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Dr. Jen's Diabetes Diary

The Diary of a Diabetes Psychologist

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Archive for November, 2010

Do you ever reach the bottom of a packet of crisps or biscuits and wonder how you got there? Or had a bad day at work or an argument with your partner and automatically reached for the ice-cream or a chocolate bar? Perhaps you’re someone who needs or would like to lose weight, and know what you should be doing, but can’t seem to follow the seemingly simple advice to “eat healthier” given by your healthcare professionals, who are also at a loss to know how to help you.

The crucial concept to understand is that food isn’t just a source of fuel and energy for the body. Rather, food is intimately linked to our emotions. The connection between emotion and food is one that is set down from birth – your mother soothed you with her milk when you were crying. As you grew up, she gave you sweets to cheer you up after the upset of hurting yourself, or a biscuit when you got in from a hard day at school, or cooked you a roast dinner when you’d fallen out with a friend. Food is not just a fuel – it has been conditioned as a soother of emotions for as long as you can remember.
Fast forward to the diagnosis of diabetes and you are suddenly required to cut down drastically on what you’re eating. Not only this, but there are potentially major health consequences if you don’t. Given what you’re read above, it’s hardly surprising that encouragement by healthcare professionals to cut down on fatty sugary food are not acted upon. You know in your head what you should be doing, but it’s hard to break away from the pattern of food as an instant root to pleasure, distraction and satisfaction.
However this pattern can be changed. The goal is to reach a place in which you can make a decision about whether or not to eat when you are feeling emotional – rather than it just being an automatic response. An important point to remember is that everyone – of every shape and size – can use food to deal with their emotions, and occasionally it can be fine to use food in this way. The danger is when food becomes the only way to deal with emotions. So let’s take a look at what the psychological models teach us about how to break this pattern between food and emotions.

  1. The most important step is to become more mindful of your eating behaviour. A very practical strategy you can use to do this is to put a post-it note on the fridge, cupboard, in your wallet if you tend to buy it there and then – wherever you tend to reach for the comfort. Seeing the note itself may be enough to trigger a different response, or you might like to have a question written directly on the post-it. E.g. “Is the answer in here?”
  1. What emotion are you feeling as you reach for the food? The emotion may be positive or negative – anything that stirs up strong feelings can be relevant. Start by labelling it, is it anger, sadness, fury, excitement, hurt, disappointment, excitement, sadness, triumph, boredom, loneliness, shyness, feeling unattractive, worthless? You might like to say to yourself, “I am…..” and fill in the blank. For example :“I am [insert emotion] at [insert situation/person/trigger for emotion] because [insert reason]”
  1. What are your thoughts about what’s happened? Ask yourself at least one of the following questions, or even all of them!
  • Can food solve this emotion, or the problem that led to the emotion?
  • Am I engaging in “compare and despair” – where I compare myself to others, which makes me feel bad about myself?
  • Is there another way of looking at this situation?
  • Am I getting things out of proportion?
  • Am I mind-reading what others might be thinking?
  • Am I engaging in black-and-white thinking?
  • What advice would I give a friend in this situation?
  • Am I putting more pressure on myself, setting up expectations of myself that are almost impossible? What would be more realistic?
  • What do I want or need from this person or situation? What do they want or need from me? Is there a compromise?
  • What would be the consequences of responding the way I usually do?
  • Is there another way of dealing with this? What would be the most helpful action to take? (for me, for the situation, for the other person)
  • Am I exaggerating the good aspects of others, and putting myself down? Or am I exaggerating the negative and minimising the positives? How would a friend see this situation? What’s the bigger picture?

After having done this exercise, you may still go ahead and eat the food – don’t beat yourself up for this! Change takes time and by simply pausing and thinking about the reasons behind your actions you are making a great start. At least if you eat this time you will be making the choice and doing it with your eyes wide open.
You might like to think of some other way to dissipate or soothe these emotions – engage in a distracting and enjoyable activity, talk to someone about how you are feeling or write it down – whatever resonates for you.
Finally, next time you go to your diabetes dietician or doctor and they tell you to ‘lose weight’, perhaps you could share some of these ideas with them. Breaking out of the secrecy tied up in comfort eating is one of the most important things you can do. By becoming aware of your emotions you can see that they have evolved to support and guide you. With time, emotions can become your friend rather than an enemy to be dulled with food.

Something that I hear time and time again in my work with people with diabetes is, “I have no motivation”.

They know what they should be doing to care for their health, but they can’t seem to summon up the how.

So when I tell them, “You are one of the most motivated people I have ever seen” – they tend to stare at me in complete disbelief!

But then I explain.

They are motivated to do all sorts of things in life.

Watch their favourite TV show. Eat a delicious meal in the company of loved ones. Sleep late on the weekend. Spend a day pursuing an enjoyable pastime or hobby.

I bet there’s not a single person reading this who finds that the concept of ‘motivation’ enters their mind when they are thinking of doing these fun activities! In fact, if you are anything like me you are raring to go and experience the enjoyable feelings that these activities bring you.

So the crucial difference with these things is that they are a short-term route to good feelings – which health-promoting activities such as exercising, eating healthily or testing your blood often aren’t, especially when you are just beginning to engage in them.

No one feels motivated to do something if the costs seem to outweigh the benefits. Go to the gym in the evening or curl up on the sofa watching TV? I’m sure you can see what I mean!

So the secret with motivation is to link the activity that feels like a challenge with one that feels easy. You could:

  • Plan your exercise so it’s immediately followed by watching your favourite TV show.
  • Make the doctors appointment you’ve been putting off for months and visit your favourite museum or gallery afterwards.
  • Test your blood glucose and then phone a friend you love to chat with straight after.

By pairing the “not so fun” with the “fun”, you’ll reward yourself today, while building up health and vitality for the future.

To find out more about the concept of motivation and how to increase yours, you might be interested in the self-help guide, ‘Diabetes De-Stress’ – find out more here: http://positivediabetes.com/diabetes_book.html

It includes a set of simple, well-researched techniques based on cognitive behavioural therapy -  that can help you meet the challenges of your diabetes self-care regime with fresh enthusiasm and motivation, increasing your health and wellbeing.