Helping AN Patients Regain Body Awareness

Breathing, balance, and stability
are affected by AN.

A Norwegian physiotherapist suggests that body-awareness-oriented therapies should precede the introduction of physical activity and exercise programs for patients with anorexia nervosa (AN). According to Liv-Jorunn Kolnes, of the Department for Eating Disorders at Oslo University Hospital, Oslo, Norway, many AN patients have significantly impaired body awareness, an extremely constrained pattern of breathing, significant muscular tension, and poor postural stability, as well as an obsession with excessive exercise (Journal of Bodywork and Movement Therapies 2012; doi:10.1016/jbmt2011.11.005). They are thus “disembodied” and “disconnected” from their bodies.

The author, who is also the lead researcher and a specialist in Norwegian Psychomotor Physiotherapy (NPMP), has observed that patients with AN can benefit from a physiotherapeutic approach. The NPMP method of treatment is based on the premise that posture, respiration, muscle tension, and body awareness are closely related to emotional and psychological strain. According to Kolnes, personal experiences and stories are imprinted in and reflected in our bodies, and in NPMP special attention is given to breathing, body awareness, and body stability.

Dr. Kolnes notes that the aim of physiotherapeutic treatment is to help patients re-establish contact with their bodies and bodily sensations and to increase body awareness and “ownership” of their bodies. In the author’s experience, patients with AN are often confused about bodily sensations and states, have a lack of contact with their bodies and lack ability to describe bodily experiences. They also have a tendency to distance or dissociate themselves from their bodies—some even claim that they have no body and that they exist only in their own head. Some AN patients report they cannot feel their own feet and can’t tell if they are standing on their feet. Hilde Bruch was among the first researchers to report this finding.

According to Dr. Kolnes, an approach to improving AN patients’ body awareness may contribute to novel ways of sensing and interpreting bodily signals, to experience the body in a more differentiated way and to integrate the body as one’s own.