morty

Interview: Jeanne Rust, CEO of Mirasol

The following is the transcript of an interview I conducted last week with Jeanne Rust, the CEO of a major eating disorder clinic in Tuscon, AZ. I think you will find what she says useful.

Jeanne: My name is Dr. Jeanne Rust and I am CEO of an Eating Disorder Treatment Program in Tucson, Arizona.

The name of the program is Mirasol and we specialize in integrated treatment which means that we do the best of the cognitive behavioral model combined with the most empirically successful things in the alternative world.

Morty: Good. What are some of these alternative things? Cognitive-behavioral therapy is the most common and most effective of the therapies. What are some of the alternatives?

Jeanne: The cognitive is the most common and the most effective and it’s also why the relapse rate with eating disorders is so high.

Morty: Explain that, please.

Jeanne: Dr. Stewart Agras who is a researcher at Stanford said that only 32 percent of people that have had treatment are eating disorder-free after a year.

Morty: Yes.

Jeanne: It’s insane. That’s just not good enough. There are people that come to my clinics that have been through seven, eight, nine other treatment programs.

Now, we’re talking about several hundred thousand dollars, we’re talking about a lot of time, we’re talking about the emotional impact, the feeling of failure.

“Well, there must be something really wrong with me. I can’t get this.” This is through just strict cognitive behavioral therapy and nutritional education.

Morty: Yes.

Jeanne: So, if a standard treatment program is going to do cognitive-behavioral therapy and nutritional education 80 percent of the time and maybe a little deeper psychotherapy or other interventions, the other 20 percent, we’re the opposite. We’re 80 percent up here.

Morty: Yes.

Jeanne: Because I believe that a lot of the ideology of eating disorders lies in the brain. I think there’s a strong genetic aspect.

I think that when somebody’s coming to treatment, we need to look at every aspect, a very holistic view. We’ve got to look at their brains. We do brain mapping. We do complete physiological exams.

Jeanne: I have a naturopathic physician on the staff and I can get a rate that MD if I need that. So we do a lot of neuro-feedback. They’ll have five sessions a week. We do acupuncture. We do polarity therapy, which is form of bodywork.

We have a spiritual director. We have an R.D. as our nutritionist. Our food is all whole food, mostly organic, because I believe that food can be used as medicine as well as just good food.

Morty: Yes.

Jeanne: But because I think really when their bodies are so depleted, whether they’re anorexic or whether they’re a binge eater, nutritionally they’re not in great shape. So these are some of the things that we do.

Morty: Okay. When you say emotional eating, do you distinguish between anorexia, bulimia, and just general emotional eating?

Jeanne: I don’t think all emotional eaters are overweight.

Morty: OK.

Jeanne: I think a good number of them are. Because they learned eating disorders, whether it’s anorexia, bulimia, or compulsive eating, it’s something that somebody learns a behavior they are going to use as way of coping the stress, and we’ve read this a million times.

Morty: Sure.

Jeanne: I’ve heard that the gastrointestinal system is one of the most highly educable systems that we have.

So when somebody is under a lot of stress, whether they’re a child, a teenager, or an adult, they’ll start practicing with some eating disorder behavior and before you know it, boom, they’ve got a clinical eating disorder.

I see people who are overweight and it looks to me like they’ve tried to build a house around themselves so that they can’t be exposed to all the hurt and the pain that’s in the world.

Morty: I agree.

Jeanne: A number of these people, not all mind you, but a number of them have been subjected to one kind of traumatic event, whether it’s an accident of some kind, an automobile accident, abuse, sexual, emotional abuse, physical abuse. It’s not all sexual abuse. There’s a lot of other kinds.

Whether they have had a series of bad events or it all happened in a short period of time. So you have a woman who was involved in an automobile accident. Her mother died and her husband left her all in the same year.

She’s in a world of pain. So, if alcohol and drugs don’t work for her, boy, food sure will.

Morty: You use a wide variety of techniques; you’re sort of eclectic. If you say the study indicated that CBT was effective only 32 percent at a time, do you have any statistics on the results of your clinic?

Jeanne: We’re someplace between 65 and 70 percent at a year. That’s why I was curious about what you do and just knowing intuitively that it affects the brain.

Because this is where so much of it is. Even if there’s a genetic aspect, sometimes you see families that are just fat families and they pass that down.

Morty: Yes.

Jeanne: But if there’s that genetic thing, you’re doing what you do or whether you are using EMDR or EFT for trauma, there’s traumatic incident reduction. For some people, just they’re so sensitive in the world that just breathing can be traumatic in a sense.

Life is not good for them. But we do focus a lot on work with the brain.

Morty: Okay. As I was indicating in our conversation earlier, in addition to beliefs, we have found that there are triggers that have been conditioned.

So what happens is, for example, negative feelings like boredom, feeling unlovable, feeling depressed, feeling unworthy, etc. can be conditioned to produce eating when you aren’t hungry.

Jeanne: Sure.

Morty: We’ve discovered about 25 different triggers and we discovered that when each one of those has been de-conditioned, that that trigger no longer as you automatically eat. That that’s a large part of what seems to be the compulsive eating problem.

Jeanne: I believe that’s true, where something that is so repetitive. By the time somebody gets to the place where they’re seeking out me or they’re seeking you for some kind of relief, they for sure have conditioned those triggers.

Morty: Yes.

Jeanne: You may have been doing this for a long time.

Morty: Yes. Generally the triggers get conditioned much earlier in life. Sometimes it can be with traumatic incidents later in life, lots of stress. But very often, you can trace the original source of a conditioning to teenage years or even earlier than that, which is where a lot of the eating beliefs also seemed to start from.

Jeanne: Remember with boredom, and I always giggle when I hear that. One of my clients told me, “Oh, gosh, I eat all the time at night. I’m just bored.” Every time I have to ask him, “Well, if you weren’t feeling bored, what would you be feeling?”

He sat back, and breathed, and really thought about that question. Oftentimes, there’s a tremendous amount of anger there.

Morty: For sure.

Jeanne: Then, if you’re talking about belief systems, that feeds right into that for sure.

If they are feeling sad, if they’re feeling a lot of anger, there’s just that hurt and pain and all of that kind of thing and they’re using some of these more acceptable feelings like boredom to cover that up.

Morty: Yes. How long a stay is it for the average person or is there an average stay? Is it different for each individual at your clinic?

Jeanne: Well, its minimum length of stay is 45 days, and I have experimented all over the place with that. I started out, twelve and a half years ago, doing two-week workshops and I thought, “Now, I’ll treat them for two weeks, send them home to work with their therapist, and with the good aftercare program, they should be fine.” Well, they weren’t.

Then, I went to 28 days, and then I went to 35 days, 42 days. In all of these, I do a lot of testing, EDI, the eating disorder inventory and the Beck depression test.

Our results are pretty stable from six months to a year based on our post testing and that’s what so unusual and I attribute that to what we’ve done in the brain.

Morty: Excellent.

Jeanne: I think you’ll probably find the same thing because there’s a changed gear.

Morty: Well, there’s clearly a change in the brain. The conditioning must go through some brain pathways. So if you’re de-conditioned, you’re clearly changing neural pathways, breaking neural patterns in some way.

Same with the belief. If you think something’s true and then get to the point, you say, “Wait a minute. I just made that up. It’s not true that I’m not good enough. I don’t believe that anymore.”

There had to be some neural connection before that’s no longer there or some new neural connection. So, at some point, as far as we’re concerned, we would like to do some studies where we do functional MRIs or other type of brain scans to see what happens at the moment in a brain a belief is eliminated.

Jeanne: That would be exciting to see, wouldn’t it?

Morty: So not only do I think you could identify what happens in the brain when beliefs are eliminated and when conditionings are de-conditioned, I also think you would find a change in the brain when a significant problem like compulsive eating is eliminated. I think that could be identified in some way also.

Jeanne: One of the reasons why is because a lot of the research that they’re doing now about obesity where they’re coming up with hormone stuff.

Jeanne: Doing our work is going to the same place as you, but in a different way.

Morty: It sounds like it.

Jeanne: Ours is not as fast as yours maybe, so that’s why I’m really, really interested in what you’re doing.

Morty: Well, I’ll give you more information about it later on, but I just want to get anything else you’d like to say about your system or your clinic. How would people find out more?

Jeanne: mirasol.net. M-I-R-A-S-O-L.

Morty: M-I-R-A-S-O-L dot net.

Jeanne: Yes.

Morty: That’s not com, it’s dot net.

Jeanne: Dot net. Mirasol means sunflower.

When I chose the name for the clinic, I pictured all of my clients heading out of treatment with their little faces pointed to the sun.

A lot of them do that. One of the things that we do as well is we offer a full year’s worth of aftercare, and that’s done on the phone. The advantage of that is when our clients leave, we just don’t say bye-bye.

We continue to maintain that relationship because we’ve developed a close relationship with them.

Morty: That’s good.

Jeanne: So, if they start to struggle, we still have that release which says that we can be in touch with their therapists at home.

We contact that therapist, talk together, and then figure out what we can do to keep her from going into full relapse, and I think this is really significant for us keeping people on track.

Morty: Okay. That sounds good. What is the scale of prices for this type of 45-day in-patient treatment?

Jeanne: It might cost $1,350 a day. I’m always willing to try work with people, working around price and everything.

You’ll find we’re in the middle as far as prices go.

Eating disorder treatment is expensive because you have to have, at least for us, so many staff.

It also seems like our patients are getting sicker than they have been, say, eight or nine years ago.

Morty: So the people that are arriving, they are in worse shape now than they were earlier?

Jeanne: Yes.

We require that people be medically stable even though we’re a level one substitute facility.

We don’t do IVs or things like that because it changes the whole quality of treatment when you got people whose little neurotransmitters aren’t working.

Morty: I understand. Is there anything else you’d like to say? Do you have an overall theory or philosophy? You say it’s 80 percent alternative, 20 percent cognitive behavior.

Jeanne: No, no, no.

I didn’t say that. I didn’t say that. I said that traditional eating disorders treatment centers will use the medical model and treatment 80 percent at the time. We go in and we’re looking for other issues. The underlying issues are the things that drive the eating disorder. It’s not the behaviors. If it were just the behaviors, that would be nothing.

But it’s all of these underlying issues.

Morty: Can you explain that further? Can you give a sense what you mean by that? What do you mean by underlying issues?

Jeanne: Okay. Probably 90 percent of our patients come in with the eating disorder and depression and anxiety.

Some will have severe obsessive-compulsive disorder. There are a number of people that have multiple psychiatric issues.

Morty: Yes.

Jeanne: Schizoid personality. Just a bunch of things. So, these are things that are difficult to get out on the phone when you’re interviewing somebody for treatment.

We do get a lot of psychiatric patients. Whether we keep them or not depends on how much they want to get well.

Morty: From your point of view, do you see these as two separate issues arising at the same time or do you see most of the psychological issues like depression, anxiety, et cetera, as the primarily cause of the eating disorder?

Jeanne: Well, I don’t think it’s the cause.

I don’t think it’s the chicken and the egg kind of thing.

But I think they’re definitely a part of it.

Morty: Okay.

Jeanne: The kind of treatment that we do is now is integrative. I don’t know if you’ve heard of Dr. Andrew Weil.

Morty: Yes, I have.

Jeanne: Well, he does integrative medical treatment.

Morty: That’s right. He’s from Tucson, isn’t it?

Jeanne: Yes.

Jeanne: It’s where I got my idea of thinking, “Well, he’s doing something in the medical community, and why can’t we do that for behavioral health?”

Jeanne: It doesn’t have to be all talk therapy because that doesn’t work for a lot of people.

You can talk to a patient till you’re blue in the face and nothing is going to happen until you start working up here, in the brain.

Morty: Yes. Very good. Is there anything else you’d like to say? We’ve got a bunch of people on our mailing list, most of whom have some sort of eating disorder, generally compulsive eating, and are interested in learning everything they can. I think what you’ve told them has been very, very useful and it’s good for them to know about your facility. Is there anything else you would like to say to people who are sitting there suffering from some eating disorder right now?

Jeanne: Yes. Right now, I’m in the process of writing. This will be available free on my website. Twenty tips for people. That’s to be for people that are compulsive eaters.

I’m also writing a short e-book on, what’s it called now? I’m Young, I’m Fat, and I’m Eating Myself to Death.

Morty: Sounds interesting.

Jeanne: Here again, I’ll use client stories and then I’ll give actual interventions that people can do at home to begin to help themselves.

I think at the bottom, I’m going to put, “Do all of these things and then call Morty, too.”

Morty: Thank you, Jeanne. I very much appreciate your time and for providing this useful information to all of our audience. Good luck with what you’re doing and we shall talk again soon.

Jeanne: You bet, Morty. Thanks a lot.

Interview: Dr. Roger Gould of ShrinkYourself.com

Podcast: Play in new window | Download

Dr. Roger Gould is a psychiatrist with decades of experience in helping people resolve all types of psychological problems, including emotional eating. His focus in recent years has been trying to turn psychotherapy into more of an education process.

He was kind enough to allow me to interview him recently. During our talk he discussed the causes of emotional eating and his on-line program at ShrinkYourself.com that has been used by over 30,000 sufferers.

He doesn’t like to use the words, “eating disorder” to describe people’s difficulties with eating. Rather, he agrees with me that emotional eating is a coping strategy, an attempt to hide from negative feelings that we don’t want to feel. He says that our old self-image (which I contend is a function of your self-esteem beliefs) makes many of us feel helpless, and then we turn to eating to escape from that feeling.

Listen to the podcast or read a transcript of our interview.

Morty: Hi! This is Morty Lefkoe with Podcast #1 on our Emotional Eating Report blog. We are going to be having interviews every week with noted authorities in the field, people who have a lot of experience and knowledge with emotional eating and other types of eating disorders.

The purpose of this weekly broadcast is to give you additional information, so you can understand what is the problem of emotional eating. Where does it come from? What can you do to solve it?

We are very fortunate today to have as our guest Dr. Roger Gould. Roger has a lot of background in this field. He has a lot of experience. And I think that as you listen, you will discover a lot of useful information that will help you deal with this issue. Roger, thanks for being here.

Roger: You’re very welcome. Thanks for inviting me.

Morty: Could you give us just a little bit of your background so people know what your experience is in the field?

Roger: Yes, sure. I’m a psychiatrist and psychoanalyst. I used to be the head of Outpatient Psychiatry at UCLA. I’ve written a couple of books. One of them called Transformations, which is about growth and change in adult life. We look at the life cycle and how people have to adapt and change and learn as they go on.

Another book which is more current for our topic today is called Shrink Yourself, which is all about what one has to do to end the emotional eating. We also created a web site called http://shrinkyourself.com, which is about the same subject but takes a person through twelve weeks of very personalized, interactive software that helps them immerse themselves in all the steps that one has to go through in order to get rid of this addiction.

Morty: Let’s start at the beginning. You’re saying you seem to have a general background in psychiatry, not just eating. What is it that first got you interested in the area of eating disorders?

Roger: We developed some software to help people learn about themselves. We used it in CIGNA health plan and psychiatric hospitals and community mental health centers. Along the way, one of the places that we used it was a hospital setting for both eating disorders and substance abuse disorders.

We developed a very specialized set of programs for that. That’s what got me interested originally, and then I did some consulting work at the Pritikin Institute in Santa Monica and worked with obesityhealth.com and began to get very involved in this important and difficult issue which is as you know, Morty, which is everybody eats for comfort to some degree. It’s very easy to flip over and eat too much for comfort too often. Before you know it, you’re in a vicious cycle and it becomes a preoccupation to your mind.

Morty: How would you define or describe the flip over point? You say most people eat for comfort to some extent. What’s the difference between somebody who does that who does not have an eating disorder and somebody who does?

Roger: I don’t even like to use the word “eating disorder.”

Morty: Okay. How would you describe it?

Roger: What happens is that people who have gone long periods of time without eating to excess with emotional eating suddenly start having a lot of negative feelings, which seems overwhelming. They feel powerless. Eating then seems to be the only way they feel better, they can get comfort.

It’s not true but it feels that way and very strong, so they regress into it. A number of people go in and out of their emotional eating episodes and go for long periods of time. We have treated over thirty thousand people online and have a lot of data. There are so many people who said, “I didn’t have this problem until after I got married.”

Another person said, “I didn’t have it until after I had my first child.” Women didn’t have it until they were menopausal. Different times in life. Some people have had the difficulty since they’ve been children. It becomes a way of life and become part of an identity.

Morty: Do you find that there is generally a single stimulus that gets the emotional eating started or does it seem to be something gradual where you can’t pinpoint the exact cause?

Roger: It’s just like everything else in the human mind. It’s so complicated. You can’t really find a single cause. You can’t find a track by which it happens.

Again, some people grew up in families where the eating habits were such that overeating was promoted on a regular basis. They were younger. They exercised. It didn’t affect their weight.

They got older. They didn’t exercise. They kept the same eating habits and they started gaining weight. They had a look back and they will see what’s going on here.

Again, it can happen in various ways. There are a lot of mechanisms for it to happen. The most important thing is really how you get out of it.

Morty: Okay. I want to ask one more question before we get to that. Would you say that in all cases where there is a problem, it is a problem of emotional eating? It is eating for emotional reasons rather than for hunger?

Roger: Yes. I would say there are probably 2 or 3 or 4 percent at the most of people who are overweight or obese with a thyroid or hormonal problem or some biological problem. But when you see the people who had been hundreds of pounds overweight lose their weight once they stop their emotional eating, it’s hard to say that it was initially a biological issue when the cure is a psychological cure.

Morty: Got it. There is some emotion that seems to drive people to eat.

Roger: I would say it slightly differently. What drives people to eat is the fear of their own emotions.

Morty: Got it. Okay. Eating then is the escape or the compensation for emotions they don’t want to feel.

Roger: That’s right. They’re afraid to face. If you start from that premise, people tell you all the time about what they’re avoiding. They’re avoiding feeling overwhelmed.

They’re avoiding their own anger. They’re avoiding their prediction about how their life is going to turn about badly or a relationship is not going to work or some sort of dark or catastrophic image. If they think any more about it or feel any more, something terrible is happening or is about to happen, which makes them feel powerless. Powerlessness is really a key to the whole thing.

I like to use an example, I think I quoted it in my book, of a very intelligent forty-ish woman who was at the shopping mall with her sixteen-year-old daughter and her sixteen-year-old daughter’s friend. The kids were being very bratty.

She couldn’t control them. I said, “What did you do?” She said, “I ate six doughnuts.” I said, “Why did you eat six doughnuts? Why didn’t you deal with your bratty children?”

She said, “I didn’t know what else to do?” At that moment in time, she was overwhelmed by her feelings: she said she was powerless, helpless, had no choice, had no alternative, and all she could do was eat to get rid of the frustrated angry feelings that she didn’t want to feel. I call that food transfer. It takes you out of where you are right now.

It takes you out of your reality. It’s very tempting. All the problems go away. It’s a quick fix. An hour or two later you’re still angry at yourself. You probably eat more to get yourself some comfort from your…

Morty: From your anger. Yeah. I think we got a good sense of what it is. What is the approach you’ve used if people use eating as a way to escape these negative feelings which occur for almost all of us on some irregular basis? What do we do about it?

Roger: The simple answer is people have to learn how to engage and process their feelings and prove to themselves that their feelings are not dangerous and that they’re not helpless. The only way you can do that is you have to go through a process which is somewhat like the process of psychotherapy, but it’s also like the process of personal development which was the subject matter of my first book on transformation. Which is how do you learn the new skill of adulthood which is facing problems even if it hurts for awhile in order to keep your mind alert enough to work on them to solve them.

They don’t go away if you just eat for comfort.

Every time you eat for comfort, you derail your own adult thinking. You temporarily shut down the best part of your mind. It’s a self-defeating process and you’re spaced out much longer. That’s what has to be reversed.

The question is: how do you reverse it? Step by step. Point by point. That’s where our computer software comes in, and that’s where the book comes in. We take people from identifying what are the triggers.

What are the sore spots or the sensitive areas of their lives? What are the feelings that have been aroused in a particular concrete incident that they are observing? What is the feeling that they’re about to feel and what are they afraid of in that feeling? How can they sort that out and get down to the real truth, which is there’s nothing to be afraid of their feelings? Because their feelings are natural information systems that are pointing them towards what they need to deal with—their life, their responsibility.

Morty: I can see how therapy does that. How have you managed to put that into an online course?

Roger: It took us about twenty years. It started again when I left UCLA and had a foundation grant to try to convert psychotherapy into an educational system to marry that into our work on adult development.

Everybody has this angry spot but it’s like they’re weighed down to various degrees. Everybody has an old negative self-image that they carry around with them from childhood. That image often is a role that they played in their family. It usually has a label attached to it. It has rules of what you can do or should do.

It holds you back—that image. That self-doubt image is the thing that makes you most helpless every time you engage it. If you’re about to try to make an improvement in your life or change your behavior or go back to school or speak up or when you’ve been too mousy before or too much of a people-pleaser and you try to make that change, you run into the ideas that people aren’t going to like you anymore. They’re going to see through you.

This is a very familiar scenario of self-criticism, self-doubt, and self-sabotage. That’s really what makes people feel most helpless to be able to do. A lot of what you’re feeling is all about is leads to problems. It leads to interpersonal friction. Those all dig deeper into this whole self-doubt system.

We take the person through twelve weeks and actually take him through a transformation process in which they begin to feel these things, not just read about them. We developed a series of observational exercises to help people see that and to learn from the deeper reasons why some people, who have been obese for a long period of time starting back in childhood, hold another series of reasons to hold on to emotional eating, which is too much get into at this point of the interview.

Morty: What would be the best place for people to find out about this course you have, and to sign up for it if they’d like?

Roger: It’s www.shrinkyourself.com. They can remember the double entendre that you’d shrink yourself.

Morty: S-H-R-I-N-K-Y-O-U-R-S-E-L-F.com. shrinkyourself.com. They can get information about the program. If they like it, they can sign up for it.

Roger: There are various tools that they can use to help them think about it. We have a thing called Emotional Eating Diagnostic that helps them understand in a deeper way their emotional eating process. We have hundreds of articles that I have written and blogs. They’ll see videos of people who’ve gone through the program.

Morty: You say you’ve had thirty thousand people go through this program?

Roger: Thirty thousand people going through the program.

Morty: Congratulations! That is very exciting.

Roger: We’re very excited about it because we get unsolicited testimonials every day. There’s a whole page of them. The most gratifying is people say, “I’ve had this urge. I’ve been doing this yoyo dieting. I’m going to therapy. Nothing has really helped me understand it as well as this.”

For the great majority of people, that urge that has been such a demon in their life, spontaneously seems to go away around the sixth session, more than I anticipated. But I keep on hearing it over and over again, and it’s very heartening.

Morty: It’s a ten-session course?

Roger: It’s twelve sessions. Twelve weeks.

Morty: Twelve weeks.

Roger: Three months. It’s pretty extensive.

Morty: How much do you charge to the course?

Roger: Yeah, we charge for the course. Because of the bad economics in the world right now, we’ve actually just cut our price in half so that more people can use it. So many people have been telling us. The whole twelve weeks is only $59.95—$60. Five dollars a week.

Morty: That’s very, very small price to pay for getting rid of a problem that has wrecked havoc in literally millions and millions of lives. People have spent more than that on their dieting tools and on their dieting books.

Roger: Or more than that each day on the junk food.

Morty: That’s right. Obviously, some people have been in therapy for years and years. Therapy in general doesn’t seem to work on emotional eating, at least according to what I’ve read and the people I’ve talked with.

Roger: I think that therapy is always useful, but I do believe that by using the techniques that we have, we have such strong data. We have made changes along the way. I think we have actually discovered the focus that most therapists don’t have. Even when I see patients with this kind of problem, it’s very easy not to be disciplined and keep the focus and understanding for each episode why were you feeling helpless. What was really going on? Don’t you really have choices? Why can’t you really handle this in a better way? We’re actually developing a thing called Hunger Coach, which soon we’ll have on the site for people to use. It’ll be free for them to use.

Morty: Thank you so much for your time. I think this is very, very useful and valuable information for anybody who is concerned with the issue of emotional eating. I plan to go and check out the site and try to learn some more myself about your particular method and approach.

Again, for people who want to find out more about your program, Roger. It is shrinkyourself.com. It is a twelve-session course for only $59.95. You can read more about the course to understand what the principles are and sign up for it if you choose to do so.

Roger, thank you so much for your time today. I look forward to getting this material out to all of our subscribers as soon as possible. Thank you for the contribution you’re making to so many people. It’s a terrible problem out there.

I am happy that there are people in the world who are doing their best to help. Obviously, you’ve helped at least thirty thousand and probably will help many thousands more by the time you’re done.

Roger: Thank you. Thank you, Morty, for this opportunity.

Morty: Okay.

Emotional Eating Is An Adaptive Behavior

NOTE: I’m sorry that I have not posted to this blog in the past couple of months. We have been busy creating new products and services that will help people transform their lives, including an on-line course to teach people how to eliminate beliefs on their own.

I intend to post information about this topic here on a regular basis that you will find useful. Please let me know what type of information you would find helpful.

Someone with an emotional eating problem might be so focused on getting rid of the problem that they are not particularly concerned with why they have the problem. But understanding why they have the problem can provide them with clues on how to get rid of it.

A book I’ve had in my library for some time, The Eating Disorder Sourcebook, by Carolyn Costin, provides some really useful information on the needs that emotional eating fills for most sufferers.

Carolyn lists some common states of being for the eating disordered individual:

Low self-esteem
Diminished self-worth
Belief in the thinness myth
Need for distraction
Dichotomous (black or white) thinking
Feelings of emptiness
Quest for perfection
Desire to be special/unique
Need to be in control
Need for power
Desire for respect and admiration
Difficulty expressing feelings
Need for escape or a safe place to go
Lack of coping skills
Lack of trust in self and others
Terrified of not measuring up

She makes a few important points about this list that are worth noting:

“A person in one or more of the above states will naturally seek comfort for, alleviation of, or distraction from their feelings.” And eating when having these feelings is one of the best ways to cover up or be distracted from them.

“Eating disorder symptoms can be seen as behavioral manifestations of a disordered self.”

“… an eating disorder, for all the problems it creates, is an effort to cope, communicate, defend against, and even solve other problems. …

“… the adaptive function of an individual’s eating and weight-related behaviors must be discovered and replaced with healthier alternatives.”

Choosing “healthier alternatives” to emotional eating should only be the first step. The next steps should be eliminating the source of the problem

There are three major approaches to treating eating disorders:

Psychodynamic
Cognitive behavioral
Disease/addiction

I would classify The Lefkoe Method as a type of psychodynamic approach, in that this approach argues that it is important to address and resolve the underlying causes for disordered behaviors. If that is not done, the problems may subside for a while, but usually return.

What do you think is the source of emotional eating? Please join the conversation below.

To find out more about how The Lefkoe Method can help you eliminate your emotional eating problem, please see my eBook, The Secret to Ending Overeating For Good. http://emotionaleatingreport.com.

Emotional Eating Can Manifest in Different Ways

The single best book I’ve read for understanding all aspects of emotional eating is Geneen Roth’s best-seller, Women, Food and God.

Here are two approaches to emotional eating as she describes them:

… there are two kinds of compulsive eaters: Restrictors and Permitters.

Restrictors believe in control. Of themselves, their food intake, their environment. And whenever possible, they’d also like to control the entire world. Restrictors operate on the conviction that chaos is imminent and steps need to be taken now to minimize its impact.

For a Restrictor, deprivation is comforting because it provides a sense of control. If I limit my food intake, I limit my body size. If I limit my body size, I (believe I can) limit my suffering. If I limit my suffering, I can control my life. I make sure bad things don’t happen. That chaos stays away. …

Permitters find any kind of rules abhorrent. If they’ve ever lost weight on a diet, it was through wrenching, abject misery. They are suspicious of programs, guidelines, eating charts.

Permitters say, “I’ve gained fifty pounds in the last six months and I just can’t understand what happened.” Whereas a Restrictor operates with hypervigilence, with their antenna in constant motion like those of a sea anemone, Permitters prefer going though life in a daze. They way, they don’t need to feel pain—theirs or anyone else’s. If I’m not aware of it, there’s nothing to fix. If I go through life asleep, I don’t need to be concerned about the future because I won’t be aware of it. If I give up trying, I won’t be disappointed when I fail.

Like Restricters, Permitters operate on the need to be safe in what they consider hostile or dangerous situations. But unlike Restrictors, who try to manage the chaos, Permitters merge with it. They see no point in trying to control the uncontrollable and have decided it’s best to be blurry and numb and join the party. Have a good time. …

Restricting and permitting are subtypes of compulsive eating, which is the metadefense. A compulsion is a way to protect ourselves from feeling what we believe is unfeelable, what we are convinced is intolerable. It is a compulsion because we are compelled to engage in it. Because in the moment we are acting it out, we believe we have no choice. …

A few last words about labels. Everyone is both Permitter and Restrictor. A Restrictor turns into a Permitter the moment she binges. A Permitter becomes a Restrictor every time she decides she is going to follow a program, even if that resolution lasts two hours.

Both these types of emotional eaters feel compelled to eat and the compulsion is caused primarily by conditioning and to some extent by beliefs, as I explain in my eBook, The Secret to Ending Overeating for Good. http://emotionaleatingreport.com. For example, you will feel compelled to eat whenever you experience one of your specific triggers, such as loneliness, boredom, feeling unlovable, feeling anxiety, etc.

But it is possible for Restrictors and Permitters to de-condition their conditionings and eliminate their negative beliefs, reaching a peaceful state where their emotional eating is nothing more than a distant memory instead of a constant cycle of pain.

Research Validates Our Approach

A reader of my eBook on emotional eating, Susan Vendeland, just posted on my blog. Because she points out that a lot of current research validates my approach for eliminating overeating, I wanted to share it with you.

“Thank you for your generous sharing of your report. [http://emotionaleatingreport.com] I began teaching a college course this last semester, the Prevention of Obesity and Eating Disorders. We talked about emotional eating both as a personal problem linked to obesity and eating disorders and as a community health problem.

“I appreciate your insight into the genesis and healing of emotional eating and this is consistent with approaches taken by those who treat eating disorders including binge eating disorder. A report by the Hartman group, a market research firm in Seattle, addresses the cultural aspects of overeating in America and basically describes the widespread social acceptance of emotional eating as the driver for the ‘obesity epidemic.’

“In my course, we focus on emotional self-awareness, intuitive eating, awareness of weight discrimination and self and body acceptance to address out of control eating.

I listened to the video and appreciate what Donna [Bauer, http://emotionaleatingreport.com/blog/donna/] said about celebratory eating as well. Researchers at UCSF (Mary Dallman’s group) and others have provided evidence and a neuro-physiological explanatory model for comfort or stress eating so acceptance in the scientific community of this adverse habit is growing.

“Do you have plans to demonstrate the effectiveness of your treatment in a randomized controlled trial anytime soon?  [I am very interested in conducting such a study as soon as we find a university that wants to do such a study with us.]

“I would also like to tell you that I really appreciated the way you tried to encourage Donna to get in touch with how good she feels in multiple dimensions from gaining control of her eating (and the self-respect that accompanies that) rather than just the pleasure of losing weight and receiving myriad compliments.

“There are many people who emotionally eat but are not necessarily overweight. They may do large or even excessive amounts of exercise to compensate so weight loss should not be the goal, but rather energy, health, vitality, wellness, feeling in control, and knowing how to deal with the reality of our emotional selves. [Our goal is to help clients stop their emotional eating, which will ultimately reduce their weight, but our focus is not on weight loss as such. That is focusing on a symptom, not the cause.]

“Thanks again. You are doing very good work.”

For more details, please see my eBook, The Secret to Ending Overeating For Good, at http://emotionaleatingreport.com. You also can get answers to specific questions at my office, 415-884-0552.

You Don’t Need A Crutch

Emotional eating is the way we cope with negative feelings we don’t want to feel. By eating, even when we aren’t hungry, we get distracted from the feelings we don’t want to feel and experience a pleasurable feeling instead.

These negative feelings ultimately become conditioned and act as “triggers” that result in automatic, compulsive overeating.

When you use the Lefkoe De-conditioning Process to de-condition your many triggers, you realize that earlier in life you had (unconsciously) chosen eating as the best way to pleasurably distract yourself from your negative feelings (such as anxiety, feeling unlovable, depression, and boredom). It wasn’t that eating was necessarily the best way to cope with the negative feelings, it was just that you ate three times a day and noticed that, whenever you ate, you focused on the pleasure of eating instead of the negative feelings. That’s how eating got conditioned as an automatic response to the negative feelings.

You also realize that, in fact, there are many other things that might have worked to distract yourself from the negative feelings; you just hadn’t thought of them earlier in your life. Some activities that might have worked as a coping mechanism include a hot bath, exercise, a walk, talking to a friend, reading a book, or listening to music.

But using eating or any of these other activities to distract ourselves from our negative feelings implies that we are unable to cope with our negative feelings and that we need something to keep ourselves from facing them. In fact, although negative feelings can feel overwhelming, distracting ourselves with eating doesn’t really work. Not only doesn’t the distraction last for long, we end up feeling worse (guilty and bloated) after we stuff ourselves when we aren’t hungry. The negative consequences of other distracting activities aren’t quite as bad, but they still are only a temporary respite and the negative feelings are still there when we finish eating (or any other activity).

It actually is possible to just allow ourselves to experience our negative feelings and to realize that while we “have” these feelings, they are not who we are. We don’t have to use eating or any other distraction to deal with our negative feelings; we can just feel them and know they will pass.

If you really want to “handle” your negative feelings, the best way is not to pretend they don’t exist for a few minutes (which is the only respite eating gives you), but, instead, to eliminate the beliefs and conditionings that cause them. Every negative feeling you have is either the result of beliefs and conditionings, or the meaning you are giving current events. Events, as such, cannot make you feel anything.

Eating to feel good

If you eat to make yourself feel good, as opposed to eating to cover up negative feelings, there is a much better solution than eating, which only gives you a “high” for the few minutes you are eating.

Use the Who Am I Really? (WAIR?) Process, which enables you to experience yourself as the creator of your life, with anything possible and nothing missing. People who have used that Process report a feeling of bliss and unlimited possibilities that can easily be a substitute for eating. You can download an MP3 of that Process at http://recreateyourlife.com/free/who-am-i-really-mp3.php.

The only precondition for using the WAIR? Process is eliminating at least one belief using the Lefkoe Belief Process. You can do that free of charge at http://recreateyourlife.com.

For more details, please see my eBook, The Secret to Ending Overeating For Good, at http://emotionaleatingreport.com. You also can get answers to specific questions at my office, 415-884-0552.

She was gaining weight again

A week or so ago I called a woman who had been a client of mine several months earlier about her emotional eating problem. She had used the Lefkoe De-conditioning Process to get rid of all the triggers we could find and the Lefkoe Belief Process to eliminate all the relevant beliefs. For several months after our last session she had been eating normally and healthily and had been losing weight.

But instead of hearing that the weight had continued to fall away, she told me during my follow-up call that she had gained back all the weight she had lost and was eating badly again. I asked her why she hadn’t called me and asked for help. She said she didn’t know why she hadn’t called

In a situation like this, there are two possible explanations: First, what we had done hadn’t worked. Second, it had worked and there was some other explanation. I decided to check out the second possibility first.

I asked her to tell me everything about her life for the past few months. She told me that she had had knee surgery last December and had been unable to walk, much less exercise for over two months. That could partially account for the increase in weight, but it wouldn’t account for overeating and unhealthy eating. For example, she had totally stopped drinking Pepsi for several months but had gone back to several bottles a day. She was eating pizza for dinner frequently.

Almost in passing she mentioned that after she realized that she would be unable to exercise—which meant to her that the constant weight loss she had been experiencing probably would stop—she had the thought: What’s the use. I’ll never lose weight no matter how hard I try.

That was a new belief that partially explained the re-emergence of her eating problem. So she eliminated that belief. During the session she found and eliminated another, older, belief that had contributed to the problem: Even if I lose weight, no one will ever be interested in me, so why bother.

When we talked the following week she told me that she was not consciously doing anything different, but she was drinking far less Pepsi and had stopped her overeating. She noticed that she would unconsciously go to the pantry, look in, then realize that she wasn’t hungry, and close the door and walk away.

In a second session a week later she told me why she had not been eating healthily during the prior couple of months. Because she was unable to shop and cook for herself because of the foot surgery, she ate whatever her children brought home—usually pizza—and wouldn’t ask them to buy her something healthier and less fattening.

The beliefs she identified and eliminated that caused this behavior included: I can’t count on other people. I’m not worthy. I have to do it on my own. These beliefs explained by why hadn’t asked her children or friends to buy the food that she normally purchased for herself.

A few days later I received the following note from her:

“I just want to thank you again. It is awesome to experience hunger! Before, I was eating all the time and never got hungry. I’m so happy. I feel in control of myself again. I thought if I called you, I was a failure, but now I see how we can still take on bad beliefs that we need to get rid of. I won’t wait next time. Thank you again. I appreciate you so much!”

So although her “relapse” could have meant that the de-conditioning and the belief eliminating hadn’t worked to stop her emotional eating problem, on further investigation we discovered that what we had done previously had worked—and there was a little more that needed to be done.

Don’t ever give up hope. It is possible to totally stop your emotional eating problem.

For more details, please see my eBook, The Secret to Ending Overeating For Good, at http://emotionaleatingreport.com. You also can get answers to specific questions at my office, 415-884-0552.

Why Are Sweets A Particular Problem For Emotional Eaters?

Many emotional eaters don’t care what they eat when they are triggered with a negative feeling. They eat whatever they can find in the kitchen because they have been conditioned to eat.

Other emotional eaters specifically crave sweets. They will eat non-sweets if that is all that’s available, but they prefer sweets when they have been triggered (or when beliefs drive them) to eat.

Why emotional eaters prefer sweets

There is research that explains why many emotional eaters prefer sweets. In a Newsweek article (June 25, 2009), Kate Dailey described some of the research.

“The desire for sweetness is hardwired into humans—give babies a little sugar on their lips and they’ll smile. That’s because up until the advent of artificial additives, sweet flavors signified calorie-dense foods. …

“Whether one likes the taste of sugar a little or a lot, sweet foods react with everyone’s brains in the same way—by producing a rush of chemicals, including dopamine, which creates an opiate-like effect. ‘In Sweden, sweet-tasting foods like sugar solutions are used as anesthetic to do minor surgeries,’ says Dr. Kampov-Polevi. Sugar water is also used in the US on babies for minor procedures like blood draws.”

Consider why emotional eaters eat when confronted with negative feelings. As I’ve described in detail in prior posts, they want to escape those feelings by going numb. To the extent that sweet foods, in particular, numb us somewhat, then sweet foods would be the most effective type of food to give an emotional eater what she wants.

Sweets reduce anxiety

Further research indicates that in addition to numbing us, sweet foods also create positive feelings that serve as a pleasurable distraction, thereby effectively reducing the stress that is caused by most negative feelings.

Dr. Charles Raison, at Psychiatrist at Emory University Medical School, points out that, “In addition to stimulating brain reward centers, sweet food markedly affects stress hormones in ways likely to provide a sense of temporary reprieve from anxiety.” That is precise what emotional eaters want.

One of the most impressive studies to demonstrate how sugar reduces stress was reported on by UPI just a few months ago (November 10, 2010). The wire service story states:

“Eating, sex and other pleasurable activities provide more than enjoyment, they reduce stress by inhibiting anxiety responses in the brain, U.S. researchers say. [Emphasis added.]

“Yvonne Ulrich-Lai, a research assistant professor, and James Herman, professor of psychiatry and behavioral neuroscience, both at the University of Cincinnati, and colleagues also indicate that these reduced-stress effects continue for at least seven days.

“’These findings give us a clearer understanding of the motivation for consuming “comfort food” during times of stress,’ Ulrich-Lai says in a statement. ‘But it’s important to note that, based on our findings, even small amounts of pleasurable foods can reduce the effects of stress.’

“Twice a day rats were provided access to a sugar solution for two weeks. The rats with access to sugar had reduced heart rates and stress hormone levels ….

“Rats fed a solution artificially sweetened with saccharin showed similar stress reduction responses, as did rats given access to sexually responsive partners. But sugar supplied directly to the stomach did not blunt the rats’ stress response, the researchers say.

“’This indicates that the pleasurable properties of tasty foods, not the caloric properties, were sufficient for stress reduction,’ Ulrich-Lai says.”

While it might be somewhat harder to stop eating sweets than other foods, it still is possible to de-condition eating so that it is no longer the main way emotional eaters deal with negative feelings. Moreover, it is possible to eliminate the beliefs and conditionings that cause the negative feelings. And even most importantly, it is possible to learn to live with negative feelings without having to do anything to “cope” with them.

For more details, please see my eBook, The Secret to Ending Overeating For Good, at http://emotionaleatingreport.com. You also can get answers to specific questions at my office, 415-884-0552.

Why Do You Keep Eating After You’re Full?

In order to understand why people with an emotional eating problem keep eating after they are full, you have to understand what eating means to them.

Emotional eaters don’t want to face unpleasantness in their lives. They don’t want to feel any negative feelings. So they eat to get a pleasurable distraction from the feelings, to numb themselves, or to go unconscious when negative feelings show up in their lives. (I call these negative feelings “triggers,” because they “trigger” eating as an automatic response.)

How long are you able to escape the negative feelings? Usually only for as long as you are eating! So if you are having feelings you want to escape from, how long would you want to eat? … For as long as you possibly can, because the feelings will be suppressed only while you are eating and will re-surface as soon as you stop eating.

So you will start eating whether you are hungry or not in response to your triggers. And you will keep eating long past the point of being hungry whenever the triggers are present. Most emotional eaters have at least 15 different triggers, so at least one is present almost all the time.(As I point out in my free eBook, How To Stop Emotional Eating For Good, http://emotionaleatingreport.com/, triggers are the main source of emotional eating, but beliefs usually are involved also for most people. And the beliefs are affecting you all the time.)

When you de-condition eating as the conditioned response to the triggers, you will no longer automatically want to eat when a trigger appears in your life. At that point you can choose other things to distract you from the negative feelings; you can find alternative ways to cope with the triggers.

But there is a better way to handle the negative feelings.

Instead of looking for a healthier way to suppress your negative feelings, why not just allow them to be? True, they don’t feel good, but what if you just allowed yourself to feel bored, lonely, stressed, anxious, etc. when those feelings arose? What if you faced your feelings instead of looking for some way to avoid them?

Here is a suggestion on how to do it.

After you eliminate a belief using the Lefkoe Belief Process (if you haven’t already done so, go to http://recreateyourlife.com/free where you can eliminate some of the most common beliefs free), you go into an altered state of consciousness where you have the profound experience that you are the creator of your life. You no longer experience yourself as the sum total of your beliefs; you experience yourself as the creator of the beliefs, as consciousness.

In that state it is clear you have feelings, but you are not your feelings. You have thoughts, but you are not your thoughts.

When you are in that state it is easy to make a distinction between your “self” and your “SELF.” After you’ve made that distinction you are able to observe your feelings (which still feel very real) without being at the effect of them, without being run by them.

When I use this method when I am having an upset, I imagine myself outside my body, looking at Morty, and saying to him: “Morty, you are really upset. I wonder what you believe that is causing this upset.” The mere act of talking to myself in this way enables me to distinguish between who I really am and the “Morty” who is having the feelings. And doing that significantly minimizes the impact of the feelings.

Whatever technique you use, once you have de-conditioned eating so it is no longer an automatic, unconscious response to your triggers, see if you can allow yourself to experience your feelings. They might not feel good. But you will survive them, I promise. And facing them is the first step to getting rid of them permanently.

For more details, please see my eBook, The Secret to Ending Overeating For Good, at http://emotionaleatingreport.com. You also can get answers to specific questions at my office, 415-884-0552.

It’s About Escape, Not Food

If you truly want to understand the nature of emotional eating, you should study Geneen Roth’s best-selling book, Women, Food and God. It is beautifully written and filled with really useful information.

“I tell them [people in my retreats]that if compulsive eating is anything, it’s a way we leave ourselves when life gets hard. When we don’t want to notice what is going on. Compulsive eating is a way we distance ourselves from the way things are when they are not how we want them to be. I tell them that ending the obsession with food is all about the capacity to stay in the present moment. To not leave themselves. I tell them that they don’t have to make a choice between losing weight and doing this. Weight loss is the easy part; anytime you truly listen to your hunger and fullness, you lost weight. But I also tell them that compulsive eating is basically a refusal to be fully alive. No matter what we weigh, those of us who are compulsive eaters have anorexia of the soul. We refuse to take in what sustains us. We live lives of deprivation. And when we can’t stand it any longer, we binge. The way we are able to accomplish all of this is by the simple act of bolting—of leaving ourselves—hundreds of times a day.”

Apart from the lovely way that Geneen says this, she is extremely perceptive when she says that compulsive/emotional eating is the refusal to face reality, the refusal to face anything uncomfortable or difficult. So emotional eating is a way to escape reality.

Again Geneen describes the real issue so well:

“Her [the compulsive eater] problem is not about the food she consumes. Her problem, though it eventually would become excess weight, is not weight. It’s that she doesn’t know—no one ever taught her—how to “face” (as she calls it) her “deficiency.” The emptiness. The dissatisfaction.”

I’ve found over 20 distinct triggers that cause emotional eating. But what they all have in common is something uncomfortable that we don’t want to face. Emotional eaters chose eating as a way to numb themselves to that discomfort. But as Geneen clearly points out, the real issue is not the eating, it’s our unwillingness to live in the moment and face the uncomfortable.

Solving this problem is three-fold:

First, you need to de-condition eating, so it isn’t what you automatically use to go unconscious, in order to numb yourself to the uncomfortable thoughts and feelings you don’t want to face. Once you’ve done that, you will no longer eat automatically whenever you have uncomfortable feelings you want to escape.

Second, you need to eliminate the beliefs and conditionings that cause the thoughts and feelings that are so scary to you.

Third, you need to discover that you have thoughts and feelings, but they are not who you are. (The “Who Am I Really?” Process will help you with this.) That realization will make it easier to allow yourself to experience and just “be with” your negative thoughts and feelings, without needing to do anything to escape them.

For more details, please see my eBook, The Secret to Ending Overeating For Good, at http://emotionaleatingreport.com. You also can get answers to specific questions at my office, 415-884-0552.