are due to a lack of embodiment, which is a way of feeling and being functionally and wholly integrated with oneself both internally and externally. In EDs, body size, shape, and weight subsume the entire experience of one’s sense of self and become the center of one’s universe, the sun around which every lesser thing revolves.
“When embodied,” she says, “we are living in and from the body.” It is no longer the enemy, something separate from the rest of self to be controlled or punished. To Cook-Cottone, embodiment is not only a human right, but the right from which all others grow. Her goal is for the body to become a resource for physical and emotional transformation.
To foster body/mind, internal-external integration, embodied practice involves attuned self-care, mindfully attending to the present, extending self-compassion for human foibles and struggles, and finding meaning and purpose in life. “It is a way of being that promotes a sense of well-being, agency, common humanity and purpose . . .”
The book provides a history of philosophical roots and psychological models of embodiment and lays out and presents three practices for the development of the embodied self: mindful self-care, mindful awareness and presence, and purpose/mission. The author explains where emotions reside in and how they affect the mind/body, especially the workings of the parasympathetic nervous system when it is under stress and enduring trauma. She goes on to show why physical and emotional self-care are so crucial to recovery from EDs.
Cook-Cottone describes the importance of mindfulness and heartfulness in fostering embodiment. She describes how meditation and yoga make us more present to ourselves and to the world and provides research on why these methods are such powerful healing tools for people with EDs—quieting the mind, facilitating self-attunement, and promoting self-compassion, loving kindness, gratitude, and body appreciation and integrity, which she describes as “a full-on acceptance of what is, and ownership of our choices.”
A later section of the book is devoted to explaining the need for and difference between mindful and intuitive eating. The fact that the book is about so many other aspects of life beyond eating underscores the author’s premise that EDs are about so much more than food and size. The final chapter focuses on mindful and supportive relationships, including the necessity of learning self-validation, connecting to heartful desires, being authentic, balancing self- and other-care, and dealing with difficult people without returning to disordered eating.
Melding theory and practice elements, Embodiment would make an excellent textbook for college students studying about EDs and for novice or seasoned therapists looking to learn a new approach to ED treatment. The book is replete with valuable practices, guides, meditations, scripts and exercises to use in therapy sessions to promote embodiment. Although the abundance of research is welcome, the book would read far more smoothly if citations did not interrupt the flow of the text and were done, instead, via endnotes. A sprinkling of case studies is included; more of them would have improved the transfer of theoretical concepts to clinical application and enhanced the readability of already highly (and unnecessarily repetitive) dense prose.