270: Losing Weight vs Gaining New Habits

Today’s podcast features an esteemed colleague and beloved friend, Dr. Angela Krumm, who will describe her personal victory over a recent weight gain. We will illuminate the TEAM-CBT techniques she used so that you can use them yourself if you’d like to lose some weight. But I have to warn you that you have to do these techniques using paper and pencil. If you try to learn and use them just from listening, they will not be effective. As an aside, if you go to my website, www.feelinggood.com, you’ll find a free chapter offer at the very bottom of my home page. If you click on it, you’ll receive two unpublished chapters from my most recent book, Feeling Great, with crystal clear instructions on the methods you’ll learn about in today’s podcast. Angela’s biosketch goes next, including how she joined David’s Tuesday training group when she was a post-doctoral fellow in clinical psychology and how she ultimately developed the TEAM-CBT certification program at the FeelingGoodInstitute.com. Hopefully Angela can help with this paragraph! As the podcast begins, Angela explains how she’s always viewed herself as a very fit, health-conscious woman who actually completed some marathons in the past. But during 2021, her life has been complicated by a number of tragedies and traumas, including: Angela’s father was sadly diagnosed with terminal cancer and died within four months. Angela had many personal injuries that impacted her capacity to exercise, including a laceration of her retina and a fractured toe. In addition, she fell backwards over a ledge in her backyard and plunged eight feet. She sustained a concussion and experienced many lingering symptoms for 6 to 8 weeks including dizziness, brain fog, and sensitivity to light. She described what happened next like this: All this time my weight kept creeping up. I stopped caring about exercise, and during the COVID crisis, food become a joy and an escape. Then, I had a wake-up call, an ah-ha moment when everything suddenly changed. Angela described attending a wedding, and her husband was the photographer. When she saw herself in the photos, she was shocked that she no longer recognized herself because of the weight she’d gained. She also noticed that the day of the wedding, she’d eaten six huge but delicious chocolate chip cookies that her niece had baked. She says, It hit me, and I didn’t have to think twice. There’s a history of diabetes in my family, and I didn’t want to keep gaining weight and struggle with all the medical complications of type 2 diabetes. I want to be healthy and fit so I can live to an old age and enjoy my children and grandchildren! She used behavioral and TEAM-CBT skills to tackle the problem, starting with setting specific goals for herself. She said that lots of her patients who are overweight have vague goals, like “I want to lose some weight” or “I want to get in shape,” but general goals won’t be effective. In TEAM, you always focus on something specific. Angela explained the critical difference between Outcome Goals and Process Goals. An example of an Outcome Goal would be telling yourself that you want to lose ten pounds or whatever your goal might be. There’s a big problem with Outcome Goals. You might go on an extreme, like fasting or eating very little, so you can lose weight fairly quickly. Then you will feel happy and tell yourself that you’re done when you’ve achieved your goal. The big problem is that you haven’t modified your eating habits, and that’s exactly why you will quickly gain back all that weight you temporarily lost. Process Goals are different. Instead, you focus on the number of calories you can eat each day in order to lose weight, and then you make wise food choices within your calorie limit. In addition, you start out with a gentle but consistent exercise regimen, and then you slowly build up to more exercise. Angela started with two workouts per week and built up to four weekly workouts over time. She also set modest and realistic goals for weight loss, setting a calorie limit that would allow her two lose weight slowly, at the rate of just ½ pound per week. This plan has allowed her to lose 21 pounds, and she was looking terrific today! She has been using a free app called Lose It which provides her with all the information she needs for tracking calories bd weight, along with her BMI (Body Mass Index). She’s now on a maintenance diet of 1800 calories per day and she’s really pleased with it. We also illustrated several powerful motivational TEAM-CBT techniques, including: The Triple Paradox. You divide a piece of paper into three vertical columns where you list Advantages of your habit / addiction: First, you list all the GOOD reasons to continue with the status quo of unlimited eating and little or no exercise. Disadvantages off change: Next, you list all the negatives and hassles associated with dieting and exercise. Core values: Finally, you list what your overeating and slacking on exercise shows about you and your core values that’s positive and awesome. As you can see, instead of pushing yourself, or your patient, to change, you go in the opposite direction. You take the role of the subconscious resistance to change, and list all the really powerful reasons to continue with your habit or addiction. In other words, you try to convince yourself NOT to change! Oddly, this usually triggers tremendous motivation to CHANGE. This paradox is one of the key features in all of TEAM-CBT. You can see Angela’s Triple Paradox workshop if you click here. The Habit / Addiction Log. Here you record your tempting thoughts, such as: One more treat today won’t hurt. I deserve it/ I’ve had a tough day! That brownie looks SO GOOD! I’m an active person so I deserve to eat whatever I want. The Devil’s Advocate Technique. This is a powerful role-playing technique where you challenge and crush the tempting thoughts. We illustrate this technique with role-playing on today’s podcast. Angela plays the role of her Self-Control thoughts and Rhonda and I play the role of the Devil, tempting Angela to give in to her tempting thoughts. The Problem / Solution list. You divide a piece of paper into two columns by drawing a line down the middle. In the left column (Problems), you list all the things that will sabotage your efforts to diet. In the right column (Solutions), you list solutions for all of those problems. You can see Angela’s Problem / Solution list if you click here. We also discussed the issue of therapist resistance to these rather unconventional techniques. The problem is that therapists and counselors are trained to help. This paradoxically triggers patient resistance. TEAM-CBT requires one of the four “Great Deaths” of the therapist’s ego—the death of the co-dependent self that feels the compulsion to save, rescue or help the patient. David gave a personal example of the extremely adverse effects of “helping” when he was the patient in an interaction with a health professional at Kaiser Permanente in California. The physician’s zeal for helping actually had the opposite effect of driving David away, and he did not go to the doctor for the next ten years. So now you have a feel for the TEAM-CBT approach to habits and addictions. These methods can be surprisingly powerful but remember. You’ll have to do them on paper, as Angela did, if you want success. Rhonda and I will probably offer a free, two-hour workshop on habits and addictions in late January, and if you attend, you’ll have the chance to try some of these techniques on for size. We hope you can join us! Thanks for listening! And thank you, Angela, for sharing your personal example and for your awesome teaching. Rhonda, Angela, and David PS, I thought you might enjoy this "selfie," showing the amazing results that are possible after just a few weeks with TEAM-CBT!. Keep in mind that I'm 79. Just imagine what a few weeks of TEAM could do for you!

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