Intuitive Movement During Recovery – Interview with Ellen Masson
During recovery from an eating disorder, exercise can be a difficult area to navigate. Intuitive Movement is a method of exercising which supports individuals to continue moving in a body-positive, non-judgemental and enjoyable way. To learn more about Intuitive Movement, our dietitian Kirby caught up with movement expert Ellen Masson (check out her instagram here).
If you want to jump straight to the juicy details, click on the following questions and it’ll scroll you down to the appropriate sections of this blog.
About Ellen: Ellen Masson is a Health At Every Size (HAES)® aligned accredited exercise physiologist (AEP), personal trainer, and strength and conditioning coach. Ellen is passionate about supporting individuals through eating disorder recovery, with specialist training in motivational interviewing, Cognitive Behaviour Therapy, Acceptance and Commitment Therapy, and chronic pain management. Ellen is leading the way in body-positive practice, and generously offered her time to share her work with DDD Centre for Recovery.
Intuitive Movement supports individuals to heal their relationship with exercise during recovery. It involves tuning in with and responding to the bodies needs prior to, during and after activity, allowing individuals to adapt their exercise and recovery based on their body’s needs. Unlike typical approaches to exercise, Intuitive Movement shifts focus from the type of activity to the reason for doing activity. It encourages individuals to move in ways which bring fulfilment and enjoyment, rather than to punish their body or change its shape. During recovery from an eating disorder, Intuitive Movement can be used in conjunction with nutrition counselling and mental health support to support individuals to form a stronger connection to their body and mind.
For more information about Intuitive Movement, you can read Kirby and Ellen’s conversation below!
How are Exercise Physiologists involved in Eating Disorders Recovery"?
Kirby: Can you describe the role that an exercise physiologist plays in eating disorder recovery?
Ellen: I think it's important just to zoom out for a second. There are three main areas that eating disorders generally effect - your relationship with exercise, relationship with food, and relationship with mind.
Traditionally, a combination of psychology and nutritional interventions are used to treat eating disorders. However, we're leaving out this entire segment that the eating disorder attaches to. And that's what my role as an exercise physiologist is, to prescribe safe exercise at a level that doesn't interfere with recovery but allows the individual to gain the health benefits associated with movement. I also help clients address the underlying unhelpful beliefs about exercise that contribute to the ED pathology and work towards improving their overall relationship with exercise.
I want to ensure that the client is still able to do something that might be part of their coping strategy, rather than taking it away and leaving them with nothing to lean on. Abstinence (from exercise) often gets presented as a good option for people in eating disorder management, but often you're recommending absence to people who are just entering a psychological intervention. The eating disorder tends to remove all of the individuals healthy coping mechanisms with exercise being the only thing holding them together. And then some people recommend removing it from them. That doesn’t sit well with me, when there could be alternative options to keep that person engaging in some level of safe movement.
Intuitive Movement during Eating Disorders Recovery: How To?
Kirby: On that topic, can describe what Intuitive Movement is and what role that can play in recovery?
Ellen: The definition changes based on who you are, but I'm going to share what I believe intuitive movement is. I think it is learning to appropriately respond to your psychological and physical cues prior to, during, and after exercise. The sensations you pick up on then impact the kind of exercise you do. It enables you to change the movement you need based on how you're feeling, and after exercise it informs what you need for recovery or what you might need for movement the day after.
People with eating disorders tend to exhibit behaviours that mark a very poor relationship with exercise. Often these behaviours include rigidity and inflexibility. You’re participating in the same things every day at the same time. And you're compelled to do that - you’re stuck in a guilt-shame spiral with exercise. So if you're unable to participate in exercise for any reason, you feel intense guilt and shame. This can also lead to engaging in eating disorder behaviours in response to the guilt and shame. And often exercise is motivated by a drive for thinness as well as being a punishment, either for messing up certain rules or to purge. So we have these tendencies that get wrapped up in a poor relationship with exercise. And the reason why I'm bothering to define this is because intuitively movement is the opposite of this, which is why it's so powerful in terms of eating disorder recovery.
The goal and first principle of Intuitive Movement to rejuvenate the body, not exhaust or deplete it. That's really important, because it addresses the punishment element of exercise. Exercise should enhance a mind body connection, and it shouldn't allow you to disassociate away from the experience that you're in. It should help alleviate mental stress and physical stress and not produce more stress, so you shouldn't be leaving exercise feeling worse than when you came into it.
Another really important principle is providing genuine enjoyment and pleasure, not pain or dread when it comes to exercise. A lot of people who have eating disorders have a lack of enjoyment in exercise, they're doing it purely as a purging behaviour, to burn calories, or to punish or to hurt themselves. They intentionally engage in activity they don't enjoy just for that outcome. Trying to teach people to find movement that is actually fun, that they actually love that they actually feel motivated to do because of the social engagement, and has nothing to do with those physical things, is really empowering for people. It helps address those core pillars that you see in poor relationship with exercise.
I also think that the ability to be able to be self-reflective and stay present during movement is important. Because the fitness and health cultures preaches “no pain, no gain” and “if you're not sweating buckets, you haven't done it properly”. You can't actually connect with your body or mind when you're doing that, you have no choice but to dissociate. And so learning to become more present to yourself helps you become more present to your own needs, too, which is something that I find people with eating disorders tend to shut off from.
Do’s and Dont’s of Exercise in Recovery
Kirby: Are there any certain types of exercise that you do or don’t recommend within Intuitive Movement?
Ellen: No particular exercise is off limits. A lot of people have an assumption that higher intensity exercise is off limits with Intuitive Movement, and that's just not true. It's more about the ‘why’ behind the movement than the actual movement itself. So I might ask “are you doing this because you genuinely want to? Are you doing this because you enjoy it? Are you doing this because this is what is going to make you feel nourished and mentally stimulated? Or are you doing this exercise because you ate a piece of cake and you feel terrible, and you're at the gym because you're trying to exercise it off?” It’s the reason behind the exercise which is most important.
However, if you have an eating disorder, some types of exercise and intensities may be contraindicated based on your medical status and progress in recovery. So we also need to consider this when using Intuitive Movement in eating disorder recovery.
Kirby: How does Intuitive Movement approach rest compared to typical models of exercise?
Ellen: A lot of mainstream exercises are very rigid and prescriptive. You rock up, you have to do certain things for this long, at this weight, for this amount of time, at this intensity. And the problem with this is that you're not taking into account all of the factors that impact a person's ability to exert themselves on any given day. There are so many different factors that affect performance, including mental health factors, what your body feels like, sleep quality, food intake and injury or illness.
Let’s take rest periods as an example. I encourage people to rest for as long as they need, it’s never a set time period. The only time I see it as being beneficial is if we're doing exercise for a specific health criteria. For example, if some has osteoporosis and we’re exercising with the goal of increasing bone density, we might be more exact about the exercise protocol that we use. Often, I find I need to encourage people to rest for longer periods then they initially want too. I normally tell people to wait until their heart rate and physical sensations returned to baseline. Most people will want to jump straight back into it after only 20 seconds. So, when teaching people how to listen to their body, you really need to actually force them to rest for a very long period of time to actually understand what the sensation of being fully recovered is like. You can’t exercise without having recovery, it's just as critical as the movement itself.
Kirby: How do you introduce the concept of Intuitive Movement to your clients?
Ellen: I provide clients with a lot of education about Intuitive movement though experiencing it first hand. They experiential learning could include learning how to check in with yourself before exercise, figuring out the exercise options you have to choose from, learning what feels good on your body and applying the appropriate amount of rest. My role is of a coach in these circumstances, we are working it out together as everyone’s movement needs are so unique. A lot of people also have very unhealthy beliefs about exercise, which intrude on people's ability to move intuitively. Often, there has to be a lot of education about the emotions they are struggling with that underpin those unhelpful exercise beliefs to allow them to move more intuitively.
Kirby: Can you recommend any resources for anyone who wants to know more about exercise and eating disorders recovery?
Ellen: If you were interested in reading something, I would definitely recommend you read Safe Exercise at Every Stage. It has detailed guidelines about safe exercise for individuals with eating disorders.
Additional Resources
- Safe Exercise at Evert Stage (SEES) Guidelines: https://www.safeexerciseateverystage.com/access-sees-guidelines
We hope that you enjoyed this interview!
To find out more about Ellen:
Into The Red Zone (her podcast) - Fumi has previously talked about Dancers, Eating Disorders, Body Image, and Recovery. Listen here.
You can see Ellen at:
Wellness in Motion (in Lindfield)
Haven (body positive gym for womxn in Summer Hills)