Beruflich Dokumente
Kultur Dokumente
5 Core Skill-Sets to
Overcome Overeating
Pavel Somov, Ph.D.
07/09
Copyright © 2009
PESI, LLC
PO Box 1000
3839 White Ave.
Eau Claire, Wisconsin 54702
PESI strives to obtain knowledgeable authors and faculty for its publications
and seminars. The clinical recommendations contained herein are the result
of extensive author research and review. Obviously, any recommendations for
patient care must be held up against individual circumstances at hand. To the
best of our knowledge any recommendations included by the author or faculty
reflect currently accepted practice. However, these recommendations cannot
be considered universal and complete. The authors and publisher repudiate
any responsibility for unfavorable effects that result from information, recom-
mendations, undetected omissions or errors. Professionals using this publica-
tion should research other original sources of authority as well.
07/09
MATERIALS PROVIDED BY
As part of his private practice he has been involved with gastric bypass
pre-operative psychological evaluations. Dr. Somov has peer-reviewed
publications in the area of Logotherapy, Psychodrama, Substance Use,
Pain Psychology and Hospice Outcome research.
CONTINUING EDUCATION INFORMATION FOR ATTENDANCE AT LIVE SEMINAR
360 Degrees of Mindful Eating: 5 Core Skill-Sets to Overcome Overeating
Note to All Attendees: Listed below are the continuing education credit(s) for today's teleseminar. Be sure to:
Step 1 Read the applicable licensing announcement and follow all procedures. This will assure proper verification of your attendance
and your credits.
Step 2 Certificates of Successful Completion will be emailed/faxed within 30 days of the event. PESI, LLC provides a certificate
listing course accreditation(s). PESI, LLC charges a $10.00 replacement fee for duplicate certificates requested after
the original certificate has been sent.
COUNSELORS:
PESI, LLC is recognized by the National Board for Certified Counselors to offer continuing education for National Certified Counselors. Provider #:
5896. We adhere to NBCC Continuing Education Guidelines. This course qualifies for 1.5 contact hours.
Procedures: 1. Counselors – sign attendance lists.
2. Counselors – a certificate of successful completion will be faxed/emailed within 30 days of the event.
SOCIAL WORKERS:
PESI, LLC, 1030, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB), (1-800-225-
6880) through the Approved Continuing Education (ACE) program. PESI maintains responsibility for the program. Licensed Social Workers should
contact their individual state boards to review continuing education requirements for licensure renewal. Social Workers will receive 1.5 continuing
education clock hours for participating in this event
Procedures: 1. Counselors – sign attendance lists.
2. Counselors – a certificate of successful completion will be faxed/emailed within 30 days of the event.
PSYCHOLOGISTS:
PESI, LLC is approved by the American Psychological Association to sponsor continuing education for psychologists. PESI, LLC maintains responsibility
for this program and its content. PESI is offering this activity for 1.5 hours of continuing education credit. Full attendance is required. No partial credit
will be offered for partial attendance.
Procedures: 1. Psychologists – please sign the attendance lists.
2. Psychologists – documentation of attendance will be faxed/emailed within 30 days of the event.
ADDICTION COUNSELORS:
PESI, LLC is a Provider approved by NAADAC Approved Education Provider Program. Provider #: 366. This course qualifies for 1.5 contact
hours. Full attendance is required. Partial credit will not be issued for partial attendance.
Procedures: 1. Addiction Counselors – sign attendance lists.
2. Addiction Counselors – a certificate of successful completion will be faxed/emailed within 30 days of the event.
NURSES/NURSE PRACTITIONERS/CLINICAL NURSE SPECIALISTS:
PESI, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on
Accreditation.Nurses in full attendance will earn 1.5 contact hours. No partial contact hours will be issued for partial attendance.
Refer to Iowa Nurses for Procedures.
IOWA NURSES:
PESI, LLC, is an approved provider by the Iowa Board of Nursing. Provider #: 346. Full Attendance at this course qualifies for 1.5 contact hours.
Full attendance is required. No partial contact hours will be issued for partial attendance.
Procedures: 1. Nurses – Sign attendance lists. Complete post-test/evaluation form (may be completed anonymously) and return it to
PESI, LLC at end of event or you may submit it directly to the Iowa Board of Nursing, 400 SW 8th Street, Ste B, Des
Moines, IA 50309-4685.
2. Nurses - Certificates of Successful Completion will be faxed/emailed within 30 days of the event for those who attend the
entire seminar. Partial contact hours WILL NOT be awarded for partial attendance.
3. It is recommended that nurses contact their individual state boards to review continuing education requirements for
licensure renewal. PESI, LLC does not submit attendance records to your state licensing board.
**Out-of-State Nursing Licenses: If you are licensed in another state, it is permissible to receive more than one certificate.
CALIFORNIA NURSES:
PESI, LLC is a provider approved by the California Board of Registered Nursing, Provider Number 6538 for 1.5 contact hours. Full attendance is
required to receive a certificate of completion. This certificate must be retained by the licensee for a period of four years from the course date.
Procedures: 1. Sign attendance list and provide license type and number at time of registration.
2. Complete post-test/evaluation form and fax to PESI, LLC at end of event.
3. Certificate of completion will be faxed/emailed within 30 days of the event.
CALIFORNIA SOCIAL WORKERS/MARRIAGE & FAMILY THERAPISTS:
PESI, LLC is an approved provider with the State of California, Board of Behavioral Sciences. Provider approval #: 1745. This course meets the
qualifications for 1.5 hours of continuing education credit for MFCCs and/or LCSWs as required by the California Board of Behavioral Sciences.
Procedures: 1. Sign attendance list and provide license type and number at time of registration.
2. Complete post-test/evaluation form and return it to PESI, LLC at end of event.
3. Certificate of completion will be faxed/emailed within 30 days of the event. The certificate will include your name and
license number.
REGISTERED DIETITIANS & DIETETIC TECHNICIANS, REGISTERED:
PESI, LLC, PE001, is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR) from
June 1, 2009 through May 31, 2012. Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 1.5 continuing professional
education units (CPEUs) for completion of this program/materials. Continuing Professional Education Provider Accreditation does not constitute
endorsement by CDR of a provider, program, or materials. This program/material is designated as LEVEL 2.
Procedures: 1. Registered Dietitians & Dietetic Technicians, registered - sign attendance list.
2. Registered Dietitians & Dietetic Technicians - certificates of successful completion will be faxed/emailed within 30 days of the
event.
Section 1/7
Introduction: Broadening the Definition of Mindful Eating
• Defining overeating
• History of mindful eating
• Contributions of Buddhist psychology to
managing eating behavior
• Beyond the “raisin meditation”
UNLESS YOU’
YOU’RE EATING TO SATISFY BODY NEEDS, YOU’
YOU’RE OVEREATING
OVEREATING IS ANY EATING THAT EXCEEDS THE NEEDS OF THE BODY
Pavel Somov, Ph.D.
copyright, 2009 www.eatingthemoment.com
Jon Kabat-Zinn (b.1944) is the founder the Center for Mindfulness in Medicine,
Healthcare and Society; author of Full Catastrophe of Living and Wherever
You Go, There You Are; introduced a mindful eating exercise, “raisin
meditation,” which appears to have kicked off contemporary mindful eating
self-help genre.
Pavel Somov, Ph.D.
copyright, 2009 www.eatingthemoment.com
4 Contributions of Buddhist Psychology to Mindful Eating
Ōryōki Meal: Process Focus and Fullness Recognition
Oryoki is a meditative form of eating that emphasizes mindfulness by
adhering to a precise order of eating movements, and stopping when
you are full; “oryoki” means “just enough.”
HARM
REDUCTION
APPROACH,
LEVERATING
GREATER
MINDFULNESS
DURING
EMOTIONAL DIFFERENTIATING
EATING, CRAVINGS FROM
REDUCING HUNGER
COPING
PERFECTIONISM
SOMATIC
PATTERN-DISRUPTION, MONITORING,
CONDITIONING AWARENESS, REDEFINING
MINDFULNESS OF FLAVOR, of FULLNESS
MOVEMENTS OF EATING,
ETC.
SATIETY INDEX EDUCATION,
NON-FOOD FOCUSED PREVENTING OVEREATING
CELEBRATORY EATING, THROUGH RESIDUAL SATIETY
SHIFTING FOCUS FROM SOCIAL
BINGE-EATING TO SAMPLING & PRE-LOADING ON LIQUIDS &
SAVORING SMELL
Section 2/7
Hunger Recognition Training
CRAVING ==
/ HUNGER
• Craving is a pseudo-hunger signal that mimics hunger.
Cravings prompt us to eat as if we were hungry, when we
actually aren't.
Shall you satisfy your craving? Make a conscious choice: eat or don't
eat. Note in your essay that you made a conscious choice to eat or
not eat but resist the temptation to specify which particular
choice you made. After all, the idea is not to track your
"abstinence resolve" but to help you differentiate your cravings
from hunger and to practice making conscious choices about
eating.
RELAXATION
METHOD
When you notice the first craving thought, tap your index
finger on your knee and re-focus on the up and down
movement of your chest.
The chances are your breath-focus (which is, in this case, the
relaxation element) will be disrupted by another craving
thought.
At that point, “just notice” the thought, “ground it away,” so TAP WHEN YOU
to say, by tapping the index finger on your knee, and NOTICE A CRAVING
immediately refocus on the “breath-space” in between the THOUGHT and
craving thoughts. REFOCUS ON
BREATH
Do this until there are no more craving thoughts to tap
away, until you comfortably rest in the “breath-space” of
calm mind. Pavel Somov, Ph.D.,
copyright, 2009, www.eatingthemoment.com
Section 4/7
Process-Focus Training
PROCESS FOCUS:
4 ASPECTS OF EATING TO NOTICE
PATTERN-DISTRUPTION EXERCISES
Put on wrist weights and try eating a few meals with them
on. Note a new-found appreciation for the previously
ignored precision of your eating movements. Note the
difference in your level of mindfulness.
L/R L/R
Eating with a Non-Dominant Hand
PATTERN-DISTRUPTION EXERCISE
Utensils are part of the ritual of eating. They cue our hands (and minds) to a certain
complex of motor behaviors. As such, a utensil is an ignition key to the
mindlessness of eating.
Utensil U-Turn
To this day some cultures employ their hands for eating instead of utensils. Whatever
your opinion of eating with your hands might be, at least try it. Eat a dish – say,
rice – with your hands. Get extra napkins. If eating in company, consider having a
central bowl for an additional degree of intimacy. Note the new choices you have
to make: should you pinch clusters of rice with your fingers and carry it over to
your mouth a pinch at a time or should you use one of your hands as a make-shift
bowl while you feed yourself from it? Appreciate this new interface of touch
between your body and the food, with the skin of your fingers suddenly becoming
a source of information about the heat and the texture of the food. Now, if you
are a hand-eater to begin with, I invite you to a similar “utensil U-turn.”
Experiment with using utensils.
• Continuum of fullness
• Fullness recognition exercises
• Redefining fullness: from stomach fullness to
mind-fulness
STRANGEREASONS
STRANGE REASONSWE
WESTOP
STOPEATING…
EATING
You stop eating because you ran out of the food you like
You stop eating because you ran out of time. Not out of food, not out of appetite,
but out of time. Back home after a long day at work, you stand in the kitchen
grazing and browsing the mail. Feeling guilty about putting your spouse on hold
while you “veg out,” you promise that you’ll be up in five minutes to say goodnight.
And now that the time is up, you gotta go.
You stop eating because the entertainment came to an end. The show you’ve been
“snacking to” has ended. With nothing fun to watch, you stop eating, because
“just eating” is boring.
You stop eating because you’ve been busted overeating by your partner. Now that
your nutritional “crime” has been witnessed, you stop, not out of fullness, but out
of shame. “I’ve had a long day, can you just get off my case, please?!” you protest,
slamming the pantry door.
Pavel Somov, Ph.D.
copyright, 2009 www.eatingthemoment.com
A Continuum of Fullness: Three Stopping Points
Assuming you were hungry in the first place, the following three
sensations happen after you begin eating.
• First, the sensation of hunger goes away. This is a moment of
HUNGER RELIEF.
RELIEF This happens almost too fast for us to have time to
enjoy a meal. If you stop eating at this point, then you no longer feel
the painful emptiness of hunger, but you also do not yet feel full.
• If you keep on eating, you will next experience a moment of
PLEASANT FULLNESS as the food distends the lining of your stomach,
but not so much as to cause pain.
• If you keep on eating, you will eventually experience a moment of
UNPLEASANT FULLNESS as the stomach distends to a painful degree.
Zip It (a “lo-
lo-fi biofeedback”
biofeedback” exercise)
To become more mindful of fullness, tune in to the gradual changes in your stomach
distention as you fill it up with food. Get a gallon-size Zip-Loc . This transparent
plastic bag will represent your stomach and will serve as a visual barometer of
what’s going on in your stomach.
Prepare double portions (one for you and one for the bag). As you eat, place equal
amounts of food into the Zip-Loc bag in front of you. Say you are eating a serving
of pasta. When you’ve finished the plate, dump the same amount of pasta into the
bag. Notice the plastic bag bulge and expand; notice your stomach bulge and
expand. As you chug down a glass of lemonade, pour a glass of lemonade into the
plastic bag. Notice the plastic bag bulge and expand; notice your stomach bulge
and expand. Having a slice of carrot cake? Dump a slice of cake into the bag.
Notice the plastic bag bulge and expand; notice your stomach bulge and expand.
To leverage more mindfulness of the gradual changes in your stomach distention,
“feed” the plastic bag one bite at a time – one for the mouth, one for the bag.
Notice the plastic bag bulge and expand; notice your stomach bulge and expand.
When done “feeding” the bag, see if you can zip it! Pavel Somov, Ph.D.
REDEFINING FULLNESS Pavel Somov, Ph.D.
copyright, 2009 www.eatingthemoment.com
Section 6/7
Mindful Emotional Eating Training
Sure, it’d be optimal to never have to cope with food. But in the
meantime, as you help clients work on the long-term goal of
food-free coping, help them rethink their habit of emotional
eating with compassion. Before they can give up emotional
eating altogether, help them learn to make better use of this
coping strategy, by becoming a more mindful emotional
eater.
Rituals
are
centering
The autonomic nervous system (ANS) of your body consists of the sympathetic
nervous system (SNS) which is activated during stress and prepares the body
for flight or fight, and of the parasympathetic nervous system (PNS) that is
responsible for conservation of energy and rest.
A choice to eat can be seen as an attempt to turn on the PNS. While eating has
been associated with increased in PNS activity (Uijtdehaage, Stern, and Koch,
1992), the mere act of mindless eating in and of itself is unlikely to turn on the
PNS when you are stressed. But mindful, conscious eating might: smell and
taste your food to assure maximally prompt activation of the parasympathetic
relaxation response.
2 CAMPS:
Abstinence vs. Harm Reduction
• Abstinence Camp: DO NOT EAT TO COPE
Then, identify how you feel and what you are trying to cope with. You might follow this by stating your
expectations of how you wish to feel after you eat. Then, consciously consider what you will eat and decide
on a “dose.”
Then, with mindfulness of the process of eating, eat the food. Take your time to savor and appreciate the
flavor of the food as well as the subtle changes in your state of mind and body. Use pattern-interruption
techniques (eating with non-dominant hand) to slow down and remain present.
Pause to check to if you have attained a desired emotional state; if not, proceed with another serving and
check again.
When you feel you have attained a desired state (whether you use psychological or somatic/physiological
markers for that), allow yourself the realization that you have once again been able to successfully self-
soothe with food. Congratulate yourself on another coping success.
Aha! Aha!
Aha!
EACH MEAL –
AN OPPORTUNITY TO AWAKEN THE EATING ZOMBIE
to a GLOBAL/WORLDVIEW-LEVEL AWARENESS
Hmm, everything’s
interconnected (a sense of
connection, belonging)
Aha!
INSIGHTS ACCUMULATE…
ACCUMULATE… PATTERNS CHANGE…
CHANGE… WE GET WELL…
WELL…
PAVEL SOMOV, PH.D., AUTHOR OF “EATING THE MOMENT” WWW.EATINGTHEMOMENT.COM COPYRIGHT 2009
360 Degrees of Mindful Eating: 5 Core Skill-Sets to Overcome Overeating
Program Objectives
Please use the objectives below to answer the online objective questions.
At the completion of this seminar, I have been able to achieve these seminar
objectives: