F or most of her life, the woman did not allow herself to eat cake. She feared that if she started, she could never stop. The presence of cakes at every birthday party she attended was tormenting her. Her thoughts about cakes kept her so busy that she imagined eating cakes.
The woman's unhealthy relationship with food eventually led her to Michele Smith, a licensed professional advisor who runs a private practice called The Runaway Fork in Westfield, New Jersey. Under Smith's guidance, the woman decided to overcome her fear by eating a sheet cake alone.
The client took her first bite, but it was not the experience she had dreamed of. It tasted artificial and waxy. She thought that maybe it was just the frosting she didn't like, so she took another bite and focused more on the cake itself this time. It only confirmed the terrible taste of her first impression. The woman threw out the whole cake.
The client's craving for cake had caused her years of suffering, but when she finally ate it carefully, she found that she didn't even like it, says Smith, who is also a licensed psychological counselor in New York ,
"There is all this unnecessary suffering for food, weight and body," continues Smith. At the same time "there seems to be a lack of services for everyday people who have no eating disorders [but] who want to discuss and heal their relationship to food, body and weight."
This is why Smith, a certified Mind Body Eating Coach and a member of the American Counseling Association, founded her private practice to help people who have difficulty in their relationship with food. She doesn't have a precise wording to explain this particular niche she has worked out in her counseling practice, but it differs from nutritional counseling, which focuses on helping customers figure out what to eat. Instead, Smith cares who clients are as "eaters". This includes connecting their food relationship with other areas of life and psychosocial factors such as anxiety, depression and trauma that professional clinical advisors work with every day.
Researchers are not entirely sure how foods fit in with general mental health, but recent studies suggest a strong link. In general, eating can promote well-being in three ways: 1) by providing the brain with the nutrients it needs to grow and make new connections, 2) by suppressing inflammation and 3) by promoting intestinal health.
In 2017, the world's first clinical depression clinical intervention study, SMILES, found that a modified Mediterranean diet (which promotes whole grains, fruits, vegetables, legumes, low-fat / unsweetened products) Dairy products, raw unsalted nuts, lean red meat, chicken, fish, eggs and olive oil are used, while sweets, refined cereals, fried foods, fast foods and processed meats have been discouraged, leading to a significant reduction in depression symptoms compared to typical modern diets with fast food, processed foods and refined carbohydrates.
A randomized controlled trial published in PLOS ONE last year supports the results of the SMILES trial. The researchers found that adults who ate Mediterranean for three weeks had less anxiety and stress, and a significant decrease in their symptoms of depression.
These and other results suggest that counselors should no longer look at mental health in isolation, but as part of a complex system that includes human nutrition.
A missing piece of the puzzle on mental health
Lisa Schmidt, a licensed consultant, certified whole food nutritionist, and instructor at Arizona State University School of Social Work, suggests that people rarely think about what they eat. “The food is perceived as disturbing. It's something that people don't have time for until they're just so hungry, need to eat, and when you get to that point, you often make very poor dietary choices, ”she says.
For example, on the way to their next meeting or to pick up their children, people can take fast food and eat it in the car. If they have trouble sleeping later in the evening, they assume that this is related to their anxiety and overlook any connection with the food, adds Schmidt.
"Most people do not know that the type of food we choose [to eat] can help regulate our nervous system and may be the missing link in mental health care," notes Schmidt.
Schmidt, an ACA member in a private practice in Scottsdale, Arizona, says that mood-related disorders often have a food component because diet-related nutritional disorders affect mood. The usual American diet, often referred to by the acronym SAD, often causes people to be hungry, tired and in a moody mood, she continues. People often alternate between escalation periods in which they fill up with caffeine, processed sugar, and refined carbohydrates and periods of hunger. This unhealthy pattern leads to moods, explains Schmidt.
In addition, stress (which is common in fast, disturbed lifestyles) regulates people's reactions to the nervous system. When people are stressed and in combat or flight mode, their bodies excrete glucose into the bloodstream and urge them to run away from real or imaginary danger. Then the pancreas secretes insulin to regulate blood sugar levels, explains Schmidt. These fluctuations in blood sugar levels affect mood and can make people "hungry" and angry, she adds.
Two researchers from the University of North Carolina at Chapel Hill recently investigated the underlying mechanism for the complicated "hangry" reaction. Their results challenge the theory that Hanger is only the result of low blood sugar. They found that hunger-induced feelings can lead to tantrums and anger when people are in stressful situations and are unaware of their physical condition. In other words, hunger attacks could, in certain contexts, turn into other negative emotions.
This suggests that people should slow down and pay attention to both their physical and emotional signals. Smith advises her clients to carefully prepare the scene before eating and to tell them that eating should be stress-free, relaxing, and enjoyable. To do this, they can use a candle or play soothing music. You shouldn't be talking on the phone, watching TV, or walking around, she says. And although some families use dinner to reprimand their children, there shouldn't be any quarrels over food, Smith adds.
Because breathing is the quickest way to relax body and mind, Smith instructs patients to take as many deep breaths as they need to calm them down before they start eating. She also advises customers to put their forks between the bites or use their non-dominant hand to slow them down and fully experience their food.
Mindful eating also means approaching food with all your senses, says Smith. She often illustrates this type of eating at the meeting by sensualizing customers – especially those who tend to eat fast or distractively while working or staring at a screen – while eating a Girl Scout Thin Mint biscuit can be addressed. During this activity, Smith asked clients to forget their deep-seated dietary rules, their negative self-talk, or whatever is in their minds, and to focus on their physical eating experiences.
First, she has customers looking at the biscuit so the brain registers that there is food. Next, let her touch the biscuit and notice its texture. Then Smith asks her to smell the spearmint because the smell affects our pleasure or displeasure when eating. Once customers put the biscuit in their mouths, slowly roll it on all parts of their tongue without biting it. When they finally bite the biscuit, they listen to the sound and notice how it tastes and when the taste wears off. At the end of the exercise, Smith asked customers to rate their experience as pleasant, uncomfortable, or neutral.
For most Smith customers, this simple exercise is an experiment that opens their eyes. They often admit that they usually just throw the biscuit into their mouths and don't think twice. When people learn to slow down and eat mindfully, they can better recognize when they are full or when they no longer taste their food. Smith says one of her clients found through the exercise that she didn't really like thin mint cookies even though she had eaten them all her life.
It's one thing to tell customers what mindful food is. it is another thing for them to experience and feel it themselves, says Smith. "Mindful eating as a practice can be helpful to reawaken appreciation for food [our]", notes Schmidt, author of Sustainable Living & Mindful Eating. "When we wake up, how we feel and what we experience, we have the opportunity to change."
The emotional toll of restrictive eating
"Any diet is a form of food restriction," says Smith. "If you put certain foods out of circulation or if you think certain foods are bad or prohibited, you will actually be leading to overeating through this feeling of disadvantage." The night before someone started a no-carb diet, this could happen the case his binge on bread as "farewell" (often referred to as "supper" food). People who follow diets never get used to anything, and when exposed to restricted foods, they can overeat, which only reinforces the notion that they cannot be trusted for a particular food, Smith adds.
Heather Shannon, licensed clinical advisor, has written a book chapter on Strategies for Managing Diet-Related Stress for Volume 1 of Stress in the Modern World: Understanding Science and Society. She says the judgmental mindset that is common on most diets often sneaks into the character's judgment: "I am bad because I have eaten this carbohydrate" or "I feel terrible that I have betrayed my diet by eating this cupcake, ”For example.
Shannon, who offers coaching and teletherapy as a psychotherapist at the Lotus Center in Chicago, had a client who was fit and healthy but focused on losing three pounds. The client woke up one morning and felt great, but when she stepped on the scales and found that she had gained a pound, her mood changed. She felt from wonderful to terrible in two seconds.
Fixing on a result like the number on the scale or the number of times a person went to the gym this week is a big part of the fear, says Shannon, and opens up the possibility of good and bad labeling ( eg "I am bad because I only went to the gym once this week"). Instead, it helps clients focus more on their habits and what habits make them feel good, healthy, and connected to their bodies. "If you treat your body really well, the result is always what your body should be," she says.
Smith, a certified guide to intuitive nutrition, helps customers let go of the diet mentality and reawaken their intuitive eater. In the model of intuitive eating there are no "good" and "bad" foods. Smith describes it as "a non-dietary, flexible way of eating, following your inner feelings of hunger and satiety to judge what, when and how much you eat."
Smith points out that not every customer is automatically ready to put all groceries back on the table. Under these circumstances, counselors can instead help to raise awareness of diets and possible detriment to customer life. For example, counselors might ask: how did your diet affect your relationships with others or how did it change? How much time and money have you spent on diets? How has that affected your social life and mental health? What has changed in your life from dieting?
Schmidt also tries to help customers change their attitude to food. "The diet isn't determined by an episode," she says. "It's eating behavior over time." For this reason, she advises customers to follow the 80-20 rule, in which decisions are made 80% of the time that are whole foods (mostly plant-based). You don't have to worry that in 20% of the cases they will do something good or treat yourself.
"We eat for reasons other than just to nourish our bodies," says Schmidt. “We eat as part of celebrations and the food is pleasant. A very restrictive, Spartan way of eating – especially one that demonizes a certain food group – can lead to eating disorders and cause problems for some people. … And research shows that this type of diet fails in 95% of cases. "
Instead of adopting the latest fad in nutrition, people should find a way to eat that they can follow for the rest of their lives and that supports their health and mood, says Schmidt.
Dealing with Food Moods
When customers understand biological hunger and still grab food without feeling hungry, they often take part in emotional eating, says Smith. This can mean that a client is eating due to an unresolved trauma or grief. Perhaps the client has perfectionist tendencies and uses food to relieve anxiety. Or maybe eating is the way a customer deals with a marriage or job that makes them unhappy.
Smith works with customers to find out how they feel – such as being scared or lonely – when they feel emotional hunger. "This is where the mental health piece comes in," she says. "You talk about food, but the main cause of food is really psychological problems. You are people who like. You need limits. You have to be assertive. You have to say no to people and you cannot use them. Therefore them food to deal with it. "
Shannon, author of the ACA blog posts "Nutrition for Mental Health" and "How Does What You Eat Impact You Feel?", Finds the approach of internal family systems effective to uncover underlying problems related to emotional eating, especially when Customers this have a playful side. First, she helps clients identify the part of themselves that eats excessively by asking how that eating part of them feels in their bodies. One client could feel it in the stomach, while another client perceives it as the trainer's whisper in the ear.
Shannon also instructs customers to personalize the part of them that eats too much by naming it (e.g., the snacking part, the cake, or even a human name like Maria) , Then both you and the customer can easily address and reference this personalized part.
Shannon could ask the part, "What happens if you eat too much?"
And the part almost always provides an answer. For example: "Well, I feel like I'm working too hard, and I need it because it's my pressure relief valve." Or "I feel like I can't count on people, so I'm counting on food."
Smith and Shannon both warn that customers keep a food journal that records food intake or weight. They say that activity takes customers out of them rather than aligning them internally. They also warn that it can promote obsessiveness. However, they agree that customers can benefit from recording their feelings and emotions related to food. For example, a client could write down what he or she feels immediately after overeating to determine what emotions are associated with the behavior.
Schmidt encourages customers to keep a food and mood journal, but not to track food intake or promote weight loss. Instead, the goal is to help customers create awareness of when they eat and how they feel before and after eating. Ultimately, this gives them a better understanding of how eating affects their mood and how the mood affects their eating habits.
It provides an extreme but not unusual example: During the recording, a customer noticed that he did not eat anything until 2:00 p.m. They felt terrible, but only had 10 minutes to eat, and ate a protein bar and soda. Immediately afterwards, they felt good, but an hour later, the client was hungry, crazy, and stressed again.
"Most people … spend less than two minutes a day thinking about what they're going to eat. They only react," says Schmidt. "Therefore, it is very important to raise awareness of all of ours To strengthen habits, including our refueling habits. "
If people don't provide their bodies with fuel in a healthy way, they will have difficulties, says Schmidt. Chronic pain, substance abuse, anxiety and depression are all issues where eating is a big component, she claims. Schmidt had a customer who ate seven to nine bowls of frozen loops for breakfast while recovering from drug use. People who have recovered from substance use could often transfer their addiction to food, especially heavily processed, sugary foods, she says.
Smith encourages her customers to view their relationship with food with compassionate curiosity. Clients can see dietary changes as an experiment to find out how their bodies respond or what works best for them, she explains. If customers are unable to fully master their new coping skills and continue to focus on emotional eating, Smith advises them to feel sorry for themselves and say, "I reach for food and know that I'm not hungry. I'm looking forward to the day that I can cope with my feelings without eating anything. "
Stay in the frame
Smith has found that many consultants are reluctant to speak to customers about food issues and argue that this is outside their scope and that special training is required to become a certified eating disorder specialist or nutritionist. But she encourages the advisors to rethink this way of thinking. "It is not outside the [counselors’] framework to talk about people's relationship with food. It is such a critical part of everyday life. So a large part is missing from not looking at it," says Smith.
"You don't have to talk about the grams of protein per se, which is not in our scope … to really help someone," she continues. "Because [clients are] is out to talk about it and they need this space. And it is connected to so many other areas of life [e.g., trauma, grief, anxiety, depression, stress] that consultants can do more than just talk about. "
As a certified health trainer, Shannon says she would never prescribe food to customers or tell them what to eat or not, but that doesn't stop them from talking about food at the session. In fact, she checks for possible food problems on her admission form by including general questions like: What do you generally eat for breakfast, lunch, and dinner? Do you nibble or skip meals? Do you eat too much or too little? In her first session with customers, she discussed this information and asked follow-up questions to gain a better understanding of the customer's relationship with food and how it could affect their mental health.
"Even if you're not a nutritionist, we all know some basic things. We all know that whole foods are better than processed foods. We all know that excessive sugar is not helpful," Shannon says Reason advises advisors to look for basic nutritional information to find out if food could be part of the mental health puzzle of the customer.
Instead of telling customers what to eat, Shannon takes a behavioral approach and asks, “What do you eat and how does it work for you? What do you think could work better? “Sometimes she also provides customers with helpful resources and advises them to talk to their doctor or nutritionist about other options that they could pursue.
Schmidt believes that discussing alcohol consumption with customers is a good way to talk about their diet in general. In her experience, alcohol is common in patients with mood disorders, and since alcohol is a nervous system depressant, it is not recommended for these patients. As Schmidt talks about her alcohol consumption, he will ask other questions about her diet, such as: B. whether they eat breakfast regularly or whether they eat a lot of processed, high-sugar foods. From there, she might suggest that customers try to limit the amount of added sugar they eat and experiment with eating fresh fruit as a snack or dessert most days of the week. Schmidt will also use the healthy food plate created by Harvard Health Publications and nutrition experts at the Harvard School of Public Health to help customers imagine how to prepare meals that support a balanced mood.
Schmidt recommends that counselors interested in the relationship between diet and mood experiment with their own eating habits to determine how this affects their mood. "It is particularly difficult for a counselor who has a poor diet to talk about the relationship between food and mood with a client," she says. Much like the counselors meditate themselves before teaching clients, Schmidt believes that counselors should first reorganize their own diets to include mainly plant foods, limit caffeine, and limit or eliminate alcohol.
After consultants experimented with the relationship between diet and mood alone, they can ask customers to perform a chain analysis. For example, if a client has panic attacks, the advisor might ask, “What do you remember that you did something just before the panic attack? Did you have something to eat or drink? If so, what did you eat or drink? “Perhaps the client remembers drinking coffee or alcohol before the panic attack. The advisor can ask if the client has noticed a change in his or her mood after drinking three cups of coffee or excessive alcohol before experiencing a panic attack. This technique will help customers relate their eating habits, which are ultimately under their control, to the way their mood is affected, says Schmidt.
Smith admits that the advisor's scope limits how far they can go in dealing with nutritional problems with clients. For example, consultants cannot offer their customers nutritional advice. "This creates this barrier, which is difficult to circumvent," she says. "So you have to contact other professionals like nutritionists and nutritionists and really work as a team." Consultants can either work with a nutritionist to find out which nutritional treatments and approaches are best for clients or to work with clients to ensure that they are committed to their own nutritional preferences (e.g., use wellbeing plans instead of weight loss) or speak to the nutritionist if they believe that a particular nutritional approach is harmful or will not help them.
When should advisors refer to a nutritionist? Consultants have referred clients to Schmidt in their role as a nutritionist because they suspected that their clients had an eating disorder or were tinkering with food. Schmidt believes that it is also a good idea to turn to a nutritional specialist if clients often talk about food or their body in the consultation, are extremely overweight or underweight, and the condition is disruptive or suddenly significant has lost.
When looking for sources of recommendation, Schmidt recommends that consultants seek out specialists who are trained in the "health of all sizes" approach. This promotes acceptance of the size and serves as an alternative to the weighted approach.
Smith agrees that "the focus must always be on well-being and not on losing weight". She advises advisors against referring clients to nutritionists, nutritionists, or doctors who track calories, encourage weighting, or engage in fat shame. Instead, she suggests searching for health professionals who teach intuitive eating and work on a weight-neutral model .
Add to piece of food
People routinely look for shortcuts or a magic ball to solve their problems, and this tendency extends to food consumption. We know from research that Schmidt tends to eat 30% more of the food that they consider "healthy". The researchers even have a name for this tendency to overestimate an item's overall health based on a single claim like low-calorie or low-fat: the halo effect on health. This halo effect seems to encourage people to eat more than they would otherwise because they feel less guilty about eating the food.
Customers often come to Smith because they are confused and do not know what to do. Sie haben jahrelang mit wenig oder keinem Erfolg eine Diät gemacht und sind durch alle widersprüchlichen Ernährungsempfehlungen verwirrt. Für Smith kommt es auf eine Kernfrage an: „Wie fühlt sich das in Ihrem Körper an?“
"Sie schließen Frieden mit dem Essen", sagt sie. "Dies ist Ihre Reise von einem, und nur Sie können wissen, ob sich Pizza gut anfühlt oder erschöpft und wann und unter welchen Umständen." Die Beratung kann Kunden dabei helfen, sich auf ihre eigenen einzigartigen Ernährungsbedürfnisse und -präferenzen einzustellen und dieses Stück mit ihrer Stimmung in Verbindung zu bringen betroffen, sagt Smith.
Schmidt rät den Beratern, sich auf das Ganze zu konzentrieren und sich nicht auf einen bestimmten Essansatz einzulassen. Stattdessen geht es darum, Klienten zu helfen, ihre eigenen Verbindungen zwischen dem, was sie essen, und den Auswirkungen auf ihre Stimmung herzustellen.
Da jeder Mensch einzigartig ist, kann der Ernährungsrat, der einem Berater persönlich zugute gekommen ist, den Klienten des Beraters möglicherweise nicht weiterhelfen. Die Mehrheit der Klienten (und alle Menschen) müssen jedoch mehr Obst und Gemüse essen. Wenn Berater sie dazu ermutigen, könnte dies enorme Auswirkungen auf die Gesundheit und die Stimmung der Klienten haben, so Schmidt.
„Eine persönliche Beziehung zu Lebensmitteln und ihren lebensspendenden Eigenschaften zu haben, ist eines der erstaunlichsten Geschenke, die wir uns selbst machen können, und den Status von Lebensmitteln und Essen für unsere Kunden zu erhöhen“, sagt Schmidt. "Klienten zu verstehen, dass der Prozess der Nahrungsaufnahme und Fütterung ein zentraler Bestandteil ihrer Genesung ist, ist eine Botschaft, die unabhängig davon ist, was sie essen sollten."
„Ernährung ist immer ein Teil des Puzzles“, fügt Shannon hinzu. "Wenn Sie also die Ernährung verstehen …
werden Sie mit Ihren Kunden möglicherweise doppelt so effektiv arbeiten."
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Lindsey Phillips ist ein mitwirkender Autor von Counseling Today und UX-Content-Stratege. Kontaktieren Sie sie unter [email protected] oder über ihre Website unter lindseynphillips.com.
Briefe an die Redaktion r: [email protected]
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Die in Artikeln von CT Online geäußerten Meinungen und Äußerungen geben nicht die Meinung der Herausgeber oder Richtlinien der American Counseling Association wieder.
