Char Wilkins is a mindfulness-based psychotherapist who is trained to teach Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, and Mindfulness-Based Eating Awareness programs. Char has led several professional training retreats for the UCSD Center for Mindfulness.
By Char Wilkins
I found my way to meditation years ago out of necessity- not unlike how people come into therapy and the mindfulness-based courses I teach. Knowing how useful meditation had been in my own life, I began looking for a way to incorporate mindfulness and meditation into my psychotherapy practice for individuals and in groups. The intersection of abuse, body image and eating/food issues is insidiously woven together for many people. Each year I find myself sitting with an increasing number of women struggling with disordered eating borne out of stress and suffering.
Bringing mindfulness into working with painful and habituated coping mechanisms, whether a situational practice or an entrenched eating disorder, seemed to be an appropriate next step. Through mindful eating exercises and meditation, most of the women I see individually or in MB-intervention programs report that food cravings lessen, they gain skills in self-regulating not only with regard to food and eating but in all areas of their lives, and they become more aware of what, how and the hunger that drives their eating or non-eating. Mindfulness isn’t a cure and it isn’t for everyone, but it can facilitate change.
There is never just one way to address any behavior that arise out of fear or ignorance, but the integration of mindfulness into a treatment plan can be useful to both therapist and client when difficulty around food/eating and body image are part of the landscape. For the healthcare professional, being fully present to the client through the lens of mindfulness provides an anchor for the clinician and a steadying presence for the client. When the pull to be directive with a client about what to do, eat or not eat arises, it’s valuable for the clinician to skillfully attend to their own feelings of anxiety, inadequacy or fear that could cloud their ability to remain fully present and non-judgmental. For the client, the introduction of mindfulness meditations and exercises offer the possibility of a skillful approach to being with difficult emotions, thoughts and behaviors, and a way to be aware of and with physical sensations in body. Once learned, mindfulness skills are not dependent on the therapist and this helps to shift the client’s locus of control from external to internal.
When working with habituated eating patterns from a mindful stance, the goal is never weight because weight is only a symptom. Just as in meditation where relaxation is the not the goal although it is often a welcomed by-product, weight gain or loss is not the goal. Rather the focus is bringing eating into balance with other important aspects in the client’s life. Because unhealthy eating habits are often closely linked to depression and anxiety, trustworthy ways in which to develop awareness and tolerance of uncomfortable thoughts, feelings and physical sensations are an important consideration of mindful eating practices. Compassionate acceptance of what is here right now brings with it a different perspective and the possibility of choice.
The idea of “acceptance,” “non-doing” or “non-striving” often elicits feelings of agitation, frustration, inadequacy and fear of passivity from the client. To someone used to following strict diets, excessive exercise or other regimes, cyclical binges or habituated overeating, the idea of not doing something about it can be frightening for client and clinician, even when both are aware of the merciless cycles these behaviors create. Using the principles of mindfulness and mindful eating encourages self-referral, a reduction in impulsivity and a way to steady one’s self in challenging moments.
Once trained in mindfulness meditation and mindful eating practices, a clinician might begin by introducing the concept of mindfulness through the raisin exercise or a simple breath meditation. My colleague, Jan Chozen Bays, has simple and short, focused eating exercises in her book, Mindful Eating: a guide to rediscovering a healthy and joyful relationship with food. And there are more and more books, trainings and workshops that can help and support healthcare professionals in this much needed eating awareness work.