Mindfulness for Prolonged Grief

by Sameet M Kumar

  Exercise can help you get more in touch with the active role you still have in creating and re-creating your life after your loss. It’s also an important way to take care of yourself at any time, but especially in difficult times. The reluctance to take care of yourself that shows up as not exercising can also manifest in other areas of your life, including eating well. Therefore, the next chapter explores how you can nourish yourself mindfully, expanding and deepening your mindfulness practice in the process.

  Chapter 6

  Mindful Sustenance

  The emotional burden of grief can make it tricky to start and maintain an exercise routine. Hopefully, the previous chapter has helped you with that, and by now you’re starting to feel the emotional and physical benefits of regular exercise. Although you may not be feeling happy all the time (which isn’t a realistic goal for anyone), you may have a bit less distress or find that your distress isn’t as intense or doesn’t occur as often. You may feel that some of the intense sharpness of your pain is beginning to dull. This will be an ongoing and gradual process. Grief isn’t like a footrace with a finish line at the end. Sometimes it just fades in intensity over what can feel like an eternity as it becomes part of who you are.

  Physical activity has long been linked with emotional health and well-being. Mindfulness meditation and exercise as part of your daily routines can be incredibly helpful in boosting your ability to feel better. Even if the gains sometimes last only a few moments, those are moments better spent with healing and nurturing feelings rather than with the difficult emotions of prolonged grief.

  Mindfulness and exercise can help you feel better by deliberately manipulating how your body feels, but you also need to focus on the fuel your body uses for all of your activities, including meditation and exercise. It would be unrealistic to suggest that you can feel better with mindfulness practice and exercise if your eating habits don’t reflect your commitment to self-care. Practicing regular meditation and exercise but eating doughnuts and ice cream all day is hardly wellness! Fortunately, building on your work in previous chapters, you can use the increased somatosensory awareness you’ve gained through mindfulness meditation and a health-promoting exercise regimen to establish and maintain good eating habits. This is a crucial piece in what I see as the four pillars of well-being: mindfulness practice, healthy sleep, regular exercise, and a healthful diet.

  Eating Well

  For many people in our culture, the word “diet” means a quick weight-loss plan. There are hundreds to choose from, ranging from low-carbohydrate, high-protein diets to entirely plant-based vegan diets. In this book, I use the term “diet” to mean the food you’re choosing to eat, rather than a weight-loss plan or other nutritional fad.

  Your diet is composed of two equally important features: what you eat, and how much you eat. Both the quality and the quantity of the food you eat have a big influence how your body feels and how you feel about your body. With difficult mood states, such as depression and anxiety, people often have a poor satiety signal, meaning it’s harder to tell when they’re hungry or full.

  Plus, when grief is intense, you may feel as though what you’re eating isn’t very important, as long as it does the job of meeting your basic needs. With prolonged grief, few people are able to maintain either a healthy weight or healthy eating habits. You may have lost a lot of weight in your grief or, at the other extreme, you may have gained quite a bit. Not knowing when you’re hungry or full and eating out of convenience or necessity rather than for health can take a profound toll on your body and mind over time.

  The satiety signal becomes impaired because the body is releasing a steady stream of the stress hormone cortisol. Normally, cortisol is produced in short bursts throughout the day, with the highest level in the morning, just upon awakening, and the lowest level after you go to sleep at night. This helps give you energy to start the day and prepare your body for breakfast after sleeping. When faced with chronic stress, including prolonged grief, your body steadily releases higher levels of cortisol. Over time, this can weaken your immune system, alter your sleep cycle, and increase your blood pressure. It can also make you crave sweets. Part of what cortisol does is alter how the body maintains blood sugar levels in order to give you quick energy. When cortisol levels are chronically high, the body may crave carbohydrates or sweets, as they are most easily converted into blood sugar. It’s not a coincidence that what we normally think of as comfort foods tend to be high in carbohydrates and laden with sugar.

  Fortunately, regular exercise can help regulate the pattern of cortisol release. You can help the process along—and help your mood—by making more conscious food choices. Diet can have a profound impact on mood, and, conversely, mood can have a profound impact on diet.

  A recent study (Davison and Kaplan 2012) found that people experiencing mood disorders, such as depression, tend to eat fewer healthful foods, such as whole grains, vegetables, and fruits, than others. This means you may find yourself eating more foods that are high in fat, sugar, and salt or more processed meat—again, comfort foods. You may not be surprised to learn that in the sample of people studied, almost half of those who were depressed tended to eat meals not prepared at home. Of course, restaurant meals and fast food are typically higher in fat, sugar, and salt. As a consequence, most of the people in this study who were depressed also had higher cholesterol levels.

  As you can see from this study, the combination of depression and poor diet can have devastating consequences on long-term health. My hope is that by practicing mindfulness meditation regularly and exercising frequently, you’ll develop a greater level of awareness of your body and its needs, and that this will help you make healthier choices about the food you eat.

  To promote healing at all levels, you need to make sure you’re putting healthful fuel into your body, choosing meals based on the greater somatosensory awareness you’ve developed as a result of meditation and exercise. Your mindful awareness will also aid you in noticing the difference in how your body feels as a result of the food choices you make.

  The practices in this chapter will help you devote more mindfulness to the health choices you make at every meal. I recommend that you read through them first, and then begin to practice them as often as you wish.

  practice: Eating with Gratitude

  In many Buddhist traditions, people extend gratitude for all of the hard work that went into each meal before eating. This practice can also help you be more mindful of your meals and the food choices that you’re making. It will help you consider the sources of your food and how it has been processed. In general, the more healthful the ingredients and processing methods (if any), the more healthful the meal will be for you.

  As with any mindfulness exercise, make sure your television and phone are off before you begin. Although you may have been trying your best to avoid silence during meals because it heightens your loneliness, this practice involves eating with presence and thankfulness rather than fear, stress, or distraction. If difficult emotions come to the surface, observe them as they try to dominate your experience, and watch how they fade away as you bring your awareness back to belly breathing and being present for the meal you are eating.

  In Buddhist traditions, it’s also common to dedicate enjoyment of the meal to all beings that they may share and benefit from it. This allows you to fully experience the delicious flavors and health-giving properties of the food in a way that perpetuates the interconnected processes that brought the food to your table. You become the recipient of a complex supply chain and also the hub in extending your potential outward for the benefit of others. You are no longer eating in isolation, but as a participant in an infinitely complex web of being. Even a simple meal is part of everything that goes into it and comes out of it.

  Before you begin to eat, take three mindful belly breaths as you gaze at the food before you. Place your hands a few inches over the food and thank all of the hard work that went into getting this food to you. Yo
u can thank the farmers, the farmhands, the truck drivers, the grocers, and whoever purchased the food and prepared the meal. If you’re eating meat, you can also thank the animal for giving up its life to sustain yours.

  If you say a prayer before meals in your faith tradition, you can add something along the following lines after your prayer, to better focus your mindful awareness on the food you are about to eat: “I give thanks to all beings who allowed this meal to be put together to nourish my body, spirit, and mind. To all living things everywhere, I offer the enjoyment of this meal. May it provide me with the energy to practice wisdom and compassion for the benefit of all and myself.”

  practice: Eating Mindfully

  The legendary mindfulness meditation pioneer Jon Kabat-Zinn (1990) has used a mindful eating exercise as part of his instruction for decades. In his groups, participants are presented with a single raisin to eat mindfully. You can do this exercise by yourself, at home using the guidelines below. Be sure to wash your hands first, since you’ll be eating with your fingers.

  If you don’t have any raisins, any single, bite-size morsel, such as a small piece of dried fruit or a nut, dried cherry, or cranberry works well. If you only have larger dried fruit, like dates, apricots, or figs, cut off a piece about the size of a raisin for this exercise. Place this near you for the meditation session. Read through all of the instructions for this exercise before you begin so you don’t have to disturb your practice to refer to the book.

  Get comfortable in your sitting meditation posture. Become aware of your surroundings, as you’ve become accustomed to doing in your meditation practice. Then bring your awareness to your body and breath.

  Take twenty-one mindful breaths, silently counting the breath each time you exhale. If you keep losing count, do your best and aim to meditate on your breath for about ten minutes.

  Place the dried fruit or whatever food you’ve chosen in your palm. Look at it mindfully. Notice its texture and its weight. Breathe for another twenty-one breaths while just looking at this tiny, single bite of food. As your mind wanders, return your gaze to the food in the palm of your hand.

  Place the food in your mouth, between your front teeth. Don’t start chewing right away. You can touch the back of the fruit gently with your tongue. Notice any thoughts or feelings that arise. Does it feel strange to just have this piece of food between your teeth for so long? Take twenty-one breaths with this single bite between your front teeth, being mindful of its presence. Swallow any saliva you accumulate.

  Start chewing slowly while maintaining your belly breathing. Count each time you chew, and try to chew at least ten times before you swallow. Notice the act of swallowing a single bite mindfully.

  To complete this exercise, take another twenty-one mindful breaths. Be particularly aware of how your body feels after being nourished by a single bite.

  It is surprising how immense a single bite can feel when eaten mindfully. Yet we so often shovel food into our mouths, bite after bite, without paying any attention to the food or the act of eating. If you’ve grown accustomed to eating unhealthy foods, this may be part of the reason.

  After doing this practice, you can extend this approach to the first bite of any meal. In addition, you can begin your meal with the practice of eating with gratitude to heighten your awareness of the food you’ve chosen and dedicate the benefit of your experience of the meal for the enjoyment and benefit of all beings everywhere.

  You may not always be able to take a full twenty-one breaths at each stage of your first bite of a meal, especially if you’re eating in a public place. In such cases, you can take three mindful breaths instead. The important thing is to take the first bite of your meal mindfully. Make sure it’s not too hot, then hold a bite inside your mouth for a moment without chewing it. Be mindful of each time you chew. Notice how the textures and flavors change each time. Notice how it feels to swallow the food. And notice how your body feels as it integrates the food into itself. Does your meal help you feel healthy? Does it feel good to digest this meal? How does your body feel after eating this meal?

  Amidst the pain of prolonged grief, eating may have become just another mindless and undesired chore eclipsed by the pain of loneliness. You may have found yourself choosing convenience over sustenance. A lot of people going through grief find themselves dreading mealtimes, which often seem to highlight the sense of isolation that comes from losing a loved one. Mindful eating can help by turning your awareness to your meals, rather than the absence of your loved one. You’ll be more focused on what is present during the meal rather than on what is absent. Instead of choosing to being distracted by the television during meals, you can begin to relearn how to enjoy your food.

  Healthy Food Choices

  I’m sure that, like me, you have witnessed the rise and fall of countless health fads over the years. Low-carb, high-protein diets, vegan raw food diets, cabbage soup diets, and many others, even cookie diets, have claimed to be the secret to weight loss. Many of them have dubious nutritional value, so although you may lose weight, you probably won’t be getting the balanced nutrition your body needs for long-term optimal health.

  Of all the diets that have been hyped, one does have a lot of good scientific evidence behind it: the Mediterranean diet. Before I explain it, a word of caution: If you have particular dietary needs or concerns, stick to what works best for you. If that isn’t a concern, let’s take a look at what kind of foods would ideally be part of a more mindful approach to eating.

  The Mediterranean diet has captured the attention of medical researchers since the 1940s. This type of diet was exemplified by people living on the island of Crete. At that time, because of local conditions left after World War II, the diet of Crete’s denizens consisted of fresh wild greens, whole grains, fruits, vegetables, and legumes (peas, lentils, or beans). While the main source of fat was olive oil, most people ate a bit of cheese or yogurt every day. Very little red meat or poultry was available, so most people consumed these foods in only limited quantities, if at all. Their main source of animal protein was fish and other fresh seafood. They also drank red wine from time to time.

  Notice what’s missing in the Mediterranean diet. There is no fast food, no drive-through fare, no candy, and no ice cream or other rich desserts. There is no prepackaged or processed food or what Michael Pollan calls “foodlike substances” (2009, 1): things like sugary cereals, sweet yogurt drinks, nacho cheese sauce, microwave meals, or packaged snacks. Everything was made with natural, wholesome ingredients that your great-grandmother could have recognized.

  Again, note that the Mediterranean diet that confers such impressive health benefits is composed of the types of foods and portion sizes that were typical in Crete, Greece, southern Italy, southern France, Spain, Portugal, and Morocco after the war (Keys 1995). Also note that, although we may idealize what the Mediterranean region is like, after World War II everyone there was touched by trauma and loss. Everyone knew someone who had died or been killed or displaced by the war. This was hardly the same landscape we see in tourism brochures today. In the many decades since World War II, the diets of people living in that region have changed, as has the region.

  I personally try to follow a Mediterranean diet and limit my intake of animal-based proteins. I don’t adhere to a low-carb diet, nor am I vegan, but my body seems to function better with whole grains, fruits, and especially leafy green vegetables like kale and collard greens. This type of lifestyle works well for me, and I feel more energetic and healthier when I eat this way. With this type of diet, each meal becomes a source of life-sustaining energy rather than something that seems to weigh me down. But again, if your physical health requires you to follow a different diet, please ignore the recommendation to try a Mediterranean diet.

  Healthy Portions

  In addition to being mindful of what you eat, you also should be aware of how much you eat. In the United States, we take pride in the abundance available to us. However, we usually consume port
ions in excess of what our bodies need. As a species, we have never had this combination of large portions of food, processed food, and a sedentary lifestyle available to us. The toll on our health has been staggering.

  Many people don’t know what healthy portion sizes are. If that applies to you, here are some guidelines. Please note that the following list shows the amount considered to be an adequate portion per meal:

  For meat, the size of a deck of cards

  For vegetables, the size of a baseball or your fist

  For grains, slightly smaller than a baseball

  For cheese, one and a half ounces, about the size of three dice

  This gets complicated in that, although these recommendations may be true on average for each meal, you may consume more than a recommended portion of some foods at some meals and less at others. For instance, if you have a cheese sandwich on whole-grain bread, you may exceed the recommendation for how much cheese and bread you should have during a meal. However, if that’s all the cheese and bread you eat that day, you’re doing fine. In general, you can use the information I’ve given you to roughly estimate how much of each of the main food groups you should eat, but also remember to enjoy your food!

  You can find more information about healthful portion sizes and recommended number of servings daily at the US Department of Agriculture’s website www.choosemyplate.gov, under the “MyPlate” tab.

  Putting It All Together

  I generally like to make sure that my lunch or dinner is dominated by plant-based ingredients. The largest portion of each meal is usually a green salad with a little olive oil, or cooked greens and vegetables. Whole grains and beans, fish, cheese, or nuts typically make up the rest. Dessert is usually fruit and yogurt or cheese with honey. Breakfast is usually oatmeal or whole-grain bread with fruit or honey. Of course, these are only suggestions. Play around with a variety of healthful whole foods to see what you come up with for yourself. As time goes on, I believe you’ll appreciate how much better your body feels more than you miss eating unhealthy foods.