Starting March 3, 2010, we will be offering another course in Mindful Eating (for those of you in the Chicago area). We developed these classes to help people who feel caught in compulsive eating or dieting patterns, and who want to find their way to a more natural and satisfying relationship with food. You might be asking yourself, Are mindful eating classes the right approach for me? To find out, try considering these statements:
I sometimes binge or eat compulsively
I’ve tried restrictive diets and they don’t work for me
I know I sometimes eat because of stress or emotional needs
I’d like to feel less guilty about my eating and my weight
It would be easier to deal with my eating if I could manage my stress better
I want to learn to eat in a way that nourishes and respects my body
I really value health and wellness, and would be willing to spend a half hour a day to develop this area of my life
I’ve been interested in meditation, yoga, or tai chi
I have a spiritual side
I’d like to develop more patience, acceptance, and forgiveness
I’ve been able to apply myself to activities that require home practice, like music lessons, workouts, or schoolwork
I would like to give and receive help with others in my situation
I’m open to taking a new approach to eating
The more you agreed with these statements, the more likely you are to find mindful eating classes helpful. For more information, call Dr. Mary Connors at 312-372-5501, or visit our website.
Image via WikipediaPeople who are struggling with binge-purge problems often find it stressful to make important changes in their binge purge cycle. One of the most difficult aspects of recovery can be tolerating the feelings of fullness that occur after eating. This is not simply a difficulty after a binge, but also after a normal sized meal or snack.
We'd like to get some ideas out to therapists who are taking a mindfulness approach with eating disorders. If you are a person who purges after eating, please talk to your therapist before trying to practice any of these techniques. They may not really be right for you. If you are not seeing a therapist now - what are you waiting for? It's really important to take a purging problem seriously.
One of the strategies we recommend for dealing with uncomfortable fullness is: do something else for half an hour. Take a walk, call a friend, do something absorbing and distracting. Lots of people find that if they can engage in some activity for 30 minutes, the "urge to purge" subsides and the feeling of fullness is less bothersome. It's really important to get through that critical half hour.
In a way, this sounds like an anti-mindfulness approach: try not to pay attention to how you are feeling. In fact, I'd still call it a mindfulness approach, because it is best to engage in the alternate activity with complete mindfulness: while you are walking, really be present in the here and now, be fully aware of your body and your surroundings. It's a matter of bringing our wisdom to bear on the situation. It always good to know what mindfulness practices are too advanced for us. True mindfulness of fullness after a meal can be very hard to actually attain.
We have been working on a "Mindfulness of Fullness" protocol, and wanted to share our ideas with other mindfulness-oriented therapists. We think that the best time to introduce the idea of being mindful of fullness is after the client has already established a basic mindfulness practice, and can pretty reliably use it to calm and center herself. When it seems possible to try it, a mindfulness of fullness meditation can look something like this:
The best situation in which to start the practice is after the client has eaten something that she knows is healthy and nutritious. The feeling of fullness should be noticeable but not overwhelming. It might well be possible to practice this in the office, with the therapist guiding the meditation, during a session that follows lunch or a snack.
Ask the client to rate the sense of fullness she is currently experiencing on a scale from 0 - 10, with 10 being the most full she has ever felt in her life.
Start with a mindful breathing exercise, especially one like our "Mindful Breathing II" (from the right-hand column). It might be good to pay attention to the breath at the nostrils instead of in the belly, just because it's a less conflicted and complicated sensation. If the client is doing this at home, it might be best to actually listen to the mp3 rather than to simply do it from memory. It will support her more in an anxious situation.
Ask the client to get in touch with her reason for doing this meditation: "I want to learn to tolerate my fullness so I can live a longer, healthier life." "I don't want to be afraid of my body any more." "I want to learn to nourish my body." Then, you might try guiding the client through the following steps.
When you're ready, try to notice whatever you can about your present moment experience. If you can, try to notice each element kind of dispassionately. "There's a tightness in the stomach. A thought about purging. A fear of being fat. A desire to learn to eat in a healthy way. "
Try to notice which experiences are just body sensations, which experiences are judgments, which experiences are emotions, and which experiences are thoughts. When you figure it out, you can label the experience: "just thinking" or "just feeling" or "just sensation."
Remember to breathe throughout the exploration, and anytime your anxiety rises.
Try to figure out which aspects of your experience are "optional." Can you let go of making that judgment right now and simply focus on what is basic and real and present? It might be possible to eventually let yourself be aware of your fullness as a simple body experience, without all of the judgment and striving and thought and emotion that you typically add to it. If you can let go of your reactivity to the sensation, and simply be with the sensation as it is, that's a really important milestone.
Rate the sense of fullness you experience on a scale from 0 - 10, with 10 being the most full you have ever felt in your life.
End the meditation with more calming breathing. Again, the "IHP: Mindful Breathing II" exercise is a good one, but the "MARC: 3 minute Metta" could be really helpful, too.
The goal is to be able to tolerate fullness for what it is, a basic and essentially rewarding human experience. Mindfulness can help our clients free themselves from the reactivity and self criticism that turns that experience into something frightening and toxic.
I can't help but pass along this article in the Boston Globe about the causes of depression and the beneficial action of Prozac. The neuroscience in this article is really interesting. Seratonin may not be the really helpful brain chemical in the action of the SSRIs! Instead, there is a class of proteins (known as "trophic factors") which help brain neurons grow and survive.
Numerous studies had shown that chronic stress damages the brain by suppressing the release of trophic factors. In a series of influential papers published earlier this decade, Duman demonstrated that the same destructive hallmark is seen in depression, so that our neurons are deprived of what they need.
"The mental illness occurs when these stress mechanisms in the brain spiral out of control," he says.
Once that happens, the brain begins to shut itself down, suppressing all but the most essential upkeep.
It is thought that Prozac, and behaviors which help depression, like exercise, apparently work by increasing the release of these proteins and promoting the health of brain cells. A fascinating new theory, in part for its identification of "chronic stress" as one of the risk factors of depression. Apparently, stress can become so harmful that susceptible individuals can develop a kind of organic brain syndrome that actually shrinks brain tissue and results in the syndrome we have come to know as clinical depression.
I'm again reminded that mindfulness (like diet and exercise) is one of the great "protective factors" available to us. Mindfulness not only helps to reduce stress by helping us to see through the stressful mental dramas our minds create on a seemingly endless basis, it also helps us to open up to the true joys of life. It's not hard to imagine that this could actually be healing to the brain!
Thanks to Delany Dean for alerting me to this article through her "my del.icio.us" list.
Image via WikipediaIncreasingly, therapists are becoming interested in encouraging mindfulness, in themselves and their clients. Research has suggested that people in therapy benefit from their own mindfulness practice, and they also benefit from their therapist's mindfulness practice. Some studies have even found better outcomes in psychotherapy when the therapists have a personal mindfulness practice. Steven Hayes, the founder of ACT, believes that therapists must be acting from their own mindfulness in order to be truly helpful to others.
An interesting question comes up: How can we assess the current level of mindfulness of someone we are talking to? Are there things that occur in our conversations that increase or decrease mindfulness?
One way to approach the evaluation of mindfulness is to describe how a person is paying attention.In order to accomplish this, we have to describe mindfulness as it manifests in our typical conversations, with the data that is accessible to an observer. Consider this common type of interaction: someone is telling you what happened when they talked to their sister yesterday. How could we determine whether the story-teller is being mindful? Here are some thoughts about principles, and examples to help in that assessment.
Mindfulness is non-defensive. It does not attempt to refuse any experience. Mindfulness is accepting, and not reflexively judgmental. As a listener, you might pay attention to whether your comments responded to, or are they ignored or deflected?
Mindfulness is here and now attention. So in our hypothetical situation, does the story-teller have any awareness of the here and now communication (including you in the conversation, asking your opinion, questioning whether you understand, vs just narrating; making eye contact; talking about feelings or thoughts in the present while telling the story). Subjectively, do you as the listener feel engaged and present? That's a pretty good indication of whether you are being seen by the speaker.
Mindfulness does not confuse the nature of experience. When we are remembering an interaction with our sister, we're aware that we are engaged in remembering. When we're talking to someone, we are aware we are talking to someone.
Mindfulness does not over-identify with any experience. We do not confuse mental states with external realties (cognitive fusion). Instead of saying things like "I'm a terrible person," the mindful speaker would say "I felt critical of myself."
Mindfulness is flexible and not preoccupied. Is the narrative characterized by black and white thinking or dogmatic assertions?
What could we do to support mindfulness during this hypothetical conversation?
Listen actively. Helping a person engage with you will bring their awareness into the present.
Ask questions about current thoughts or feelings (I see you felt very angry when she said that. As you look at your feelings now, do you still feel angry? Are there any other feelings?)
Bring the person’s attention to something in the present-moment conversation (the person's mood, changes in posture, etc.)
Process something in the here-and-now interaction (how did you feel when I asked you that question?)
Support their awareness of breathing, especially if they are uncomfortably "carried away."
Bring the person’s attention to a cognitive fusion ("You mentioned that you hate your job, but I wonder if what you actually hate is the way you are approaching your job.")
Learning to be mindful in a conversation is a crucial social skill.Many of us have the habit of not listening while we are talking, and our relationships can suffer as a result.Mindfulness could reverse that pattern. Also, when we consider that insight depends on the ability to observe oneself non-judgmentally, learning to be mindful in our conversations can increase the chances of learning something about ourselves in real time.
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