Despite the title of this post, it isn’t really about why low-carb is harder the second time around per se. It’s more about attitude toward dieting and why diets in general are difficult, sometimes even the first time. What with it being a new year and all, I figured I would go ahead and get things stirred up early with my thoughts on the psychology of dieting.
I can’t begin to count the number of people whom I have seen in my office who have fallen off the wagon and who told me that they just couldn’t stick with their low-carb diet for any number of reasons.
A typical conversations goes something like this:
MRE: (In this drama, MRE is yours truly, the long suffering physician) So, Mrs. X, I see that you gained a little weight this week. What happened? Is there a problem we need to go over?
Mrs. X: Oh, no, not really. I had to put my mother in the hospital this week, and I just couldn’t diet with all that going on.
Other answers could be: My kids all came home from summer camp, and I just couldn’t stick to it with all that going on. Or my husband lost his job, and I couldn’t low-carb with that going on. Or I’m going through a divorce. Or … You get the picture.
These excuses bring to mind an absolutely wonderful book that I highly recommend, The Happiness Hypothesis. It was written by Jonathon Haidt, an associate professor of psychology at the University of Virginia and is filled with interesting perspectives on happiness, what it takes to be happy and even the scientific basis of happiness. The cover of the book has a sort of blurred photo taken from underwater of what appears to be an elephant with a rider on its back, which is central to Dr. Haidt’s thesis.
Dr. Haidt describes our minds and bodies (and by bodies he means not just our corporeal bodies but the working mechanisms of our bodies) as being akin to a rider on the back of an elephant. Our conscious, thinking minds he casts in the role of the rider, and the rest of us as the elephant. The rider can control the elephant as long as the elephant wants to be controlled. And if the elephant is okay with being steered and directed, then to all appearances, the rider is in control. But, if the elephant has other ideas, the rider basically just goes along for the ride.
Every time I think of this image, I’m taken back to our youngest kid’s dorm room in college where he played a bit of video he had taped from one of those Fox (I think it was Fox) shows from years ago called When Good Pets Go Bad. It was a video of a woman who, along with her three young children, went for a ride on the back of an elephant. The elephant was a part of some sort of performance and had been placidly giving rides to all comers. Once this particular family got aboard, the elephant decided it had put up with enough nonsense and went rogue. It stormed out raising hell and tearing up everything in site with the poor mother and her kids hanging on for their lives. The family ended up unharmed after the rampage, but the elephant had to be destroyed. Our kid loved the video showing all the people running in horror from this irate elephant and would play it in frame by frame mode so that he could see the looks of terror on all the faces of all those trying to flee. MD and I, being the attentive parents that we are, must have watched this video a dozen times as he pointed out all the nuances that he loved so much, so it is firmly etched in my mind.
This rogue elephant scenario is what Dr. Haidt thinks happens to us from time to time. Our rider (the conscious part of us) wants us to do something, but the elephant part of us doesn’t want to, and so the rider just hangs on for the ride while the elephant goes wherever it wants to go. We can put this in dieting terms. Our rider decides that the elephant needs to go on a diet. As long as the elephant is up for it, the diet hums along. But if the elephant has other ideas, the rider becomes an ornament. If things are going well, the rider has the appearance of control; if things aren’t going well, i.e., we had to put Mom in the hospital, then the elephant takes over. And the rider accepts it. He says, hey, I couldn’t control this beast because we had to put Mom in the hospital, and you know how he gets when we have to put Mom in the hospital. He wants to eat, and I, the rider, have to go along with him.
Yale psychologist Paul Bloom presents another way of looking at this situation in an enlightening article in the November 2008 issue of The Atlantic. He puts forward the idea that we all have multiple selves that we’re constantly dealing with, arguing with and trying to fool.
Let’s say that we’ve dined large late at night and are headed for bed. As we crawl into the sack with belly distended from a carb overindulgence and lie flat, we start getting the ol’ acid reflux feeling. We sit up, burp, drink some water, rub our chest and grab for the Tums. The self that is suffering says, ‘That’s it, I’m dieting tomorrow. I can’t stand feeling like this, not for one more night.’ The next morning the self that wakes up is a different person who isn’t experiencing reflux, doesn’t have a distended belly and is hungry. And, by God, hungry for some waffles, at that. The feel-good morning self may not abide by the rules laid down by the refluxing self the night before.
Bloom relates a story told by the Nobel laureate economist Thomas Schelling about his own multiple selves:
As a boy I saw a movie about Admiral Byrd’s Antarctic expedition and was impressed that as a boy he had gone outdoors in shirtsleeves to toughen himself against the cold. I resolved to go to bed at night with one blanket too few. That decision to go to bed minus one blanket was made by a warm boy; another boy awoke cold in the night, too cold to retrieve the blanket … and resolving to restore it tomorrow. The next bedtime it was the warm boy again, dreaming of Antarctica, who got to make the decision, and he always did it again.
Then Dr. Bloom goes on to tell his story of his own dual selves:
Late at night, when deciding not to bother setting up the coffee machine for the next morning, I sometimes think of the man who will wake up as a different person, and wonder, What did he ever do for me? When I get up and there’s no coffee ready, I curse the lazy bastard who shirked his duties the night before.
We are all like this. One of our selves makes a promise that another has to keep, or, more likely, try to weasel out of. One of ourselves gets us in a fix that one of our other selves has to get us out of. ‘What on earth was I thinking? How did that happen?’ our responsible self says when our fun-loving self does something incredibly stupid.
My responsible self says ‘No golf unless you get this project finished first.’ As the day wears on and my golf-addict self realizes that there is still enough light to get in at least 9, and it says ‘Hey, I’m almost finished, I’ll do it when I get home.’ When I get home, my tired self who wants to grab a glass of Jameson and kick back says, “Geez, why didn’t I just finish this job instead of playing golf? I’m a member of a golf club, for God’s sake; I can play any time, so why today when I had all this hanging over my head?’
And that’s the problem with all these selves. At least all my selves, and, I suspect, most people’s selves. These selves can outwit one another, and if the selves aren’t careful or if there isn’t a father-figure, responsible self towering above the others, not much gets done.
These two authors astutely identify the ways we as humans tend to deal with life. And since the part of life were talking about in this post is diet, these observations apply.
Our rider says diet, our elephant, in the throes of hunger, says screw that, I’m out of here. And the rider goes along for the ride.
Or our one comfortably-fed self gets us into a diet that our other hungry or our stressed-out self wants no part of and so bolts.
If you believe these two psychologists, we are pretty much doomed to stay overweight, insulin resistant, diabetic, etc. because when it comes right down to it, we don’t really have any control. What can we do as the rider of a runaway elephant? What can we do if our good self makes the deal but the other self won’t keep it?
If you think these ways of looking at dieting are outlandish, just tell me how many times you’ve heard (or even said) these words about a specific food (high in carbs, usually): I just couldn’t help it. I couldn’t resist. I gave in to the cravings. I couldn’t control myself.
Go back through the comments of the last couple of posts and read how many people wrote how they couldn’t deal with carb cravings. Probably the most common excuse I heard for dietary indiscretion from my patients was that they just couldn’t control their diet when under some stressful situation. The cravings got the better of them.
It sounds reasonable. Psychologists write about elephants and riders and multiple selves fighting with one another because that’s how most people tend to react. But it doesn’t have to be that way. We are not that helpless.
Back in the early 1980s a psychiatrist, William Glasser, M.D., wrote a book titled Take Effective Control of Your Life that I read at the time and thought to be one of the more insightful books I had ever read. The paperback version of that same book appeared a couple of years later under the title Control Theory. Both editions are now out of print but pre-owned copies can be had for pennies from Amazon. This is a book well worth reading. And not just for dietary help.
Dr. Glasser has gone on to bigger and better things and has become famous for an an entire school of psychiatric therapy. I’ve read most of his books, and profited from them all, but the one mentioned above is a true gem. I don’t understand why it still isn’t in print.
The insight that Dr. Glasser had and that I recognized in myself and in my patients as soon as I read his book was that people spend all their time worrying and stressing about things they can’t control and end up ceding control over the things that they can control completely.
Going back to our example at the start of this post, my patient who put her mother in the hospital didn’t have any real control over any part of what was happening. She couldn’t control her mother’s disease, she couldn’t really control much of anything that went on in the hospital. But she worried constantly about these things she couldn’t control and abandoned her diet, over which she had total, 100 percent control.
People do this all the time. One of the very few things we have complete control over is what we put in our mouths. Unless someone hogs us down, pries open our jaws and force feeds us, we have total and complete control of our eating. Yet how many times have we heard people say (or have said ourselves), I just couldn’t do the diet with all this going on. I lost all control.
Dr. Glasser understands about the rider and the elephant and the multiple warring selves, although he doesn’t call them such. And he has a game plan for dealing with them, which puts the control squarely in our hands.
He explains that all behavior has four components. He doesn’t explain these in dietary terms, but I will.
1. the physiological component
2. the feeling component
3. the thinking component
4. the doing component
We don’t have any control over the first two and only partial control over the third. But we have total control over the fourth, the doing component. Let’s look at how this all works with food.
Imagine you’re sitting in your office minding your own business when a co-worker comes in with a box of fresh, hot donuts, sticks the box in your face and says, ‘Have one.’ What happens?
First, your physiology kicks in. Your pancreas says, uh oh, here comes some sugar. Better get a little insulin cranked out to get ready for it. You get a spurt of insulin and your blood sugar starts to fall.
Then, as your blood sugar falls, you start to feel hungry. And your stomach starts to churn as it gets ready. This is the feeling component. And you have no control over this. It all happens and it is totally beyond your control.
Then you think about how good a donut would taste. And you imagine it. And you say to yourself, hey, it’s only one. What could it hurt? This is the thinking component, and you do have some control over it. But with the physiology and feeling components hard at work, it’s difficult not to think about the donuts. Difficult, but not impossible.
And all the above happens in just a few seconds.
Then you grab a donut and eat it. The doing component. You have complete control over this component. You choose to eat the donut. All the other components are ragging on you and you cave. And you say you had no control, but you really did. If someone had told you they were going to shoot you if you ate one of the donuts, you wouldn’t have eaten it. All the other three components (at least the first two) would have been acting the same, but you wouldn’t touch the donuts. You can control the doing component if you want to. Problem is the other three components gang up on you, trying to disable your will.
But, this can all the dealt with.
Dr. Glasser realized that the physiology to feeling to thinking to doing progression could be reversed. Since you have complete control over only the doing component, you’ve got to do something. And once you do, you can foil the progression. Because if you take different action, you can drive the progression the other way.
If you get up from your desk and say, No thanks, then leave your office and go involve yourself with something else all the components start to fall in line. Once you start doing something different, you start thinking about it, then your feelings of hunger go away and soon even your physiology falls into line. Your liver produces glucose to make up for that the little spurt of insulin knocked down, and soon you’re back to normal. And it doesn’t take all that long.
So, basically, we can be driven by a progression over which we have no control to abdicate the one thing we do have control over, our actual active doing. Or we can use our ability to do something to reverse control all the components that we don’t have direct control over.
Realizing that I had this ability to control the seemingly uncontrollable made a huge difference in my life years ago and continues to do so today. Knowing that I can control virtually any behavior, but especially my dietary behavior, by simply focusing my attention and effort onto a task or other activity has kept me on the straight and narrow multiple times when strong temptation fell in my path.
If the high-carb demon is goading you to go face down, telling you that you have uncontrollable cravings, just force yourself to go do something else. Soon the cravings will be gone. It takes a little practice, but it helps to repeat the mantra: I have 100 percent control over what goes in my mouth.
Take the advice of Dr. Glasser. Start worrying less over those things you can’t control and accept that you have no control over them. And take back control of the things you can. If you do so, you will be a much happier person. And a much thinner person.