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  • Please make the modifications that I indicated on the last version.This is what you wrote in the last version: “Relapsing is the result of withdrawal symptoms in the absence of the substance. Then comes relapse”Dieting should be on the same level as loss of control in its own box and the same with relapsing. On the right should be withdrawal symptoms linked to dieting. This is what leads to relapsing.This is how you have it on the word document for this slide:Features of an addiction: Psychological and BehavioralPsychological dependence: need and loss of controlLoss of control: binge eating, overeatingEmotional, compulsive eatingWithdrawal symptoms in the absence of the substance Cycles of dieting and relapsing in indulging
  • Figure 1. Summary of the main points elaborated in the text. When drug-taking is initiated, dopaminergic and glutamatergic neurotransmission in the mesocorticolimbic system is activated. Dopamine and glutamate interact in a complex way in the NAS. The net result of these interactions may be a reduction of medium spiny neuron activity and a decrease of GABAergic output from the NAS (see Nestler111 and Wise. In the addicted state, different dopaminergic projections may be altered differentially, resulting in an altered dopamine–glutamate interaction that ultimately lead to aberrant control over behavior by the drug and to compulsive drug-taking behavior. The shift from controlled to compulsive drug intake may also involve a shift from the NAS to the striatum (STR) as the structure controlling behavioral output. During withdrawal and drug-free period, dopaminergic and glutamatergic activity within the mesocorticolimbicbsystem normalizes but remains in a hypersensitive state (indicated by asterisks). Exposure to drug, stress, conditioned cues, or appropriate electrical stimulation can trigger a full-blown relapse.
  • Studies show that diet together with psychotherapymethods increases the success of weight loss programsHypnotherapy group with stress reduction achieved significantly more weight loss than treatment with dietary advice only or one form of hypnotherapy only.Randomized, controlled, parallel study of two forms of hypnotherapy (directed at stress reduction or energy intake reduction), vs dietary advice alone in 60 obese patients with obstructive sleep apnea on nasal continuous positive airway pressure treatment. Journal of Consulting and Clinical Psychology (1986) J Stradling, D Roberts, A Wilson and F Lovelock, Chest Unit, Churchill Hospital, Oxford, OX3 7LJ, UK.
  • Level 1 and 2 both in redChange arrove

Psychology, Spirituality and Lifestyle Changes in Naturopathic Medicine Psychology, Spirituality and Lifestyle Changes in Naturopathic Medicine Presentation Transcript

  • Psychology, Spirituality and Lifestyle Changes in Naturopathic Medicine Maya Nicole Baylac N.D. Hawaii Naturopathic Retreat Center A healthy body + an open heart + a positive and creative mind = a happy spirit!
  • Lifestyle Change Model for Physical and Mental Health awareness mental emotional physical Nutrition & Exercise Psychotherapy Philosophy Meditation Liberate Educate Motivate Behavioral Changes
  • Cardiovascular Disease (CVD)  CVD is the leading cause of death for men and women in the world  In Europe and the United States ONE out of THREE deaths is due to CVD  Worldwide ONE out of FOUR deaths is due to CVD  China has the lowest CVD in the world  Future projections show that the number of deaths will continue to increase (WHO – Fact Sheet #317 March 2013)
  • The American Heart Association Study: Heart Health and Lifestyle The incidence of blood clots were compared in: 30,000 + adults Aged 45 / older Followed 4.6 years They were then divided into 3 groups rated according to their adherence to Life’s Simple 7. The groups were: Inadequate Average Optimum
  • Life’s Simple 7: 1. Being physically active 2. Avoiding smoking 3. Eating a healthy diet 4. Keeping a healthy weight 5. Maintaining healthy cholesterol levels 6. Keeping blood pressure down 7. Regulating blood sugar levels
  • Results of Study The America Heart Association Study: Life’s Simple 7 and CVD 38 % lower risk 44 % lower risk Optimum Health Average Health Risk of Blood Clots Compared to Inadequate Group: Inadequate Health high risk
  • Conclusions of Study The America Heart Association Study: Life’s Simple 7 and CVD Heart-Healthy Lifestyle May Prevent Lethal Blood Clots. Medline Plus, May 2, 2013. “Adherence to the Life’s Simple 7 goals was also associated with reduced incidence of cancer,” said Laura J. Rasmussen-Torvik, lead author of the study. Recommendations of WHO “Most important behavioral risks for cardiovascular diseases can be prevented by addressing risks factors: tobacco use, unhealthy diet and obesity, physical inactivity, high blood pressure, diabetes and raised lipids”.  Maintaining ideal levels of physical activity and body mass index were the most significant factors related to lower risk of blood clots.
  • Life’s Simple 7: How Simple Are They? 1. Being physically active 2. Avoiding smoking 3. Eating a healthy diet 4. Keeping a healthy weight 5. Maintaining healthy cholesterol levels 6. Keeping blood pressure down 7. Regulating blood sugar levels NOT SO SIMPLE: THE INCIDENCE OF OBESITY KEEPS GROWING WORLD WIDE – IN SPITE OF PEOPLE TRYING TO HAVE HEALTHY WEIGHT
  • U.S. Facts “Despite the recent push to improve our diet and get us exercising (thanks, Michelle Obama), national obesity rates haven’t budged much over the past few years, the latest government statistics show.” – Time Magazine In 2008, medical costs associated with with obesity were estimated at $147 billion Overweight and obesity-conditions that affect an estimated 97 million Americans are the second leading cause of preventable death in the U.S. Obesity Rates Continue to Climb
  • Obesity Rates Continue to Climb 27.00% 28.00% 29.00% 30.00% 31.00% 32.00% 33.00% 34.00% 35.00% 36.00% 37.00% 2000 2008 2010 Obesity Rates Obesity Rates 30.5% 33.7% 35.7% Journal of American Medical Association Increase of 5.7% from 2000 to 2010 in the United States Obesity is defined by exceeding the BMI of 30kg/m2
  • Dieting is the Most Common Method Used to Lose Weight 55% of the total adult population, nearly 116 million adults are dieting at any given time. Roughly 25 million men and 43 million women are dieting to lose weight. Another 21 million men and 26 million women are dieting to maintain weight. 91% of women surveyed on a college campus in the mid- 90s had attempted to control their weight through dieting.
  • Long-term Failure of Weight Loss Dieting Source: Long-term weight-loss maintenance: a meta-analysis of US studies 1,2,3 James W Anderson, Elizabeth C Konz, Robert C Frederich, and Constance L Wood © 2001 American Society for Clinical Nutrition Meta-analysis reviewed 29 research reports of long- term weight loss maintenance after a structured weight loss program involving various diets. Results: 3.2 % sustained weight loss maintenance, averaging 3.0 kg, 5 years later.
  • Bariatric Surgery Used in Most Severe Cases Does Not Work Long Term “Bariatric surgery holds considerable promise for initiating weight loss in extreme obesity. Yet, potential long- term benefits may not be fully realized without sustained lifestyle amelioration”. American Journal of Lifestyle Medicine Maintaining Weight Loss Momentum after Bariatric Surgery
  • Why this Failure of Calorie Restriction and Public Education? Obesity and overweight is treated as a simple metabolic problem. Obesity is a complex bio-psychosocial phenomenon involving the adaptation of our brain to our modern environment: high food availability and palatability, which hijacks the brain reward system, and reorganizes the brain around addiction rather than around a homeostatic function.
  • The Hijacking of the Brain Reward Centers by the Food Industry Obesity is the result of a maladaptive eating behavior as a response to this environment The modern environment exerts an unprecedented pressure-manipulation on people’s mind to transform their feeding behaviors
  • Models of Energy Balance and Motivation to Eat Restrictive Pre-industrial Model Modern Industrial Model Reprinted by permission from Macmillan Publishers Ltd: International Journal of Obesity, Vol. 33, S8 – S13 ( June 2009)
  • The Problem Today: low energy requirements abundance versus scarcity high reward for extremely palatable foods The system has evolved to guarantee survival in a nutrient scarce environment And has rewarded the eating of fatty sugary food with pleasure
  • Food in the RestrictiveNatural Pre-industrial Environment
  • Food in the Abundant Artificial Modern Environment
  • Today the environment has created a shift from the homeostatic feeding behavior, to the hedonistic feeding behavior.
  • Hunger and Satiety: A Homeostatic Mechanism  Hunger is the body's way of making sure it is provided with energy, in the form of nutrients from food  It involves the hypothalamus and the reward system of the brain (nucleus accumbens, ventral tegmental area) and prefrontal cortex  The eating behavior is initiated by internal physiological stimuli translated as hunger  The eating behavior is terminated by a psychophysiological signal of satiety and pleasure  Those signals involve a large variety of chemical messengers connecting with the anatomical structures
  • Stomach Hunger: Homeostatic Regulation Brain Cortical and Sub Cortical Centers
  • Hunger and Satiety: a Homeostatic Mechanism Stimulate Feeding Decrease Energy Expenditure Inhibit Feeding Increase Energy Expenditure The Key Chemicals Players as we Know Them Today Anandamide β -Endorphine Dynorphin GABA
Galanin Ghrelin
GHRH Neuropeptide Y Norepinephrine Calcitonin Amylin Bombesin Somatostatin Cytokines Cholecystokinin CRF, TRH, MSH Dopamine Insulin Leptin Neurotensin Serotonin
Glucagon Enterostatin
  • Stomach Hunger Homeostatic Regulation by Dopamine in the Hypothalamus
  • Brain Sites where Opioid Agonists or Antagonists Modulate Food Intake Le Merrer J et al. Physiol Rev 2009;89:1379-1412 ©2009 by American Physiological Society The Reward System of the Brain
  • Hunger and Satiety: A Homeostatic Mechanism Hunger and satiety cycle about a 6 hour period Secretion of opioids signal pleasure Decreased dopamine secretion signal satiety Adipocytes secrete leptin Eating behavior follows with increase of blood sugar, insulin and nutrients in the blood Increased dopamine secretion perceived as hunger, motivation to eat or appetite Increased levels of ghrelin, the hunger hormone, increases dopamine secretion Low nutrients, low insulin and low blood sugar, stimulate increase and secretion of ghrelin from the fundus of the stomach and neuropeptide Y from the small intestine Dopamine inspires the motivation to eat when hunger hormones signal the need for energy The hypothalamus is the center of hunger and satiety Hunger and Satiety Hormones
  • The Hijacking of the Brain by the Food Industry:Stomach Hunger and Brain Hunger This homeostatic mechanism is normally primed by: HUNGER [hunger: the mental translation of a physiological state of need for food to create energy] This homeostatic mechanism can also be primed independently of hunger by external cues such as: SMELLS SIGHTS STRESSORS It can also be primed by internal mental cues: MEMORIES OF PAST PLEASURABLE EXPERIENCES BOREDOM OR SADNESS EXTERNAL CUES / INTERNAL EMOTIONAL STATES CAN OVERRIDE HUNGER
  • Brain Hunger: Cravings and the Reward System A craving is a strong desire to eat certain foods without hunger. This is possible because the brain has evolved to prefer fatty sugary food that have a high value for survival. Our brain gives these foods attention, desires them and wants them. On the contrary aversive stimuli (poisons) are also attended but as a result avoided and unwanted. Fatty and sugary substances release opioid like chemicals and create a pleasurable feeling.
  • Dopamine and Food Cravings Neurocognitive Model Derived from Franken (2003)
  • Brain Hunger: Cravings and the Chemical Players The Players of the Reward System are: DOPAMINE OPIOIDS Terminates the eating behavior Generates liking and pleasure The pleasurable experience is encoded in the brain Initiates the eating behavior Motivation to eat Wanting food Glutamate
  • Brain Hunger: Sensitization and Addiction  Sensitization refers to intensification of a behavior (eating) upon repeated exposure to a stimulus (specific food).  The urge to take the drug (specific food) becomes so powerful that it gains control over and suppresses voluntary behavior.  “Addiction is the continued use of a mood altering substance or behavior despite adverse consequences”. The Medical Dictionary
  • Cravings, Sensitization and the Brain Reward System Stimulus Fatty, Sugary Foods Sight and Smell Cravings Eat Liking Hedonic Response Pleasure Memory Created Sensitization ↑ Opioids POMC (1) Repeating Behavior ↑ Dopamine Pathways Reinforcement (1) Pro-opiomelano cortin (POMC) Desire To Eat
  • The Creation of a Pavlovian Conditioned Reflex Cravings require a prior exposure Presentation, mental representation or an associated stimulus can trigger cravings or desire for the specific food Presentation or mental representation stimulate the encoded memory The more often the pleasurable experience is repeated, the stronger the pathways and the more compulsive the behavior: sensitization Associate stimuli can trigger cravings
  • Features of an Addiction: Triggers Sight, smell, texture or food imagery • Initial release of dopamine, desire to eat, anticipation of pleasure • Salivary glands respond with salivation Stress in response to danger used to mean energy was burned up. Stress primes the hunger pathways Boredom, sadness or anger most common negative feelings
  • Features of an Addiction: Psychological and Behavioral Psychological dependence: Need Emotional eating Compulsive eating Loss of control Binge eating Overeating Dieting Withdrawal symptoms in the absence of the substance Relapsing
  • Features of an Addiction: Psychological and Behavioral Psychological dependence: Need Emotional eating Compulsive eating Loss of Control Binge eating Overeating Dieting Withdrawal symptoms in the absence of the substance Relapsing
  • Stagesof Addiction: Cravings,Withdrawal, Relapse From Tzschentke, T.M. & Schmidt, W.J., Glutamatergic Mechanisms in Addiction Molecular Psychiatry (2003) 8, 373–382. doi:10.1038/sj.mp.4001269
  • Features of an Addiction: Obsession No reinforcement of other rewarding behavior: dancing, singing, sex, running may not be available. “Addiction is far more than seeking pleasure by choice. Nor is it just the unwillingness to avoid withdrawal symptoms. It is a hijacking of the brain circuitry that controls behavior, so that the addict’s behavior is fully directed to drug seeking and use.” "Now we're not just talking about energy balance," says Gene-Jack Wang, head of medicine at Brookhaven National Laboratory in Upton, New York. "We're talking about human psychology."
  • Evidence of Food Addiction in Obesity Citations Among obese persons, Spitzer et al. (1993) found prevalence rates of Binge eating disorder (BED) of about 30% for those in weight control programs, and 5% for those in community samples. “The data are so overwhelming, the field has to accept it”, says Nora Wolkow Director at The National Institute on Drug Abuse. “Drugs have addictive properties because they tap into appetite's pleasure network. Food, you might say, is the original addiction.” On www.beyondchange-obesity.com, Cynthia Buffington, Ph.D., reports that studies by bariatric psychologists found that “nearly 80 percent of gastric bypass pre-surgical patients suffer from food addiction.” She adds, “Our collaborative studies found that more than 90 percent of pre-surgical morbidly obese patients use avoidance stress coping behavior to handle emotions, seeking comfort from negative feelings and stressful situations through the use and, sometimes, abuse of food.”
  • Evidence of Food Addiction: Human Neuro-Imaging Studies Fatty Foods as Addictive as cocaine, in growing body of science Pictures of Milkshakes lit up the same brain regions on MRI as in alcoholics anticipating a drink In 2004, Mark Gold, professor of psychiatry and neuroscience at the University of Florida compiled a series of articles on overeating and eating disorders and noted “neuro-imaging studies have supported the hypothesis that loss of control over eating and obesity produced changes in the brain which are similar to those produced by drugs of abuse.”
  • Evidence of Food Addiction: Sugar and Fat Digestion Produces Opioids as in Cocaine and Heroin Colantuoni et al (2002) analyzed over a hundred peer reviewed articles, each of which showed that humans produce opioids – the chemically active ingredient in heroin, cocaine and other narcotics – as a derivative of the digestion of excess sugars and fats. Several studies by professors of psychology at the University of Washington, Princeton University, the University of Los Andes (Merida, Venezuela), the Yale University School of Medicine and the National Institute on Drug Abuse have shown that the excess intake of sugar can produce what is called endogenous opioid dependency. Sugar can create a mild addictive reaction as it is digested, and this can affect a person’s brain chemistry in the same way that alcohol and other addictive drugs do. Opioids are a key chemical compound in this reaction, and in many of the most powerful addictive drugs, such as cocaine, morphine and heroin. In 2007 French experiments showed that rats prefer water sweetened with sugar or saccharine to hits of cocaine. Bordeaux National Research Council. Rat and Human Studies on the Addictive Properties of Fatty Foods and Sugar
  • Evidence of Food Addiction: Fatty Foods and High Fructose Corn Syrup  28 scientific studies and papers on food addiction have been publishes this year, according to the National Library of Medicine databases showing the evidence of the addictive property of fatty foods, high fructose corn syrup.  Coca-cola Co.(KO), PepsiCo, Northfield, Krafts and Kellogg Co, Battle Creek MI, declined to grant interview with their scientists notes Times magazine.
  • Evidenceof FoodAddiction:InducedBinge Eating ofSugar in Rats: Dopamineand OpioidsResponse “Rats maintained on a diet schedule that induces binge eating of sugar can result in several behaviors and changes in the dopamine and opioid brain systems that resemble an addiction. “ Series Food and Addiction: Environmental, Psychological and Biological Perspectives (5/2010) Bart Hoebel's studies of rat junkies show that every drop of sugar syrup they swallow causes a surge in their dopamine levels—a benchmark of desire and a biochemical marker of substance abuse.
  • Withdrawal Symptoms from Sugar Addiction: Nicole Avena’s Rats Show Anxiety, Shakes and Tremors Nicole Avena Neuroscientist at the university of Florida, just published a study on rats and sugar: “The animals show withdrawal symptoms including anxiety, shakes and tremors when the effect of the sugar was blocked with a drug. Scientists were able to determine changes in the levels of dopamine in the brain similar to those seen in animals on addictive drugs”.
  • The Making of Fat: Neil Bernard, M.D., in his book Breaking the Food Seduction: The Hidden Reasons Behind Food Cravings—and 7 Steps to End Them Naturally, summarizes the scientific research demonstrating that there are selective foods which break down into addictive ingredients and do the same thing to a person’s brain as cocaine does. DOES THE SAME THING TO A PERSON’S BRAIN AS COCAINE DOES Various other chemical preservatives found in processed junk food Refined salt Hydrogenated oils Monosodium glutamate (MSG) High-fructose corn syrup (HFCS) Addictive Properties of Certain Foods
  • The Making of Fat Highly stimulating processed foods play into the brain preferences for concentrated food. Low nutrients in processed foods do not stimulate adequate amount of leptin the satiety hormone, unless large quantities are ingested. “Snack food” is designed to make us fat—by giving our taste buds a supernormal stimulus, while withholding the nutrition that has always gone along with that stimulus in evolutionary time.
  • Addiction Reorganizes the Brain Brain imaging evidence shows that the brain’s “cortex changes with overeating and obesity so that the mouth and tongue increase in geographical area,” Gold Thoughts, desires, cues, feelings trigger the hunger pathways independently, creating learnt pathological reward pathways With every use, the enabling circuits become stronger and more compelling creating an addiction Reversing food addiction is not just a matter of giving up something pleasurable the obese person has undergone a reorganization of the brain. Treating obesity requires dealing with every aspect of this reorganization.
  • Addiction Reorganizes the Brain: Rational versus Irrational, Cortical versus Subcortical  When the obsessive or addictive thought occurs, obsessive or addictive action follows.  The prefrontal area is weaker than subcortical systems or,  Subcortical systems are stronger than prefrontal area  The experience of cravings is irrational and there is a deficit of prefrontal inhibitory control over subcortical systems that mediate incentive appetite responses and automated unconscious response.
  • How do we Heal the Addicted Brain? Physical level Nutrition Whole Food Diet Not Calorie Restriction Sleep 8 Hours per Night Exercise Start Small
  • Nutrition Weight-loss dieting, by definition, requires lowering food intake below the amount the body needs to maintain its present form. So, in a valiant attempt to regain homeostasis, the dieter's stomach-hunger system lowers levels of the satiety signals leptin and insulin and pumps the hunger hormone ghrelin into the bloodstream. Any kind of weight loss diet sets you up for biochemical warfare with stomach hunger. The body does not know when it is overweight it only knows when it is in jeopardy of losing weight. Whole Food Diet rather than Calorie Restriction
  • Nutrition, Sleep and Exercise Nutritious organic raw foods for the brain Supplemental neurotransmitter precursors with cofactors Healthy fats, essential fatty acids Eliminate stimulants such as coffee, sugar and chocolate
  • How Do We Heal the Addicted Brain?  Creating New Pathways  Education and psychotherapy  Stimulate and support motivation for change
  • Education: How to Overcome the Power of the Addicted Brain Why will power does not work The brain and the palate Properties of addictive foods How dieting sets them up for bingeing How to prepare food and shop Alternatives to food for pleasure Avoidance of triggers
  • Psychotherapy Themes: Explore compulsive overeating, secret eating, emotional eating, binge eating, obsessive food thinking, loss of control Develop alternatives to overeating to cope with difficult emotions when people use foods to medicate feelings Explore alternative sources of pleasure: Exercise, sex, art, friendships Develop appreciation for life in general
  • Psychotherapy Methods: Cognitive Behavioral Therapy Cognitive Behavioral Therapy has shown good results when combined with a dietary approach Hypnosis Research shows that hypnosis is efficacious. Benefits of hypnosis increase over time. Journal of Consulting and Clinical Psychology (1996).
  • Psychotherapy Methods: Hypnosis Works by Itself A study of 60 females who were at least 20% overweight and not involved in other treatment showed hypnosis is an effective way to lose weight. Hypnosis can more than double the effects of traditional weight loss approaches. An analysis of five weight loss studies. University of Connecticut, Journal of Consulting and Clinical Psychology in 1996 (Vol. 64, No. 3, pgs 517- 519).
  • Combination of Methods Show Better Results than One Method Only  Studies show that diet together with psychotherapy methods increases the success of weight loss programs.  Hypnotherapy group with stress reduction achieved significantly more weight loss than treatment with dietary advice only or one form of hypnotherapy only.  Randomized, controlled, parallel study of two forms of hypnotherapy (directed at stress reduction or energy intake reduction), vs dietary advice alone in 60 obese patients with obstructive sleep apnea on nasal continuous positive airway pressure treatment. Journal of Consulting and Clinical Psychology (1986) J Stradling, D Roberts, A Wilson and F Lovelock, Chest Unit, Churchill Hospital, Oxford, OX3 7LJ, UK.
  • Motivate: Motivational Interview  Miller and Rollnick (1991) developed this method to be applied to the field of addictions.  The motivational interview empowers patients to change their behavior by presenting the discrepancies between their current behaviors and their larger life goals.  This technique forces patients to identify reasons for change on their own and can be a powerful motivator for those who are ambivalent.
  • Motivate:Support the Desire for Change Know what stage the patient is at Group: Overeaters Anonymous Be an inspiring model Eliminate social network which support the addiction
  • Psychology of Change: The Trans-Theoretical Model of Change Move from contemplation to action. Know where your patient is on the stages of change. This model involves five stages through which a person will pass on the way to eliminating a behavior. Prochaska and DiClemente (1992). The trans-theoretical model of change.
  • The5stagesofChanges:ProchaskaandDiClemente (212L.Joranbyetal.) First stage Pre-contemplation The person does not recognize the behavior as a problem Second stage Contemplation The person can recognize the behavior but maintains ambivalence about changing Third stage Preparation stage The person wants to change the behavior but is unsure of how to go about change Fourth stage Action stage Now actual change takes place Fifth stage Maintenance stage Focuses on maintaining the new behaviors and avoiding regression into the old behaviors
  • What is Mindfulness? Mindfulness is a state of heightened awareness. It is comes from the Buddhist tradition of meditation. Mindfulness has been defined as “bringing one’s complete attention to the present experience on a moment-to-moment basis” (Marlatt & Kristeller, 1999, p. 68). Mindfulness brings about separation of the observer (the witness) from the contents of awareness (thoughts). Mindfulness allows the meditator to monitor her/his thoughts as they arise in the present time, rather than be victimized by them.
  • Why Mindful Awareness?  The addicted brain cannot cure itself.  Fighting the unconscious with will power gives more energy to unconscious patterns.  It is a self-reliant method and can be used in daily life when the addicted behavior is triggered.  Cravings are automatic, pre attentive involuntary emotional impulsive and irrational with a sub cortical base and avoidance would be aware attentive voluntary cognitive, planned and rational (control) with a cortical base.
  • Mindfulness and Addiction Promotes understanding and compassion rather than judgment and conflict with the addicted self. It allows the unconscious patterns to emerge to the conscious mind. It provides the opportunity for the rational mind to evaluate thoughts and dis-identify from them. It can create a window where the witness has the power to make a conscious decision. It has been used efficiently to break the cycle of addiction and compulsive behavior.
  • Mindfulness and Addiction  Mindfulness does not reinforce the addiction pathways.  Gives the opportunity to fully experience the desire as it arises and release it.  Brings dis-identification with the desire to binge or eat compulsively.  Allows the opportunity to commit to higher values.
  • Mindfulness and Addiction: Bring awareness when the desire arises Pause (Find a place to sit) Breathe Witness, or be mindful of the thoughts (can write them) Go through the Advantages of not acting on the cravings Connect with higher self and reconnect with determination and decision to quit DO NOT ACT (last stage of change) Indulge consciously or Choose an alternative (first stage of change) How to use mindful awareness to break the automatic subcortical response to cravings. Dr. Baylac’s method.
  • Diagram: Mindful Awareness and Cravings Wants Desires Cravings Fatty Sugary Foods Conscious Avoidance Conscious Awareness Mindful Contemplation Unconscious Automatic Response Compulsive Eating Binge Eating Alternative Choices Abstinence Level 1 Level 2
  • Four Steps Conscious Attention by Dr. Schwartz for OCD Brain lock: stuck neurological gear that causes thoughts to be acted out before the action can be stopped. 4 step self-treatment method of conscious attention to transform the automatic mind and its physiological substrates in the brain in the treatment of OCD, UCLA school of medicine. Dr. Jeffrey Schwartz. 5 steps self-treatment by Dr. Gabor Mate, adapted from Dr. Schwartz OCD treatment to behavioral and substance addiction (5th step added).
  • Five Step Mindfulness Method for Addictive Behavior Step 1 Relabel: “False belief” rather than “Need”. I do not need to have a piece of chocolate right now. Step 2 Reattribute: Blame the brain “This is my brain sending me a false message” Step 3 Refocus: Buy time knowing that the desire is impermanent. Find something else pleasurable to do. Step 4 Revalue: What this addictive urge has done for me, my friends, husband children Step 5 Recreate: My Life has been created by automatic mechanisms, it is now time for me to create my life. Excerpts from “In the Realm of Hungry Ghosts” North Atlantic Books Berkeley, CA
  • Mindfulness in Psychology  Mindfulness Based Stress Reduction (MBSR). It was developed in a behavioral medicine setting for populations with a wide range of chronic pain and stress-related disorders.  Dialectical Behavioral Therapy (reconciles acceptance and need for change), 20 weekly sessions and has been applied in both group and individual formats (Safer, TeIch, & Agras, 2000; 2001; TeIch, Agras, & Linehan, 2000; 2001).  Mindfulness Based Cognitive therapy, 8-week group intervention for depression based largely on Kabat-Zinn’s (1990) MBSR program.
  • Research on Mindfulness and Binge Eating Disorder Pilot research involving 18 obese women, (1999). Findings: Reduced bingeing episodes and symptoms of anxiety and depression. Increased self-acceptance and self-control around food. Kristeller and Quillian-Wolever are now replicating the pilot study with about 150 men and women with binge- eating disorder and who weigh on average 240 pounds. Dr. Kristeller and Killan-Wolever
  • How to Cultivate Mindfulness  Conscious eating  Conscious walking  Sitting meditation
  • Lifestyle Change Model for Physical and Mental Health awareness mental emotional physical Nutrition & Exercise Psychotherapy Philosophy Meditation Liberate Educate Motivate Behavioral Changes
  • Depression and Suicide:  Depression is the most common cause of suicide.  90% of people who die by suicide suffer from clinical depression.  Suicide is the 10th leading cause of death in the US (2009).
  • Trends in Depression Clinical depression or Major Depressive Disorder as defined by the DSM 4 1 out of 10 people suffer from depression in the US and 1 out of 20 in the world Depression affects more women than men and the number of depression has almost double from 1999 to 2009
  • Trends in Depression 0 2 4 6 8 10 12 14 16 18 20 Total Men Women 1999 2009 10.1 17.6 2.8 5.1 7.3 12.5 Number of adults (in millions) treated for depression Number of Treated Cases for Depression Among Adults Age 18 and older, by sex, 1999 and 2009 Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 1999 and 2009. MEPS. Statistical Brief #377
  • Depression and Psychiatry Depressed people seek help from a general practitioner rather than a psychiatrist In the month prior to committing suicide, 50% of patients saw a primary care physician, while only 20% saw a mental health professional. (Luoma JB et al. Contact with mental health and primary care providers before suicide: a review of the evidence. Am J Psych. 2002; 159:909-916)
  • Depression and Psychiatry: Psychotropic Drugs Studies have shown that psychotropic drugs work only 50% of the time, only slightly better than placebo. Many patients have tried psychotropic medications and have personally experienced no benefit, and instead, only experience side effects. “Psychotropic medications are known to have adverse effects. They cause weight gain, metabolic syndrome and Type 2 Diabetes in children and in adults. Studies have shown that patients taking SSRIs have an increased incidence of GI bleeding, cardiac arrhythmias, and bone loss; similar to the bone loss seen with glucocorticoids”. (Katherine Falk, M.D. Integrative Psychiatrist, ACAM conference 2013)
  • Alternative Psychiatric Intervention: Physical Level Sleep Rest Exercise (boost mood better than anti depressants, accordi ng to studies) Whole Food Nutrition Supplementation • Vitamins, minerals, amino acids, herbs, home opathy, antioxidan ts, and fatty acids Treat primary illness or other medical issues
  • Alternative Psychiatric Interventions: Emotional Level Psychotherapy has been abandoned by psychiatry for psychotropic drugs. Psychotherapy and personal contact instead of psychotropic medications. • Cognitive behavioral therapy • Reichian Breathwork • Dialectical Behavioral Therapy • Group therapy
  • AlternativePsychiatric Interventions: Emotional Level, Causes of Depression  Listen  Deal with major illness  Drug use, alcohol, coffee, tobacco  Medications side effects  Major Life Events, losses  Deal with past physical, emotional, or sexual abuse, PTSD  Obsessive negative thinking  Relationships  Social network, isolation, loneliness  Connect with nature
  • AlternativePsychiatric Interventions: Motivate:Promote Positive Thinking Motivational interview Review belief system: The Work of Byron Katie Conscious decision to live and be happy Create Purpose Find Meaning Promote self reliance Resolution and detachment from the past Life in the present
  • Alternative Psychiatric Interventions: Educate Academic education “The art of happiness” by the Dalai Lama The brain and its preferred pathways The purpose of misery The fear to be free Seriousness and happiness Spontaneity acceptance and trust
  • Alternative Psychiatric Interventions: Liberate Practice all day long as needed Witness negative ideation Make the choice to live Make the choice to be happy Meditation not Medication: Conscious Awareness
  • Alternative Psychiatric Interventions: Liberate • The meditator does not state I am depressed but I observe negative or suicidal thinking Dis-identification with the symptoms of depression: negative feelings and emotions • to change his focus on positive thoughts of gratitudeThe observer has the choice • to talk himself rationally out of his negative thinkingThe observer has the choice • can develop tolerance, compassion for himself or others and non-judgmental attitudes The observer The Benefits of Conscious Awareness and Mindfulness
  • Naturopathic Doctor Tools: LOC and Groups Listen Observe Compassion Develop Team Treatment Work Refer Patient to Support Groups
  • For More Information Maya Nicole Baylac N.D. Hawaii Naturopathic Retreat Center, Inc. www.HawaiiNaturopathicRetreat.com www.RawDetox.org www.MindYourBody.info contact2013@hawaiinaturopathicretreat.com 1-808-933-4400 (U.S.) 239 Haili St. Hilo, HI 96720