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Why social connection is a key ingredient to success in recovery

 

Living with an eating disorder and determining the road to recovery can feel like an isolated, uncertain and scary place. A big part of these feelings may stir from a fear of abandonment or aloneness, which can be challenging, especially if we have a limited support network of people who can directly relate to our situation.

Reaching out to a friend or relative who may never have experienced or witnessed an eating disorder before may leave you feeling misunderstood or uncomfortable opening up fully. However, seeking support groups and reaching out to like-minded people can be a crucial pillar in your healing journey. 

Whilst eating disorder support group research is limited, we know that they have been helpful for individuals and families with other conditions, including cancers, hospitalised adolescents, and bereavement, with the most beneficial effects associated with regular and long-term attendance. (1,2,3,4) Human connection is powerful, and it’s been shown to reduce the risk of relapse.

This article will dive into the potential power of support groups in eating disorder recovery, touching on some of the fantastic research by a critical name in this field – Dr Daniel J. Siegel, a Clinical Professor of Psychiatry from UCLA’s School of Medicine. 

 

Who is Dr Siegel?

Dr Siegel has done extensive research into attachment, human relationships and the neurobiology of children, adolescents, families and communities. 

He is a pioneer in ‘interpersonal neurobiology’ – an interdisciplinary approach looking at the sciences that make up the human experience and connection, encompassing mental health, anthropology, sociology, developmental psychology, and so much more. (5, 6)

Dr Siegel encourages this ‘consilient’ approach to medicine in its practice – one that considers multiple fields, theories, and ways of thinking, to reach a more holistic, inclusive attitude to health. (6)

He developed the term ‘mindsight’ to refer to our cognition in this synergetic way and is the director of the Mindsight Institute – an online platform of courses, tools and videos to explore this area deeper.

 

What is ‘mindsight’?

Mindsight is a term coined by Dr Siegel, which highlights the way in which we see ourselves and our brains and connect with others on a deeper level.

It can be described as the detachment of our thoughts from the ‘self’ and our identity. It is the acknowledgement of our feelings and emotions without being overwhelmed by them. Developing a practice and awareness of ‘mindsight’ can separate and overcome these consuming thoughts and beliefs about ourselves, which may be more damaging than helpful. (6) It can be seen as similar to developing a mindfulness practice or using yoga as a crutch in recovery.

Mindsight is something we can learn and develop with experience – rewiring our thought patterns and brain structure to serve us best. These connections can be formed throughout life and not just in childhood – emphasising the power of our brain’s neuroplasticity and its adaptability to change.

 

What does neurobiology say about human connection?

Research has demonstrated that these interpersonal connections between others in our day-to-day life catalyse further neural integration and stability, boosting our emotions, attention, mood, thoughts and behaviour. (6)

It stimulates the growth and activity of fibres in the brain that are integrative – such as the prefrontal cortex, hippocampus and corpus callosum, which are all responsible for strengthened connections between various brain regions. (6)

Studies have shown that the prefrontal cortex can be an indicator of social network size, cognitive competence, as well as empathy and understanding of others. This has been found with online interactions, too. (7, 8, 9, 10)

 

Why are our interpersonal relationships important?

Dr Siegel believes that by schools, society, and parents or carers, we are taught to believe that the ‘self’ is merely comprised of you as an individual, in your body, and little else. The two have been ‘equated’, and this is taught to us from a very young age. (6)

The reality is, in fact, that our ‘self’ goes far beyond this – the self is indeed within us, but also between us.

The ‘self’ includes our connections with other individuals, our society, and the planet as a whole. When we open the ‘self’ up to this, we receive and give compassion, kindness, empathy and love to those around us. (6)

We don’t live in isolation, but in connection, and the idea of the ‘American Dream’ and individualistic societies are not always quite as ideal as they seem. To ignore that humans crave and depend upon common understanding and collaboration is perhaps a reductionist and outdated view.

Relationships give us a sense of being seen, heard, felt and connected – and create well-being in our bodily lives – the mind and body. Well-being is dependent on this integration and sharing of energy and information. (6)

In modern medicine, physical symptoms have gained far greater focus than one’s lifestyle, experiences and individual needs. This is not optimal medical practice – and research shows that a person-centred care approach can be more effective, empowering and rewarding, with longer-lasting benefits, too. (11, 12, 13)

 There have been several studies carried out on the practitioner-patient relationship, and many have shown that the empathy provided to a patient has a profound effect on healing, immune response and mental health. (14, 15). There was found to be improved compliance and greater satisfaction when individuals felt heard and understood.  (16)

Practitioners who were attuned to their patient’s conditions were the ones who saw the best clinical outcomes, as well as feedback measured by the consultation and relational empathy (CARE) measure. In the study, participants were even found to recover more quickly from a cold when a more empathic approach was used. (17)

 

The PART theory 

PART is a framework of Dr Siegel’s, which stands for the following:

 

Presence:

Being present with another person, giving them the time and holding space to listen to what they have to say.

Attunement:

Focusing our attention on the inner nature of a person, their internal being. Taking the time to affirm their journey and make comments of empathy goes a long way.

Resonating:

Not becoming the other person entirely, but making an effort to deeply feel their feelings and be changed and moved by their situation.

Trust:

Engaging and inviting interpersonal integration to build rapport.

The above elements can be applied to a support setting to create a safe and open space for individuals, within a group or one-to-one, to create integration and interpersonal connection. (6)

We hope you enjoyed reading this article and learning more about the sheer power of connection and relationships – which is why we encourage you to make social support a priority as you may prepare to recover from an eating disorder.

Our all-new THRIVE programme includes weekly support groups with peers, so you can feel empowered, beat disordered eating and heal your relationship with food. Sign up today!

If you are seeking some 1-1 guidance on your recovery journey, remember you can also get in touch with one of our dietitians today and book a free, no-obligation discovery call.

Stay strong, brave, and beautiful! 

 

Priya Chotai, BSc ANutr

EHL Team x 

 

References

1. McGee SJ, Burkett KW. Building a support group for parents of children with brain tumors. J Neurosci Nurs. 1998 Dec;30(6):345-9. DOI: 10.1097/01376517-199812000-00005. PMID: 9949973.

2. Stevinson C, Lydon A, Amir Z. Cancer support group participation in the United Kingdom: a national survey. Support Care Cancer. 2011 May;19(5):675-83. DOI: 10.1007/s00520-010-0887-9. Epub 2010 Apr 28. PMID: 20424867.

3. Yvert A, Radjack R, Moro MR. Groupe de parole pour adolescents hospitalisés : un appui pour grandir [Support group for hospitalised adolescents: support for growing up]. Soins Psychiatr. 2017 Nov-Dec;38(313):19-22. French. doi: 10.1016/j.spsy.2017.09.004. PMID: 29173568.

4. Gibson A, Wladkowski SP, Wallace CL, Anderson KA. Considerations for Developing Online Bereavement Support Groups. J Soc Work End Life Palliat Care. 2020 Apr-Jun;16(2):99-115. DOI: 10.1080/15524256.2020.1745727. Epub 2020 Mar 28. PMID: 32223368.

5. Siegel DJ. Mindfulness training and neural integration: differentiation of distinct streams of awareness and the cultivation of well-being. Soc Cogn Affect Neurosci. 2007 Dec;2(4):259–63. DOI: 10.1093/scan/nsm034. PMCID: PMC2566758.

6. Siegel, D. (2014). Interpersonal Connection, Self-Awareness and Well-Being: The Art and Science of Integration in the Promotion of Health. Lecture, University of California, Los Angeles (UCLA).

7. Lewis PA, Rezaie R, Brown R, Roberts N, Dunbar RI. Ventromedial prefrontal volume predicts understanding of others and social network size. Neuroimage. 2011 Aug 15;57(4):1624-9. DOI: 10.1016/j.neuroimage.2011.05.030. Epub 2011 May 15. PMID: 21616156.

8. Kanai R, Bahrami B, Roylance R, Rees G. Online social network size is reflected in human brain structure. Proc Biol Sci. 2012 Apr 7;279(1732):1327-34. DOI: 10.1098/rspb.2011.1959. Epub 2011 Oct 19. PMID: 22012980; PMCID: PMC3282379.

9. Powell JL, Lewis PA, Dunbar RI, García-Fiñana M, Roberts N. Orbital prefrontal cortex volume correlates with social cognitive competence. Neuropsychologia. 2010 Oct;48(12):3554-62. doi: 10.1016/j.neuropsychologia.2010.08.004. Epub 2010 Aug 14. PMID: 20713074.

10. Noonan MP, Mars RB, Sallet J, Dunbar RIM, Fellows LK. The structural and functional brain networks that support human social networks. Behav Brain Res. 2018 Dec 14;355:12-23. DOI: 10.1016/j.bbr.2018.02.019. Epub 2018 Feb 20. PMID: 29471028; PMCID: PMC6152579.

11. Ndoro S. Effective multidisciplinary working: the key to high-quality care. Br J Nurs. 2014 Jul 10-23;23(13):724-7. DOI: 10.12968/bjon.2014.23.13.724. PMID: 25072333.

12. Beach MC, Inui T; Relationship-Centered Care Research Network. Relationship-centered care. A constructive reframing. J Gen Intern Med. 2006 Jan;21 Suppl 1(Suppl 1):S3-8. DOI: 10.1111/j.1525-1497.2006.00302.x. PMID: 16405707; PMCID: PMC1484841.

13. Mercer SW, Reynolds WJ. Empathy and quality of care. Br J Gen Pract. 2002 Oct;52 Suppl(Suppl):S9-12. PMID: 12389763; PMCID: PMC1316134.

14. Coulter A, Oldham J. Person-centred care: what is it and how do we get there? Future Hosp J. 2016 Jun;3(2):114-116. DOI: 10.7861/futurehosp.3-2-114. PMID: 31098200; PMCID: PMC6465833.

15. Kim SS, Kaplowitz S, Johnston MV. The effects of physician empathy on patient satisfaction and compliance. Eval Health Prof. 2004 Sep;27(3):237-51. DOI: 10.1177/0163278704267037. PMID: 15312283.

16. Stewart M, Brown JB, Boon H, Galajda J, Meredith L, Sangster M. Evidence on patient-doctor communication. Cancer Prev Control. 1999 Feb;3(1):25-30. PMID: 10474749.

17. Rakel DP, Hoeft TJ, Barrett BP, Chewning BA, Craig BM, Niu M. Practitioner empathy and the duration of the common cold. Fam Med. 2009 Jul-Aug;41(7):494-501. PMID: 19582635; PMCID: PMC2720820.

 

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