Ifs, Ands, or Butts

One might think their reasons for straying from their diet plan are reasonable, BUT sabotaging thoughts can be devastating to the person who wants to lose weight. They can be dealt with in a positive way, AND that will make it possible to stay on your plan IF you want to get rid of that big “butt”.“I would have gone to the gym BUT my friend called and asked me to go shopping.” “I was planning to make my lunch and bring it to work, but I didn’t have time to go to the grocery store.” ”I meant to sign up for the meditation class BUT missed the deadline. Maybe I’ll do it next time.” ”I wanted to stay on my diet; BUT when I saw the short ribs on my neighbor’s plate, I just had to have them.”
When you use the word BUT as a conjunction you negate the first half of the sentence. BUT means that although you considered making the healthy choice on your diet, you gave yourself another option.
Dr Judith Beck, author of The Beck Diet Solution, teaches the concept of ” no choice”. She says just because you want
something doesn’t mean you have to have it. If you put exercising, eating only what you’d planned, and managing your stress in the ‘no choice’ category you take away the inner struggle. Its the same concept as brushing your teeth or paying taxes–these aren’t optional. You may not like it or think it’s fair, but you do it anyway to avoid the consequences of not doing it. Who would choose dentures or major fines?
Although it’s important to acknowledge your feelings, you can still do what’s in your best interest by giving yourself no choice when it comes to straying from your plan.
“I have so much to do today AND I’ll have to find a way to prioritize my chores so that I get on the treadmill for a half hour.”
“I’m under a huge work deadline AND I’ll make time for my back exercises because it will help me to feel better. Ugh, I wish I didn’t have to.” It’s OK to express your feelings if you do not let them deter you from doing what you need to do.
“I do not feel like going to the gym AND it’s important that I get my blood pressure down so that I can live a healthy, long life. I want to know my grandchildren!”

Did you ever notice that people with smaller butts say AND?

Ellen is a psychotherapist in private practice in San Francisco and Redwood City, California. She specializes in Cognitive Behavioral Therapy and incorporates the use of mindfulness into the treatment of depression, anxiety, and emotional overeating. She runs a holistic weight loss program called Center for Thoughtful Weight Loss,
http://www.thoughtfulweightloss.com/.

"Feed" Your Feelings or Nurture Your Spirit

Denial is an unconscious coping mechanism that gives you time to adjust to distressing situations.  But when you remain in denial you deny yourself the ability to thrive.

In summer of 2008 Zoe, a then 74 year old woman came to my presentation, “What’s Eating You: Tools for Permanent Weight Loss”.  She told me that her diabetologist had recently informed her “you’ll never get rid of your belly.”  If that wasn’t enough to discourage her, the sleep disorders specialist said, “Since you can’t tolerate wearing the CPAP apparatus for your apnea, you’ll need to lose 65 pounds, but I know you’ll NEVER do that.”  She walked away feeling angry, humiliated, and discouraged, then cancelled her follow up appointment.  Zoe thought, “What’s the use. I’m fat and I can’t change it.”  She felt hopeless about losing weight- she’d been on multiple diets throughout her adult life and each time she lost weight, she gained it back and more.

Unfortunately, the doctors’ words allowed her to rationalize her denial of the severity of her health problems (diabetes, coronary artery disease, stage 3 renal failure, diverticulosis and asthma).  She continued making poor food choices until she reached 252 pounds.  She wasn’t able to take a bath because she couldn’t lower or raise herself in or out of the tub.  Her family was having discussions about installing a walk in tub for $ 14,000.  When I heard her story I realized that Zoe may have been close to reaching her bottom, the place where positive change for a compulsive overeater becomes possible.

I handed Zoe the Beck Diet Solution Weight Loss workbook  and told her that another client of mine had lost 131 lbs using this model.  We discussed what she’d need to do to lose weight and keep it off for good. I asked about her feelings.  Like many people, Zoe said, It’s not about feelings, “I just like to eat.”  I asked her if she’d like to see her granddaughter get married.  In tears, she said “I’ll try the program.” I told her what Jillian Michaels says about just trying–it’s planning to fail.

And so she began.  She worked through the workbook, journaled her calorie counts at each meal and learned to plan ahead.  It seemed her compulsive nature was working in her favor.  She began exercising daily.  As the pounds came off and the clothes got bigger, Zoe felt empowered.

We’d schedule phone sessions. When I noticed she’d sometimes avoid talking about her progress, I’d ask about her level of stress and how she was coping to soothe her anxiety.  Zoe said most days she was able to notice her cravings and allow them to pass by keeping busy with work and other interesting activities. Finally, she admitted that she was having some very tough days. It was then that I learned she is the caregiver for a severely mentally ill son.  She also has job stress as director of a school. Zoe was beginning to make the important connection between her anxiety and unhealthy reliance on food to comfort herself.

We discussed the following strategies for managing stress and calming emotions:  taking a walk or other aerobic exercise, diaphragmatic breathing, progressive muscle relaxation, having a cup of tea, leafing through a magazine, reading and writing emails, calling a friend, completing a task, hugging a friend or family member, taking a shower (completely incompatible with eating)), relaxing in the bath, imagine being with a favorite friend, reading, or watching a funny movie and laughing.

Two years later Zoe has lost 53 pounds. Her insulin needs are less than 1/3 of what they were; her kidney function is stable.  Her doctors are amazed and thrilled with the change in her attitude and behaviors.  Instead of just trying, she is DOING one day at a time.

Zoe’s success story can be yours as well.  Email Ellen at ellen@thoughtfulweightloss.com and learn what to do about What’s Eating You.

Ellen is a psychotherapist in private practice in San Francisco and Redwood City, California. She specializes in Cognitive Behavioral Therapy and incorporates the use of mindfulness into the treatment of depression, anxiety, and emotional overeating. She runs a holistic weight loss program called Center for Thoughtful Weight Loss, www.thoughtfulweightloss.com.

Ellen is a psychotherapist in private practice in San Francisco and Redwood City, California. She specializes in Cognitive Behavioral Therapy and incorporates the use of mindfulness into the treatment of depression, anxiety, and emotional overeating. She runs a holistic weight loss program called Center for Thoughtful Weight Loss, http://www.thoughtfulweightloss.com/. You can email Ellen at ellen@thoughtfulweightloss.com.

Copyright © 2010  Ellen N. Resnick, LCSW

 

Clean Your Thoughts Not Your Plate

I imagine that many people would have healthier relationships with their bodies and food if the message instilled at the family dinner table wasn’t, “You can leave the table when your plate is clean”.

We are often our own worst enemies when it comes to negative self talk.   Not only do we beat ourselves up mercilessly with thoughts like, “I’m fat, ugly, not smart enough”, we also have automatic thoughts, right below the level of consciousness that sabotage our efforts at weight loss, i.e., “I’m tired, I need some chocolate to make it through the meeting”, or “I don’t care; it won’t matter anyway”.   Some overweight adults still hear mom saying “Good girls clean their plate.”

In my first blog, I mentioned the three questions I encourage my clients to ask themselves repeatedly–what am I thinking, what am I feeling, and what is it I REALLY need right now?   Here’s how we use the tool at the Center for Thoughtful Weight Loss.  Yesterday, a weight loss client came in and said it was her husband’s birthday. I asked how they’ll celebrate, knowing special occasions have meant relapse in the past, not just extra calories for one meal.  “We’ve decided to have a healthy meal at home because it’s the best present we can give each other.  No need for wine or dessert.  It’ll be a simple delicious meal with some presents on the table.”  A big component of her success is planning ahead for situations that derailed her efforts in the past.  She has a two week training coming up out of town this summer for work.  Her plan is to bring an extra suitcase filled with healthy food choices.  She chose a hotel that is $30.00 extra per night, but has a full kitchen and a gym. Her intention is very clear– “Traveling and the stress of a two week business trip will not sabotage me.”.  While away, she’ll continue to talk with her diet buddy for support and problem-solving. She’ll schedule a phone therapy session with me to talk about grief issues that have sabotaged her for years, but only recently have been addressed without using food to numb out.

She brought in a surf board necklace (see last week’s blog about surfer dude) as a reminder to stay present so that she can catch her insidious sabotaging thoughts and correct them with self honoring, helpful thoughts.  In cognitive behavioral therapy we think about helpful vs harmful thoughts, behaviors, and social interactions. 

When we identify the sabotaging thoughts or what David Burns (author of the best selling self help book Feeling Good calls cognitive distortions), we have the opportunity to change our thoughts and self talk to accurate, realistic, and helpful thoughts, resulting in choices that
are in our best interests.

Here are some examples of sabotaging thoughts and helpful, accurate responses.  You can see which ones help people remain on plan and which lead to more eating to cover up feelings of sadness, worry, boredom, loneliness, anger, shame, and guilt.

  ST  (sabotaging thought): ” It’s okay to have cookies in the cabinet- they’re for treats.”
  HR ( helpful response):  “I need to accept that having unhealthy food choices around is testing myself beyond my ability to resist temptation.  It’s a mistreat not a treat the way I eat these cookies.”
  ST: ” I don’t have to track all my calories – it’s too time consuming”.
  HR:  “Not tracking keeps me from having consistent weight loss – it’s the # 1 tool of successful maintainers.”
  ST : ” Things are hard; I deserve  this double cheeseburger.”               
  HR :  “Things will  still be hard if I give in to this temptation.  Resisting will build up my confidence-I’ll call my friend, John; he’s a great listener, and I need some support and encouragement tonight.”

Sometimes we have to peel the layers of the onion to get to the thought that leads to the emotion that results in overeating.  Sometimes we need help figuring out what the hot thought is and what we need in that moment.

Feel free to email Ellen at Ellen@thoughtfulweightloss.com  if you’d like help figuring out What’s Eating You.

Ellen is a psychotherapist in private practice in San Francisco and Redwood City, California. She specializes in Cognitive Behavioral Therapy and incorporates the use of mindfulness into the treatment of depression, anxiety, and emotional overeating. She runs a holistic weight loss program called Center for Thoughtful Weight Loss, www.thoughtfulweightloss.com. You can email Ellen at ellen@thoughtfulweightloss.com.

Copyright © 2010 Ellen N. Resnick, LCSW

Ride the “Crave Wave”

A few months ago a weight loss client came in for a visit.  I couldn’t help but notice something odd looking falling out of her purse. I could only make out what looked to me like straw hair – it seemed like an odd doll for a mom of teen boys to be carrying around. 

My curiosity got the best of me and so I asked what it was.  Out came ‘surfer dude’.  “OMG, that’s amazing,” I said. “He is just perfect”. A few weeks earlier I had taught her Alan Marlatt’s concept of urge surfing, part of relapse prevention nomenclature for addictive behavior of any kind, including compulsive overeating.  If there is no opportunity to “use” Marlatt says, a craving typically lasts for less than thirty minutes.  If there is no opportunity to use, there is no inner struggle, and it’s the inner struggle that feeds the cravings. This is true for everyone, but few people give themselves the chance to prove it.

Ok, so where’s the surfer in this story?

Anyone who has struggled with food cravings knows that there are times that no matter what we do we to fight the cravings, we feel it’s just not possible to resist them.   It’s like trying to stop a waterfall from flowing.  Marlatt says, “Don’t try to stop the flow because you can’t.  Step back and become an observer of the waterfall, or your cravings, impulses, and urges for the peanut M and M’s.  Just watch the cravings come and go without judging yourself for having them.  Don’t berate yourself for your lack of willpower.  Simply use mindfulness (moment to moment, non-judgmental awareness) to experience your urges without giving in to them.  The urge may come very strongly, and still, you simply watch it, describe it to yourself in full detail, and let it go.  Some people think about sending the craving down the river on a bed of leaves.  Others send it off into a bubble in the sky. Still others send it on a conveyor belt and watch it go by.  It may come back; and when it does, simply put it back on the belt and watch it go round again.  Did it change the second time around?  Did you experience your urge exactly the same way or did it get more or less intense?  It doesn’t matter, as long as you are an observer without self judgment.  And if you notice yourself judging, simply say “judging” to yourself and put your judgments on the belt and watch them go by as well. The waterfall may feel like it’s going to come crashing down on you.  Out comes “surfer dude” who teaches you to ride the wave of the craving without getting caught in the undertow of emotions.   Our feelings can be strong sometimes just like food cravings, or urges for alcohol.  Get out “surfer dude”.  He or she will help you observe your emotions without going under. 

You can ride the crave wave!

Keep practicing.  Go out to the ocean and watch what the surfers do when they fall.

Ellen is a psychotherapist in private practice in San Francisco and Redwood City, California. She specializes in Cognitive Behavioral Therapy and incorporates the use of mindfulness into the treatment of depression, anxiety, and emotional overeating. She runs a holistic weight loss program called Center for Thoughtful Weight Loss, www.thoughtfulweightloss.com. You can email Ellen at ellen@thoughtfulweightloss.com.

Copyright © 2010 Ellen N. Resnick, LCSW

Ellen Resnick's Biography

I began working with people on behavior change in 1990 as a social
worker on a diabetes team at a prominent San Francisco hospital. It
became clear early on that managing one’s diabetes was directly
related to how people manage their lives and, in particular, their
stress. Often, I was seeing very bright people making very bad
choices. I soon became a student in Cognitive Behavioral therapy,
learning how people’s thoughts impacted their moods and behaviors,
including decisions about food, exercise, and managing stressful
situations.

My interest grew and I wrote a talk called “What’s Eating You: Learn
the Tools to Overcome Emotional Overeating”. The ideas seem to have
struck a chord with people. I began to treat depression, anxiety, and
relationship issues and voilà my clients were soon thinking clearer
and making better choices for their health–life affirming, self
honoring vs. self sabotaging and self defeating choices. They were
learning how to manage emotions without numbing out with food.
Fast forward to 2008. Although people were making better choices in
the moment, they didn’t have all the tools they needed to make good
decisions outside their comfort zone, i.e. when traveling, work
meetings (you know–when the large chocolate chip cookies appear after
the sandwiches big enough to feed a family of three), when they are
out with friends, celebrating, bored, lonely, procrastinating, at
their grandmother’s house, or with a ‘food pushing’ friend (“come on,
loosen up-it won’t matter this once.”). So, my next talk emerged:
“What’s Eating You: Ten Skills to Manage Stress and Enhance Well
Being”. People learned the importance of attitude–having hope that
this time they wouldn’t yo-yo because they’d have skills to handle
every situation with awareness of what they needed in that moment.
Soon, I was taking a picture of each of my clients. I’d ask them to
grab the hand that they eat with, leave the kitchen, take some calming
breaths and ask themselves three crucial questions: “What am I
thinking, what am I feeling, and what is it I REALLY need right now?”
Then came the job of building individual toolkits–things each person
could do if they were bored or sad or lonely, etc. My clients got
creative making pretty boxes and binders with ideas for self soothing.
Some chose knitting or jumping rope; others called their friends for
support as needed. The choices are endless IF you are mindful of what
you are needing and can slow your impulse to soothe with food down
long enough to make a self honoring choice. That is the work.
Fast forward to 2010 and I wrote two new talks: one adapted from
Judith Beck’s work that I call “What’s Eating You: Learn the Tools
for Permanent Weight Loss”, and the newest adapted from Susan Alber’s
work that I call “Eat, Drink and Be Mindful : Soothe Your Way to
Weight Loss”. The first talk teaches 42 cognitive and behavioral
skills for permanent weight loss. The second I now refer to as
“surfer dude”. Huh? Ok, surfer dude is about Marlatt’s concept of
‘surfing the urge’ which will be next week’s blog topic. Stay
tuned….


Ellen is a psychotherapist in private practice in San Francisco and
Redwood City, California. She specializes in Cognitive Behavioral
Therapy and incorporates the use of mindfulness into the treatment of
depression, anxiety, and emotional overeating. Her website
is www.ellenresnick.com She runs a holistic weight loss program
called Center for Thoughtful Weight Loss, www.thoughtfulweightloss.com. 
Ellen is also a skilled couples’ therapist.  She is an Assistant Clinical
Professor in the department of psychiatry at UCSF where she worked
from 1995-2003 specializing in women’s mental health issues and brief
treatment. She ran the Cognitive Behavioral therapy group program for
women with depression. Ellen continues to supervise psychiatry
residents at UCSF. She lectures extensively in the Bay Area. Feel
free to email Ellen at Ellen@thoughtfulweightloss.com