Teaching Yoga to Women with Eating Disorders


Laura Sevika Douglass, our guest editor, for this issue of Integral Yoga Magazine discusses the importance of creating a safe space for her classes and the role her personal spiritual practice plays in her service to others. Sevika shares her experiences and insights about teaching Yoga for women with eating disorders, as well as the value of the documentation she creates and the supervision she receives in her work.

Nine women nervously assemble in the warm,downstairs parlor of a Victorian home that serves as a residential treatment center for women with eating disorders.  One young woman pulls the sleeves of her green sweater down to cover her hands as she explains, “Yoga makes me nervous, so I might come out of the poses to relax.” Her body is rigid and the corners of her eyes tight. “Great!” I say, “Do whatever you can to adjust the practice to make it doable for you.” Even a gentle Yoga class is difficult for many of these women. 

Eight million Americans suffer from eating disorders; more than 90 percent of these are women but the number of men is increasing. They dream about food, steal food, hoard food and cook food for others—while denying themselves even the most basic nutrients. They regard their bodies as “other,” a burden worthy only of loathing. The clinicians who run the residential program where I teach Yoga know that recovery is not easy or ensured. The progressive directors have chosen to integrate nontraditional, awareness-based therapies such as Yoga in the hope of giving these women one more tool with which they might recover.

Eating disorder specialist Dr. Kelly Gunderson explains, “The incorporation of  Yoga [into treatment] is to integrate some awareness of their bodies as living, breathing entities that they are connected to as opposed to the body as a separate thing that they hate and try to manipulate. It is a tricky thing, because while the group leader is trying to increase body awareness, if they focus too much on body awareness or body parts it can be kind of overwhelming and irritating.” Increasing body awareness is decidedly a challenge at the clinic. When teaching regular adult Yoga classes, I watch the students’ movements and give hands-on postural adjustments, which increase intelligence and ability to learn through the body. This is a no-touch treatment facility, as many women are recovering from trauma, so hands-on adjustments are not possible. Additionally, many women dislike being watched as they practice Yoga; it is difficult for them to not view another’s gaze as criticism.

Practicing Yoga together (as opposed to the instructor watching and correcting the postures of the participants) is effective in this setting. It deflects attention away from the teacher and onto each individual’s unique experience of the present moment; this optimizes the idea that it is they (and not the teacher) who are able to invoke the calm experienced in Yoga class. Demonstrating the basic postures of Yoga while making suggestions to increase awareness helps to reveal the clarity and calm that yogic theory understands exists beneath the surfaces of even the most tumultuous minds. As we hold paschimotanasana, the full forward bend, we scan for tension. I ask, “Are the corners of the eyes relaxed? Is the tongue pressed against the roof of the mouth or the teeth?” These simple questions can have profound meaning for an individual who is just learning how to self-soothe and relax.

In many ways, teaching at the clinic is not much different from teaching a regular Integral Yoga Hatha class. The basic elements of an Integral Yoga class are all present (chanting, eye movements, asana, pranayama and meditation).  The task of the Yoga class remains to create a quiet place of reflection, a space in which students can feel safe to experience the present moment. What is different about this class is that most of the participants come to the class immersed in incredible suffering. As we explore the present moment through simple stretches and deep breathing, students are brought into intimate contact with this pain. Many find the inner resources necessary to transform suffering into understanding; many do not.

As a Yoga teacher, it is decidedly not my job to fix the anxiety, pain and struggle that is a palpable backdrop to this class. If I am not here to fix, what exactly is my job? The writer and healer Henri Nouwen states, “When we honestly ask ourselves which person in our lives means the most to us, we often find that it is the one who, instead of giving advice, solutions or cures, has chosen, rather, to share our pain and touch our wounds with a warm and tender hand.” Nouwen’s words provide a pivotal insight into the role of Yoga for those in the midst of intense suffering: the Yoga class can be a safe place in which the student can experience the present moment. During moments of stillness and peace we may be able to experience ourselves untarnished from our own self-definitions; we have the experience of being harmonious and at ease. Students literally ask, “What is that mystical state that I feel after class?” It is the experience of the present moment free of chronic negative thoughts and self-critique. It is, quite simply, relaxation.
The safe space created in the Yoga class is built, in large part, by accepting students exactly as they are; even when this includes loathing the practice of Yoga or the emotions of anxiety, anger, sadness and fear. For many students allowing these emotions to surface and to experience and feel them—without reacting to them—is a totally new and often healing experience. As a Yoga teacher, it is not always easy to be accepting of the anger, hurt and anxiety that may surface in a Yoga class.

In an attempt to understand the difficulties that surface in the simple work I do with people with eating disorders, I write for thirty minutes after each class. I document what happened, record comments people made and note what worked and what didn’t. This practice is not unique to Yoga therapists and teachers, but is a standard part of most clinical care; it is used by chiropractors, psychologists, social workers and other professionals to increase self-reflection and make our intuitive methods explicit. Documentation also serves an educational value, as we can draw upon our writing to share what we have learned with others who are serving similar populations.

Documentation is also an invaluable aid when I encounter the thought that my simple work is ineffective. At this juncture I can share my documentation with a clinical supervisor. Clinical supervision consists of meeting regularly with another professional to discuss the work that I do in a structured way. For example, it can be easy to interpret the anxiety or frustration of the women as caused by the Yoga class, rather than seeing that these feelings just exist and surface in the Yoga class. Subtle misperceptions on the part of the teacher can gradually undermine the best intentions, if not dealt with in an ongoing forum. Clinical supervision is not a customery aspect of a Yoga therapist’s work; however, it can assist us to learn from our experiences, to progress in our expertise, and to ensure good service to our students.

Perhaps nothing ensures good service to my students more than maintaining spirituality as the foundation of my work at the clinic. Spirituality is a way of life that brings awareness to every moment; it is an understanding of the value of human life that helps us appreciate the unique relationships we have with each other, with our teachers and with knowledge, health and truth. In my work at the clinic, a spiritual perspective helps me see that I learn from my students as much as they learn from me; it is a commitment to understanding how meaning, belonging and direction are disrupted by the illness of eating disorders.

Spirituality is also about being committed to nurturing myself so that I am available to serve the women at the clinic.  My ability to teach and be present in difficult situations would waver without the nurturance of a daily practice of Yoga in the form of service, self-reflection, study of spiritual texts and the practice of Hatha Yoga. Swami Satchidananda said, “If you lose your peace, you won’t be able to help anyone else, let alone yourself.” As a Yoga teacher who is working with people who have experienced tremendous pain, my sense of peace is frequently challenged by flares of negativity and discomfort that arise during class. I do not always understand the origin of their problems, but I do accept the difficulties these women are facing. The poet Rainer Maria Rilke wrote, “Your task is to love what you don’t understand.” Through spiritual practice, I have learned that I can be present with the sharp-edged truth of resistance and irritation—that this too is a part of my spiritual journey. 

After the group Yoga class, one student is sitting on the bottom of the stairs with her knees pulled up to her chest, the hood of her sweatshirt pulled over her head. “How are you feeling?” I ask. I am a little worried, since she mentioned at the beginning of class that Yoga makes her nervous. “No, I’m great,” she says. “I feel so relaxed.” I realize in such moments that Yoga, as simple as it is, is a significant component of what people are learning here.

About the Author:
Sevika Douglass is an adjunct faculty member at Hindu University and Lesley University. She considers Sri Gurudev to be her inspiration for integrating the teachings of Yoga into the classroom and into her life. She continues to work to bring greater awareness about the benefits of Yoga to the mental health field. For more information please visit: yogapsychology.org. 

Reprinted from Integral Yoga Magazine, Fall 2008

By Sevika Laura Douglass, PhD

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