1. 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!

2. Lifestyle Change Model for
Physical and Mental Health
awareness
mental
emotional
physical
Nutrition &
Exercise
Psychotherapy
Philosophy
Meditation Liberate
Educate
Motivate
Behavioral
Changes

3. 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)

4. 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

5. 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

6. 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

7. 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.

8. HOWEASYISITTOMAKETHESELIFESTYLECHANGES?
NORMAL WEIGHT
NORMAL CHOLESTEROL
NORMAL BLOOD
PRESSURE
NORMAL BLOOD
SUGAR
Stop
Smoking
Start
Exercising
Eat a
Healthy
Diet

9. 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

10. 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

11. 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

12. 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.

13. 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.

14. 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

15. 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.

16. 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

17. 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)

18. 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

19. Food in the RestrictiveNatural
Pre-industrial Environment

20. Food in the Abundant Artificial
Modern Environment

21. Today the environment has
created a shift from the
homeostatic feeding
behavior, to the hedonistic
feeding behavior.

22. 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

23. Stomach Hunger:
Homeostatic Regulation
Brain Cortical and Sub Cortical Centers

24. 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

25. Stomach Hunger Homeostatic Regulation by
Dopamine in the Hypothalamus

26. 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

27. 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

28. 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

29. 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.

30. Dopamine and Food Cravings
Neurocognitive Model Derived from Franken (2003)

31. 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

32. 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

33. 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

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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."

40. 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.”

41. 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.”

42. 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

43. 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.

44. 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.

45. 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”.

46. 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

47. 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.

48. 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.

49. 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.

50. How do we Heal the Addicted Brain?
Physical level
Nutrition
Whole Food Diet
Not Calorie
Restriction
Sleep
8 Hours per
Night
Exercise
Start Small

51. 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

52. 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

53. How Do We Heal the Addicted Brain?
 Creating New Pathways
 Education and psychotherapy
 Stimulate and support motivation for
change

54. 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

55. 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

56. 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).

57. 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).

58. 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.

59. 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.

60. 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

61. 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.

62. 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

63. Liberate:
MINDFUL AWARENESS

64. 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.

65. 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.

66. 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.

67. 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.

68. 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.

69. 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

70. 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).

71. 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

72. 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.

73. 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

74. How to Cultivate Mindfulness
 Conscious eating
 Conscious walking
 Sitting meditation

75. Lifestyle Change Model for
Physical and Mental Health
awareness
mental
emotional
physical
Nutrition &
Exercise
Psychotherapy
Philosophy
Meditation Liberate
Educate
Motivate
Behavioral
Changes

76. 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).

77. 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

78. 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

79. 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)

80. 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)

81. 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

82. 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

83. 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

84. 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

85. 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

86. 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

87. 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

88. Naturopathic Doctor Tools:
LOC and Groups
Listen
Observe
Compassion
Develop Team
Treatment
Work
Refer Patient
to Support
Groups

89. 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