Shame is an inevitable component of binge eating disorder, so although it’s the most common of eating disorders, it’s rarely discussed.
Binging was a carefully hidden secret for me since my early teen years. I remember getting upset over a running injury and devouring a chocolate cake. Not a piece of cake — a whole chocolate cake — and it was still mostly frozen. Binging was my normal; I didn’t believe change was possible. So even as I got degrees in nutrition and ate more nourishing foods, there were still nights where I’d polish off a can of frosting, and suffer through the inevitable self-loathing hangover.
I learned to meditate over 20 years ago. It opened the doors to a lifelong practice of meditation techniques, including Vipassana and yoga, and spiritual exploration with wonderful teachers. As I practiced and practiced, I noticed that I was able to listen more deeply to both my patients and myself, and felt less stressed in my daily work as a medical doctor.
It wasn’t until 15 years ago when I began to work with The Center for Mind-Body Medicine that I learned the importance of teaching my patients these skills, too. Stress is a contributing factor for 80% of all chronic illness in our country, and numerous studies have shown the power of meditation and mind-body skills to reduce the effects of stress and even reverse illness. I talk at length about this in my book, The Immune System Recovery Plan, A Doctors 4-Step Program for Treating Autoimmune Disease. At Blum Center for Health we teach these skills in Mind-Body Groups, following the model developed by The Center for Mind-Body Medicine.
On day one of the Mind-Body Medicine Professional Training Program, our first large group modality is shaking and dancing. “Oh no,” I think, “I get to shake this body I usually ignore, in front of 250 people I don’t know. How silly will I look and will released energy make me sick in some way like throwing up or hurting my legs or my replaced hip joints?” A breath of relief comes as Dr. Gordon says we are to close our eyes. What was I thinking anyway? I am in a room of professional health care providers, with a doctor standing right next to me.
Every meeting at The Center for Mind-Body Medicine starts with a minute or so of Soft Belly Meditation, which is deep breathing with the simple mantra, “soft….belly”.
Most interns and guests look a little wide-eyed at the first meeting here when the meditation is announced. Perhaps they’re thinking “What have I gotten myself into?” or “Who are these people?!” I know I did, when I started working here. But after attending meetings at other companies and meetups, where you launch into business without the benefit of a meditation, I definitely notice a difference.
Our signature mind-body medicine technique is something Founder and Director James Gordon, MD calls “Soft Belly”, by way of encouraging each of us to relax — which few of us instinctively do these days.
We sit quietly, breathing in through our nose and out through our mouth, which both calms the sympathetic nervous system and awakens the parasympathetic nervous system, creating a feeling of relaxation in the mind and body. Dr. Gordon suggests we think “soft” as we breathe in and “belly” as we breathe out, reminding ourselves to relax our belly so we can take in full, healing breaths rather than shallow, tense ones.
Since my first Mind-Body Medicine Professional Training Program in 2006, there have been so many moments in which I have given quiet thanks for all that I have learned and experienced with the Center. The moment captured in this photo is but one of many. Having facilitated mind-body skills groups in all kinds of places with all kinds of people, young and old, I have noticed so many common themes, including one I’ve heard Jim refer to as the “equal opportunity group experience.”
On a recent trip to London, I was interviewed during Depression Awareness Week about my book Unstuck’s UK release by The Guardian newspaper. The reporter was particularly interested in CMBM’s Global Trauma Relief program and our work to bring population-wide psychological healing to places around the world that are afflicted by war and natural disaster. You can read the piece here:
I’m certainly pleased that the author recognizes CMBM’s groundbreaking efforts to teach and support hundreds of thousands of people in Kosovo, Israel, Gaza, Haiti, Southern Louisiana, as well as US military returning from Iraq and Afghanistan. It’s a shame, however, that his tone is so dismissive of integrative medicine and that he fails to recognize the fundamental importance of self-care for psychological and physical healing.
Please note that as of this writing, corrections are being made online for several factual errors, including the following:
- In Gaza, we trained 90 clinicians initially, only a few of these were “educators” (as the article states)
- CMBM now has 160 groups meeting in Gaza each week, not 48, as reported.
Beyond factual errors, though, I’m disappointed in the tone of the article. I want to emphasize that our approach to psychological trauma relief is not about “belief,” as the article repeatedly implies. It is based on hard evidence that is just as rigorous – actually more so – than most of that provided by the drug companies he seems to accept as the standard.
It is a common misconception (and prejudice) that psychological and nonpharmaceutical research is less stringent and reliable than clinical drug trials. Each of the approaches that we use, including meditation, guided imagery, biofeedback, autogenic training, yoga, self-expression in words and drawings, and movement and exercise, has a significant research base, one which demonstrates decreases in stress levels and improvement in mood. The CMBM approach combines these into a comprehensive program, and The Center for Mind-Body Medicine takes great care in scientifically researching, documenting, and publishing our findings of our approach in peer-reviewed journals. We recently published a randomized controlled trial (RCT) on our work with war traumatized children in Kosovo that shows an 80% decrease in symptoms of PTSD (read the abstract here).
This was the first RCT of any intervention with war-traumatized children, and sometime in the next few months, we will be publishing a study (in the International Journal of Stress Management) that shows similar results—80% decrease in PTSD symptoms, significant decreases in depression and hopelessness—in war-traumatized youth in Gaza. This study is particularly important because the gains that were achieved over ten weeks of once-weekly group sessions were largely maintained at seven months’ follow-up—in spite of ongoing conflict and severe economic hardship.
The point is that this approach is not alternative. It is fundamental. It makes human and scientific sense. We have an approach that works with large groups of people in developed countries as well as those ridden by disaster. It is flexible, inclusive, and culturally acceptable. And the groups in which we train caregivers can be led by anyone—teachers, and religious and community leaders, as well as health professionals; and the scientific evidence for its effectiveness continues to accumulate. And as the article states, CMBM will continue to be there to provide our program of mind-body medicine for people suffering from psychological trauma, to teach them, and help them help themselves.
Yesterday I told you about James (from the National Police), Ty Rose (an anesthesiologist and teacher), and Marilyn (a pediatrician). (Here is the link, if you missed it.) Now, here is Mercedes’ story.
We go around the circle to “check in” about our emotions and what’s happening right now, this moment. It is Mercedes’ time to ‘partager,’ or share. “Most of you,” she begins, “have seen how I was last time,” and I remember – and imagine that all the others remember as well – how at the very first training, in December, she sat erect in clothes that hung like armor, her face as immobile and solemn as the great statues on Easter Island, speaking occasionally and telegraphically about the death of her husband and her daughters, and her own despair.
Mercedes now opens her hands and, amazingly, grins. “I have found calm,” she begins, “doing the deep breathing and the shaking and dancing every day,” (she is emphasizing now). “And I have found much more as well.”
“On the anniversary, January 12th, my daughter and I and our whole community were in Church. And everyone was so sad, but tense also and unable to express the sadness. And I let myself cry. And then my daughter was able to cry too. And in my crying I found strength. And I asked myself ‘what have I learned in the Mind-Body program and how can I use it to help everyone in this Church?’ And I began to sing a song – I have never done this before. And my voice grew stronger, and I asked everyone to lift their arms and glorify God. And they all began to sing and lift their arms, and cry. And I sang three songs and then we opened our eyes and we were all calm.”
She concludes, “you know I work as a teacher. But my students no longer call me teacher,” she says, wagging her finger and pausing with what I cannot help but think is a mischievous grin. “now,” she goes on, “they call me ‘mommy’.”
Thank you for reading my accounts of CMBM’s trainings in Haiti, and these stories from our trainees. I hope you are finding the people as amazing and their stories as touching as I do.
Now that the first 120 Haitian professionals have completed our Initial and Advanced Trainings in Mind-Body Medicine, they will begin to offer Mind-Body Skills Groups to their family, friends, community, and at their institutions, and I will be sharing more of their stories here as they teach and share with others, and learn and grow themselves.
I’m not quite sure when or even how it happened but Haiti is starting to feel like home. Not in the sense that I have my family with me, or know where to do grocery shopping, or can lay my hands on the books I love most.
It’s something else, an ease with people, a sense of words and actions contributing to something really good – right now and for the future — a welcome, even an embrace that keeps expanding. It swells from the team around me, and from the 120 people — doctors, psychologists, nurses, midwives, teachers, priests and nuns and voudoun healers — who come to our training with great fidelity and teach the techniques they are learning from us to friends, family, and patients as soon as it is humanly possible. “In order to keep the training inside me always, I have to share it with others,” one young teacher announced this morning.
In the days after Yehlie’s first communion we complete the training we began in December. My ‘small group’ of participants, gathered together again, begins as always with a few minutes of soft belly meditation – slow deep breathing, in through the nose, out through the mouth, with the belly soft and relaxed — quieting our nervous systems, our minds and bodies. And then we “check in”, tell each other what has happened since we last saw each other and share what we are feeling “right now.” Already it is becoming a commonplace for us, a way to regularly connect with those around us, outside as well as within the training. “Check in,” laughs one priest, “is almost now a second religion.”
There are still major problems and issues – almost half of our group is still not living in their homes, and there is abiding sadness for those who have died, but there is more energy for understanding and meeting current challenges.
We discuss the short term memory loss that bedevils several people and makes them apprehensive, even in their thirties or forties, about Alzheimer’s disease. I say it is highly unlikely, that trauma has long been known to obscure memory. And one of the other doctors in the group assures us that her memory – devastated amidst the loss of her brother and her husband — has begun slowly to return: “Sharing my emotions, accepting help from others, permitting my own tears – it as if the memory flows back with them.”
This doctor’s face is no longer constricted in pain as on our last visit, but open, changeable, easy with laughter as well as tears. Many of the faces I see are equally changed. James, who is head of psychology for the National Police, scrupulously kind, but painfully thin and equally serious in December, is ten pounds heavier, relaxed, expansive. And the woman I think of as “the Teacher,” as immobile and expressionless as mahogany in devastated grief at the loss of husband and home two months ago, is now a river of feeling and words.
One participant says, “The earthquake brought us so much pain, but also we are seeing it brings good things to the people who survive. Psychology [i.e. traditional therapy] was useless to me and my community – no one could go because it meant you were crazy. Now with CMBM approach I am helping myself and others too.”
Says another, “On January 12th, the anniversary, when everyone in my church was so tense, I taught them the breathing. And as I relaxed I let myself cry, and found my strength, and then we cried together, my children and my friends. And then I sang a song – I have never led a song any time – and I asked everyone to sing with me and praise god. And we did, three songs, and then we all felt more calm.”
It is so encouraging to see the positive changes in our trainees, and to hear that our participants are taking the techniques back to their homes, churches, workplaces. Giving the people of Haiti practical tools for their own emotional healing, and empowering them to teach these tools to everyone they meet, will, we hope, help the Haitian people heal themselves.
Sometimes, on this first anniversary of the earthquake, it feels like very large, steady hands are needed to pull together the two sides of the gaping wound that is Haiti, hands that Michelangelo might fashion for this purpose.
I find myself looking around as we circulate through tent camps with little food and water, no health care or education or employment for the tens of thousands of people I see, for the hundreds of thousands who still live like this all across the region. “How can this be?” I shout – but only inside my head – how can we, Americans, the world community, all of us, let this continue? Our hearts were touched a year ago. Politicians said the right things, famous people answered phones on television and lent their shine to the pleas for help. Billions of dollars were pledged. Where are they? Why is there scant organization, no plan, so little mercy and fellow feeling?
It worries me, as much for ourselves–the privileged, literate, and apparently protected– as for those who live exposed to heat and rain and hurt.
In one of our workshops on January 11, 2011, the day before the anniversary, two men – a priest who tends a devastated parish and an accountant who has left his paying job to bring whatever order he can to two tent camps– share their drawings. (Read more about CMBM’s drawing exercise in this earlier Haiti entry.)
The accountant, a large serious man, sees himself planted in the midst of a quilted crop of families, cooking fires and plastic sheeting; the priest’s drawing of his slim black-clad figure is bright with God’s light refracted through a mirror framed in rainbow colors. The drawings of their “biggest problems” are, with no other guidance, no consultation, virtually identical. One side of the pages shows effort – to salvage and succor, hands reaching out, shovels in the earth – and a row of disconnected figures: “the ones who could help but don’t” “the rich and powerful who do not care.” They are barely sketched, drained of color. On the other side of the page, the people in the camps are suffering, but they do have bodies and expressions.
We need to offer them help, ourselves, in order to be human; and we need this at least as much as they need our help. That is the key to a happier future anniversary.