Weight Loss Tip: Today I share with you an unorthodox idea that helps me decrease my carbohydrate and overall calorie intake: I drink hot chicken broth when I get the urge for a savory drink. In a previous tip I advised that the easiest way and first step toward a healthier and less caloric diet is to give up calorie-rich drinks, such as sodas, juices, and the like. Many alternatives, like water, carbonated or flavored water, and unsweetened tea, are neutral to slightly sweet in taste. Sometimes, as a change, you may want a savory drink low in calories. Last year when prepping for colonoscopy I drank clear chicken broth the day before. I found I liked it and was able to otherwise fast the whole day without ravenous hunger. So, now I drink hot organic low-sodium chicken broth – not homemade – when I’ve grown tired of the four or five different teas I’ve drank that day. Eight ounces of broth are between 15-20 calories, depending on brand. To the low sodium broth I add my sodium-potassium mixed salt to taste. You can add your favorite hot sauce, like sriracha, if you like. Unconventional, but you never know what works for you until you try it.

Weekly Photo

Today’s graffiti photo is from a Chicago alley off of McLean and Oakley Streets. If you’re ever in Chicago, nearby is a great casual Costa Rican restaurant called Irazu. I love their steak sandwich called the Pepito. What makes this sandwich so tasty is it is smothered in a traditional Costa Rican sauce called Lizano Salsa. This savory and sweet concoction is available online if you want to try incorporating it into some of your own dishes.

Rumination Vs. Coming to Terms

Today I start a new series: conundrums in mental health. Take the headline above: when does thinking about a past unpleasant, painful, or traumatic event lead to healing and when does it lead to continued or even greater suffering? We’re told – rightly so – that avoiding confronting past pain is a strategy bound to fail. After all, the past doesn’t stay buried, but rather intrudes on us when least expected and in surprising indirect ways, ways that stress us and lead to emotional and behavioral dysregulation. This stress and these dysregulated emotions and behavioral responses cause more problems, which perpetuates and intensifies the suffering originally caused by the past trauma – think PTSD as an extreme example.

So, a more adaptive solution would be to confront one’s past traumas. This indeed CAN be an effective, healing approach. But, as we may have learned from our own experience, or that of people close to us, or that of our patients, thinking about the past doesn’t always lead to self-healing. It may, just as easily, lead to a continuation or heightening of the pain. Thus, the conundrum: if avoidance doesn’t work and focused thinking about the past often does not work, what then does work?

The answer is that there are adaptive and maladaptive ways of thinking about and reliving the past; some strategies lead to healing and some to continued poking of the past’s hornet’s nest. Discussion of these different strategies is the focus of today’s article. In future articles, not necessarily published in a week-by-week stream, I will cover acceptance vs. change, sensitization vs. desensitization, worry vs. problem-solving, and a natural vs. constructive self.

Let’s begin with consideration of the word “rumination” because understanding its meaning leads to understanding why certain cognitive strategies fail. Rumination, in its original sense, is the act (by a ruminant, like a cow) of chewing cud. Chewing cud is repetitive and unchanging. Rumination as a human cognitive strategy does not work because it is repetitive and unchanging. If ruminative thinking of a past trauma does not lead to change in perspective, understanding, or narrative development, then nothing about our relationship to that past painful event has changed. In effect, the work of remembering and reliving the past is wasted and, indeed, often worse than wasted because it likely leads to a multi-factorial visceral (whole-body, emotional, sensory, and cognitive) experience of the pain, one that is dragged from the past into the present. Research data strongly bear this out (See Nolen-Hoeksema, 2000).

So, rumination can further scar. Not only by once again causing a reliving of the pain, but also by teaching the thinker that his or her reflexive strategies don’t work – they only seem to make the problem worse.

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Coming to terms, on the other hand, in its very words connotes movement, movement from one state of mind, one of “stuckness” within the pain to another state of mind, one of healing, acceptance, mastery, emotional equilibrium, understanding, and continued life purpose. The question is, of course, what mental strategies facilitate this movement toward healing? Here are some clues.

A 2005 research paper by Kross, Ayduk, and Mischel explored what distinguishes rumination from “reflective processing of negative emotions.” The authors tested the effects of two cognitive variables when subjects were asked to think about a past event associated with an angry emotional response: types of self-perspective (immersed vs. distanced) and types of emotional focus (what vs. why). In the “immersed” perspective, subjects viewed the remembered event from their own eyes, while in the “distanced” perspective they viewed it as from the point of view of an outside observer. In the “what” focus, subjects were instructed to represent the past event in its concrete, emotionally arousing, “hot” features. In the “why” focus, subjects were instructed to focus on the abstract, informational, and emotionally “cool” features of the past event. The researchers found that subjects taking the distanced-why perspective were able to maintain a “cool” reflective processing of emotions associated with the event without reactivating their “hot” negative emotions, the type of emotions that often lead to unconsidered, reflexive, and maladaptive approach-avoidance strategies.

In summary, to heal from the past, a person needs to maintain a “cool head,” one that enables a reflective state of mind that leads to a movement in one’s relationship to that past event, toward healing and understanding.

Until next time,

Dr. Jack


Today’s Quotes

“Speaking isn’t neutral or passive. Every time we speak, we bring forth a reality. Each time we share words we give legitimacy to the distinctions that those words bring forth.”
– Freedman and Combs

“The therapist’s task should not be a proselytizing of the patient with his own beliefs and understandings. No patient can really understand the understandings of his therapist nor does he need them. What is needed is the development of a therapeutic situation permitting the patient to use his own thinking, his own understandings, his own emotions in the way that best fits him in his scheme of life.”
– Milton Erickson

“As we become aware of ourselves as storytellers we realize we can use our stories to heal and make ourselves whole.”
– Susan Wittig Albert