From the Desk of Dr. E. Lee Rice
Eat to Live or Live to Eat — Are You Addicted to Food?
Married to Your Work — Till Death Do You Part?
Fanatic or Fantastic: Exercise Addiction Explored
Reflecting on the Scar: The Use of Journal Writing As A Recovery Tool

From the Desk of Dr. E. Lee Rice

Every year, we dedicate one newsletter to a disease that affects millions of families across our nation – addiction.  Addiction has many faces, and in this newsletter, we’re exploring some of the permutations of addiction that are often overlooked.  We begin with Quan Campbell, exercise physiologist, who presents information on how exercise routines can become unhealthy compulsions.  Lifewellness nutritionist Sabrina Chyzyk discusses the biology and indications of food addiction.  I’ve also included an explanation of how and why work addiction develops – an article that will no doubt resonate with several of our clients in high-stress careers!  We’re also pleased to have special guest author Charles Gillispie who tells us how expressive journal writing can engage recovering addicts.

I’d also like to extend a warm welcome to the newest member of our Lifewellness Institute family – Arjun Krishna Rao, a beautiful baby boy born to Dr. Naresh and Sneha Rao on Tuesday June 4th 2007.  Welcome Arjun - may the beauty and mystery of this world fill you with wonder throughout your life.

Be well,

Lee Rice, DO

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Eat to Live or Live to Eat — Are You Addicted to Food?
By Sabrina Chyzyk, RD, CDE

We’ve all heard the phrase “I am addicted to chocolate.”  But is this really possible? At what point does the enjoyment of food escalate to a full-fledged addiction to eating?

Certain foods, like chocolate, sugar, and cheese, contain chemical compounds which may stimulate the brain’s secretion of dopamine. Dopamine is a neurotransmitter released in reaction to or anticipation of a naturally enjoyable experience.  The U.S. Department of Energy Brookhaven National Laboratory has conducted research showing that merely seeing, smelling, and having a small taste of a favorite food stimulates dopamine to be released in the brain.  In other words, at the sight and smell of food, the brain rewards you with pleasure, encouraging you to eat more.

This neuro-chemical stimulation can have a powerful influence on an individual with a diathesis for addiction.  It creates a physical component to a mental and emotional relationship between eating and feeling good.  Sometimes, the combined power of psychological and physiological associations will foster unhealthy and even dangerous eating patterns.

Here are some characteristics and signs of food addiction:

• Obsession or preoccupation with food
• Lack of self-control when it comes to food
• The need for restriction
• A sense of pleasure or comfort with food and the inability to stop using the food to create that feeling
• A compulsion about food resulting in bingeing
• A need to eat resulting in physical cravings
• Hiding food or secretly bingeing
• Feelings of guilt after eating
• Emotional eating
• Weight affecting way of life

 To break an addiction to food, consult with a physician, psychologist/counselor, nutritionist and/or a 12-step group such as Overeaters Anonymous.  These resources can help you recognize situations which trigger cravings and learn how to avoid them if possible. 

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Married to Your Work – Till Death Do You Part?
By Lee Rice, DO

In academics, business or medicine, some individuals seem driven to work longer and harder than everyone around them.  This personality type has often been defined as “Type A” – competitive, ambitious, inflexible and overbearing.  However, these outward characteristics may mask other traits – personal dissatisfaction, fear of intimacy, low self-esteem, fear of failure, and – in some cases – a compulsion to experience stress.

People who demonstrate these traits are often considered “workaholics,” though a more fitting term would be stressaholics.  Stress addiction can go undiagnosed and untreated because it is a ‘socially acceptable’ addiction – it’s not illegal and it can’t be seen in any blood test.  In fact, overachieving stressaholics may find themselves winning awards, garnering praise from employers, increasing revenue, and succeeding in business.  Their accomplishments are often beneficial to an approving society that applauds and rewards them.  Nonetheless, over time, these stressful lifestyles can become detrimental to their health, family and psyche.

But why would stress, which most of us find unpleasant, be addictive?  Part of the answer lies in the body’s chemical reaction to stress.

The body releases two types of chemicals in response to stressors: catecholamines (epinephrine and norepinephrine) and glucocorticoids (cortisol and cortisone).  These hormones have global effects on the body, including increased blood glucose levels, muscle tension, increased blood pressure, increased heart rate and dilation of the pupils.  Experts have theorized that workaholics are addicted, in part, to the chemical rush and excitement achieved through this hormonal release.

As is the case with addictive behavior, there is a price to pay.  Health deteriorates under a prolonged state of heightened stress.  Stressaholics often suffer from insomnia, irritability, poor eating habits, weight gain, cardiovascular disease, weakened immune system, muscle pain, depression, anxiety, digestive problems, ulcers, headaches, exhaustion and hypertension.  Heightened stress levels can also leave these individuals vulnerable to other addictions – cigarettes, alcohol, narcotics, overeating, etc. 

Taking a vacation or reducing the workload won’t necessarily help.  Stressaholics often manufacture stressful situations in order to achieve neurochemical excitement – by running late for a plane, by delaying work until just before a deadline, by taking on more work than they can handle and taking increasingly greater business risks.  Even when relaxing, a stressaholic may be feeling anxiety, guilt and distraction because he or she is not working. 

Stressaholics are most easily identified through their interpersonal relationships.  Often, these individuals cannot maintain healthy, long-term relationships because they feel compelled to work long hours and fixate on work when at home.  The typical stressaholic may be an absent partner or parent, and may bring work home and on vacations.  Renowned business and family consultant Tom Kardashian, of Zink University, often sees how work addiction can disrupt family life.  "Workaholics always wish they had spent more time with their kids and family earlier in their careers," explained Dr. Kardashian. 

The friends and family of a stressaholic may feel angry and abandoned, and may eventually turn away from the stressaholic altogether.  This abandonment, in turn, leads the stressaholic to work even longer hours, to bury their emotional problems behind business success.

The most important part of reversing the unhealthy cycle of overworking and stress addiction is reaching out for help.  This is a particularly difficult task for self-made executives who pride themselves on their independence.  It often takes the intervention of family and close friends to help them recognize how far out-of-balance their lives have become. 

With love and support, the unhealthy patterns can be broken and a more meaningful life can be achieved.  Dependence on societal rewards is replaced by enhanced self-acceptance, improved life balance and greater relationship intimacy – beginning with improved self-knowledge and acceptance.

Recovering workaholics can learn to reach a state of acceptance of “what is” and forgiveness when life falls short of “what should be.”  By letting go of the notion that happiness constantly requires more pressure, stressaholics can experience enriched lives imbued with meaning, joy and emotional peace.  In essence, it is a spiritual solution.

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Fanatic or Fantastic? Exercise Addiction Explored

By Quan Campbell, MS

Everything in excess is opposed to nature.  - Hippocrates

As Hippocrates noted, almost anything is harmful when done in excess.  Yes, even the revered activity of exercise is not immune from this universal truth.

Anyone, beginner or Ironman, wants to commit to an exercise routine, but commitment can become compulsion.  How do you know when you’ve crossed the line and become addicted to exercise?  Here are some indicators:

• Passing up social interactions with friends and family to exercise more
• Exercising during injury, illness or fatigue
• Obsessively thinking about exercising when not exercising
• Feeling withdrawal (anxiety, resentment, depression) when circumstances prevent exercise
• Feeling you can never exercise enough
• Exercising in all of your free time

It is estimated that less than 1% of the American population is addicted to exercise.  With gaining popularity and acceptance of the "exercising lifestyle," this statistic is expected to be on the rise.  Often, exercise addiction is coupled with eating disorders.  People most commonly vulnerable to this disease are those that are intense, high achieving and perfectionists. 

Exercise creates a natural “runners’ high” by releasing endorphins into the bloodstream, so it’s common to feel anxiety, irritability and depression when a workout routine in changed.  But exercise addicts feel these emotions at a much greater intensity.  They are also more likely to harm themselves through overtraining, exercising during illness and exercising with injuries – which can lead to even more serious health problems.

Like any other addiction, loving support and finding a counselor to connect with are often the first steps to recovery.  Remember: everything in moderation!

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Reflecting on the Scar -

The Use of Journal Writing As a Recovery Tool

By Charles Gillispie, MFA, LISAC

"In this poor body, composed of one hundred bones and nine openings, is something called spirit, a flimsy curtain swept this way and that by the slightest breeze.  It is spirit, such as it is, which led me to write. . ."   Basho

Basho was a traveling poet and student of Zen meditation.  He is most famous for a travel journal he wrote in 1689, Narrow Road to the Interior, which describes a trip he took to Northern Japan:

"In which year it was I do not recall, but I, too, began to be lured by the wind like a fragmentary cloud and have since been unable to resist wanderlust, roaming out to the seashores."

Basho's book is full of brief paragraphs, often followed by very short poems, which describe the people and places he encountered, as well as his own moods and perceptions:

              "Autumn---even birds and clouds look old."

With a little guidance and encouragement, we can all benefit from journal writing.  Like Basho, we can celebrate and record our journey into the "interior"—the landscape of our struggles, hopes, insights and experiences.

Therapeutic Journal Writing

James Pennebaker, a professor of psychology at the University of Texas, reports that writing, in-and-of-itself, is not necessarily therapeutic.  In fact, many of his clients who suffer from anger and depression report feeling worse after writing in journals.  The process of writing about feelings, without any direction or structure, seems to exacerbate suffering instead of providing relief.

Dr. Pennebaker notes however, clients do report relief from journal writing under specific conditions.  For example, clients who record events and thoughts as well as emotional experiences report greater relief after writing.  Combining these three elements of daily life into a cohesive narrative is an essential component of therapeutic journal writing. 

Additionally, Dr. Pennebaker reports that clients who write for at least twenty minutes a day for three days in a row find greater emotional comfort after writing in their journal.  People in recovery can utilize these findings to receive more benefit from writing.

The Use of Sentence-Stems and Repetition

Dr. Nicholas Mazza, founding member of the National Association for Poetry Therapy, believes that structure is an essential component of therapeutic journal writing.  Structure can help us explore uncomfortable feelings while providing a positive direction.  Dr. Mazza favors the use of sentence-stems and repetition to create meaningful poems or paragraphs.

The following journal entry is copied, with permission, from the journal of a young woman in treatment for substance abuse.  It represents the use of sentence-stems and repetition.  It was written after the young woman agreed to end a romantic relationship, over the phone, that had been extremely abusive and destructive:

I used to trash my emotional wreckage onto those who neither deserved nor understood

But now I peel off the layers and stand naked in the              responsibility of my grief

I used to stab the dagger into my heart and demand any willing boy to pull it out

But now I'm stitching up the wound and reflecting on the scar          tissue

I used to play on words to be a puppet for applause

Now I am down on my knees in amends for my guilt

I used to die in the apocalypse with every mistake

But now I live in the moment with every experience

I used to crave the bittersweet lingering of the past

But now I'm driven by the desire to savor the curiosity of tomorrow

I used to see God in the pleasures I was granted

But now I see God in the ironic challenges I face

There was a time when I let go of the past for him

And now, finally, I let go of all of this for me.

The author reports that she used the sentence-stem and repetition with great reluctance in her journal.  She thought the structure would mute her voice and her range of emotions.  However, she discovered that the structure helped her stay clear of the habitual thoughts and feelings toward her boyfriend and opened a new avenue of hope and strength.  In fact, she reports being surprised by the power that comes out in the entry.  She sees a quality of self-esteem she would like to experience more.

Considerations for Practice

Journal writing, as a recovery tool, provides a number of advantages.  First of all, the journal is immediately available to us, whenever we need it.  As we practice therapeutic journal writing, we can develop much needed skills in mood management and regulation.  Hopefully, as we become proficient in the use of specific structures, we will discover important information about our barriers to recovery.  This material, when uncovered, can deepen and enrich the counseling experience for both clients and counselors.

Perhaps most importantly, the therapeutic journal can become our record of progress in recovery.  In the tradition of Basho's travel journal, the therapeutic journal becomes a mirror reflecting our spiritual struggle, our spiritual accomplishment, as well as our spiritual need.

Charles Gillispie is a licensed substance abuse counselor employed by Cottonwood de Tucson.  He specializes in the use of creative writing as an adjunct to cognitive behavioral therapy.  Articles about his work have appeared in Addiction Professional, Journal of Poetry Therapy and the Therapeutic Recreation Journal.

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