See Text: Pp. 32 & 33

Disordered Body Awareness Relevant Research: Meditation and Interoception at Work.

Farb et al. (2007) examined the brains of novice meditators engaging in exactly the kind of present-centered body aware meditation that underpins our yoga therapy practices and found strong activation in the medial prefrontal cortex (mPFC), a part of the brain that plays a large role in interpreting the meaning of states of the body. Farb et al. suggest that through the activation of both the insula and the mPFC, even novice meditators are able to experience an event as it is, and thereby consciously appraise its meaning. Our discussion also benefits from research such as that gathered by Kozasa et al. (2012), which finds that long-term meditators are able to attend to a task with less prefrontal cortex activation. That is, regular meditators can pay more attention with less effort. There’s also evidence that the hippocampus, associated with the modulation of arousal and responsiveness, is also strengthened with regular meditation practice (Hölzel et al., 2011).

The implications are that meditation activates the brain in a way that can move the practitioner out of a reactive, judgmental, habitual thought-feeling pattern and toward the capacity to choose how to perceive and assess the present moment circumstance. Farb et al. also found that even novice meditators experienced a decrease in activity in the amygdala, a part of the brain particularly related to emotional responses. Their results are confirmed by research into the brains of experienced meditators that suggests that long term meditation practice is associated with decreased activation in and size of the amygdala (Davidson & Lutz, 2008; Gotink et al., 2018; Kral et al., 2018). Therefore, meditative practice strengthens the capacity to shift out of habitual story and downgrade the emotional response associated with that story. The takeaway from this research is exciting: even for novices, meditation improves attendance to the sensations of the present moment without emotional stimulation. This minimizes the likelihood of being pulled into a thought-feeling story, caught up in ensuing emotion, and consequently compelled to dissociate.

Yoga and Positive Self-Concept: Relevant Research

A review of the literature supporting yoga efficacy in the mitigation of negative self-image and its impact on awareness and behavior is becoming a (gratefully) lengthy task! Here’s an amuse bouche of what’s out there. A 2019 review of 61 articles found that yoga significantly increased body awareness (Rivest-Gadbois & Boudrais). Compared to women who participated in aerobic exercise or no exercise at all, Iyengar and Ashtanga Yoga participants enjoyed “significantly greater body awareness, body responsiveness, body satisfaction, and less self-objectification” (Daubenmier, 2009). Female yoga practitioners report lower levels of self-objectification and disordered eating than their aerobic-exercise only counterparts (Prichard, 2008). When compared with practitioners of other forms of exercise, yogis were found to enjoy high rates of body awareness and responsiveness to bodily sensations, factors which positively mitigated the degree of self-objectification practitioners engaged in (Daubenmier, 2009). Yoga has been found to positively impact self-awareness and self-acceptance in ways that can inform healthier life choices (Douglass, 2009).  Significantly lower rates of disordered eating have been associated with participation in yoga, whereas time spent in purely cardio-based exercise was associated with greater eating disturbance (Martin, Prichard, Hutchinson, & Wilson, 2013).

A 2019 study examining the impact of yoga nidra in a population of burn patients found statistically significant increase in both self-esteem and body image (Ozdemir & Seritas). Yoga nidra is an interesting tool as while there isn’t movement associated, there is a pronounced degree of paying attention to one’s self. Yoga nidra focuses the mind on felt sensations without asana or movement as a stimulus. Yoga nidra also engages with purposeful crafting of self-concept (i.e., identifying, noticing, and cultivating inner resource). Therefore, yoga nidra can be considered powerful medicine for DBA.

Another avenue of research ripe for exploration is the role of spirituality in the efficacy of the practice. While we know yoga and meditation “work” in scientific terms, there is the layer of the spirit—something unquantifiable. Researchers Dittmann & Freedman (2009) examined how “how postural yoga and perceived spirituality relate to factors that influence body dissatisfaction and disordered eating” (p. 276) and found correlation between one’s connection to the spiritual elements of the practice, and benefit garnered. This ineffable area is one that could be further explored. In the mitigation of something like DBA, which is both physical and something else, exploring that something else in a reliable and validated way will be an asset. In the meantime, gratefully, it seems to be enough to just do the practice.

References

Daubenmier, JJ. (2009). The relationship of yoga, body awareness, and body responsiveness to self-objectification and disordered eating. Psychology of women quarterly, 29. 207-219.

Davidson, R. J., & Lutz, A. (2008). Buddha's Brain: Neuroplasticity and Meditation. IEEE signal processing magazine, 25(1), 176–174. https://doi.org/10.1109/msp.2008.4431873

Dittmann, K. A. & Freedman, M. R. (2009). Body awareness, eating attitudes, and spiritual beliefs of women practicing yoga. Eating disorders, 17(4), 273–292. https://doi.org/10.1080/10640260902991111

Douglass L. (2009) Yoga as an intervention in the treatment of eating disorders: Does it help? Eating Disorders,17, 126-139.

Farb, N. A., Segal, Z. V., Mayberg, H., Bean, J., McKeon, D., Fatima, Z. & Anderson, A. K. (2007). Attending to the present: mindfulness meditation reveals distinct neural modes of self-reference. Social cognitive and affective neuroscience, 2(4), 313–322. https://doi.org/10.1093/scan/nsm030

Gotink, R. A., Vernooij, M. W., Ikram, M. A., Niessen, W. J., Krestin, G. P., Hofman, A., Tiemeier, H., & Hunink, M. G. M. (2018). Meditation and yoga practice are associated with smaller right amygdala volume: the Rotterdam study. Brain imaging and behavior, 12(6), 1631–1639. https://doi.org/10.1007/s11682-018-9826-z

Hölzel, B. K., Carmody, J., Vangel, M., Congleton, C., Yerramsetti, S. M., Gard, T., & Lazar, S. W. (2011). Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry research, 191(1), 36–43. https://doi.org/10.1016/j.pscychresns.2010.08.006

Kral, T. R. A., Schuyler, B. S., Mumford, J. A., Rosenkranz, M. A., Lutz, A., & Davidson, R. J. (2018). Impact of short- and long-term mindfulness meditation training on amygdala reactivity to emotional stimuli. NeuroImage, 181, 301–313. https://doi.org/10.1016/j.neuroimage.2018.07.013

Kozasa, E. H., Sato, J. R., Lacerda, S. S., Barreiros, M. A., Radvany, J., Russell, T. A., Sanches, L. G., Mello, L. E., & Amaro, E., Jr. (2012). Meditation training increases brain efficiency in an attention task. NeuroImage, 59(1), 745–749. https://doi.org/10.1016/j.neuroimage.2011.06.088

Martin, R., Prichard, I., Hutchinson, A. D., & Wilson, C. (2013). The role of body awareness and mindfulness in the relationship between exercise and eating behavior. Journal of sport & exercise psychology, 35(6), 655.

Ozdemir, A., & Saritas, S. (2019). Effect of yoga nidra on the self-esteem and body image of burn patients. Complementary therapies in clinical practice, 35, 86–91. https://doi.org/10.1016/j.ctcp.2019.02.002

Prichard I, Tiggemann M. (2008) Relations among exercise type, self-objectification and body image in the fitness centre environment: The role of reasons for exercise. Psychology of sport and exercise, 9: 855–866.

Rivest-Gadbois, E., & Boudrias, M. H. (2019). What are the known effects of yoga on the brain in relation to motor performances, body awareness and pain? A narrative review. Complementary therapies in medicine, 44, 129–142. https://doi.org/10.1016/j.ctim.2019.03.021