Dr. B's Blog

Mindfulness of Eating

The Buddha told monks to take meals silently, with no books or conversations to distract them, only an awareness of what their body needs to get through the day. When they felt full, they stopped eating, even if that meant leaving food in the bowl.

As a full-time therapist at the Carolina House, a residential facility for eating disordered women, I spend a lot of time thinking about how to use DBT skills, particularly mindfulness, to help our residents deal with their various eating issues. For these women, food is terrifying. I teach them mindfulness skills to help them manage their fear around food and prevent the use of symptoms such as restricting or purging. It’s a hybrid of treatment for OCD, with exposure and response prevention, and systematic desensitization.

Regardless of the mixture of behavioral therapies that takes place at Carolina House, the core of my teaching involves mindfulness. A recent book by Jan Chozen Bays called Mindful Eating: A Guide to Rediscovering a Healthy and Joyful Relationship with Food further illustrates the benefit of using mindfulness to bring balance to one’s diet. Pay attention to your hunger and satiety cues and let your body tell you what you need. There is one caveat to that belief: our bodies can be easily fooled into thinking we need more (or less) than we actually do. If you’re having trouble regulating your meals, start by meeting with a nutritionist to get your perceptions in line with reality and then use mindfulness to get you the rest of the way there.

Ψ Bad research or poor journalism?

Welcome to the Wall of Shame, Yorkshire Evening Post. You are the inaugural post. You nailed it so well that I created this award just for you. In one article, you did everything right/wrong.

  • Sensational headline? Check.
  • Unsourced “research”? Check.
  • Picking on a highly stigmatized group? Check.
  • Cherry picking what’s likely a small paragraph in the discussion section and making it the focus of your article? Check.

It’s articles like this one that made me really start this blog. The title of the article reads “Internet surfers caught in a web of depression.” Oh my god! The carnage and brutality we have inflicted upon our fellow man!

And the opening sentence is even better

A “dark side” to the internet suggests a strong link between time spent surfing the web and depression

I’ve got several problems with this article but the first has to do with the lack of citations. How am I supposed to determine whether the research methodology was sound without a link to the original article? I suppose I can’t with this

Source: n/a

at the bottom of the page. I’d like to believe that research conducted on the internet can be valid (I did my dissertation by collecting data online, after all). In other words, I know how hard it is to get a valid sample on the web.

But, let’s assume that they’ve got a valid sample. The article above pulls out one particular juicy tidbit from the research

Her team identified a small group of 18 hard-core internet users who spent many hours online each day and were classed as “internet addicted”.

Their average depression score was more than five times higher than that of non-addicted users, and they were more likely to be moderately or severely depressed.

Wait. They found a (very small - 1.2%) sub-sample that was more depressed than the rest of their sample? Wow! What groundbreaking research! (That’s sarcasm in case the keyboard didn’t convey the message.) They had a reasonably large sample size and then they try to draw conclusions from 18 participants? That type of work wouldn’t have garnered a passing grade in my graduate school research design class and I wouldn’t even consider submitting a poster to a conference with a sample that size.

Here’s the thing: these findings may be legitimate. We know that spending too much time doing anything that’s not social can contribute to social isolation. (Please read that sentence again. See what I did there? I can do this “research” stuff too!) And that social isolation is correlated with depression. But to put this type of information in a mainstream media outlet? I don’t know if it’s necessarily bad research but I know that’s just irresponsible journalism.

The Case for Compassion

I’m not a big proponent of the “love yourself” school of psychology. I mean, I do believe that self-love is an important part of one’s psychological health, but I don’t think I often say those particular words in a therapy session. I’m sure that in the moment, when I’m being mindful of the situation and my patient’s emotions, those words may come out of my mouth because they make sense at the time but that particular phrase just gets people’s cynicism worked up. If someone said that to me with a straight face, I might have a hard time taking them seriously, so I couldn’t easily use those words unless it really fit the situation.

That said, I am a big proponent of compassion. To me, the root of psychological well-being isn’t love but compassion. Compassion allows perspective-taking. It allows validation or firm guidance. It allows for a deeper, more adult connection between two people even if there’s no “love” in the room. That’s why I found this article so interesting.

Recent studies of compassion argue persuasively for a different take on human nature, one that rejects the preeminence of self-interest. These studies support a view of the emotions as rational, functional, and adaptive—a view which has its origins in Darwin’s Expression of Emotion in Man and Animals. Compassion and benevolence, this research suggests, are an evolved part of human nature, rooted in our brain and biology, and ready to be cultivated for the greater good.

I often find evolutionary explanations for observed phenomena to be a little like waiting for the coin flip and then calling “heads!” as if you knew it would be heads all along, but that doesn’t stop me from liking the results the article talks about. I find that tempering my cynicism with some good old fashioned pollyannaism to be a nice balance.

Read the whole article here. Discuss below if you’d like.

Mmm. (Or: More on Music and Mindfulness)

Following up on my recent blog entry on music and mindfulness, I stumbled across an article on Science Blogs about how music affects our brains. I didn’t read the journal article this article summarizes article before I posted my entry or before my latest DBT-U music and mindfulness practice, though I wish I would have.

The article stated more clearly than I could have why I find music such a good focus for mindfulness and why I find familiar songs to be extremely effective foci for my practices. Essentially, my brain is fooled into expecting patterns in the music and when it doesn’t get what it expects, it wakes up and takes notice.

Music only excites us when it makes our auditory cortex struggle to uncover its order. If the music is too obvious, if its patterns are always present, it is annoyingly boring.

This matches up nicely with my recommendation that the piece of music be complex enough to be interesting. And probably why I don’t really like pop music much.

Using music

Let me get this out of the way at the beginning of this post: I can’t sing. I can’t play any musical instruments. I have not one whit of musical ability in any of my cells. My 3 year-old son will say “Share my song with you tomorrow, baba” as his polite way of asking me not to sing. 

But I love music. I can’t get enough of it. I can listen to the same song endlessly. I’ll listen to the percussion. Listen to the strings. Listen to the vocals. The ups and downs, highs and lows. I find that each time I listen to a familiar song, really listen, I’m rewarded with something new. 

Not coincidentally, I frequently use music a the focus of my mindfulness practices, both for my personal practice and my groups’. There are few characteristics I try to keep in mind when selecting a song for a practice. Obviously these aren’t essential but they’re a good starting point, at least:

  • Layers. Choose a song with some complexity so your exploration is rewarded.
  • Interesting lyrics. I don’t necessarily mean “understandable” lyrics. Some of my favorite songs for mindfulness are in languages I don’t understand. Some are perfectly understandable.  And some I should understand but are completely unintelligible. I doesn’t matter if you’re looking for story-telling or for another instrument.
  • Length. For group practices, I generally look for songs that are about 4 - 5 minutes in length. For my personal practices, I might select something a little longer.

As I said, these are just guidelines to get you started on your search. When you first use this particular practice, remember to be effective. Make sure you will be uninterrupted and, if possible, use headphones. Pick an instrument and follow it throughout the song. Even when it’s not “there”, see if you can hear it. Remember to follow your breath while listening to the music.

Please post in the comments if you find this practice to be helpful and if there’s a song you like to use. Other suggestions are also welcomed.

Jon Kabat Zinn Teaches Mindfulness

In yet another example of how many resources there are on the web, I found Jon Kabat-Zinn teaching mindfulness. Dr. Kabat-Zinn is the author of many mindfulness tomes and one of the creators of Mindfulness Based Stress Reduction. Needless to say, he’s an expert on mindfulness and psychotherapy. Here he is teaching mindfulness.