Body Sense

Restorative embodied self-awareness as a pathway to well-being.

Psychotherapy, Medication, or Body Sense for Mental Health?

Alternative ways to improve mental health.

Are you feeling down or anxious? Are you looking for a way to feel better? Recent research shows that exercise, meditation, and massage work equally as well as psychotherapy in alleviating these unwanted feelings. Psychiatrist and therapist Roger Walsh has called these and other daily practices—like eating well, being in nature, improving interpersonal relationships, doing service activities, and religion/spirituality—Therapeutic Lifestyle Changes (TLCs). Writing in the October issue of the American Psychologist, Walsh reviews research showing how each of these areas contributes toward improvements in mental health, sometimes alone and sometimes in conjunction with psychotherapy and medication. "Unlike both psychotherapy and pharmacotherapy," according to Walsh, TLCs "are free of stigma and can even confer social benefits and social esteem." In addition to their mental health benefits, TLCs can improve physical health and quality of life and reduce the risks of neurodegenerative diseases.

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I have reviewed similar research findings in this blog series and in other writings to make the case that all these diverse TLC practices are linked by a common causal factor: body sense. Body sense, or embodied self-awareness, is the present moment consciousness of emotional feelings and body sensations. Body sense is the link between the mind and the body. It is the mental state of being embodied as a sensing, feeling being. The neurophysiology of embodied self-awareness is still an emerging science but there are clearly networks devoted to sensing the internal condition of the body and these networks are linked into others that lower stress hormones, engage the parasympathetic nervous system, and activate the immune system. It is as if our internal pharmacy is more likely to be activated if we simply pay attention to the parts of ourselves that are in the most need.  

Take exercise as one example. Most of the research on exercise and health does not take account of the person's mental state during exercise but it's quite clear that there are benefits no matter what your mind is doing while you exercise. You can go to the gym, get on the machine of your choice, turn on the headphones or watch TV, or mull over the day's events and you'll still get benefits from exercise. Is there any gain to paying attention to your body while exercising? It turns out that, yes, noticing your muscle exertion, movement coordination, breathing, weight shifting and any emotions that come up (good or bad) improves fitness, well-being, cognitive function, and social relationships over and above those conferred by exercise alone. And, by way of review of previous posts, there are many ways to activate your body sense to support and enhance the effects of cardiovascular exercise. If bouts of exertion can be interspersed with rest periods to allow for feeling the body (interval training). You use motor imagery to remember and imagine the body sense of different parts of your workout so you don't have to do as many reps to get the same benefit. A complete exercise diet involves not only cardiovascular workouts but slow movement practices like tai chi, yoga, Feldenkrais, and Rosen Method Movement that afford more opportunity to tune into the body.

Exercising outdoors, or green exercise, can sharpen the senses and wake up the body in ways that are different from exercising indoors. Aside from the benefits of nature mentioned in the article by Walsh (freedom from urban noise, stress, and distraction) the vastness of mountains, deserts, and woods and the wildness of rivers and oceans impact our body sense. Being in nature has been shown to bring us more in touch with ourselves and remind us what is important in our lives. Nature enhances our sense of connection and belonging of the self—a feeling of "oneness"—between ourselves and other people, animals, plants and trees, and the earth itself.

Let's consider nutrition and the role of body sense. According to Walsh, deficiencies in omega-3 fatty acids found in fish oil and other sources are associated with depression, anxiety, bipolar disorder, ADHD, and schizophrenia, and supplementation with Omega-3s can reduce the symptoms of these disorders, sometimes without complementary psychotherapy or psychotropic medication. Similar findings are available for Vitamin D supplementation.

At first glance, it may be difficult to connect taking these nutritional supplements, or eating food rich in these supplements, with body sense. It may seem that the impact of nutrition (or exercise for that matter) on mental health is derived primarily from the neuro-restorative effects that occur at a purely cellular level. There is research, however, showing that mindfulness in food choices and in feeling the body's state of satiety and the effects of particular foods as they enter the body plays a role in weight loss and maintenance. Weight loss programs that include a mindfulness component—such as tracking food intake or eating meditations—are based on the idea that people pay too much attention to how they are perceived by others or in relationship to a normative body image and not enough attention to the present moment awareness of how they feel while eating.

Still, one could argue that simple supplements like Omega-3's have nothing at all to do with body sense. The very fact of taking a supplement, however, or choosing foods high in that substance, increases the attention we pay to what we put into our bodies. We are also more likely to look for and notice the presumed effects of those supplements. In other words, taking a supplement involves the mind and the body, and if done with body sense attunement to one's own internal feelings and experiences, you may get the extra boost that comes from activating the neural networks for self-healing that are regulated by body sense. It would be nice if there was research on using supplements with and without body sense, analogous to some of the research on exercise, but such research does not yet exist.

In the meantime, I'm going to continue to trust in my own senses and feelings about what makes me feel better and happier. I'm convinced that there is sufficient research to consider body sense as an amplifying agent to enhance the effects of any treatment including psychotherapy, medication, and TLCs. It's also useful all by itself and I've mentioned many treatment and educational practices in the blog that help to enhance body sense.

It would not, however, be justified to say that body sense is all one needs for health. I take the medications my doctor prescribes and submit to surgery when needed. I also participate in all the TLCs that Walsh mentions, and more. Walsh, however, tells us that practitioners who use TLCs for their own health are more likely to recommend them to their clients. It helps to promote client's body sense if therapists are also embodied and engage in body sense practices So, I'm biased. I guess you'll just have to try them for yourself.

Alan Fogel, Ph.D., is a Professor of Psychology at the University of Utah in Salt Lake City.

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