Impulsive people and meditation

[_anicca_]

I have binge/purge type Anorexia Nervosa (I have been inpatient, even), and I feel that mindfulness can help slow down the process of binging and purging (through viewing the links of dependent origination), but it is no cure.
As Ben said, mindfulness is just one piece of the puzzle. For me, I'm very mindful of the feelings that are arising, and I have an understanding of the process, but I still lack the ability to fully allow the discomfort of the urges to just be; there is definitely a lot of identifying. A holistic approach has to be incorporated and it takes a lot of work on the individuals part to undo all of their habitual tendencies before they finally go away.
Imo, eating disorders are a great example of papanca (conceptual proliferation)! If I step on the scale and it reads something like 99 lbs, instead of seeing the number, I will begin to associate it with myriad thoughts of "Oh - I'm gaining weight!", "I don't like this number.", or "I must lose weight!" instead of just seeing a number. Eating disorders usually start out very innocently - either as diets or comfort eating - but they soon turn into something that overtakes us. Papanca in action!
I don't think that it is accurate to say that someone who is impulsive or depressive should be excluded from the benefits of mindfulness - that is just like saying that you are too dirty to take a bath! Of course, I'm not a psychologist hahaha

[Pinetree]

I don't think that it is accurate to say that someone who is impulsive or depressive should be excluded from the benefits of mindfulness - that is just like saying that you are too dirty to take a bath! Of course, I'm not a psychologist hahaha

Yes, but I believe the question here is how effective can we deliver the mindfulness training.

Hence the need to close their eyes

Now, if something doesn't work, my first thought would be to make some changes.

The easiest one which comes to me is to replace the raisin with something similar that wouldn't be so easy to recognize.

[The Thinker]

Hello,

In my practice as a dietitian who tries to use 'mindfulness' with patients with eating disorders, I have of course come across a number of people who dislike the idea and are completely averse to any form of relaxation/inward-looking technique. Typically they are the kind of people who are very talkative, fidgety, who can't even keep their eyes closed when they are not asleep. During a training session with a mindfulness teacher (who is also a psychologist), he explained to us dietitians that some personality types exclude the use of such techniques, and he mentioned (among others) the impulsive type and the depressive type.

So my question is: if an 'impulsive' person wanted to practice buddhist meditation, is there any advice that is usually given in Buddhist circles? More generally, is there any way, based on your experience, that I could still try to use 'mindfulness' with such patients?

Thanks in advance for your input.

The patient must want to know how or else it would be unethical or even dangerous to introduce something that may be perceived wrongly(meaning of religion?)

The teaching of the four noble truths is the standard introduction that needs to be penetrated by the seeker to really appreciate the further practice of meditation and indeed its goal. I could only suggest that the seeker could be guided by yourself to the source of the teaching for their own investigation if they appreciate the benefits of the treatment(meditation) that they are already receiving.

If you are interested in this, you may like to read this!

[_anicca_]

Yes, but I believe the question here is how effective can we deliver the mindfulness training.

MIndfulness of things that are more obvious (like body movement, such as in walking meditation), would be a good start. Impulsive people usually cannot be mindful of the thought that is coming up (I.E. "I want to binge"), but it may be easier for some to be mindful of the action that follows ("I am walking to the kitchen to binge, I am putting food in my mouth, there is a taste").
As a matter of fact, the Bulimia Help Method by nutritional therapist Ali Kerr has a page on ""mindful binge eating". This can be useful because it shows people that they are the ones in control of their actions, and it slows down the process.

[lostitude]

I have binge/purge type Anorexia Nervosa (I have been inpatient, even), and I feel that mindfulness can help slow down the process of binging and purging (through viewing the links of dependent origination), but it is no cure.
As Ben said, mindfulness is just one piece of the puzzle. For me, I'm very mindful of the feelings that are arising, and I have an understanding of the process, but I still lack the ability to fully allow the discomfort of the urges to just be; there is definitely a lot of identifying. A holistic approach has to be incorporated and it takes a lot of work on the individuals part to undo all of their habitual tendencies before they finally go away.

Oh no! And I thought, there was my silver bullet! So when you feel an urge coming up, even if you settle into mindfulness, you will not be able to sit through that urge until it just melts away? Is the problem that it doesn't melt away, or that there are just too many thoughts pouring in for you to reach a proper state of defusion/observation of those thoughts? or something else that makes it not work?

The easiest one which comes to me is to replace the raisin with something similar that wouldn't be so easy to recognize.

mhm... such as?

[lostitude]

The patient must want to know how or else it would be unethical or even dangerous to introduce something that may be perceived wrongly(meaning of religion?)

Oh no, the idea was never to impart any religious teaching to my patients. Not only is it absolutely illegal in my country, I am also simply not qualified! I'm approaching mindfuless from a medical perspective (MBSR).

If you are interested in this, you may like to read this!

?

[Pinetree]

mhm... such as?

What ? Are you running out of dried fruit ?

goji, dates, apricots, peaches, apples, pears, figs, cranberries, cantaloupe, plums, blueberries, cherries, sour cherries, gooseberry (I know of red/green/yellow/black sorts), seabuckthorn, citrus fruits, coconut, strawberries, aloe vera, mango, papaya, pineapple, ginger, banana

I'm not sure how deep the fruit knowledge of your patients is, but you probably can judge to some extent. I'm thinking it would be more difficult to recognize a small slice or dice from a bigger fruit. Most people I know wouldn't be able to guess what a little cube of coconut is.

In my area, you can buy little sweets, of different shapes, which are made of ground fruits, cereals, seeds, with natural flavors. And the list of potential ingredients is in the dozens, you really can't guess the taste just by looking at it. And if you can't buy that in your area, you got here a free business idea for you.

Not sure if this is a concern for just a taste test, but for your information, some dried fruit is in fact candied fruit, with added sugar (the seller should know which ones). In fact, some of them cannot be properly preserved through drying without adding sugar.

[_anicca_]

Oh no! And I thought, there was my silver bullet! So when you feel an urge coming up, even if you settle into mindfulness, you will not be able to sit through that urge until it just melts away? Is the problem that it doesn't melt away, or that there are just too many thoughts pouring in for you to reach a proper state of defusion/observation of those thoughts? or something else that makes it not work?

I have come to the realization that it is because of the amount of self-judgment and non-acceptance I have in regards to the behaviors. Instead of just letting it be, there are stories that come along with it - "I'm such a terrible person for doing this.", "Why do I binge and purge?", "Everyone thinks I'm a failure.".
Mindfulness is just remembering to watch what mind is doing in the present moment. There are other dimensions within it such as sati (awareness), sampajanna (an awareness of where we want to go and where we have been) , dhamma-vicaya (analysis) , and Appamada (watchfulness).
All of these things have to work in unison.

Technically, I suppose it is a lack of mindfulness, but it takes a while to fully bring mindfulness to the process.

Self-judgment and striving to overcome the eating disorder all fall into the bigger picture of a lack of acceptance of the present moment. Ego is creating stories.

Mindfulness is the fuel that you need to overcome these issues.

[Pinetree]

I have come to the realization that it is because of the amount of self-judgment and non-acceptance I have in regards to the behaviors.

Ok, but how does that relate to the urge ? Not sure what's actually happening ... so when you have an urge, you try to be mindful about it, then you start to judge yourself, then what ?

I'm thinking there are some straightforward tasks for you: make the difference between the thoughts, the urge and the action/behavior. The thoughts are just thoughts, it doesn't mean that you have to follow them, and the urge is just an impulse, a feeling, there is no need to do anything about it.

Have you tried mental noting ?

[_anicca_]

I have come to the realization that it is because of the amount of self-judgment and non-acceptance I have in regards to the behaviors.

Ok, but how does that relate to the urge ? Not sure what's actually happening ... so when you have an urge, you try to be mindful about it, then you start to judge yourself, then what ?

I'm thinking there are some straightforward tasks for you: make the difference between the thoughts, the urge and the action/behavior. The thoughts are just thoughts, it doesn't mean that you have to follow them, and the urge is just an impulse, a feeling, there is no need to do anything about it.

Have you tried mental noting ?

This relates to the urge - which is an unpleasant feeling, essentially - because it perpetuates the feeling by clinging. Usually what happens is the unpleasant feeling will arise, then comes doubt ("I'll never be able to overcome this.", "These techniques aren't working.") and/or resignation ("I might as well do it anyways").

I think you're right in terms of differentiating between the thoughts, urge, and action. I have not tried mental noting, as the people who I have practiced with does not use this method of meditation, but I will begin to incorporate it into my daily life. The process happens so quickly, that it is very difficult to see in the moment. The conditioning is very strong.

Metta

[Pinetree]

The process happens so quickly, that it is very difficult to see in the moment.

In my experience, few months of practicing noting will make it easier to see the complexity of such mental states.

If you want to try it, maybe the easiest way is to start at times during the day when you feel more relaxed and there is no pressure, by noting body movements and postures: sitting, standing up, walking left-right, brushing teeth, washing hands, lifting/lowering arm etc. Until you build up the actual noting skill, it may be a little difficult, and if you find yourself not knowing what to note, just note "confused" or "distracted" few times and as soon as you're ready, get back to noting whatever daily activity you were doing. With practice, your mindfulness will stay with the actual activity you're performing, and noting just happens in the background, reminding you of what you're experiencing.

[Kamran]

Its not known why exactly, but systematic self-monitoring increases self-control. Both CBT and mindfulness are self-monitoring methods. Just the act of writing down what you eat each day will make you eat better and lose weight, for instance.

[_anicca_]

The process happens so quickly, that it is very difficult to see in the moment.

In my experience, few months of practicing noting will make it easier to see the complexity of such mental states.

If you want to try it, maybe the easiest way is to start at times during the day when you feel more relaxed and there is no pressure, by noting body movements and postures: sitting, standing up, walking left-right, brushing teeth, washing hands, lifting/lowering arm etc. Until you build up the actual noting skill, it may be a little difficult, and if you find yourself not knowing what to note, just note "confused" or "distracted" few times and as soon as you're ready, get back to noting whatever daily activity you were doing. With practice, your mindfulness will stay with the actual activity you're performing, and noting just happens in the background, reminding you of what you're experiencing.

I will add the noting, along with sending lovingkindness to these phenomena.

Thank you

[Myotai]

mindfulness on its own is, in my humble opinion, a mistake.
Let's not forget the lesson of Anders Behring Breivik who used 'mindfulness practice' to still his nerves before setting off a bomb that killed eight people and shooting dead 69 people.
On its own mindfulness may just make your patients more mindfully overeat or undereat and make it much more difficult to undo unhealthy habits. That is why meditation practices within Buddhism are never divorced from other aspects of the Path that include the maintenance of moral conduct, generosity (inc. service), the development of concentration and wisdom (inc. the intellectual understanding of the Dhamma through study).

My advice to you is to refer your patients to a qualified Dhamma teacher. This I think will be far more beneficial than cobbling something together.
all the best,

Ben

..best and gentlest argument against McMindfulness I have heard yet!

[Maarten]

You don't really need to meditate in order to develop some mindfulness. If you just want them to be able to correct their impulsive behavior when it becomes problematic then they won't need very strong mindfulness. You could just have them remind themselves to be mindful when a difficult situation arises.

So if they would indulge themselves every time they walked past a McDonald’s, they would just tell themselves 10 times every morning: 'I will be mindful whenever I walk past the McDonald’s. I will not walk in. I will walk on and then I'll reward myself with a healthy snack and some exercise'.

This kind of programmed mindfulness works very well. This mantra will pop up in their mind whenever they would be in a challenging situation.

Maybe for such people exercising will work better as a form of relaxation. Not everyone has to meditate of course.

With Metta,

Maarten