Me: Pretend I have two tool boxes: one I have labeled the intellectual tool box and the other I have labeled the emotional tool box. I would like you to tell me which box I should use if I have to make a business decision?
Patient: (100% of the time): intellectual tool box
Me: Very good. Letís change the scenario and pretend I have to make a parenting decision where my child wants me to be their friend and I really should act as a parent. Which tool box should I use?
Patient (90% of the time): intellectual tool box
Me: Very well. Okay, now here is a situation for you. Pretend you have had a stressful day, would you use your emotional tool box or your intellectual tool box?
Patient (100% of the time): emotional tool box
Me: Is food in your emotional tool box? What foods are in your emotional tool box?
Me: Very well. Let's look at two statements and I want you to tell me which tool box is being used in the following situation:
My kids have driven me crazy all day. I deserve to eat half this cake. (emotional tool box)
A glass of red wine would complement this seafood dish. (intellectual tool box)
Encouraging patients to move food and alcohol into their intellectual tool box and out of their emotional tool box is a way to start the conversation of behavioral modification. If patients are unaware that they use or how often they use food to calm themselves, and or comfort themselves, they will not be able to change their behaviors.
The second part of the dialogue is to help patients to fill their emotional tool box once they have moved food and alcohol out. It has been surprising to me how many patients have been stumped by the question, "Other than food, (or alcohol) what calms you down, makes you feel better?" Providing guidance and encouraging patients to think about other activities that they enjoy are very important to help them build a cadre of resources to draw from when they are stressed and fatigued. Healthy tools might include: exercise, taking a nap, listening to music, meditatation, funny jokes, watching a comedy, or spending time with others. The goal is to have a full emotional tool box, filled with behaviors that will help induce health, not cause one to gain weight.