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Developing Discomfort Tolerance

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Developing Discomfort Tolerance

(Something to try when you get hungry)

By: Warren Huberman, Ph.D.

One of the most common questions I am asked by patients prior to surgery is “What do I do if I want to eat something after surgery when I know I’m not hungry?” This question stems from anxiety regarding emotional eating and the possibility of weight regain. Many patients recall that these thoughts and feelings triggered relapse from previous efforts to lose weight. There is also the growing concern about what is being called “addiction transfer.” Patients are nervous that if their ability to eat is inhibited by the surgery or by efforts to avoid eating that this urge will somehow morph into some other maladaptive coping mechanism like consuming alcohol. Interestingly, despite much anectodotal discussion about “addiction transfer” there is not much clinical support for such a phenomenon. But the question remains…”What do I do if I want to eat after surgery and I know that I’m not hungry?”

Many patients tell me that they have tried at least one of hundreds of suggestions to cope with hunger…drink some water, go for a walk, eat something healthy, do a crossword puzzle, call a friend…and the list goes on and on. One suggestion that is seldom discussed is to do nothing at all, but rather to try and understand and tolerate the discomfort. Perhaps this sounds shocking to you. Our culture places such a premium on being comfortable that we seem to have lost the ability and the skills to tolerate discomfort. We have 26-way adjustable seats, televisions in every waiting room, drive-through pharmacies, and remote controls for every electronic device. Heaven forbid that we experience any inconvenience or discomfort! Where did we get the idea that we must be comfortable all the time? Why do we believe that we must deperately try to distract ourselves away from all sources of discomfort such as hunger or emotional distress by talking with friends, taking walks or doing crossword puzzles?

These activities of distraction, although not harmful, are a means of escape. By engaging in one of these activities we are essentially telling ourselves that “I can’t stand the discomfort of being hungry…I must find something to distract myself away from this absolutely intolerable feeling…danger, danger, danger!” It’s simply not true.

The next time you experience the urge to eat something when you’re not truly hungry, instead of engaging in an activity to escape from the discomfort, sit with it for a few minutes. Examine the feeling and ask yourself just how intolerable it is. Consider rating it on a 1-10 scale and ask yourself if you truly “can’t stand it!” Is it a mild discomfort or genuinely painful and intolerable? Try sitting in a chair and taking a few deep breaths over the course of two to three minutes and see if you can manage to reduce the anxiety and discomfort. Sounds crazy but at times it will most certainly work. By practicing this exercise and gaining some mastery and control over your response to the discomfort of hunger, you learn that you can actually tolerate the discomfort. Therefore, it is less likely that you will feel anxiety the next time the hunger occurs as you will know that you can “stand it” and that you don’t have to run away. This is how we develop discomfort tolerance and the ability to take care of ourselves despite the presence of discomfort. We try very hard to teach it to our children as we do not indulge all of their crying episodes and tantrums. We teach them to try and cope until the discomfort subsides. It is a great skill to learn to tolerate discomfort and ride it out until it subsides. Try it out!

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