Chronic Illnesses and Diet part 3

Visualization and Chronic Disease

To the ten steps of the Body Clock Prescription, I'd suggest adding visualization, another powerful tool for controlling chronic disease. Life consists of moving forward into images. You get to the dry cleaners to pick up your laundry by making a mental picture of the journey and moving forward into that picture. No picture, no laundry. With visualization, you are going to create an inner picture in order to realize your intention, not just in the outside world of the dry cleaner but in the inside world of your immune system.

The first step is to get the knack of meditation so that your mind and body are in a receptive posture for visualization. Let's assume that you've learned to enter a meditative state; riding on the letter M, your mind can enter a new space within your consciousness. From here, you can take one step forward into your imagination and make a picture of what you want to accomplish in your body.

The effectiveness of this approach was initially proven in an experiment conducted with doctors suffering from terminal or advanced cancer. They were shown accurate images of their own cancer cells and of their immune system cells and were asked to create a realistic visualization of the immune system cells attacking the cancer cells. Most of the doctors successfully curbed their cancer — not to the extent of actually curing it, but in most cases there was measurable improvement. Since then, numerous experiments have shown that a less accurate image of the enemy is just as effective.²

About twenty years ago I used to meet one evening every month with a group of other doctors, including Dr. Bernie Siegel, one of the pioneers of visualization. Bernie shared fascinating examples of the kinds of imagery cancer patients chose to promote healing of their illnesses. It seemed important that the image be accurate in its intent; it was disconcerting when patients chose wimpy defensive images that were the imaginary equivalent of trying to beat their cancer with a wet noodle. People who chose aggressive images did better; lions, tigers, sharks, polar bears and knights in shining armor do better work than a little girl gathering up cancer cells into snowballs and throwing them over the fence.

But what's a good image if you have chronic inflammatory disease? In this case, redness, heat, swelling and pain afflict some part of your body as it reacts to an enemy that the doctor hasn't been able to discover or that has disappeared from the scene of the crime, leaving your immune system in a perpetual dither. You need a picture that is soothing but not self-defeating by way of quieting your immune reactions to the point of defenselessness. This is where a chemical or an abstract image may be more appropriate. By chemical image, I mean something along the lines of `Let's put out the fire'. Remember that inflammation is an expression of your body's fire burning out of control. Whether it is in the skin, the digestive tract, the lungs, the heart, the nose or the eyes or, for that matter, whether or not it is producing palpable heat, some kind of uncontrolled fire is at the bottom of a lot of chronic illness. Parkinson's disease, for example, has been characterized as a fire in the brain. And the oxidative damage in the chemistry of autistic children constitutes a kind of fiery injury to their RNA and DNA.

If you are going to employ visual imagery to quench the fire, then why not use pictures that are more effective than merely aiming a fire hose or throwing ice water at it? Instead, try mobilizing your body's powerful natural resources for quenching the inflammation, calling on your body's clouds to release rainwater on the brush fires of the prairie where the inflammation resides. This could be your intestine if you have colitis, your joints if you have arthritis, your skin if you have dermatitis, your lungs if you have bronchitis and so on. You can even get technical and make your raindrops into vitamin C, vitamin E, beta-carotene and other potent antioxidants. Communication between your meditating-visualizing brain and the resources of your body is more dynamic and more specific then you know.

When Bernie Siegel began talking about people's responsibility for their own health and healing in the face of serious illnesses such as cancer, people accused him of 'blaming the victim' by placing an unreasonable burden of guilt on the sick person. But you can't really take control of your health without believing that your health is to some extent under your control. Even a person who has been a victim of some catastrophic accident must believe that he or she can exercise control over healing, to at least a small but critical degree, through the expression of intention in prayer or visualization or by the exercise of sheer willpower.

For people with chronic illness, the lines of causation are more ambiguous than they are in an accident. However irrational it may be, all of us feel guilt for things that happen, like the ill-timed flareup of cold sores just before an important public appearance. Feeling guilty won't get you anywhere, but feeling responsible is the key to taking charge. If you feel like you're the passive victim of the event, you may miss a chance to engage your body's resources for healing. Only by feeling that you can take responsibility for your own health will you be able to make the changes that are necessary for regaining that health in the face of chronic illness.

Effects of dieting on eating control

Dieting causes problems with the control of food intake. Attempting to diet results in increased calorie consumption in certain situations. Dieters feel more out of control than non- dieters, and experience chaotic eating patterns.

Dieters aim to eat less and to control their food intake. Women often attribute their perceived 'large size' to their inability to eat appropriately, believing that the reason why they are over their desired weight is because they overeat. Women look at other people's eating behaviour and believe that they eat less and at different times and understand their own behaviour in terms of loss of control. Dieting is regarded as a means to impose self- control and an external structure on their food intake. However, there is no evidence to suggest that, before dieting, women who are over their desired weight eat any differently or experience more episodes of loss of control than women who are at their desired weight. There is no evidence to suggest that larger women are more out of control than their thinner counterparts, or that women who decide to diet have experienced more overeating than those who don't.

However, there is evidence to suggest that dieting increases episodes of both perceived and actual loss of control. Imposing the dieting structure on food intake appears to have the opposite to the desired effect.

Perceived loss of control

Because of the limitations set by the diet, any food which is eaten beyond these limits is regarded as overeating and attributed to loss of control. Eating which would usually be seen as a large meal, a special occasion or a treat is regarded as overeating and indicative of lost control. The urge to eat which would usually be regarded as hunger is registered in terms of craving, and giving in to this urge is regarded as a weakness.

One woman said: 'When I start to diet I want to eat things I shouldn't eat. I want to buy fattening foods when I know I am on a diet.' She did not eat any more than before she began to diet; however, desires to eat certain foods are perceived as being a problem.

Actual loss of control

One of the main effects of dieting is that it contributes to actual loss of control over eating. Dieting causes increases in the preoccupation with food, making food more attractive, it alters responses to food, resulting in certain foods becoming 'forbidden', which triggers specific states of mind, and it causes mood changes. All these contribute to actual loss of control and result in the dieter eating more than she would have if she hadn't dieted in the first place.

One woman said that she found the diet very difficult. 'I feel depressed about dieting. I overate to start off with, felt depressed and then ate more. I felt that eating would make me happier, but I just felt guilty and wanted more to eat.' Dieting resulted in her eating more than if she had not tried to diet in the first place.

Another woman said: 'I can't cope at the moment with the feelings of deprivation that I get when I go on a diet. It wells up inside me and I panic and eat.' The diet made her feel deprived, and so even though she wasn't eating less, she then ate more to compensate.

Dieting aims to control food intake and to reduce food consumption. It aims to impose a structure on the dieter's behaviour and to result in weight loss. It doesn't appear to achieve either of these aims. The cognitive and emotional changes which occur as a response to dieting undermine attempts at eating less, and cause overeating, the very behaviour dieters are trying to avoid.

Men and dieting part 1

A couple of years ago I was explaining my area of research at a job interview. After I had given what I considered a clear and full account of my work, the only man in the room said 'There is an obvious logical error in your work'. I was totally taken aback and meekly asked what it was. 'What about men?' he said. I had never really considered men in relation to dieting before. My interest in the area stems from being a woman myself, and I always felt that it was nice to work on something that men hadn't managed to monopolise yet. This post is a concession to that male interviewer, and to the many other men who have told me 'it's just as bad for men'.

Men also have role models and heroes. Over the centuries, literature has been full of ever changing images of the ideal man. In 1813 Jane Austen wrote in Pride and Prejudice:

Mr Darcy soon drew the attention of the room by his fine, tall person, handsome features, noble mien; and the report which was in general circulation within five minutes after his entrance, of his having ten thousand a year.

Attractive men were tall, straight and rich.

In the 1950s Charles Atlas used to be the ideal man. Men were sold work-out kits and body-building equipment. They had to be large, powerful and strong. They were men of few words and lots of muscles. But what is the message now? Do men have an image that they have to conform to?

It is often assumed that the media focus only on women's bodies in their attempts to sell a wide variety of products. Most adverts still have women modelling anything from clothes to cars

to cleaning fluid. I asked several men if they felt there were pressures on men to look a certain way.

One 25-year-old NHS manager immediately replied: 'Definitely' and proceeded to provide a detailed description of the ideal man:

You have to be tall, in a sharp suit (casual but smart), exuding money. The ideal body is well built, wide shoulders, a v-shaped back tapering to a firm bottom with dimples and a flat stomach.

He felt that men used to be proud of their beer guts but now they were ashamed and hid them.

Another 25-year-old man said that the ideal man was summed up by the actor Richard Gere: 'Not over-muscular, fit and at fighting weight. So that you don't really notice his body, but it is capable of doing what it's supposed to do without impairing itself' He felt that the ideal body was to do with fitness and health. He felt that the ideal body was one that was not noticeable because it was 'how a man's body should be'. Another felt that the ideal man was 'lithe, fit, stubbly and dark haired'.

I also asked several men what these images meant to them. The most common answer was that being tall, thin and fit meant that you were in control, and control was central to the 1990s' image of the ideal man. It also meant that you were healthy and confident and therefore capable of being a success in all other areas of life.

With the rise of the 1980s' work ethic, men in the media have become leaner; they look hard working and healthy. The ideal man does not self-indulge, he is in control and in command of his life. Hedonism seems to be becoming a thing of the past and this is illustrated by the contemporary ideal man.

So where do these images come from? These pressures seem to come from three sources: other men, women and the media.

One man said: 'Other men joke about putting on weight. They say "you're letting yourself go a bit" or suggest that you should take up squash at lunchtime.'

Another said, 'You overhear women talking about firm bottoms and flat stomachs and you realise that that's what they expect.' He also said: 'You know that women find certain film stars attractive. You also realise that they know nothing about them apart from how they look and what their bodies are like, so you realise that it is their bodies that make them attractive.'

The pressure also comes from the media. Over recent years there has been an increase in men used in advertising, all of whom are thin and stereotypically attractive. Media men have become less hedonistic and increasingly in control and reserved. In a recent television advert, a young man is used to advertise healthy pre-cooked meals. He is thin, healthy and represents clean living and self-control. He looks sensible. Male heroes of the 1960s and 1970s had an air of excess and debauchery about them. Now men are tame and controlled. The only media man that any of the men I interviewed could think of who was outside this image was Jack Nicholson who personifies total hedonism, self- indulgence and pleasure. Perhaps his attractiveness comes from his obvious rejection of social norms, and his ability not to conform, not to use tricks and not to be influenced by what other people expect.

Women tend to assume that men can get away with a greater variety of looks, sizes and shapes than women. It is believed that the male personality can compensate for many (but not all) physical characteristics. Woody Allen is a sex symbol; the female equivalent would never have even made it through the studio door. However, the media do seem to present an image of the ideal man of the 1980s and 1990s. How do men respond to these images? Do men feel dissatisfied with their bodies?

In 1968 Diabiase and Hjelle carried out a study to evaluate men's idea of the ideal body size. Groups of fat, average and thin men were shown silhouettes of male bodies which were also fat, thin and of average weight. The men were then asked to say which size they preferred and why. All the male subjects regardless of their own size preferred the average weight. They felt that both the thin and fat bodies represented qualities such as being shy, dependent and withdrawn, whereas the average-size body represented being active, energetic and dominant.

The men in the study showed a preference for a particular size. But was this reflected in a dissatisfaction with their own size?

Men and women were asked to rate their ideal size and their actual size. All the women subjects showed a large discrepancy between how they felt they looked and how they wanted to look, but the young men in the study did not. Regardless of their actual size, they felt satisfied with their weight.

Although men may report an ideal size and a preference for a particular body size this does not seem to be reflected in a dissatisfaction with their own size. It would seem that men are not directly affected with worries about their weight.