eyebrows, attthe way up. 2.
Close youreyeUds andtake adeep breath. 3.
Exhale; let your eyesrelax and let your body float.
As you feel yourselffloating, you permitone hand or the other to feel like a buoyant baUoon and aUow it to float upward.
As it does, your elbow bends and your forearm floats into a vertical position.
Sometimes you may get a feeling of magnetic puU on yourhand asit goes up.When yourhand reaches thisvertical po sition, it becomes a signal for you to enter a state of meditation and increase your receptivity.
In this state of meditation, you concentrate on this feeling of imaginary floating and at the same time concentrate on these three messages: 1.
Formy body, overeating is a poison. 2.
I need my body to live. 3.
I owe my body this respectand protection.
In the beginning, do these exercises as often as 10 different times a day,* preferably every 1-2 hours.
At first, the exercise should take about a minute, but it will come more rapidly with practiced As you meditate, reflect on the impUcations of these critical points and then bring yourself out of this state of concentration by counting backwards in this manner: Three, get ready; two, with your eyeUds closed, roU up your eyes (do it now); and one, let your eyeUds open slowly.
Then, when your eyesare back into focus, slowly make a fist with the hand that is up and, as you open the fist slowly, your usual sensationand control returns.
Let your hand float downward.
This is the end of the exercise, but you retaina general, overaU feeling of floating.
By doing this exercise (at least) 10 different times each day, you can float into this state of buoyant repose.
Give yourself an island of time.
Twenty seconds, 10 times a day, in which to use
I have some patients who must do this 15 times daUy, including once before each meal. t Requiringonly about 20 seconds eachtime.
Howto Curb Carbohydrate Craving or Overeating 199
this state of extra receptivity to reimprint these three points. Re flect upon it, then float backto your usual state of awareness and get on with what you ordinarUy do.
Camouflage Now, suppose an hour or two passes and you want to do the ex ercise.
You don't have the privacy and you don't want to attract attention.
Here's the way to camouflage.
There are two changes.
First, you close your eyes and then roU your eyes up, so that the eye roU is private.
Second, instead of your hand coming up as done in the hypnosis session [with the hypnotist], let it come up and touch your forehead.
To an outsider, the exercise looks as though you are in deep thought.
In 20 seconds you can shift gears, establish this extra receptivity, reimprint the critical points, and shift back out again.
You might be sitting at a desk, a table, or may be in a confer ence,in which case you leanoveron your elbowwith your hand already on your forehead, you closeyour eyes,roU them up, and shift into the brief meditative state.
By doing this basic or camouflaged exercise every day, every one or two hours, you estabUsh a private signal system so that you are ever alert to the messages you are sending yourself and the commitment you are making to yourselfand your good health.
HOW TO DO IT
It is possiblebut unlikely that you wiU be ableto master this technique without training from a professional medical hypnotist. Sufficient training should be possibleto accomplishin a single office visit with a doctortrained in medical hypnotism.I stress the necessity of usingthe services of a doctor because I have had patients who, upon visiting nonphysician hypnotherapists, were convinced (you might even say conned) that many office visits were necessary, and spent considerable sums but faded to learnthe technique. (If the word"hypnotism" auto- maticaUy conjures up images of charlatans and carnival sideshows in your mind, this may be a reason.) You should be able to locate a competent medical hypnotist by phoning the department of psychiatry at the nearest medical school or
200 Treatment
teaching hospital.
Ask for the secretary/assistant to the chairman of the department, and then ask who their top MD hypnotherapist is.
Your insurance may or may not cover the visit, depending on your plan, but it almost certainly wUl not pay for a nonphysician hyp notherapist.
When you visit the MD hypnotherapist, bringeither this book or a photocopy of the above paragraphs so that he/she wUl know exactly whatyou are seeking.
If youUve withina reasonable distance of New York City, Dr.
Spiegel's office is located on East Eighty-eighth Street and his office phone number can be located in the Manhattan direc tory.He is the hypnotherapist to whom I refer my patients.
In Trance and Treatment he is very emphatic on the foUowing
AcceptresponsibUity for Your Eating Behavior.
It is very tempt ing to blameyoureating behavior on your parents, yourwife,the mayor, Watergate, the moon, the tides.
As soon asyou seethe ab surdity of that you wiU realize that of aU the things you do in Ufe, there is nothing in which you are more clearly 100 percent re sponsiblethan your eatingbehavior.
Reflecton the fact that most of the things you do in life have to take into account other con siderations or other people, but in your eating behavior you are in business for yourself.
I should note that Dr.
Spiegel's three points, or messages, were de veloped for the treatment of obese overeaters, not necessarUy diabet ics but certainly people at higher risk for developing type 2 diabetes.
For many of my patients, his three points hit the mark.
For others, the points they want to stress are more closely attuned to their personal situations, and you can customize your approach as weU.
I have one patient who is simultaneouslylosingvision and kidney function.
This patient's personal points are to curb overeating in order to preserve eyesight and to stayoff dialysis.
Another teUs herselfthat she doesn't want to be like the ladywho Uved across the street from her when she was a kid , the woman was diabetic and had both her arms and legs amputated.
Another patient is a fund-raiser , his points areattuned to the greater likelihoodof people making donationsto someone who is slim and trim rather than obese.
Makes sense.
Some people havea difficult time remembering to hypnotize them selves every 1-2 hours, so for these people, I recommend an alarm
HowtoCurb Carbohydrate Craving orOvereating 201
watch (which youcanpurchase quite reasonably) that canbesetto go offevery hour.
Getone that has a vibration mode ifyoudon't wantto be beeping regularly,* and you can use the camouflage technique if your situation requires it.
For those who learn how to hypnotize themselves and do it 10-15 times a day, I've found that the success rate for curbingcarbohydrate craving is about 80 percent.
For those who hypnotize fewer than 10 times a day, the success rateisessentiaUy zero.
I cannotoveremphasize thevalue of engaging in autohypnosis when yousit downat a table for a meal, especiaUy if you're in a restaurant and have not yet ordered.
I have patients who are walking around with normal blood sugars only because they have been successful using this technique.
It has the added benefit of having no toxicity whatsoever, and it might be used to change other behaviors (smoking, biting fingernaUs, and so on).
There is, however, a major problem with autohypnosis.
I find that many patients either refuse to try it or eventuaUy stop doing it, even when itworks.
The foUowing section offers asolution toovereating that people have beenmorethan wiUing to pursue and continue to use.
WHAT IF YOU CANNOT BE HYPNOTIZED OR OBJECT TO AUTOHYPNOSIS?
I have a simple, patented technique that has had a very high success rate for those of mypatients who otherwise have great difficulty con trolling carbohydrate intake.
I have been prescribing it for several years but cannotyetbe certain that it wUl work indefinitely.
It relates to the "runner's high" that people often experience during and after exercise, but it doesn't require running.
You may already know that very strenuous, prolonged physical exercise and climactic sexual activity cause the brain to produce en dorphins, also known as the body's own opiates because they are pro duced internaUy (or endogenously , so they're known in medical
An excellent source for such products is e-PUl, LLC, 70 Walnut Street,Welles- ley, MA, (800) 549-0095, orwww.medicalwatches.com. I recommend their Pager Vibrating Multi-Alarm ($75.95). It will give asmany alarms asyoudesire if used in the "repeat countdown" mode.
202 Treatment
circles as "endogenous opiates") and bind to receptors in the brain that bind actual opiates, such as morphine and codeine.
Endorphins cause a pleasant, relaxed feeling, simUar to that of narcotics, but to a mUder degree andwithout producing a tolerance.* You may haveno ticed that serious runners and many professional athletestend to pre fer protein foods, don't crave carbohydrate, and don't become fat as longas they continue theirsport.
It wouldseem that theirendorphins prevent overeating and carbohydrate craving without losing their ef fect over time as do traditional appetite suppressants.
This technique involves a medication caUed naltrexone, which was originaUy introduced as a treatment for narcotics addicts because of its abUity, in large doses, to prevent addicts from getting high on nar cotics.
In large doses, naltrexone wiU block the brain's receptor sites for endorphins, rendering them ineffective.
However, when taken in smaU doses, it also appears to raise endorphin levels in the brain.
A verysmaU dose of naltrexone taken at bedtime appears to block endorphin receptors for about 8hours.
Thebrain maycompensate for this by making more endorphins than usual that then keep working throughoutthe foUowing day, when receptors are no longer blocked.
I've found that a smaU dose of naltrexoneused in this way is very ef fective in controUing carbohydrate addiction and overeating in gen eral for about 73 percent of thosewho have tried it.
Furthermore, just like the endorphinsmadeby athletes, naltrexone, thus far in my expe rience, seemsto work for a prolonged period, perhaps indefinitely.
I've had only five patients who discontinued naltrexone because of uncomfortable side effects.
These effects included tiredness, headache, and difficulty concentrating on complex tasks.
Such problems always occur afterthe firstdose or a dosage increase.
When they occur,I must either lower the dose or discontinue the medication.
One patient whosnacked between dinner and bedtime also hadin somnia.
Since naltrexone made him tired, we were able to use it to treat his insomnia and his snacking simultaneously.
Naltrexone is suppUed in 50 mg tablets.
For the low dose that I prescribe, I use a compounding chemist to put naltrexone powder into smaU capsules , usuaUy about 4.5 mg.f
In medical terms, "tolerance" refers to declining efficacy over time, so that higher andhigher doses are required to produce the same results. fThe compounding chemists that most of my patients use are Rosedale Pharmacy, phone (888) 796-3348, and Rockwell Compounding Associates,