Dr. Kessler, in his book the End of Overeating, devotes the latter section of his book to the theory of treatment. And before we can even begin to protect ourselves from all the stimuli, we have to recognize just how vulnerable we are. And to do that, we must be mistrustful of our brain. We have to learn to recognize when a conditioned response is being triggered and stop our response. And that’s not easy.
Effective intervention draws us away from the conditioning power of a stimulus before it triggers its usual response. It reminds us that it’s possible to say no. Intervention begins with the knowledge that we have a moment of choice — but only a moment — to recognize what is about to happen and do something else instead.
Our vulnerability to the stimuli will not disappear. Once those pathways have been established in our brain, we can lessen their force and we can build new ones, but the old connections will remain. Dr. Kessler uses ex-smokers to illustrate the way the connection between a cue and a memory is never fully severed.
Cigarettes are a good illustration because they build the same sort of highly reinforced connections as hyperconditioned overeating (and cocaine addiction, for that matter). For many people, the urge for a cigarette never completely goes away and can resurface at certain times or in response to certain triggers even decades after you’ve quit smoking. While the substance itself may have been removed from the body and we have worked through any systemic physical withdrawal, our brains have been rewired by the addiction.
I could certainly empathize with that description. I quite smoking on July 26, 1996 after smoking — often quite heavily — for roughly two decades. That was almost sixteen years ago, but hardly a day goes by that something doesn’t trigger a desire for a cigarette. I can still remember the sensation and anticipate the “rush” from that initial drag. And it takes an act of will each time to tell myself I’m not a smoker. After this many years, it’s not particularly difficult to resist anymore, but those old pathways are definitely still there.
Of course, we can live without cigarettes. We can’t live without food. So how do we overcome conditioning and create a more healthy pattern of eating? The very first step is awareness.
Being aware means that you have a conscious knowledge of the risks of a given situation. “You have to figure out the situation that leads you to eat, that leads you to start the chain of behaviors,” said Miltenberger. “That is the absolute first step — to catalogue all of the stimuli, all of the situations, all of the cues that start that chain.”
Once we can identify the premonitory urge, the initial step in the compulsion, we can begin to train ourselves so we don’t respond to it. We can set up competing behaviors. And we can formulate thoughts to quiet the old ones we are trying to remove. Most of us also require support. We can’t do it on our own. But it all starts with awareness.