by Chris Grosso
She added a caveat. “I don’t know what the future holds. So maybe ten years down the line I’ll feel differently about this. The only reason I use that language around it and have the experience of feeling recovered is that the urge is gone, and that’s distinctly different. That’s not to say ten or fifteen years from now I couldn’t lose a family member or go through a divorce and everything might change. If there’s one thing that’s constant, it’s change.”
I appreciated that and could certainly relate. What support did Chelsea receive in recovery and in her recovered state, especially in terms of yoga, community, and the service of others?
Chelsea described these as three distinct medicines that are all connected. “Community was the first dose of medicine I got, and that was in the hospital. Part of my treatment came through the support system of nurses, doctors, and other patients, which I’m sure is true of most recovery programs. Other people there were on a healing path as well. What I found was that I went in feeling worthless and not deserving to live, to eat, and community gave me a sense of having a place where I belonged—a place at the table. It began with that.
“I had a few nurses who were so kind to me, and on days when I’d wake up and say some mean words like ‘Fuck you. Leave me alone. I hate you,’ they’d reply, ‘No, Chelsea, I know you’re having a hard day, but come walk around the floor with me. I’d like to spend some time with you.’ I’d question why they’d want to be with such a miserable human being, and they’d tell me I wasn’t miserable. So part of what community gave me was a sense of my own worth and place among people and in life. Community also gave me an opportunity to give to others and have somebody else’s back. It wasn’t just about me anymore.”
This was a natural segue for Chelsea into service, which started in the hospital but then permeated her yoga community. “It showed up in simple things like breath—being in a room and breathing and having a visceral sense that I was breathing with others, that I was not alone in my struggle, that I was not alone in my life experience. Like most mental illnesses, the eating disorder was isolating, and my experience is that I’m a lonely consciousness in a bag of flesh.” Yoga classes got her through this because of her sense of connection, and it’s branched out from there. “These days I have it all over the place. I’ve got it in my organization, my friend circles, in salsa-dancing circles—it’s just a sense that you matter to someone else and someone else matters to you.
“I always come back to that wonderful poem by Mary Oliver, ‘Wild Geese,’ in which she writes about how, no matter how lonely we are, we all have a place ‘in the family of things.’ That’s my sense of community. You have a sense of a place, of family, of things, and the service piece emerges from that. I found that gave me a sense of meaning beyond myself. Getting involved in volunteer and service opportunities made it not about me anymore. My health and my well-being and my waking up are tied to others, to something bigger than me.
“When I was nineteen, I got involved with Big Brothers Big Sisters, and that was fantastic. I had a little brother named Andy who was eight years old, and I would take him out to eat once a week. His mom was disabled, and the only food they had available was Taco Bell. Right after my mom was diagnosed with dementia, I met up with Andy. I remember experiencing so many of feelings. I had a physical and visceral feeling of fullness and could hardly conceive of eating. I didn’t know how I was going to put food into my body, but I took Andy out to IHOP because that was his favorite restaurant. He was going through this phase of if my favorite color was blue, his favorite color would also be blue. He looked at the menu and looked at me and said, ‘Chelsea, what are you going to order?’ I looked at him and realized that if I ordered what I wanted to order, which was a garden salad with no dressing, he’d order the same thing. How could I pass this thing that took me to such a dark place on to someone I loved? How could I share that with him? The service relationship I had with him was more important than my self-starvation as a coping mechanism. I ordered the ham-and-cheese omelet.
“I think that’s what service is. It’s a sort of medicine that, if used in the right way, creates a relationship or purpose that can be more important than self-sabotaging behaviors. Whether that’s with a human being or a cat, or is just a sense of connection to the world in general, suddenly your well-being is tied up with something bigger than you—it’s not just about you anymore. I’ve found that to be a massive catalyst to my growth.”
I also connected to what Chelsea said about the embodiment piece of her recovery. “Yoga and meditation gave me an ability to sense what was happening inside my body. I didn’t have a sense of when I was hungry or full. My heart would start beating out of my chest, and I would think I was dying. I call that ‘interoception’ or ‘interoceptive awareness’—which is your ability to sense what’s happening inside your body at any given time. I found you can’t have a happy, healthy, free life if you aren’t living inside your body with a sense of awareness and two-way communication. For me, yoga built up that ability to recognize what was happening inside my body and then eventually an ability to self-regulate, which is that two-way communication.”
Yoga, community, and service led Chelsea to create Eat Breathe Thrive. It’s a program that combines yoga, meditation, and psychoeducation to help people fully overcome food and body-image issues. I appreciated on EBT’s website that it said the program taught individuals critical skills for long-term recovery, including how to track hunger and fullness signals, cope with difficult emotions, and create a sense of being at home in one’s own skin.
First, how can individuals who struggle with eating issues (which I do myself) learn how to track hunger and fullness signals? How can we learn to cope with difficult emotions? Did Chelsea have a specific practice or technique to share? And to create a sense of home in one’s own skin—that is huge. Could she talk about this?
She tied it back into interoception or interoceptive awareness. “There are lots of different types of interoception—hunger, fullness, heart rate, muscle stretching, tension, body temperature, thirst, and more. During the past six years I’ve worked with clients with eating disorders, one thing that I’ve seen—and I would say this seems to be true of substance abuse, too—is that they tend to have very poor hunger and fullness signals, and they seem to be hypersensitive, along with other types of interoception. For example, they may not be good at saying they’re hungry and need to eat. They don’t have that hunger signal coming up and telling their brain to eat. They’ve trained themselves to ignore it. Same thing with fullness. They might be hypersensitive to heart rate, so when their heart starts to beat out of their chest, it comes as such an overwhelming experience of panic or rage.”
In her work, Chelsea had observed something I was concerned about as well. “What I find with eating disorders and most mental illnesses is that people have a lot of tools in their toolbox, but they don’t use them at appropriate times.” Right? Why was that?
“For instance, if we’re dealing with anxiety and panic, in a moment of anxiety, we may want to go for a run. That’s probably the worst thing you can do for your body in the middle of anxiety. If you go for a run, you’re going to kick your sympathetic nervous system higher into gear. A practice to move it down might be something like restorative yoga, or yoga nidra, or diaphragmatic breathing. These have all been shown to activate the parasympathetic branch, and vice versa. If I’m in the middle of depression and I’m feeling lethargic and I can’t get myself out of bed in the morning, then I need something to activate my sympathetic branch, like breath of fire or a Vinyasa yoga class, or a run around the block, or a bike ride, or a loud social situation, or a cold shower. Part of what we’re doing with Eat Breathe Thrive is teaching people how their bodies work, how their nervous system works, and helping them identify tools that are already in their toolbox that they can use more effectively.”
This brought me to a third component I wanted to explore, one I think is big for many people: How we c
an learn to feel a sense of home in our own skin in a way that we can accept and that we’re comfortable with?
This is probably the emergent process of Chelsea’s entire program, but there’s no single tool or method. “I think part of that process of creating a sense of home in your own skin is dropping into the knowledge, the realization, that you are in no way separate from yourself, from your physicality. You are a conscious being, a sentient being having a human, physical, embodied experience. Your body is the substrate that allows you to have a conscious experience in this form. My words, my thoughts, my feelings, my sense of connection with others all live and emerge from my body. There’s nowhere to be but at home. This is your home because you cannot leave it. You’re beautifully and magnificently and phenomenally tied up with this thing called your body.
“I think the other part of that realization is recognizing that often the judgments we have about our bodies are nothing more than the judgments we have about ourselves. We talk about our relationship with our body, but what we’re talking about is our relationship with ourselves. When we say we’re not worthy or that our body is too much or too fat, that’s often a reflection of ‘I’m too much’ or ‘I’m too greedy’ or ‘I’m not enough’ or whatever. We’re talking about how we feel about ourselves.”
Chelsea gave me so much to think about. Another thing I found fascinating was how she combined her yoga training with a study of neuroscience. What light could she shine on the neuroscience underlying disorders and addictions—from anorexia and bulimia to drug and alcohol addiction, to sex addiction and workaholism? What’s going on with our physical chemistry, and how can we then take this knowledge and begin to make lasting changes in our behavior?
This was something Chelsea was passionate about! There was one thing she especially wanted to delve into. “We can talk a lot about the autonomic nervous system, but I can’t point to an area of the brain solely responsible for causing eating disorders. We can say that most addictive disorders tend to have similar effects in the brain, but the research is so new. We know that dopamine is involved in addictive disorders, but dopamine is also involved in movement and in brushing your teeth. I would say that when it comes to neuroscience, so far, as of 2017, our instruments are very blunt. For the past decade, fMRI [functional magnetic resonance imaging, a type of brain scan] has been one of the most popular tools in neuroscience. What it allows us to see is where blood is going in the brain. This means we can put somebody in a scanner and tell him or her to think about drinking alcohol or food and look at where blood goes in the brain. We’re not looking at the cause of addiction or anorexia, but instead at what parts of the brain appear active when we’re thinking about food or alcohol. Neuroscience is starting to give us a picture of what might be involved, but I would say the big takeaways are not simplistic. I’m very excited for the day when we’ll have an instrument that allows us to look at the entire body and the entire nervous system. I’d love to be able to do the yoga asana downward dog in an fMRI scanner, but you can’t do that right now.”
Chelsea turned me on to the work of Marc Lewis, author of Memoirs of an Addicted Brain. “He says that addiction isn’t a disease in the same way that cancer is a disease. It’s not something you get infected with. Humans have evolved to have reward pathways in the brain, so, for example, you might initially find that alcohol or dieting or cookies are rewarding. What your brain does is get hyperfocused on that reward, and the neural pathways to that reward deepen. Think of it like a path through the woods: If you walked on that path repeatedly for ten years, the plants and trees around it would grow thick and hard to navigate. You’ve got a nice path, but it takes you to a swamp that’s horrible—like addiction, dieting. But you’ve walked down that path many times because the brain created reward pathways, and it’s nearly impossible to walk down another pathway that might also be rewarding—like community or connection. Part of the process of recovery is like wandering through the woods seeking a different reward. Eventually trees will start to grow over that old pathway.”
Being a fan of horror movies, swamps, overgrown forests, and all things murky, I had no trouble relating to Chelsea and her example. It reminded me of so many times in my life when I’d had to venture out after returning to drugs and alcohol and begin clearing a new path (both metaphorically and literally). Let that be yet another testament to anyone who is struggling while reading these words—it absolutely is doable. You can do this. I swear.
I had another question for Chelsea, one that was more neurobehavioral than neuroscientific, but I knew she’d have great insights. There have been many recent studies about genetics and epigenetics related to both eating disorders and substance addiction. What did she think about the connection? How can we undo what seems to be hardwired or rewired?
It turns out she’s passionate about the genetics and epigenetics around eating disorders and substance abuse. “Mostly because I think there’s a lot of misinformation out there. One thing we do know is that eating disorders and substance abuse issues are highly heritable. Studies suggest that the heritability for anorexia, bulimia, and binge eating disorder is 54 to 83 percent,2 which tells us that if we’re looking at the causes that lead to conditions like full-blown eating disorders, 54 to 83 percent of the causes are due to genetics or epigenetics. That’s fascinating. Another one that blew my mind is that individuals are 11.3 times more likely to develop anorexia nervosa if one of their parents has had the illness, and between 4.4 and 9.6 times more likely to develop bulimia if one of their parents has had the illness.3 That’s kind of mind-blowing. If one of your parents dealt with an eating disorder, you come into the world 5 to 12 times more likely to develop it. Talk about having the odds stacked against you.
“I don’t know the research on substance abuse right now, but I’d imagine it’s even higher than that. That said, genes alone don’t cause eating disorders or substance abuse issues. There are biological causes, psychological causes, and social causes. I find that there’s a lot of variation between individual cases. The other thing we’ve learned over the past couple of decades through genetic research is that almost no expression of genes is solely genetic—it’s almost all epigenetic. Epigenetics is essentially the study of genetic and environmental interactions—how your genetics interact with your environment and how that affects what’s expressed. For example, you may have inherited a gene that predisposes you to be six feet tall, but you must have certain environmental factors present to fully embody that genetic predisposition. If you’re malnourished growing up, you’re probably not going to reach the full potential of your height.
“The same is true with eating disorders and substance abuse. You might come into the world predisposed to develop substance abuse issues, but there are environmental variables that must be present for you to express that genetic predisposition. Many of those environmental things are psychological. We talk about big T traumas and little t traumas, and we define trauma as any experience that overwhelms our ability to cope. Kaiser Permanente conducted the Adverse Childhood Experiences Study (ACE Study) on 17,000 people in the 1990s.4 It’s one of the greatest studies on trauma out there. It found that adverse childhood events or experiences are essentially traumatic experiences. Eighty percent of individuals who experience adverse childhood events meet the criteria for at least one psychiatric illness by twenty-one years old.”
Think about that: 80 percent!
“The other thing they found is that two out of three adults experience at least one adverse event in childhood, and that more than one in five report three or more. The powerful thing about this is that in addition to showing that adverse childhood events can kick those genes into gear and cause substance abuse issues and eating disorders and things like that, they found that they predispose one to heart disease, diabetes, every single variable you can think of physically, even early death. Trauma shortens life-spans. The study demonstrated that if you have those environmental factors present, you’re more likely to tur
n on the genes that cause cancer, diabetes, substance abuse, and things of that nature. I think if there’s one sort of misunderstanding out there, it’s that genes alone cause substance abuse.”
I was grateful for Chelsea’s knowledge and empathy. It illuminated my life trajectory in a way I hadn’t considered before. Perhaps if certain social conditions had been different, I wouldn’t have ended up becoming addicted to alcohol. Perhaps if my family’s economic situation had been different, I wouldn’t have had such deep issues around money and feeling worthy of it in my life. There were a whole lot of maybes and what-ifs I watched come up, but as I did, I was able to say fuck that! We are who we are today, and that’s a beautiful thing. I thank all the environmental, economic, social, and geographical components that laid the foundation for my life experience, culminating in this day. It really is all good. For sure.
PRACTICE
Tracking of Needs
Chelsea tuned me onto a practice to rebuild interoception and interoceptive awareness. It’s a tool that’s helpful in rebuilding hunger and fullness symbols, and it’s easy! It’s a simple belly-breathing meditation in four parts: sensation, need, reaction, and action.