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Mindfully Managing the Holidays with Dr. Josie Levine

A psychotherapist shares tips for those living with diabetes

Laura Kolodjeski of Sanofi US DiabetesLaura Kolodjeski

Dr. Josie Levine
Dr. Josie Levine

Glance around your local grocery and department stores and it would seem the holiday season is upon us. From Halloween right on through the winter holidays, we have many upcoming occasions to gather with family, friends and co-workers to celebrate. The trick is how to stay on track with your health goals while also enjoying the festivities. For some tips on how to do that, I turned to Dr. Josie Levine, Ph.D. Josie has been a psychotherapist for nearly 25 years, and a Wellness and Health Coach for four and a half years, focusing on helping people who live with diabetes. She also lives with type 2 diabetes herself.

When Josie was very young, her father was diagnosed with type 2 diabetes. He passed away ten years later. “All my childhood I was growing up with a father who was very ill,” she said. “He was insulin dependent and I would often see him taking his shot. His diet was bland and he avoided sugar. His experience was definitely influential on my perception of diabetes. When I was young I saw the disease as something fatal. I didn’t know that it could be particularly well managed.”

Fast forward to 2009 and Josie started noticing issues with her own health. “I’d always had robust health,” she said. “My diet was pretty good, and I’d been exercising daily for about 20 or so years. Yet I started putting on weight, and began to have a tremendous range of systemic issues. The scariest symptoms were when I couldn’t lift my foot; it just kind of drooped. Then I got a numbness in my legs. I was also losing language; I would know what I wanted to say, but by the time it came out of my mouth I couldn’t think of a particular word or the words were sometimes a little jangled. That got my attention.”

Josie had been seeing her doctor for menopausal symptoms, but when she went to her with these newer symptoms, the doctor ordered a blood glucose test. She also suggested that Josie cut out all carbohydrates for the weekend before her test. “By Sunday evening many of these symptoms had disappeared,” said Josie. “I was furious because I knew what it meant. When I got the blood test and my blood sugar level was in the high 300 range, I can’t say I was entirely surprised because I’m aware of the genetic risk factor for type 2 diabetes.”

To help cope with her new type 2 diabetes diagnosis, Josie turned to her mindfulness training. “I have been a practitioner of mindfulness for more than 20 years,” she said. “It’s fundamentally a mental training where you pay deep attention to every moment and watch what comes up in the mind and the body. If you’re hearing a sound, you would notice that you’re hearing a sound. If you’re tasting you notice you’re tasting. You can’t be living in the past or the future. Mindfulness training helps us remember, through repetition and practice, to come back to the moment. There’s a great contentment and peace.”

This mindful perspective helped Josie change how she viewed food. “Prior to my diagnosis, I would end up eating a lot more than my body needed because I wasn’t receiving the indicator of being physically full,” she said. “One of the ways in which I applied mindfulness to changes in my diet was to really familiarize myself with different types of hunger. Only physiological hunger needs to be fed, the rest are all pleasure or emotional. Any cravings for a particular type of food that arrives in your mind when you’re not physically hungry, that’s emotional eating. I learned not to feed that.”

The practice of eating mindfully can be helpful when facing a season of holiday potlucks. “There are things that you can do on both the practical level and with mental attitude to prepare yourself,” said Josie. “Eat some of your safe foods beforehand so you’re not hungry. If you are contributing a dish, make sure that whatever you take is for you. Then make a mental inventory of the food as you go in. Immediately look at the foods that are there, identify which ones you can eat, which ones you should avoid and do that in a moment to yourself. Pay attention to that.”

Being aware of sensory input can also help frame experiences with food. “Try to understand what sense is first receiving the food. You are seeing the food,” she said. “Recognize that you are receiving information through your eyes. The food is as visual as the table it is on, the people in the room, the room itself. Receiving that information doesn’t necessarily mean you have to eat the food. I use this time to check in with my stomach – am I physically hungry? If I don’t feel that sensation of being physically hungry, I don’t need the food. It’s not easy, but it can be helpful.”

Josie offers more mindfulness tips and experiences via her blog, Mindfully Managing Diabetes. “I started blogging one year ago,” she said. “Blog post ideas can come from anywhere; while I’m out walking my dog, or working with a coaching client. For example, I received an email from a woman who disclosed to me that, apart from the doctor, she has told no one, not one person that she has type 2 diabetes because she feels ashamed. Her e-mail so touched me and got me thinking that she’s not the only one; there have to be others. So that grew into a blog post; I just felt I had to address it. That post got a lot of attention. Clearly it resonated for people.”

I could just chat with Josie for hours. The concept of viewing food as simply visual information is an interesting one. Josie’s insights have me looking at upcoming holiday gatherings in a different light. My thanks to her for sharing her story and tips.

All the best,

Laura K.

Disclosure: Dr. Josie Levine received no compensation for this post. All opinions contained in this post reflect those of the interviewee, and not of Sanofi US, its employees, agencies or affiliates.

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