I used to work at a health clinic in Calgary, Alberta where I got to work with a number of patients suffering from various physical health problems (ex: diabetes; obesity; hypertension). Now, you might be wondering – why would a psychologist be working with these people? Well, psychologists can play an important role for many health problems – in fact, we have a whole field in psychology devoted to this (behavioural medicine/ healthy psychology).
In an effort to show how psychology plays a role in various health problems, I’m going to follow-up my last post (on chronic pain), by discussing a new health problem:
Obesity.
Specifically, I’m going to talk about how a specific psychological factor (experiential avoidance – a mouthful, I know!!) can impact how much food people eat.
Research shows that over-eating (including binge-eating) is more likely to occur when stress and/ or negative emotions are present.
However, people do not necessarily overeat every time they feel stressed, sad or upset. Another important factor is emotion regulation. Emotion regulation refers to a person’s ability to manage their negative emotions, and not allow these emotions to lead to regrettable behaviour.
Some people have poor regulation strategies. If someone often eats unhealthy food when feeling stressed or upset, this would be considered a poor strategy. The pattern of turning to food (or drugs or alcohol or sex,…) to feel better is not really new in Western society. However, what has changed is the ease with which we can get access to these things (but I’m digressing a bit here).
There does appear to be a certain segment of the population that are more likely to use eating for emotion-regulation (i.e., emotional eating). An important question then becomes, why have they “chosen” food instead of drugs? There are several potential answers to this question, which I will address later.
Perhaps an even more important question is, what kind of emotion regulation strategies are these ‘emotional eaters’ using? Well, to answer this question we must examine a particular style of emotion regulation – called experiential avoidance. However, for simplicity sake, let’s just call it EA.
EA can be a bit of a complex concept to explain. It will help to explain what it means by describing it as a process. So, here goes.
When people use EA, they…
(1) really do not like negative thoughts, feelings, stress, uncomfortable body sensations (e.g., anxiety symptoms), etc. You might be thinking “Hey, no one likes those things!” True, but you can not like something yet still tolerate it. People who have problems with EA have A LOT of trouble tolerating these things.
(2) they decide (often unconsciously) that they are simply unwilling to experience these problems, and
(3) they do something (often quickly) to control or escape these unwanted experiences.
For example, if a person does something unethical, they can (a) ponder their actions and process their guilt, or (2) avoid thinking of the mistake and suppress their emotion. In this example, the former strategy can be thought of as an ‘acceptance’ or ‘willingness’ to experience negative thoughts and emotions. The second strategy is ‘avoidance.’
Certain kinds of EA strategies are healthy and normal under certain contexts. For instance, trying to suppress boredom and disinterest while in a conversation with a friend or colleague is normal, and expected by social standards. However, when you chronically try to avoid or suppress psychological experiences, it can sometimes lead to psychological problems in the long run.
There are several ways in which avoidance/ suppression can cause problems:
(1) there can be what psychologists call a “rebound effect.” This occurs when we try to suppress something, but our attempts to suppress it only end up making it stronger. A classic example of this is the pink bear experiment (Spend the next minute trying not to let the image of a giant pink bear enter your mind – it’s near impossible).
In fact, researchers have shown that trying to suppress negative thoughts only increases their frequency over time (primarily under stress),
(2) EA can make people feel inauthentic and disconnected from their true self. I have worked with many people who constantly try to be very, very positive people (always trying to shut out negative things in their life). These people were not experiencing a full and genuine life (everyone feels sad, angry, anxious, etc. at least some of the time), and they experienced psychological problems as a result.
(3) many negative psychological experiences are actually somewhat useful. Worry (in moderation) helps people anticipate and prepare for potential problems in the future. Self-criticism can be considered a useful self-monitoring process that allows someone the opportunity to identify mistakes and make necessary corrections.
Of course, the question now becomes, how does EA lead to binge-eating? Well, research shows that individuals with a tendency to engage in binge-eating also tend to overuse EA strategies.
Why are binge-eating and EA associated?
Well, eating can be considered to be an avoidance strategy. Eating can help someone distract from unwanted experiences, and can directly calm any physical discomfort the person is feeling. Unfortunately, this strategy works really well. And so, people are more likely to repeatedly use it.
A similar problem is seen in other problems like depression and anxiety. People with depression or anxiety sometimes use alcohol or drugs to blunt the intensity of their emotional experience (i.e., the depressed person feels less sad and the anxious person less anxious, at least for the short term). However, these EA strategies can impair recovery because the processing of emotion is an important component of treatment (this latter point is beyond the point of this post).
The take home message here is that EA is great in the short-term – but very problematic in the long-term.
So, returning to a question posed earlier in this post, why to some people choose food, while other people choose alcohol/ drugs?
There are several possible answers to this question.
First, people can learn to cope with problems by modeling their parents. Some people overeat while stressed because they learned this coping strategy from their parents. For example, mothers will sometimes bake cookies or other sweets to give to their children when they are upset. This strategy can get reinforced (i.e., it works by reducing distress in the short term), and is used repeatedly across time, and into adulthood.
Second, there is some evidence to suggest that the biological response to food involves more pleasure and reinforcement for obese individuals, relative to the general population. Similar to theories of drug addiction (ex: the link between the dopamine system and cocaine), research shows that eating also involves a similar process, where food activates pleasure centres in the brain. Research shows that this pleasure response can be greater in obese people.
Finally, individuals might learn on their own that eating provides an escape from negative emotions. They can learn this later in life (e.g., adolescence; adulthood) through the media, peers, and even by chance (i.e., they stumble onto the fact that eating relieves negative affect).
I guess one of the main points I want to make with this post is that psychology is not discussed often enough when people (ex: government agencies; other health professionals) try and brainstorm ideas for treatment and prevention. I remember a former supervisor of mine discussing an obesity conference that was held in Canada a number of years ago. The organizers had people from almost every profession there to discuss ways of lowering obesity rates. They even had city planners there to discuss how to design urban areas to lower the incidence of fast-food eating. Yet, there were no psychologists! The people there had no clue why they would even need to invite a psychologist.
I’m hoping readers get to learn a bit more about the role that psychology can play – in mental and physical health issues.
Dr. Roger Covin
Montreal Psychologist
www.drcovin.ca
In an effort to show how psychology plays a role in various health problems, I’m going to follow-up my last post (on chronic pain), by discussing a new health problem:
Obesity.
Specifically, I’m going to talk about how a specific psychological factor (experiential avoidance – a mouthful, I know!!) can impact how much food people eat.
Research shows that over-eating (including binge-eating) is more likely to occur when stress and/ or negative emotions are present.
However, people do not necessarily overeat every time they feel stressed, sad or upset. Another important factor is emotion regulation. Emotion regulation refers to a person’s ability to manage their negative emotions, and not allow these emotions to lead to regrettable behaviour.
Some people have poor regulation strategies. If someone often eats unhealthy food when feeling stressed or upset, this would be considered a poor strategy. The pattern of turning to food (or drugs or alcohol or sex,…) to feel better is not really new in Western society. However, what has changed is the ease with which we can get access to these things (but I’m digressing a bit here).
There does appear to be a certain segment of the population that are more likely to use eating for emotion-regulation (i.e., emotional eating). An important question then becomes, why have they “chosen” food instead of drugs? There are several potential answers to this question, which I will address later.
Perhaps an even more important question is, what kind of emotion regulation strategies are these ‘emotional eaters’ using? Well, to answer this question we must examine a particular style of emotion regulation – called experiential avoidance. However, for simplicity sake, let’s just call it EA.
EA can be a bit of a complex concept to explain. It will help to explain what it means by describing it as a process. So, here goes.
When people use EA, they…
(1) really do not like negative thoughts, feelings, stress, uncomfortable body sensations (e.g., anxiety symptoms), etc. You might be thinking “Hey, no one likes those things!” True, but you can not like something yet still tolerate it. People who have problems with EA have A LOT of trouble tolerating these things.
(2) they decide (often unconsciously) that they are simply unwilling to experience these problems, and
(3) they do something (often quickly) to control or escape these unwanted experiences.
For example, if a person does something unethical, they can (a) ponder their actions and process their guilt, or (2) avoid thinking of the mistake and suppress their emotion. In this example, the former strategy can be thought of as an ‘acceptance’ or ‘willingness’ to experience negative thoughts and emotions. The second strategy is ‘avoidance.’
Certain kinds of EA strategies are healthy and normal under certain contexts. For instance, trying to suppress boredom and disinterest while in a conversation with a friend or colleague is normal, and expected by social standards. However, when you chronically try to avoid or suppress psychological experiences, it can sometimes lead to psychological problems in the long run.
There are several ways in which avoidance/ suppression can cause problems:
(1) there can be what psychologists call a “rebound effect.” This occurs when we try to suppress something, but our attempts to suppress it only end up making it stronger. A classic example of this is the pink bear experiment (Spend the next minute trying not to let the image of a giant pink bear enter your mind – it’s near impossible).
In fact, researchers have shown that trying to suppress negative thoughts only increases their frequency over time (primarily under stress),
(2) EA can make people feel inauthentic and disconnected from their true self. I have worked with many people who constantly try to be very, very positive people (always trying to shut out negative things in their life). These people were not experiencing a full and genuine life (everyone feels sad, angry, anxious, etc. at least some of the time), and they experienced psychological problems as a result.
(3) many negative psychological experiences are actually somewhat useful. Worry (in moderation) helps people anticipate and prepare for potential problems in the future. Self-criticism can be considered a useful self-monitoring process that allows someone the opportunity to identify mistakes and make necessary corrections.
Of course, the question now becomes, how does EA lead to binge-eating? Well, research shows that individuals with a tendency to engage in binge-eating also tend to overuse EA strategies.
Why are binge-eating and EA associated?
Well, eating can be considered to be an avoidance strategy. Eating can help someone distract from unwanted experiences, and can directly calm any physical discomfort the person is feeling. Unfortunately, this strategy works really well. And so, people are more likely to repeatedly use it.
A similar problem is seen in other problems like depression and anxiety. People with depression or anxiety sometimes use alcohol or drugs to blunt the intensity of their emotional experience (i.e., the depressed person feels less sad and the anxious person less anxious, at least for the short term). However, these EA strategies can impair recovery because the processing of emotion is an important component of treatment (this latter point is beyond the point of this post).
The take home message here is that EA is great in the short-term – but very problematic in the long-term.
So, returning to a question posed earlier in this post, why to some people choose food, while other people choose alcohol/ drugs?
There are several possible answers to this question.
First, people can learn to cope with problems by modeling their parents. Some people overeat while stressed because they learned this coping strategy from their parents. For example, mothers will sometimes bake cookies or other sweets to give to their children when they are upset. This strategy can get reinforced (i.e., it works by reducing distress in the short term), and is used repeatedly across time, and into adulthood.
Second, there is some evidence to suggest that the biological response to food involves more pleasure and reinforcement for obese individuals, relative to the general population. Similar to theories of drug addiction (ex: the link between the dopamine system and cocaine), research shows that eating also involves a similar process, where food activates pleasure centres in the brain. Research shows that this pleasure response can be greater in obese people.
Finally, individuals might learn on their own that eating provides an escape from negative emotions. They can learn this later in life (e.g., adolescence; adulthood) through the media, peers, and even by chance (i.e., they stumble onto the fact that eating relieves negative affect).
I guess one of the main points I want to make with this post is that psychology is not discussed often enough when people (ex: government agencies; other health professionals) try and brainstorm ideas for treatment and prevention. I remember a former supervisor of mine discussing an obesity conference that was held in Canada a number of years ago. The organizers had people from almost every profession there to discuss ways of lowering obesity rates. They even had city planners there to discuss how to design urban areas to lower the incidence of fast-food eating. Yet, there were no psychologists! The people there had no clue why they would even need to invite a psychologist.
I’m hoping readers get to learn a bit more about the role that psychology can play – in mental and physical health issues.
Dr. Roger Covin
Montreal Psychologist
www.drcovin.ca
4 comments:
Thanks for posting about emotional eating! (As I had suggested...)
Interested to see its relation to the 'me' generation as well.
Yeah, the connection between poor emotion regulation (specifically EA) and obesity in children/ adolescents has not been discussed much...which is unfortunate.
Well luckily it looks like you're going to start furthering the discussion right here.
Looking forward to it!
I was really impressed with this post! i feel you could make a more prefect article on negative emotions..
Obesity Questionnaire
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