Equine-Facilitated Counselling and Women with Eating Disorders: Articulating Bodily Experience/Le Mieux-êTre Facilité Par le Cheval Dans le Counseling Chez Les Femmes Souffrant De Troubles De L'alimentation: Articuler L'expérience Corporelle (2014)

The problem of eating disorders has taken centre stage in recent years within helping professions and the larger public arena. The current diagnostic system (i.e., DSM-5; American Psychological Association, 2013) describes anorexia, bulimia, binge eating disorder (BED), and eating disorder not otherwise specified. Eating disorders affect a variety of populations, but they are largely issues that affect women of Western cultures (Blood, 2005). Although rates for these problems vary from context to context, it is estimated that between 1% and 3% of the popula- tion in Canada and the United States suffer from an eating disorder (Garfinkel et al., 1995; Levine, McVey, Piran, & Ferguson, 2012; Walters & Kendler, 1995). However, many researchers consider eating disorders to be more widespread than these rates suggest, due to the secretive nature of these problems (Maison, 1998) and issues inherent in the diagnostic system (Novotney, 2009; Swanson, Crow, Le Grange, Swendsen, & Merikangas, 2011). These problems exist on a spectrum ranging from socially acceptable behaviours such as diet and exercise to more extreme practices characteristic of what we define as eating disorders (RussellMayhew, 2007). The line between these problems is becoming increasingly blurred as evidenced by the rising number of individuals who live with what are termed subclinical eating disorders and the high preponderance of diagnostic crossover (e.g., from anorexia to bulimia; Eddy et al., 2008; Tozzi et al., 2005).Despite an explosion of research into the nature and treatment of eating disorders, these problems continue to be prevalent, chronic, debilitating, and sometimes life-threatening (Levine et al., 2012), suggesting that there is a gap in our existing knowledge base. Scholars and researchers in the eating disorder field have turned toward exploring the concept of embodiment to address this gap (e.g., Piran & Teall, 2012; Sanz & Burkitt, 2001; Stanghellini, Castellini, Brogna, Faravelli, & Ricca, 2012). Embodiment is a term that has been taken up within a variety of disciplines and refers to the many tacit ways that people go about their day-to-day lives. This includes sensations, visceral experiences, gait, posture, movements, and ones general engagement with the environment. While these modes of being often go unnoticed, they create the very means by which people construct their experiences (Shusterman, 2008). This lived and process-oriented approach has typically fallen to the wayside in favour of a cognitive-behavioural approach that emphasizes control of the body and the separation of human experience into discrete states that can be measured and objectified (Bigwood, 1991; Gremillion, 2002).In this research, I draw from an embodied understanding of eating disorders, which allows for a different grasp of these problems compared to more traditional conceptualizations. It is important to note that, in keeping with this embodied understanding, I use the terms attunement and corporeal Attunement refers to people s prereflective ways of existing in the world. Although embodiment and attunement are similar concepts, the key distinction is that attunement corresponds more closely to a relational process, or the ways that individuals alternately engage with and respond to their social and physical worlds. This can be understood as an ongoing circle existing between bodies and the world in a reciprocal dialogue; thus people are continually adjusting to a terrain or milieu that is always changing (Abram, 1996). This emerging discourse of the body encourages a shift from understanding eating disorders as individual pathologies, as espoused in the traditional medical treatment model. Instead, women who struggle with eating disorders and related problems are seen as people who accordingly express their life and relation to the world in active and communicative ways (Sanz & Burkitt, 2001).Similarly, the term corporeal refers to the bodily and communicative dimension of experience. …