Sarahjoy Marsh has been a yoga therapist, a yoga teacher, and an educator for 26 years. She recently published a book: Hunger, Hope & Healing in which she fuses yoga with psychology, neuroscience, breathing interventions, and mindfulness techniques, to bring readers with disordered eating and body image issues a practical and accessible guide to recovery. To learn more about her book, we decided to ask her a few questions, here is what she had to say:

What prompted you to write Hunger, Hope & Healing?

Over 25 years ago I began my own recovery from disordered eating. It required a leap of faith because I felt isolated and incredibly alone—I was sure that no one else understood the cycle in which I was trapped. Over the past 14 years working with women in Hunger, Hope and Healing, I have discovered that these feelings are universal. One reason I wrote the book was to convey a sense of community, compassion and support to women struggling with these issues, no matter where they live.

I also wanted to help readers return to—or experience for the first time—a fully expressed life, what I call a “360-degree life.” I teach simple yoga and mindfulness exercises to help overcome the powerful forces of shame that co-exist with eating disorders. Readers will also hear the experiences of women who are progressing on the road to recovery. I give my readers tangible tools to navigate their own journey out of suffering and back to awe.

As a first book, one of the challenges that most excited me was to be able to write in such a way as the reader would feel me speaking directly to her. I very much wanted to convey my support, compassion, and companionship to those with disordered eating, and this fueled my writing. This book is the start of a community of support—and I encourage all of my readers to join our online group on my website, to take part in an ongoing dialogue to stay on track with their personal recovery.

Why do we have cravings?

Life inherently includes cravings, hungers, and the motivation to satiate from them, the moment we are born.  As infants, we are supported by our most primitive brain (aka the reptilian brain) for primal functions such as hunger and satiation, body temperature, heart rate, respiration, and brain chemistry.  We are also supported by our limbic brain (aka the mammalian brain), which prompts us to attach to others. We are innately wired for soothing via food and connection with other humans.  Said differently, we’re born vulnerable to the ability of others to care for us; and we can’t survive without food or connection.

In light of this, life will include hunger; hunger can show up as craving.  Yet sometimes the craving for food might be a craving for connection, companionship, empathy, kindness, self-soothing.  We all experience these deeper hungers.  To the extent that we have consistent, attuned, nurturing relational experiences as infants and children, we learn that we can meet these needs and satiate these hungers both intrapersonally and interpersonally. To the extent that we aren’t in a care system (be it family, school, church, community) that nourishes our ability to identify and tend to our various hungers, we may learn to substitute food as a hunger-satiating strategy even if our hunger is actually for solace, inspiration, or friendship.

How should we deal with cravings?

The first step is awareness that cravings for food may be cravings for other kinds of nurturance or soothing.  We become aware that we are capable of complex hunger patterns. Second, we cultivate a mindful moment, with what I call Getting in the GAP: the GAP between craving and satiation, between thought and reaction, between fear and impulse. First, by getting Grounded in the here and now, using a neutral stimulus, such as feeling your feet on the ground. By paying Attention to this stimulus repeatedly and for a long enough duration (even 30 seconds), you become more Present.  Then, we practice curiosity.  For what might I truly be hungry?  What might I be craving or needing right now?  Am I thirsty? Tired? Lonely? Angry? Is my buoyancy low (am I feeling deflated, run down, less resilient?)?

As we inquire about such things, we generate options in addition to food: Hydrating. Resting. Connecting with someone to whom we feel truly understood. Adjusting our physiology (through suggestions in the book) to explore emotions.

How is disordered eating connected to depression or anxiety?

There are two ways to look at this connection. On the one hand, our brain chemistry or body physiology may be wired for depression or anxiety.  In this case, it makes sense that we reach for food and body-management strategies—such as restricting, dieting, over-exercising, purging—because we are effecting both our limbic and reptilian brains.  Food works to create a soothing response. However, the danger is that the use of food can become unskillful, maladaptive, and painfully mis-attuned to what we actually need.

Secondly—though these strategies may have started as self-soothing efforts, poignantly, they become capable of keeping us stuck in cycles of depression and anxiety. When a food strategy goes beyond basic satiation into binge-purge, chronic restriction, compulsive- or binge-eating, yo-yo dieting, we are causing dis-regulation to our brain chemistry, which can prompt depression and anxiety.

A common and painful result of disordered eating is a very powerful undertow of shame and self-hatred.  Behaviors that once soothed become painful, shameful, and self-harming. You can come to hate yourself as the very behaviors that once gave you a feeling of control, take control over you. You may tell yourself, constantly, “This is the last time I will do this,” only to repeat the same behavior the next day. This feels baffling, profoundly disappointing, and demoralizing. “When did I become so helpless?” you might ask yourself. Further, you may lose in faith in yourself: “When did I become incapable of stopping this?” Or shame: “What if other people found out? Why can’t I just be ‘normal’?”

When this becomes our chronic mental broadcast, it will generate the brain chemistry of depression—which yoga calls a loss of faith in ourselves—and anxiety—which yoga refers to as a painful separation from our innate love and belonging.

What can someone struggling with disordered eating do—now—to get started on the path to healing?

Reach out. Reach out to me directly through my website, purchase the book, find a support group, research qualified yoga therapists in your area—with experience in mindfulness, neuroscience, anxiety, depression, addiction, PTSD, and interpersonal neurobiology. (We have trained about 60 yoga therapists in the past three years, so we can provide referrals.)  Another resource would be to participate in the upcoming Hunger, Hope and Healing weekend retreat in Portland, OR on July 10 – 12 at the DAYA Foundation. We will be starting a book club this fall, which will be an online discussion and support group for students. We don’t want geography to be a hindrance.

What does research (do you have links to the research?) say about yoga as therapy for eating disorders and body image issues?

“Therapeutic yoga” helps eating disorder patients, who generally have distorted body images and unrealistic self-concepts, foster the ability to separate thought from action, develop greater self-compassion, and maintain a healthier relationship with their body. Because of its success with this patient population, yoga and mindfulness skills are increasingly being included in nationally respected treatment centers and in the private therapy sector. In a recent search for eating disorder treatment centers that include a yoga program in their treatment plan, I reviewed 20 centers. Eighty percent of offer yoga classes as part of their exercise program and 30% offer yoga therapy programs.

A study published in the Psychology of Women Quarterly reported that mind-body exercises, such as yoga, are associated with greater body satisfaction and fewer symptoms of eating disorders than traditional aerobic exercise like running or using cardio machines. Another study (Journal of Psychiatric Practice) showed that after three months of yoga, study participants reported their depression improved by 50% and their anxiety improved by 30%.

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