167196667 mindful eating compassion and the power of pause pdf

Mindful Eating, Compassion,

and the Power of Pause

Welcome!

Donald Altman, M.A., LPC 503-631-3030

info@mindfulpractices.com

MindfulPractices.com TheJoyCompass.Com MindfulnessCode.com

TheMindfulnessMovie.com

Copyright © 2013 by Donald Altman

Overview PART 1 – Intro to Mindful Eating

•  What is Mindfulness? What is Mindful Eating? •  Principles of Mindful Eating

•  Relevant Research •  Mindful Eating Exercise

•  4-Part Mindful Eating Technique •  Mindful Eater Quiz

PART 2 – The Power of Pause •  How Pausing Manages Stress and Eating •  Neuroscience and the Regulatory Brain

•  The Brain in the Palm of the Hand •  Breathing Practice for Impulse Control

Overview PART 3 – Nurturing Compassion

•  Age of Perfectionism and Comparison •  APA Study on Effects of Media

•  What is Compassion? •  Why do we need it?

•  Intentional Compassion Practice •  Closure

Intro to Mindful Eating

For months the fool may fast, eating from a tip of a grass blade.

Still he is not worth a penny Beside the master whose food

is the way. ���--The Buddha

If we live in mindfulness, we are

no longer poor, because our practice of living in the present

moment makes us rich in joy, peace,

understanding, and love. ���

--Thich Nhat Hanh

Eating with the fullest pleasure-- pleasure, that is, that does not

depend on ignorance-- is perhaps the

profoundest enactment of our connection with

the world. --Wendell Berry

Never eat more than you can lift.

--Miss Piggy

Lead me not into temptation; I can find the way myself.

--Rita Mae Brown

My doctor told me to stop having intimate

dinners for four... …Unless there are three other people. ���

--Orson Welles

WHERE ARE YOU RIGHT NOW?

OBSERVE THE BODY (Posture, Sensation, Emotion, Hunger)

OBSERVE THE BREATH

OBSERVE THE MIND (Thoughts, opinions, perceptions)

Chinese: now, heart, mind

Sati: bare awareness of body, mind, and emotions

Déjà vu or Vuja De??

What Is Mindfulness?

Accepting and living in the “what is” as opposed to the “what if.”

“Mindfulness is the nondual awareness that holds all of experience in an open, accepting way.” —Shauna Shapiro and Linda Carlson, “The Art and Science of Mindfulness (APA 2009)

“The quality of paying full attention to the moment, opening to the truth of change.” --Joseph Goldstein, Insight Meditation (Shambhala, 2003)

Mindful Eating is…

•  …Deliberately paying attention to food in a non-judgmental, non-blaming way.

•  …A means of promoting balance, choice, wisdom and acceptance around meals, body, and eating.

•  …Awareness of physical hunger and satiety cues to guide the decision of when to begin or stop eating.

•  …Accepting that there is no right or wrong way to eat, but varying degrees of awareness surrounding the experience.

What Is Mindful Eating?

What Is Mindful Eating? Mindful Eating is…

•  A set of skills that anyone can learn

•  An increased awareness of one’s stress level, hunger and satiety, and eating habits.

•  The ability to observe eating in a more open and non-judging way that lets one find balance with food and eating.

•  Not a diet, but a lifelong way of eating with awareness and informed choice

Why Is Mindful Eating Helpful? "   Helps individuals create: 1) a better fit with their inner environment:

Experiences in the body (hunger, emotions, cravings, and stress arousal)

Experiences in the mind (negative rumination, perfectionist thinking, self-critical thoughts, and distorted beliefs)

2) a better fit and better boundaries with their outer environment: Cultural and family belief systems and messages

(regarding beauty, weight, and food) Stress resulting from overwork, overstimulation,

and technology overload

“It is the position of the ADA that successful weight management to improve overall

health for adults requires a lifelong commitment to healthful lifestyle behaviors

emphasizing sustainable and enjoyable eating practices and daily physical activity”

ADA Position Statement

Mindful Eating Research

Appetite. 2010 Aug;55(1):160-3. Coping with food cravings, Alberts, Mulkens, Smeets, & Thewissen

•  Attention that brings mindful acceptance to cravings breaks the maladaptive cycle of desire by helping people mentally disengage from ongoing cravings.

•  Acceptance lets people observe ongoing cravings as transient events that will eventually fade, rather than by trying to suppress them.

•  Mindful attention acts as a brake between urge and reaction.

Mindfulness-Based Eating Study "  3-Key Elements of a Mindful Eating Practice

"  General mindfulness meditation (breath awareness) "  Patients meditated 16 hours over 7-week study

"  Eating meditation "  Mini-meditations

"  Results of 10-week Mindful Eating study (Duke Univ.) "  Overall index combining general mindfulness

meditation, eating meditation, and mini-meditations were the “best predictor of improvement in relation to binge eating and to weight loss.”--Kristeller

"  Increases level of personal control and comfort with food

Mindful Eating Training Compared to Cognitive Behavioral for Binge Eating

"  4 months after intervention, 95% no longer met BED criteria compared to 76% of the PECB (Psycho-educational cognitive behavioral) group.

"  Binges that occurred were significantly smaller "  Mindfulness also predicted improvement in weight

loss

Mindfulness-Based Eating Awareness Training (MB-EAT) for Binge Eating: A Randomized Clinical Trial; Jean Kristeller & Ruth Q. Wolever & Virgil Sheets; Mindfulness, published online, Feb. 01, 2013 DOI 10.1007/s12671-012-0179-1

Bariatric Surgery Findings

"  16X Increase in Bariatric Surgeries since 1998 "  Study looked at over 29,000 Americans who had

bariatric surgery "  Surgery does not decrease patient’s cumulative

medical costs in the 6 years following "  Even deducting for the initial $25-30K cost of the

operation, ongoing expenses were no different from the control group

"  Points out importance for lifestyle interventions

Published in JAMA Surgery, February, 2013

Food-Related Parenting Practices and Adolescent Weight Status

"  Food restriction practices highest among parents of overweight and obese adolescents

"  Non-overweight adolescents experienced higher levels of pressure-to-eat

"  Controlling feeding practices limits children’s ability to self-regulate energy intake

"  “Parents should be educated and empowered…to encourage moderation rather than overconsumption and emphasize healthful food choices rather than restrictive eating patterns.”

Published in PEDIATRICS Volume 131, Number 5, May 2013

Parent-Focused Intervention to Reduce Childhood Obesity

"  Children of parents who received dietary counseling during the first 15 months of life ate less sweetened foods and watched less television.

Published in PEDIATRICS 2013 Apr 131:652

Wired for Mindfulness

MINDFULNESS EXERCISE

Eating with Mindfulness

4-Mindfulness Bite Method I call on a dream that reminds us to focus on our fingertips, on the shape of our hand, on blood and

bone and a thousand nerve endings as we raise an apple to

our mouths. —Oriah Mountain Dreamer

4-Mindfulness Bite Method "   This method is known as the S-T-O-P method. Think

of it as STOPPING for mindfulness. A good start is to use the first four bites of any meal to devote your attention to food. Yes, it is possible to be mindful of every bite of every meal, but it takes practice.

"   For the next few minutes you will eat a raisin. If that seems like a long time, consider that you will eat this raisin as you have (possibly) never eaten a raisin before.

* This handout is copyrighted by DayOne Publishing in Discover Mindful Eating and was modified with authors’ permission.

4-Mindfulness Bite Method

"  S is the first bite and S stands for SELECT. Be purposeful in gathering this bite. You might imagine this is a food you have never tasted before. Select this bite, notice all of the colors, texture, and shapes. Choose a bite that is able to fit in your mouth easily. It is not too small or too big to chew, but just the size to savor the bite.

4-Mindfulness Bite Method

"  T is the second bite and T stands for TASTE. Your mind is fully on the sensation of eating. With this bite, you notice all the tastes that develop during the bite. Your mind is fully on the sensation of eating. You chew slowly, deliberately, and fully, swallowing with intention only when the food is completely chewed up.

4-Mindfulness Bite Method "  O is the third bite and O stands for

OBSERVE. With this bite, allow your mind to travel with this food around your mouth, down your throat and into your stomach. Notice your hunger without anxiety or fear. It is simply hunger. Observe yourself placing the fork down. You might imagine yourself dining with the Queen of England or other dignitary. You become aware of the movement of your hand, arm, and mouth. You are eating with purpose, full of poise and grace.

4-Mindfulness Bite Method

"  P is the fourth bite and P stands for PAUSE. With this bite, add an extra pause just before you put the food in your mouth. Then, during the bite, you pause in the middle of your chewing, just for a short moment. And when you're done with the bite, you add yet one more pause before taking the next morsel of food.

Are You a Mindful Eater? Copyright © 2007 by Donald Altman"

There are no “right” or “wrong” answers in the quiz. "

The 30 questions are to help you explore how you can bring more self-kindness and awareness into your meals… and your life. "

Circle each as True or False

Mindful Eating Group Exercise

Part 1: A) Discuss your experience of mindful eating with others, and how you might use the 4-Bite Mindful Eating S-T-O-P Technique when working with patients.

B) ROLE PLAY: Now that you have experienced mindful eating, explain what it means to a “patient”.

The Power of Pause

In two decades I’ve lost a total of 789 pounds. I should be

hanging from a charm bracelet. ���

--Erma Bombeck

Mr. Duffy lived a short distance from his body. ���

--James Joyce, The Dubliners

Mindfulness Intervention Reduces Cortisol and Abdominal Fat in Obese Women*

"  Psychological stress and elevated cortisol secretion promote abdominal fat. "  4-month mindfulness program for stress

eating at UCSF "  Reduced anxiety, improved mindfulness,

and reduced stress eating "  Significant reduction in CAR (cortisol

awakening response) "  Reduced CAR associated with reduction in

abdominal fat

"   Journal of Obesity, 2011, Daubenmier, Kristeller, et. al.

Stress Effects on Obesity and Appetite "   Effects of Decreased Sleep on Obesity and Appetite

"   1-week of insufficient sleep causes chronic stress "   Neuropeptide Y levels increase appetite

"   A recent study* showed that those who slept greater than 8 hours a night weighed significantly less than those who got fewer than 5 hours of sleep. "   An increase in the appetite stimulating hormone ghrelin. "   A decrease in the appetite suppressing hormone leptin.

"   National Sleep Foundation Poll: "   Percentage of individuals sleeping 8 hours or more decreased from 35% (1998) to

26% (2005). A 9% decrease in just 7 years. "   2011 Study from Centers for Disease Control found 35% sleeping less

than 7 hours nightly. 23% had trouble concentrating;18% had problems remembering; 11% had difficulty driving or commuting

* Public Library of Science Medicine (Issue December, 2004)

Neuroscience of Stress

Brain in the Palm of Your Hand

"  Triune Brain

Your Brain on Stress

"  When depressed, negative, anxious, or reactive the brain's amygdala and right prefrontal cortex get more active.

Your Brain on Stress "   A message sent to the hypothalamus signals the

pituitary, which then activates the adrenal glands to release cortisol and adrenaline into the bloodstream and prepare the body for flight or fight.

Your Brain on Stress "   The stress response actually shunts blood flow away from the

brain’s “thinking” cortex. This more ancient brain system constantly scans the environment and can be “turned on” chronically through repeated stress or memory provoking events.

Mindful Brain Resources "   Richard Davidson, Dir.. Center for Investigating Healthy Minds

"   Conducts rigorous scientific research on healthy qualities of mind such as kindness, compassion, altruism, forgiveness, mindfulness and well-being.http://www.investigatinghealthyminds.org

"   Jon Kabat Zinn http://www.umassmed.edu/cfm/

"   Global Association for Interpersonal Neurobiology Studies http://www.mindgains.org

"   Mindfulness Research Monthly http://www.mindfulexperience.org

"   Dana Foundation "   A private philanthropy with principal interests in brain science

and immunology. Free newsletter- http://www.dana.org

Stress and Telomeres

Stress, Mind Wandering and Aging Cells* -- Telomere length is a measure of biological aging and a correlate of severe stress -- Individuals reporting high mind wandering had shorter telomeres -- A present attention state may produce cell longevity *Clinical Psychological Science Jan 2013 vol. 1 no. 1 (75-83)

Breath Awareness  Rewiring the Stress

Response with Breath  20-30 sec. to turn down

stress volume  10x increase in oxygen  Lower B.P., respiration   Increase alpha waves   Increase serotonin

Teaching Belly Breathing

1)  Explain the physiology of breathing, and how it turns on the body’s relaxation system

2)  Check where they are breathing by having them put one palm on the chest, one on the belly.

3)  Demonstrate how to get a fuller belly breath by placing the hands behind the back or behind the neck/head.

4)  Problem solve how clients can use this each day.

Nurturing Compassion

What is Compassion? How can we invite it in?

Media Awareness Research "   The American Psychological Association News Release: "   Sexualization of Girls Is Linked to Common Mental Health

Problems in Girls and Women-Eating Disorders

"   A report of the American Psychological Association (APA) released today found evidence that the proliferation of sexualized images of girls and young women in advertising, merchandising, and media is harmful to girls' self-image and healthy development.

"   Research links sexualization with three of the most common mental health problems diagnosed in girls and women– 1) eating disorders, 2) low self-esteem, and 3) depression or depressed mood.

"   Schools, the APA says, should teach media literacy skills to all students and should include information on the negative effects of the sexualization of girls in media literacy and sex education programs.

"   Full text of Executive Summary, Report, and tips on "What Parents Can Do" is available at: www.apa.org/pi/wpo/sexualization.html

Suffering is part of life, just as hunger is part of appetite. We

cannot always be full and satisfied…Compassion is as

essential to the spirit as water and food are to the body. -- Ronna Kabatznick, PhD., author, The Zen of Eating

Inviting Compassion with Loving-Kindness

Loving-Kindness Meditation to Enhance Recovery from Negative Symptoms of Schizophrenia, Johnson, Kring, Brantley, et. al., Journal of Clinical Psychology Vol 65(5) 499-509(2009)

  May I be safe   May I be happy   May I be healthy   May I be at peace   May I be free from pain, hunger and suffering

Loving-kindness and compassion meditation: potential for psychological interventions , Hoffman, Grossman, and Hinton, et. al., Clinical Psychological Review, 2011 Nov;31(7):1126-32. Epub 2011 Jul 26.

Inviting Compassion with Loving-Kindness

  After practicing sending these warm feelings to oneself, you can extend that feeling to:   Teachers, mentors, guides   Family and friends   Neutral persons   Unfriendly persons   To all persons without discrimination   To those in your neighborhood, expanding to all living

beings and to whole environment which sustains us   To all beings

SLOWING DOWN EATING ���--

Slowing Down When Eating

Step 1: "  Stop whatever

you’re doing and get grounded

"  Take 3 deep breaths

Step 2: "  Rate your hunger

level. "  Notice what emotion

or hunger level you are feeling in this moment.

Slowing Down When Eating

Step 3: "  Pace your eating. "  Pause while

eating.

Slowing Down When Eating

Step 4: "  Be flexible and let

your wise and nurturing self move you in a new direction.

Slowing Down When Eating

Bibliography "   Altman. Art of the Inner Meal: Food as a Spiritual Path. 2000; Paperback 2002. "   _____. Living Kindness: The Buddha’s 10 Guiding Principles for a Blessed Life. "   _____. Meal By Meal: 365 Daily Meditations for Finding Balance Through "   Mindful Eating. 2004. "   Arpaia and Rapgay. Tibetan Wisdom for Western Life. 1999. "   Begley, Sharon. Train Your Mind, Change Your Brain. Ballantine Books, 2007. "   Brantley. Calming Your Anxious Mind. 2003. "   Chodron. Comfortable With Uncertainty: 108 Teachings. 2002. "   Epstein. Thoughts Without a Thinker. 1995. "   Fitzgerald, Randall. The Hundred Year Lie: How Food and Medicine are "   Destroying Your Health. Dutton, 2006. "   Goleman and Dalai Lama. Destructive Emotions: How Can We Overcome "   Them? "   Hayes, Follette, and Linehan, Editors. Mindfulness and Acceptance: Expanding "   the Cognitive-Behavioral Tradition. 2004. "   Hahn, Thich Nhat. Cultivating the Mind of Love. Berkeley: Parallax Press, "   1996. "   Huther, Ph.d, Gerald. The Compassionate Brain: How Empathy Creates "   Intelligence. Trumpeter, 2006. "   Kabatznick, Ronna. The Zen of Eating. Perigree Trade, 1998.

Bibliography "   Kabat-Zinn. Coming to Our Senses: Healing Ourselves and the World Through "   Mindfulness. 2005. "   Keating, T., Open Mind, Open Heart. Continuum International Publishing "   Group, 2003. "   Kristeller, J. (March/April2005). Know Your Hunger. Spirituality and Health. "   Kristeller, J., Baer, R., & Quillian-Wolever, R. (2003) Mindfulness-based treatment

approaches to eating disorders. In R.A. Baer (Ed.). Mindfulness-based Treatment Approaches. San Diego: Elsevier

"   Kornfield. The Art of Forgiveness, Lovingkindness, and Peace. 2002. "   Langer, Ellen. Mindfullness "   McQuaid and Carmona. Peaceful Mind: Using Mindfulness & Cognitive "   Behavioral Psychology to Overcome Depression 2004. "   O’Connor, Richard, Undoing Perpetual Stress. Berkley Books, 2006. "   Pollan, Michael, In Defense of Food "   Pollan, Michael, Omnivore’s Dilemma "   Roizen, M.D., Michael, and Oz, M.D., Mehmet. You On a Diet: The Owner’s "   Manual for Waist Management. Free Press, 2006. "   Segal, Z.v., Williams, J.M.G., & Teasdale, J.D. Mindfulness-based Cognitive "   Therapy for Depression. Guilford Press, 2002 "   Sen XV, Soshitsu. Tea Life, Tea Mind. 1995

Bibliography "   Siegel and Hartzell. Parenting from the Inside Out, 2004 "   Schwartz, M.D., Jeffrey. Brain Lock: Free Yourself from Obsessive Compulsive "   Behavior. Regan Books, 1996. "   Tart. Living the Mindful Life: A Handbook for Living in the Present Moment,

1994 "   Wansink, B. Mindless Eating: Why we eat more than we think. Bantam, 2006. "   Welwood, J. Toward a Psychology of Awakening Boston, Shambala Press,

2003.