Today's Date: 2/22/2012 - Site Updated: 2/22/2012

Barbara Breitman, D.Min., LCSW

Barbara E. Breitman, D.Min., LCSW is an individual, couple and family therapist with more than 30 years experience. She has helped hundreds of people to navigate the twists and turns of relationships and life's inevitable changes. Breitman knows that illness creates challenges not only for the body, but for the mind and heart. She also knows that when someone is diagnosed with an illness, it can affect everybody who cares about them. Breitman tries to understand how each person in a couple or family sees things from his or her unique perspective and to help people build bridges across their differences.

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Dear Barbara

Beyond the day-to-day medical issues that arise with managing your or someone else's diabetes, often overlooked are the challenges brought on by the "human side" of the disease. Knowing how important caring for the "whole person" is in managing diabetes, DiabetesCare.net proudly presents "Dear Barbara," a Q&A dialogue we invite you to participate in, helmed by noted therapist, Barbara E. Breitman, D.Min., LCSW.

Featured Question

Anonymous asked:

Temptation is such a huge roadblock when you have type 2 diabetes and you have to watch every single ounce of food and drink you consume. I have a major problem with temptation and I know it's why I don't make the progress I need to make with my weight and my overall health. Can you offer any suggestions on how to avoid temptations in a person's personality in general?

Answer:

Temptation is a big issue with all efforts to switch from making food choices based on what will satisfy cravings for sugary/sweet foods to making choices that are good for overall health. This is not just a personality problem. It has to do with how our brains work. After eating a sugary treat, the brain releases natural chemicals called opioids, which give us a feeling of intense, but brief, pleasure. The brain recognizes this feeling and begins to crave more of it. Researchers have identified that the areas in the brain that are activated when one craves sugar are the same areas of the brain activated when drug addicts crave drugs; which proves how powerful a sugar or sweets addiction can be. It is important to learn to distinguish between "mouth hunger" and "body hunger." Often when we are tempted it is because we see something sweet; we recognize it as pleasurable and our mouth wants to taste it. Our mouth may even begin to water with the memory of how good it tastes. But if we take just a moment to pause and tune into our bodies, we often discover that we are not really hungry, we are experiencing "mouth hunger," craving for a sweet taste. Dealing better with temptation is learning the difference between what the mouth seems to want, and what the body really wants. If you are eating enough protein, you will be more likely to resist tempting simple carbohydrates. One good behavioral way to resist temptation is to PAUSE just a moment before reaching for that treat and think. Do I really want this? Is this what my body really needs and wants? Or is this just what my mouth wants? How will my body feel after I eat this? Most of the time when we do not resist temptation, we are operating on automatic pilot. We see the food, we reach for it and it is in our mouth before we have even thought about whether or not it is healthy for us. Then we feel bad afterward, both physically and emotionally. If you build in the PAUSE before the tempting food hits your mouth, it can make a big difference in resisting temptation! Then you get pleasure from how good you feel having made a better choice, and from how much better you feel physically. Good luck!
Recent Questions
  • Anonymous asked:
    Both my husband and I were diagnosed with type 2 diabetes within a year-and-a-half of each other (him first). It's pretty evident that I have made the most progress with my weight issues, but my husband still struggles (I encourage him as much as possible). One problem - and it's a big one - has surfaced in our relationship and that is sex; he's turned away from it in our relationship and I think it has everything to do with body image. Mine is getting better with the weight loss and his hasn't changed a bit. I can't get him to talk about it, he just pushes me away with his lack of interest when I try to initiate things. Any advice?
  • Anonymous asked:
    I am so frustrated with my husband's weight gain in the past year-and-a-half; I know he is headed diabetes and probably worse. This is NOT the guy I married seven years ago. We now have two young boys and he has a stressful job that I know is contributing to this weight gain, but no matter how many times I bring up the fact that he needs to take his health more seriously he just flies off the handle in rages...He got so mad at me this past weekend when I tried to encourage him to start an exercise program to at least help with his stress level that he stormed out of the house and didn't come back for hours; it really scared the boys. How do I reach this man before it's too late for us - his family?
  • Anonymous asked:
    Having been diabetic (type 1) since childhood (I am now in my 40s) I have recently developed a fear of what's ahead of me (the future - I think about it a lot). I have been extremely vigilent in my managing my diabetes all these years, but I'm now really starting to wonder what could go wrong with my health as a result of my life-long diabetes. How do I stop the worrying?
  • Anonymous asked:
    I'm 33 years-old now and was diagnosed with type 1 diabetes when I was 14. My problem is that I have never been very good about checking my blood sugar and remembering to take my insulin. Over the years I have been hospitalized a few times because of my lapses in caring for myself - I've actually blacked-out. This isn't just a problem with my health, as I'm not a very organized person with other things I do in my life. It has been suggested to me numerous times over the years that I should speak to a psychiatrist about what people are calling my self-destructive behavior. I don't know...I've tried doing things like setting alarms to remind me to do things, but then I get distracted and forget. Do you think a psychological evaluation is worth my time?
  • Anonymous asked:
    OK, so I was recently diagnosed with diabetes and I'm really mad about it - I guess mostly mad at myself for letting it happen in the first place, but I can't seem to get passed that long enought to focus on what I need to do to get the diabetes under control. I'm not one for asking for help, but I guess that's what I'm doing now. Thank you.
  • Anonymous asked:
    Do you think it's a good idea to announce my New Year's resolution to the world of quitting smoking - as a person with diabetes I really should have done this years ago - or just keep it to myself in case I fail for the 1,000th time? I've never made "general announcements" before...maybe this will shame me into finally doing it?
  • Anonymous asked:
    I was diagnosed with type 2 diabetes earlier this year and - knock on wood - I have been doing well so far adjusting to my new eating habits and even started losing weight, although getting started with a regular exercise plan has been a struggle. Anyway, I think I'm doing great, but my girlfriend, who has been diabetic for several years is always telling me I need to do things her way and I'll see better/quicker results. Hey, like I said, I'm happy, my doctor's happy, why can't she be? She's really annoying me!
  • Anonymous asked:
    My diabetic husband owns his own company and he prefers to eat out for lunch every day - BAD IDEA! I keep telling him I am willing to HELP him by making a healthy lunch for him a fews of days a week - or every day if he wants - anything to help him. He's frustrated with his weight issues, and I'm frustrated because I want to help him, but he's tuning me out.
  • Anonymous asked:
    I've been feeling very proud of myself lately, as my blood sugar levels have been very good most days (well within acceptable limits). However, there is the occasional day when my blood sugar level is higher than it should be and I just feel like a failure. The good news is, that wakes me up to get back on track immediately with my food choices, but I just wish I could stop beating myself up on those occasional bad days.
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