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
Dj 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 ones
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 patients 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 childrens
ability to self-regulate energy intake
Parents should be educated and empoweredto
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 Ive 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
brains 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 bodys 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
satisfiedCompassion 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
youre 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
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