Eating-disorder patients heal through yoga
With yoga such a phenomenon in Vancouver-infiltrating corporate lunch hours, down-doggying its way onto television, and serving as Lotus Land's favourite exercise for the masses-it's not surprising that hospitals would see benefits for some of their patients.
The eating-disorders treatment program at St. Paul's Hospital has a yoga component specifically geared toward helping patients connect mind and body, and reduce tendencies toward overly severe, potentially fatal personal self-control. Yoga is just the beginning of reintegration into society for these patients. People recovering from an eating disorder will often need help relearning everything from cooking and cleaning to balanced exercise, shopping, and socializing with family and friends. They also need help adjusting to body-size changes during the re-feeding process. (Many patients arrive at such dangerously low weights that it's necessary to use nasogastric feeding tubes.)
But one of the most crucial aspects of reintegration is reestablishing the connection between mind and body. The disconnection of the two is at the heart of eating disorders; it works like a drug to numb emotions, leaving a person void of pain. Those who have been sick for years have adapted to this escapist coping mechanism. It becomes the norm for them in so many ways-almost a part of their identity.
"Patients with eating disorders tend to control themselves so much that the thought of letting their bodies take over can be completely overwhelming," said the program's occupational therapist, Meike Vareschi-Singh, in an interview at St. Paul's Hospital. The release that yoga provides is a healthy way to get rid of negative emotions and foster self-love.
However, the sensation can be terrifying. Patients with a history of sexual abuse, for instance, can experience flashbacks while doing yoga. It can be similarly terrifying for them to engage in a practice that highlights body awareness when they are still adjusting to a new body size. In light of this, it was important to choose the teacher carefully.
"The team decided they preferred the idea of having a yoga teacher who also knew the patients, and had an understanding of eating disorders and the struggles the patient might go through in the process," said Vareschi-Singh, who has taught the class for the past two years. In addition to being part of St. Paul's eating-disorder program team, she is a certified yoga instructor.
The classes have proven their worth. "Of all the learning patients take away from this program, yoga is something they seem to keep up in their own lives," she said. As a result, the team happily runs weekly sessions for both inpatients and outpatients, who are mostly women.
Dr. Laird Birmingham, medical director of the eating disorders program, has worked closely with patients at St. Paul's Hospital for most his career, as well as being at the centre of research and development. He told the Straight in an interview at St. Paul's that he couldn't be happier about the yoga classes, as he knows their great medical benefits. Birmingham said his late colleague Peter Beumont, a fellow specialist formerly with the University of Sydney, Australia, conducted random control studies to measure the effects of exercise on patients attempting to heal from anorexia. He said these studies showed that weight gain over time was the same, but patients who exercised rated their quality of life drastically better than those denied the opportunity. They were happier overall and did not feel deprived of movement like those who had done nothing physical throughout their healing.
Birmingham said that yoga has the extra benefit of being non-aerobic. It gets the blood flowing, calms patients considerably, and yet doesn't result in the counterproductive effect of weight loss. He explained that patients have run up to eight kilometres in the shower or done over 200 sit-ups in their hospital beds out of a panic-based need to burn calories. Considering these patients have body fat at least 15 to 20 percent less than what's considered healthy, one quickly sees the alarming nature of these actions. "What we've found is that those that go [to yoga] are less compelled to exercise in bed or in the shower. They know when the exercise is coming up, and that helps to decrease [their] anxiety," said Birmingham.
While yoga can be relaxing for many eating-disorder patients, it can set off emotional triggers in class. The tight clothing used for stretching can provoke anxiety, for example, as can the simple act of closing one's eyes while in relaxation pose, or even using certain language. "Words like bum, bottom, belly, thighs, et cetera, can set them [the patients] off, so I am a lot more careful initially," said Vareschi-Singh. These triggers must be worked through either in a pre-yoga check-in, or in one of the group-therapy sessions following class. "We talk before the class and make sure there is nothing they need to do first. We remind patients that they can stop at any time," said Vareschi-Singh. "I soften my voice, move a little closer to them, and advise they keep their eyes open during the relaxation segment if it will make them more comfortable."
But the good news is that many of the issues that arise initiate healthy discussions around personal boundaries, comfort and trust levels, feelings of being physically or emotionally invaded, and body image.
According to Vareschi-Singh, overcoming the need to numb life and relearning emotional closeness and awareness are two of the most significant obstacles to healing for these patients. Yoga, highly therapeutic and relatively nonthreatening, is the ideal therapy: a gentle reawakening of the mind and a soft embrace of the body, all helping to get patients back into the land of healthy living.