Saturday, August 3, 2013

Cognitive Medicine: Positive Thoughts & Scientific Certainty

Food Addiction is the often overlooked as a substance abuse issue, and logically so, how can one be addicted to something necessary to survive?  We tell ourselves we need more of it than we really do.  It’s simple though, we seek to find pleasure in consumption, and research shows that sweet, salty, and fatty foods activate the same sensors in your brain as drug and alcoholic addiction.  Some of us just don't need more than 1200 calories a day, our metabolic functioning is impaired, and our bodies just don't know what to do with the excess.  Our furnaces simmer at a lower fire than other people. We must develop the balance of positive thinking toward development of better cognition and design an action plan that works for us. What we need is a total eclipse of thought. Consume what we need, expend what we don’t, and find balance when we have over or under done things. For the last eleven months, I have purposefully rejected accountability to what went into my mouth at all times.  Yep, there, I said it.  I decided that I didn’t want to continue to live in the misery of thinking I had failed.  I went from loving food with limitlessness, to embracing my relationship with strict boundaries. 

13 years ago, when I had decided I needed to lose weight, I embraced a healthy, active lifestyle by getting a dog.  Hannah has been the reason I get up and walk every day.  Before age 21, I never really exercised.  In 2002, I participated in my first 10k race.  Walking it took me 2 hours and 15 minutes that first year.  Later on, I came in my best time at 1 hour and 40 minutes in 2010.  That was the best I had ever done.  It was also 1 ½ years after my Lapband was installed and before the band began to cause me extreme anxiety from the variable issues with tightness. I was eating like a dietitian, as I like to say.  My delusion was that I would run marathons, but honestly, lifelong obesity and recovery from obesity, is hard on the heart.  Extreme exercise after your body has been through so much stress can not be good for the heart.  I now advocate for strength training in the form of pilates, weight lifting, and HIIT (High Intensity Interval Training.)  

While in Austin from 2007 – 2008, I had really gotten exceptionally better at portion control and diligent logging and journaling about what caused me to eat poorly, how did I feel, process the bad episodes with intention, understand events and reactions that would make me cave to a moments that care forgot. Well, I see through it all now much more clearly in this relapse.  I realize that it is no longer an option to not be strict with myself.  I need to measure and account for what goes into my mouth at all times.  We all have different goals and needs in our personal journeys, unique motivational activations. We all process our relationships with food and others in a different light. I get that. I study it daily, and I clearly see my own faults in myself. 
I’m a solutions oriented counselor in my day job, I talk to people on the phone about their interest in medical and surgical weight loss programs I conduct a motivational interview where I question them with clarifying intention and solve a problem: give them an action plan. Some are easy, medical or surgical, this way or that way, here’s an event you should go to, let’s get you started.   However, weight is a sensitive subject, and sometimes I have had people break down on the phone with me.  I have people who suddenly, without notice, might have a false perception of context, and think I’m just a receptionist type person who is only answering the phone. 

I had an interesting conversation with someone who just suddenly after a few seconds of silence where I was entering information into the computer, accused me of passing judgment on her as being a crazy fat person, and I had to calmly reassure her that I was a trained counselor. I understood her and was not judging her. I promise, I’ll never think you are crazy, I will just try to figure out what is getting in your way and help you move it, mentally. I’m not thinking you’re crazy because you’re calling us for help. I’m not judging you.  I am not a doctor, but so while your medical problems are concerns and attributions to your mission, I can’t tell you what to take, not even for a headache. (With the exception of providing evidence based information from professional societies conducting non-biased research, I know a thinkg or two about the common knowledge of bariatric vitamin and nutrient deficiencies.)  All in all, I am a therapist with a lot of compassion and empathy for everyone’s struggle, and if I had all the time in the world, I would want to hear everyone’s story.    

As an obese child, I began ballet and tap lessons at 4.  Into adolescent and teenage years, I became so apathetic to this routine, and couldn’t find enjoyment in it.  The only exercise I every deliberately got was Wednesday ballet classes.  I hated them with a passion, as I was too obese to be graceful, and flexible enough to bend and contort myself in every which way.  Funny, Nanette means, “full of grace.”
My graces are my kind heart, intentional inquiry, studious knowledge, joyful heart, and counselor’s ear Not my ability to pleat across a church room studio with a bunch of skinny girls who felt sorry for me.  Because I know, the looks and stares didn’t really lie, and no matter how beautiful a people those girls are, at the time, in that moment, I perceived it to be that.  What you perception tells you is often what you will be.

We can’t let bullying and negative thoughts prohibit us from doing good things to take care of ourselves, ever. Therapy can be the medicine for good cognition. Processing the underlying influences and motivations from your thought processes and your actions-- having someone evaluate how you conduct your internal dialogue, and working through negativity by analyzing and reflecting feelings, processing intentions and releasing anger, hurt, resentment, apathy, lethargy, guilt, grief and loss, to find the other side of negative... it is the birthing of a new you when you find motivation to change how you think about your issues/problems/troubles. This is why "online coaching" is risky, those people can not diagnose and treat major mental, cognitive, and emotional disorders-- risking further damage to your psyche and causing more harm than good. It is often the practice of "bullying" clients with aggressive tactics rather than meeting them where they are with warmth and compassion.

Developing iron clad positive-thinking, goal directed planning, structured, scheduled meals and movement; that is how we take the first step in addressing obesity.  We accept that portion control and exercise are essential. We take journaling and logging exact intake as an evidence based personal data study to our doctor and say, “Look doc, this is what I did, and this is what did or did not happen with weight reduction.” I do not discount the genetic susceptibilities, medication side effects, or outside determinants of obesity, and proper medication, hormonal balance, proper nutrition, disease management, a positive attitude and self advocacy are essential to the treatment plan.  Environmental influences and choice are primary controllable factors for the individual.  We are all individuals, who function uniquely toward our motivations for health of mind and body.

As an advocate for a obesity prevention and treatment programs, it is with medicine and cognitive that are our health and wellness.  I think we have to employ all courses of action: medicine, education, advocacy, and community involvement. In an ideal world, we would have a community garden in every mile of every city, where we could all walk there to get our food each day.  Every park would be a community recreation center where we meet to learn about healthy lifestyles.  We would work with each other to change, not ridicule those who are trying from those who may see themselves as better off than the other because they are stronger, or perceive themselves to be wiser.  We will all respect the notion that we all have an impact from each other’s presence in the world.

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