As I have been doing research, what I have come across again and again in different models of work across different fields is that awareness is the first element necessary to enact change.

Generally, the awareness is developed first. After that, there is the phase of experimentation, intervention, cultivation. Then, there is expansion, growth, reiteration, refinement. And the process continues to iterate: further awareness, further experimentation, evolution, troubleshooting, refinement.

But what has struck me is that, indeed, awareness is really what needs to come first. In my doctoral research, I had seriously considered developing a protocol to enhance interoceptive awareness and test its impact on eating disorder behaviors/recovery. However, I decided against it because I wanted to study something more tangible, something more physical – so I elected to study somatic strategies and their impact on binge eating, with special attention to urges to binge.

I knew, however, that awareness would be a prerequisite for the participants to be able to use the strategies. If they were not aware they were in a dysregulated state, or felt too far gone, then they would likely not be in the state of mind to use sensory strategies. They might already be in the “fuck it” zone. However, in doctoral research, you’re supposed to keep your focus narrow. So I couldn’t focus on awareness AND self-regulation through somatic strategies. So I only chose the latter, but knew inside that awareness would be a critical element, and if the participants didn’t have the awareness, then my study would not demonstrate efficacy. I speculated that those with lower interoceptive awareness would not use the body-based strategies much for urges to binge (because they would miss catching the urge) and would input less EMA surveys and henceforth would not find as much value in body-based strategies… The results are TBD!

This underscores the importance of AWARENESS.

The Rescorla-Wagner Model is a psychological theory that comes from classical conditioning that, in essence, explains that positive and negative prediction errors are what cause behavior change. Is something different than what we expected? Are we surprised? For example: let’s say you binge binge binge, all the time looking at your fucking phone, scrolling on YouTube, Instagram, Facebook, watching stupid shit, stuffing your face the whole time, but you barely pay attention as you down food item after food item, throwing aside wrapper/carton/box/what have you, but you barely see it or taste it because you are so distracted and in binge zone, you barely even know all that you ate, you just gulp it and gobble it down. Your orbitofrontal cortex (OFC), the part of your brain that registers reward values, may have locked in from a long time ago that your binge foods were good or yummy, but obviously this binge eating fucking sucks, but because you are so distracted, you are totally unaware, and you don’t provide your OFC the opportunity to update the reward value of those foods and the whole experience, so it maintains its value of golly-gee-great.

If instead, you were to eat food without your phone/TV/distraction, and your brain were to register:

• the taste of the food
• Thoughts
• Feelings
• bodily sensations before, during, and after
• the whole experience

you would give your OFC a chance to update the reward value. You would provide your brain with a prediction error: wait, this isn’t as good as I thought it was (when I was on my phone and not paying attention to shit). If you were to binge and be aware, and see how fucking shitty you feel afterwards (5 min after, 20 minutes after, 5 hours after, and the next day), you could help your brain update the reward value. If you continue to do this, you will naturally not want to binge.

It might look like this:

I want to binge. (Summon everything inside yourself to eat the container of ____ and _____ without staring at your phone or TV.)

The taste of the food: super fake, overly sweet, kinda nasty Thoughts: I was thinking “I don’t care.” I just wanted to eat the food. But actually, I do care. Feelings: I was feeling kinda lonely, stressed, and restless before the binge. During the binge I was just feeling flustered and defensive. After the binge, I felt ashamed and disgusted. I didn’t need that food. It didn’t help me to feel better. And now I actually feel worse. Sensations: Before the binge I felt kind of a tingling and excitement. While eating, I felt myself getting full, my tummy bloating and distending. I continued until it was so painful, I couldn’t eat anymore. I laid down. Because of all the artificial sugars in the shit I ate, I was letting out horrible farts all night, it sounded like ducks in my bed. In the morning my bowels were scarily out of control. The Whole Experience: wow, that experience really sucked. From start to finish – to actually way afterwords, because I didn’t feel better until like 2 days later – it was horrible. Bingeing is not a part of the life I want to live.

When we can update the reward value by seeing clearly what the binges provide, it can help reduce the intensity of urges, because the brain does not suggest binges as so appealing.

(And if you do experience urges to binge, body-based strategies are here for you.)