Welcome back to the Healing Pain Podcast with Dr. Susan Albers, Psy.D

In this episode, we are exploring food, mood and its connection to chronic pain. As you head into the holiday season, I wanted to make a special episode just for you because overeating and overindulging in food can be a challenge for each and every one of us. No doubt, you will attend holiday parties, office parties, celebrations with friends and families, and run into food around every corner from Thanksgiving straight through to the New Year. This is an important topic related to chronic pain because we know the food you eat can ease your pain or the food you eat can exacerbate your pain. One of the greatest challenges with food is that it can be used as a numbing agent for times when you’re feeling down or anxious. Using food to deal with chronic pain is a vicious cycle that can lead to increased inflammation, weight gain, hormonal imbalance, irritable bowel syndrome and problems with mood and sleep, all of which make pain worst.

Joining us to discuss the food, mood, pain connection is Dr. Susan Albers. She is a New York Times bestselling author and clinical psychologist at the Cleveland Clinic. She’s the author of eight mindful eating books, including her book called Hanger Management: Master Your Hunger and Improve Your Mood, Mind, and Relationships. She’s been a guest on popular TV shows including Dr. Oz and The Today Show. Her books, programs and tips have been featured in Oprah Magazine, Family Circle, Prevention and the New York Times. In this episode, you’ll learn all about hanger management and how to successfully manage it. The connection between food, mood, emotions and chronic pain. Some tips for eating more mindfully and because preventing hanger means staying one step ahead of it. Dr. Albers will provide you with a free PDF download to her Hanger Alert Scale. This tool will help you reach for good mood foods that are nutrient-dense and packed with fiber and protein to help reduce the stress in your body. To download the Hanger Alert Scale, all you have to do is text the word, 160DOWNLOAD, to the number 44222 or www.IntegrativePainScienceInstitute.com/160download.

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Hanger Management: Master Hunger and Improve Your Pain and Mood with Dr. Susan Albers, Psy.D

Dr. Susan Albers, welcome. It’s great to have you here. 

Thank you for having me.

I’m positive that people remember you from 2014, 2015 when you appeared on a summit that I had. It was called the Healing Pain Summit One and the Healing Pain Summit Two. Back then, you just released a New York Times bestselling book called Eat Q. I know you’ve had a lot of things going on since then. We’re going to talk about your book called Hanger Management throughout the show. Tell us some of the things that you’re working on that led up to that book.

It was such a pleasure to join you. Thank you so much for having me back. I learned a lot from your summit and I know everyone else did as well. I am a psychologist at the Cleveland Clinic and author of nine books on mindful eating. It’s a topic that I’m incredibly passionate about. I help people to cope with emotional eating, mindful eating, the mindless eating habits that we have in the world. I do lots of different things. I work with people in my office, teaching them these skills and tips, easy practical things that they can do to eat more mindfully. I also do speaking at different events and engagements and also I have a lot online. I love posting things on social media every single day to help people, to find ways, to insert mindful eating skills easily into their lives. I do a lot of different things. I do some media so you may have seen me on some TV programs. I’m excited to be here with you to talk with you about mindful eating, about if you are in pain. We’ll talk about the relationship between pain management and mindful eating, as well as a variety of other topics.

You can all find Susan’s work on her website, which is EatingMindfully.com. A lot of those great videos she has are 1 to 3 minutes long. The great tips you can find them on her website. You mentioned a lot of your work focuses around eating mindfully. What did you see in your clinical practice that started to perk your antenna up a little bit around the topic of hanger or what you’re calling hanger management?

Describe what hanger is for those of you who may not know. It’s the combination of the word hungry and angry and we all have been there. It’s that irritable feeling that we get when we don’t eat well or eat well enough and suddenly we’ve come to this different version of ourselves. It can be like Jekyll and Hyde that one minute you’re fine, the next minute that you’re not. I’ve been working with mindful eating, teaching people tips for a long time. What inspired me was a couple of things. First of all, I have noticed that the relationship between how we feel impacts what we decide to eat and what we decide to eat impacts how we feel. There’s that bi-directional effect. What I found is that often people were looking at it in one direction, that when we’re feeling bad, we tend to eat. It goes both ways. I was fascinated to share with people different foods that boost their mood and different ways in which when you tune into your body, you notice the queue set that you get every single day about how to eat, when to eat and it’s about decoding your hunger.

I talk a lot about that in the book of how to decode your hunger so that you can boost your mood and make the best decision as possible. I have hundreds of clients that come in that tell me stories about things that they did when they were not eating well or dieting. Dieting definitely is not the number one reason that people get hangry. What research shows is that they tend to make a lot of decisions that they wouldn’t make. Their focus is poor when they are not eating well enough or dieting. I take a good look at this of all the benefits that you can get from eating well. The final reason that I was motivated to write this book is looking at my own family. I noticed that they are all healthy mindful eaters but when my kids, my husband, when they are particularly overly hungry, maybe they all had a long day or I picked my kids up from school. All of a sudden, the sweetest people in the world become very hangry. It was interesting to see this change of mood that people have when they aren’t eating well. You’ve witnessed this as well.

It can be the clouds part and the full moon comes out and all of a sudden, you’re this sweet person and then you’re a screaming werewolf. You want food in front of you. Oftentimes, it’s the foods that don’t help and support both your brain and your body.

There are times that people become particularly vulnerable to being hangry. The three times that I talked about many different vulnerable points in the book. About 40% of people skipped breakfast. By the time it is mid-morning, they are all of a sudden incredibly hungry and incredibly hangry. Also, another time is Friday nights. People are saving up their calories all day long to go out to dinner and they have a long wait line. The people in line are often getting restless and hangry because they’re waiting. We learn different strategies for paying attention to your hunger, feeding your hunger and choosing foods that worked for you to regulate your hunger and make you feel good.

I want to come back to some of those foods. I know they’re important. Everyone who follows this show is into nutrition and healthy eating. I know one of the great things that you talk about is not going on crash diets, it’s not going to extreme starvation diets. It resonates with a lot of people because it helps them, especially as we move toward the New Year and people looking to optimize their health. Let’s talk about emotions because often our emotions are tied to food. What are maybe 2 to 3 most common emotions that arise in people that might be prevalent in people with chronic pain as well that causes them to become hangry?

There is quite a relationship between chronic pain and emotional eating. People who are struggling with pain have difficulty soothing themselves. When we eat that food, it releases dopamine often to the brain and they are finding other ways to calm and soothe their body. It’s understandable that when we’re in pain, we make this B-line for something that instantly makes us comforted. In the long run, what we find is that it creates a whole different cycle of unright dysregulating blood sugar and adding to pain instead of soothing and taking it away. It’s a temporary fix but then creates a bigger issue in the long run. For most people, every day, some of the feelings that prevent them or stand in the way of eating well are what I call being blue, busy or bothered. Either we feel blue and we are stressed, overwhelmed and don’t feel up to eating well and super busy.

I have clients sometimes who tell me they forget to eat. They’re busy running around that it’s not high on their priority list and then by the time they do eat, they’re starving and hangry and then bothersome. Sometimes it feels like it’s a lot of effort and when you’re in pain, it can feel like one more thing to do to prepare or gather that healthy food and it can feel like why bother or I’m overwhelmed that I don’t want to do it. Those are some of the feelings that stand in the way. The good news is that there are some simple and easy things that don’t make it overly bothersome or that are easy so that you don’t feel overly taxed and you can fit this into your life because that’s what we want. We want simple and easy things that we can do and not feel even more overwhelmed.

I love the three B’s of that busy, bothered and blue. Those are easy. People can write those down and put them on a little Post-it and they can develop some mindfulness skills around it. What are some of the tips that you have for starting to turn around hanger? Let’s start with the food first because food impacts your mood. What are some of the healthier choices we should be making with regards to food and our hanger management?

There are some do’s and don’ts. What is most important to begin with is what I call hearing your hunger. I have this metaphor in the book that talks about hunger are like your neighbor who comes knocking at your door. Your neighbor knocks on your door and you’re like, “Here’s this neighbor again.” We feel with our hunger and sometimes we’re like, “I’m hungry again. What do I do?” You try to ignore it for a while, but your neighbor continues knocking on the door and then they knock and then they knock louder. Finally, you’re exasperated, open up the door and you say, “What is it that you want?” You get them whatever they want just to make them go away. We do the same thing sometimes with our hunger as well. We ignore it and then we say, “Whatever.” We will eat whatever is around in handy instead of being full and mindful of what we choose. Number one tip for anybody out there and for clients, for yourself is to hear your hunger and take it seriously when it be first begins to knock. When you hear that first knock of hunger, taking it seriously and noticing, giving yourself that tap on the shoulder when you say to yourself, “I’m too busy or not right now,” pausing and taking a moment and taking it pretty seriously. It’s interesting when my clients start to pay attention to their hunger and how their body responds to certain foods, they start to notice some patterns.

There are certain foods that particularly with pain can inflame their pain. Things around like sugars and you talk a lot about this in your program, how sugar can cause a lot of inflammation. On the other hand, the foods that when they eat them that are soothing to their body. One of my favorite foods to recommend if you have any stress or pain in your life is Mandarin oranges. I love them because they go in your bag, you can take them anywhere. They are easy to eat, they help with some sweet cravings, but they also have a great dose of vitamin C in them. We need that when we’re in pain or our immunity is down because we’re feeling stressed. We can take a mindful moment to eat it as well. It’s a very portable food. When people eat an orange, no one experiences that regret or feeling icky in comparison to other foods like fatty, sugary, salty foods. They feel good. I love that relationship with food where people enjoy eating it but they also feel good afterward.

I love that because if you look at the research on foods that have anti-inflammatory and a technical term was it’s called the antinausea septic, which means that it’s against pain or prevents pain. There’s something in citrus that stimulates the natural opioid receptors in your body. You get that feeling of feeling good. That’s why when someone peels and opens an orange, it’s like the sun came out and you feel right. You get that sensation of like, “I want that and I feel good right now.” It’s amazing how food can stimulate you to feel better but soothe you in a way that’s healthy.

Going back to the orange is that citrus aromas have been shown and tested and researched to be calming naturally. If you go into some hotels or high-end restaurants, they pump in citrus aromas because it calms people down or in spas. It’s powerful the foods that we eat and how we respond to them. Sometimes it’s on such a subconscious level and you start to pay attention to it.

Pain can be challenging and people are looking for ways to soothe themselves. Food can be one of those ways for both the good and the bad of it. How would one respond to themselves or maybe if it’s a practitioner working with a client? If someone were to say, “I understand all of this but because I’m in pain, I feel like I deserve more chocolate or I deserve more ice cream.” How do you respond to those types of questioning?

We all do that. We insert that word deserves a certain kind of food. It’s a little bit of changing your mindset of taking out that I deserve a particular food and what we all deserve is some comfort and soothing. That’s an automatic thought that we have in our heads, “I deserve chocolate, I deserve some treat.” What we deserve is soothing. When your mind tells you, “I deserve chocolate.” Yes, eating that chocolate in a mindful way. If you want chocolate, that’s great. Eating it, savoring it, but taking it out and looking at what triggered that thought. Often what you’re looking for is not chocolate, but you’re looking for some soothing in the body, identifying and you can speak to this more of where in the body you’re experiencing pain. If you feel that you need some soothing targeting that part of the body.

One of the tips I love for my clients and super easy and simple is taking a tennis ball and putting it under their feet or behind their back, rubbing against the wall and having a soothing moment of being able to relax the body. Taking some clothes or robe, putting it in the dryer or heating it up and cocooning, wrapping the body to soothe in comfort. When our mind says to us, “I deserve chocolate,” it’s, “I deserve soothing,” and trying to figure out what inside of you need soothing. That’s not always easy. It takes a moment to decode it and figure it out.

In your book called Hanger Management: Master Your Hanger and Improve Your Mood, Mind, and Relationships, I believe you have over 40 different tips on how people can help themselves or sooth themselves in ways that are more beneficial instead of grabbing for those sugary or high fat or for grabbing for food at a time when you’re not hungry. You’re confusing those hunger signals with some of the other emotional signals out that are coming up. You also have a great free gift for us, which everyone is downloading. It’s called the Hanger Alert Scare: Preventing Your Hunger. It means staying one step ahead of it. Can you tell us about the Hanger Alert Scale?

We are good at identifying when other people are getting hangry. We see those signs. They’re getting restless. They may be wandering around the kitchen looking for something. There are some pretty obvious signs. What’s harder is tuning into yourself and knowing what those cues are. I created this scale, please feel free to download it, hang it up on your refrigerator, take a look at it. It’s trying to prevent getting to that point of overly hangry. Looking at that scale and tuning in, asking yourself, “Where am I on that scale? How hungry am I physically?” Physically is an important part of that because often we say, “I’m hungry,” but when we tune in, we are feeling bored, stressed, something else. This is a way that we can tune into ourselves and prevent getting to that point of overly hungry or hangry because nobody wants to be hangry and you can master it in yourself. 

I have over 45 different tips and what I love about this format is that it’s in 45 different 1 to 2 pages. Flip through this book. It’s easy to read. I know often my clients don’t feel like they don’t have time to go from start to finish. You can flip through it at your own pace and pick out different tips from it to incorporate into your everyday life. There’s a variety of different tips, things from foods to eat but also ways to soothe and calm your body. Most importantly, the last chapter is ten different easy steps that I call the Ten S of Mindful Eating to get you started. That can be either for you or if you work with someone, clients or family members who want to get started on mindful eating. It walks them step by step through that process.

You can download that Hanger Alert Scale by texting the word, 160DOWNLOAD, to the number 44222 or you can go to www.IntegrativePainScienceInstitute.com/160download. Speaking of those Ten S of Mindful Eating, can you explain to us two of those so we have a little sneak peek about what you have going on in the book?

Mindful eating is more about how to eat than what to eat because we have a lot of mindless eating habits and ways that we interact with food that promotes mindless eating. They sound easy, but they can be challenging when we get started with them and we give our attention to them. The first S is to sit down while you eat. Think about how often we’re walking around when we eat. We roam around, we walk around and sitting at a table helps to increase our focus. We enjoy food more and we have more control when we are sitting at a table. My motto is, “Always eat off your feet.” Try it. If you find yourself wandering around while you eat, commit to a moment to sit down. Give it all of your attention. Number two is to chew slowly. It sounds easy but what research shows is that we tend to match or mirror the pace at which we are eating with other people. Even strangers who don’t know each other, research has shown that they tend to match their pace.

As you sit down and you’re eating with somebody, gauge your pace. It’s like when we’re in a car and we’re driving, we have to tune in and choose how fast we want to go. It’s the same with chewing. The more that we slow down, it helps to get your body ready to consume and digest this food. We enjoy it more, but it also slows us down a little bit to eat and enjoy this food. I always say that we can eat an entire plate of food and that takes one single bite. Slowing down is a helpful step in that. Sit down, slowly chew. One of my favorite tips is eating with your non-dominant hand, I’m right-handed. Putting the fork in my left hand is one way that it can help to slow you down while you eat. It feels a little funny at first but you’d be amazed at how much more attentive you become.

I love that eat off your feet. That’s important. That’s something that people have lost, they become so busy in life. People stand in front of TVs and computers and they eat and have whole meals like that when their body’s still in this fight or flight or not as relaxed as ideally they should be. Everyone can find your book, Hanger Management, on Amazon. It comes out on December 24th, so it’s going to be a Christmas gift. Right around that time, people are starting to think about the New Year. They’re thinking about their health. They want to lose weight, they want to optimize their health. They’re starting to even look at different types of diets and diet books. I know you’re not a big fan of diets and dieting. Tell us why Hanger Management would be the perfect companion to someone who’s changing their eating habits or their style of eating right around the New Year.

The New Year is a great time to start being more mindful of what you eat. It’s the reset date and it’s a blank slate of a whole year. If this is you, you want to improve your health, you are thinking about managing your weight or overall wants to change your relationship to food. This is perfect and this is a great time for you. Putting dieting aside and I know that’s hard because the newest and latest greatest diets that are out there, it’s tempting to go for those. Try putting those aside and what you’re going to find is that when you learn mindful eating habits, you can do it anywhere, anytime. I love this because, for many of us, we eat out, we are eating at the office and this is something that you can do anywhere. I’ve noticed with dieters, they’ll say, “I fell off my diet because we went out to dinner and I couldn’t do my diet there.” This is not what that is like. You can eat mindfully no matter what foods or eating plan is.

I know some people have specific ways that they eat, whether they’re eating gluten-free or they have an allergy or they adhere to certain food preferences. It’s fine. That’s what I love about mindful eating is that it’s for everyone, kids, adults. I teach my own kids how to eat in a more mindful way. They’re pretty young and it’s interesting to see that even kids can pick up this concept of changing the way that they eat instead of eating in front of screens and slowing down and forming these habits early in their life. If this is not you, that’s okay because these are things that anybody can learn.

Some of all of the work in your books and in your blogs, all the lectures that you give, there are such simple and easy tools for people, which is important because people are going to dive into these big restrictive diets. Even if someone may need that, they still need the behavior change and the psychological support all of your work points towards. Susan Gabe was kind enough to give a free lecture to all the participants in my function, Nutrition For Chronic Pain Certification Program because they were learning. In the program, you learned about all these different types of diets and we got to the point and they said, “I’m working on the diet of my patients and it’s going well but I noticed there are some other little things happen here.” I said, “I know the person we need to bring. It was Susan Albers.” Should we say hi to my mom, Susan?

She’s one of my biggest fans.

My Mama Tada is Dr. Susan Albers’ biggest fan.

I appreciate that. Whenever I’m on the news or such, I get an email from her, “I saw you.” What I love is that I’m not exactly how sure how old she is and your dad as well. They read the books, follow the tips and incorporate them into their life. It’s never too late and it’s helpful at any point. With my own parents who have struggled with some health issues, how much it can turn around a lot of those health issues that people have.

My dad went from 225 pounds all the way down to about 175. He’s done that through a modified Mediterranean diet, which he loves and enjoys, but he also uses some of your work in there.

What I love about your parents is that they have a lot of energy and you can see that. I’m sure it’s part of their lifestyle, how they eat and how they live.

I want to thank Dr. Susan Albers for being with us. You can find out all the information about her on her website, which is EatingMindfully.com and as we come to a close, make sure you open up a new browser on your computer, go on to Amazon and order Hanger Management. It’s available in stores on 12/24. You can get them pre-order on Amazon. It will be a great tool for anyone you know who’s moving into the New Year.

I have over $397 worth of bonuses of things that you can download and an exclusive ticket to an online class with me. Once you get the book, you can read through it and join my class. Don’t miss these bonuses. They’re awesome.

Make sure to check them out. All of that is available at EatingMindfully.com. I want to thank Dr. Susan Albers for being on the show. Make sure to share this episode with your friends and family. People are looking for ways to eat more mindfully, to lose weight and to feel better. See you next time.

Thank you. Remember to eat, drink and be mindful.

Important Links:

• Hanger Management: Master Your Hunger and Improve Your Mood, Mind, and Relationships
• Dr. Susan Albers
• EatingMindfully.com
• www.EatingMindfully.com
• http://HangerManagement.securechkout.com/5videoseries
• https://www.Facebook.com/eatdrinkmindful/

About Dr. Susan Albers, Psy.D

Susan Albers, Psy.D is a New York Times best-selling author and a clinical psychologist at the Cleveland Clinic. Dr. Albers graduated from the University of Denver and completed a post-doctoral fellowship at Stanford University in California.

Dr. Albers is the author of eight mindful eating books including her latest– Hanger Management, EatQ, 50 Ways to Soothe Yourself Without Food, 50 MORE Ways to Soothe Yourself Without Food, Eating Mindfully, Eating Mindfully for Teens, Eat, Drink, and Be Mindful and Mindful Eating 101.

She has been a guest on the Dr. Oz TV Show, TODAY show and NPR. Her books, programs and tips have been featured in O, the Oprah Magazine, Family Circle, Shape, Prevention Magazine, Self, Health, Shape, People, New York Times, Fitness Magazine, Vanity Fair, Natural Health, the Wall Street Journal.

The Healing Pain Podcast brings together top minds from the world of pain science and related fields to discuss the latest findings and share effective solutions for persistent pain.

If you would like to appear as an expert speaker in an episode of The Healing Pain Podcast contact [email protected].