In the last blog, I introduced you to Lindsay Stenovec, Registered Dietician, and her experience healing disordered eating and becoming a dietician. Lindsay is now a Mom who works with women recovering from disordered eating. Here is some of the fabulous insight she shared with me during her interview:
What are some of the things you work with that are specific to moms recovering from eating disorders?
Something that has become more and more apparent to me is that there’s a lot of shame when a mom who’s in recovery has an increase in disordered eating. They could be in recovery for 2 years, 10 years, 15 years, but if they start to realize during their perinatal journey, they’re struggling, it brings up shame. They forget to take into account that this is actually one of the riskiest times for recovery. And a small or large amount of eating disorder behaviors or thoughts that can come back into the mind are not uncommon.
When I get initial calls for support, a lot of the self-talk I hear from recovering moms is “I feel so stupid,” or “This shouldn’t be happening,” or “I can’t believe this is happening again. I thought this was far behind me.”
I’m always really quick to say:
“This is actually something that a lot of women in recovery experience. It’s one of the riskiest times for recovery. And it doesn’t say anything about your recovery or how much work you put into it. And look here you are on the phone with me! You have totally recognized what’s going on. You’re getting support. That’s you taking care of yourself. This is exactly what you need to be doing: reaching for and getting support!”
Right off the bat it’s important to make sure that they know they didn’t do something wrong; that there is nothing wrong with them. A lot of the times disordered eating thoughts and behaviors come up as a result of the hormonal changes that women experience. And pregnancy/postpartum, are big life changes. It isn’t surprising that disordered eating “coping skills” come up.
I also see that there’s a lot of worry around body changes during pregnancy and postpartum. This is a big time of change, not just physically, but also emotionally. What I have noticed is, for women in recovery, it may take a little while to open up about that. I’ve notice a trend with not wanting to say out loud or fully express the distress around body changes, because they don’t want it to be there. They don’t want to be feeling this way about their bodies. They feel shame about feeling bad about the change in their body. And so keep that really close to their vest. But over time it starts to organically come out. For moms in recovery, just know that this could be a risky time, and seeking support can help.
(Side note: shame is such a big obstacle for recovering women. I tell my clients shame stands for the false message of SHAME= Should Have Already Mastered Everything. Let’s challenge that message, again and again. You get to be human and in-process, just like the rest of the world. And you deserve compassion, just like you offer your little one.)
How can pregnant and postpartum women sort through all the food recommendations that are in magazines, doctor’s offices, and diet-culture and find what works (and doesn’t) for them?
We do have some changing nutritional needs during the perinatal period. However, oftentimes they are presented in a way that reinforces diet culture. And so there’s some work to be done regarding how we consider nutrition. How do we incorporate that into our own bodies’ wisdom? For example, if I’m working with someone who is early in pregnancy, the first trimester is often survival mode for many women who have pregnancy nausea. The cues from your body are so strong, they are very chaotic, and they are not to be messed with. So if I were to say, as a dietician
“Hey you know you should really more broccoli during your first trimester because vitamin C is very important and broccoli has lots of vitamin C,”
and then you go home and you can’t even look at broccoli because you’re going to be sick, that nutrition information is not that helpful for you! You have to say to yourself:
“OK, vitamin C might be important, so I could probably take a vitamin supplement to help myself during this time.”
And then, in the meantime, you might be eating saltines and apples. It’s a really interesting time to explore, because the cues from your body are so strong. You have really very little choice other than to go with the flow of what your body is asking for. This level of intuitive eating- of listening to your body’s cues- can be very scary or it can be very empowering. I’ve seen it go both ways.
I believe it’s very helpful to have that dietitian with you to say something like this:
“Oh, you got this piece of nutrition information. Let’s look at whether it’s supportive or not supportive to you and how could we use it in a way that honors what your body is telling you right now.”
We really have to learn what intuitive eating calls gentle nutrition. We have to learn how we can incorporate that gentle nutrition into our lives. We have to think about the different stages someone’s at, and to realize that healthy eating doesn’t mean rigidity. Healthy eating doesn’t mean restriction or not allowing yourself to enjoy food. There is no such thing as a right way to intuitively eat. There’s only listening to your body and going by what it needs. Your body does have wisdom, and it is going to be giving you different information every day. The only way you’re going to know what it needs is to is to pay attention to it and just do the best that you can.
In conclusion? Pregnancy (and postpartum) are great times to practice:
*letting go of perfectionism and shame,
*eating intuitively and listening to your body’s needs,
*being present what what-is (rather than what your fantasy wants it to be) and
*receiving support and practice being good enough.
To connect with Lindsay’s Nurtured Mama podcast, Facebook group, and resources, click HERE
Following the theme of trusting and listening to your intuition, I have a marvelous guest blog by a colleague of mine, Ondina Hatvany, a licensed marriage and family therapist in San Francisco. Please read on for her take on the Pleasure Principle and how listening to it can help improve your relationship to food and your body through the practice of intuitive eating.
The Pleasure Principle is simply this: Our bodies are wired to move towards pleasure and avoid pain. We naturally gravitate towards things that taste, smell and feel yummy and delicious. We naturally avoid the opposite. To try to fight the pleasure principle, as so many diets encourage us to do, is to fight one of our most basic instincts. Is it any wonder then that so many diets fail?
What if following and listening to our pleasure was really the secret to it all? What if by listening to our bodies instead of fighting them we started to come into a better balance around our weight and body image?
Impossible you say? Let me invite you to temporarily suspend your disbelief until you read the rest of this article…which was originally posted here: http://www.goodtherapy.org/blog/pleasure-principle-food-relationship/
assists traditional, alternative and queer couples and partners with an approach that combines the latest discoveries in neuroscience with powerful and effective developments in couples research. She uses an approach called Emotionally Focused Therapy (EFT) to help her couples get past blame and shame to a place of more understanding, trust and intimacy.
As former Director of the Eating Disorders program at the Community Institute of Psychotherapy Ondina advocates a Health at Every Size (HAES) approach that empowers women to befriend their bodies.
I stole the Opposite Land game from the most time-honored parenting resource of all: another mom. Here’s how it works: When you are going somewhere or doing something that requires a certain kind of behavior, visit opposite land first. So for example, before we go to the regular grocery store, we go to the opposite land one. In opposite land grocery stores, all the kids ride on the carts flinging their legs and feet into the aisles, toppling cans and boxes off the shelves. They race around banging into people, don’t say excuse me, and throw eggs out of the carton. They fill the cart up with cookies, chocolate, rainbow sprinkle doughnuts and NO GREEN VEGETABLES. Never. Not Ever.
This technique works if you really get into it and are silly, authentic, and loving. Then your kid knows your intention is to connect and stay connected with them. Kids are right brained and have not yet left the land of implicit knowledge, of being deeply connected with their bodies and felt-sense of another person. So if you’re not authentic and silly with opposite land, they will see right through you and know you are just trying to get them to behave in the grocery store (which, of course, you are, but in a child friendly and respecting-ly, playful way).
A Random Confession related to Opposite Land and Never Eating Tomatoes:
My child is a picky eater. Even though I am a HUGE advocate for the intuitive eating, there-are-no-bad-foods, philosophy, I still relapse into encouraging, bordering on nagging, my child to eat vegetables. As you can imagine, sometimes I “win” a particular battle, but I never (Never, Not Ever 🙂 ) win the war. My little one is all over implicit knowing on that. I know you are trying to get me to do what you want, but I am not going to leave what I know to be true in my body and my preferences. So I keep returning to presenting the food, being playful with it, model-ing eating vegetables, but not forcing them.
I recently was given a book in another great chain of motherhood wisdom (also known as passing-along-stuff-please-help-me-clear-a-little-space-in-my-house). It is fabulous. In it, Lola, the younger sister of Charlie, states that she won’t eat carrots (they are for rabbits), peas (too small and green), and:
“I absolutely will never Not Ever eat a tomato.”
Her older brother, well versed in opposite land and creative, playful parenting, assures Lola that they are not eating carrots, potatoes, peas, or fish sticks. They are eating “orange twiglets from Jupiter, cloud fluff, green drops from Greenland, ocean nibbles from the supermarket under the sea…” You get the idea.
As you can imagine, by the end of the book, Lola is experimenting with trying all kinds of new foods, including the dreaded Never Not Ever (re-named moon-squirters) tomatoes.
How does this apply to You?
(Parents, Non-parents, and people recovering from Eating Disorders, Depression, Anxiety or General Self-Hatred)
Opposite Land looks different for adults. It includes such blasphemous ideas as:
“You ARE good enough.”
“All foods are possible to eat without guilt, including chocolate cake.”
“Recovery from an Eating Disorder (Depression, Anxiety, General Self-Hatred) is possible.”
“Mistakes are allowed.”
“You can be loved the way you are.”
“There is nothing wrong with you.”
“What happened in your family of origin was not your fault.”
“It is okay to feel angry, sad, ashamed, or insecure.”
“You are not bad.”
I get it- these may seem to live in a fantasy world if you are accustomed to believing the opposite. They may seem even more preposterous than eating cloud fluff or orange twig-lets from Jupiter. But considering the possibility can be the beginning of believing it. Having a trusted loved one (spouse, therapist, supportive peer) help you in this process can be the most healing. You may even, like Lola, decide that you can sometimes, Not Always but Not Never, have the experience of being Good Enough. And that can be even more phenomenal than eating a moon-squirter.
Special thanks to Lauren Child and Candlewick Press for permission to reprint the beautiful images from:
I WILL NEVER NOT EVER EAT A TOMATO. Copyright © 2000 by Lauren Child. Reproduced by permission of the publisher, Candlewick Press, Somerville, MA.
Summer vacation is ending. People are coming back from traveling; kids are starting school. What makes summer vacation special? My childhood memories include: painting on the back porch, watermelon and roasted corn on the cob, laying on the beach (back in the day when SPF meant Super Powerful Fantastic tan). Coming back from vacation is like the “Monday” of the Dieting world: I’ll start again on Monday. I’ll get back on track on Monday. I have to go back to work on Monday, Mondays suck.
We just got back from vacation. It is interesting being a parent navigating food treat-land with a kid on vacation (and in life). In my private practice, I see many adult clients struggling with disordered eating and body image distress. But their childhood food experiences differ. Some only got food-treats on vacation, some were never allowed food-treats, some only ever ate sugar cereal, whether at home or on vacation. However, in eating disorder recovery, as in life, It’s not about the food. Let me re-phrase: it’s partially about the food. It’s more about the context of the food than the content. In other words, if you were always forced to clean your plate, were never allowed to eat treats, were never served a vegetable, or were forced to eat all your vegetables even if you had to choke to get them down, that is obviously going to influence your experience regarding food and eating as an adult! However, even more important than the content (whether it be Vegetables or Cap’n Crunch), is the message about food and listening to your body. What were you told about the context of food, eating and your body? Were you allowed to listen to and trust your body and your hunger cues? Were you able to have some choice about what, when and how much you ate? Were you listened to? Were you therefore able to learn to listen to yourself?
Intuitive vs. Controlled Eating
As someone who struggled to re-learn intuitive eating in my adulthood and is a bit anxious as a parent that my child get the right nutrition, it is a serious spiritual practice to keep my “eat your vegetables” and “do NOT give him any more sugar, Papa” tendencies in check. However, I know in my very Being, in the-Part-of-Me-That-Knows, that intuitive eating works. And I know that the more I can foster as well as not inhibit that innate knowing in my child, the more of a protective factor I create around future disordered eating (depression, anxiety, body and self loathing…)
Birch et al. (2001) outlined particular “controlling feeding practices” that parents tend to do with children:
*Pressure to eat, as a means to increase the amount of foods a child consumes.
*Restricting access to certain foods, as a means to decrease the amount of “unhealthy” foods a child consumes.
*Monitoring food intake, as a means to track the amount of “unhealthy” foods a child consumes.
Controlling feeding practices, though often done with the best of intentions by parents, often lead to interrupting a child’s food selection by either increasing or decreasing the desire for the “controlled” food item and disrupting the internal compass for hunger and satiety. (Batsell, Brown, Ansfield, & Paschall, 2002; Birch & Fisher 1998; Fisher & Birch 1999: Galloway, Farrow, & Martz, 2009: Joyce & Zimmer-Gembeck, 2009 )
So. Back to Summer vacation. We were at a lodge with a coffeeshop this past week that had every possible kind of croissant you could imagine: spinach and cheese, sausage and bacon, apple, marmalade, chocolate, nutella. My little one heard chocolate (even though I offered it as last choice hoping another would stand out and sound appealing…spinach? There’s always hope) and pounced: Chocolate! So the second day we were there, still Chocolate! On the third day, he chose something else. Direct quote:
“I’m done with that Mama.”
He chose a banana, ate it, and moved on. He listened to his body, his cues and preferences, and he had enough of the chocolate. My husband ate the croissant. I don’t know why, but I continue to be astounded at how just not interfering with the process of trusting one’s body is so profound. Bless Evelyn Tribole, Elyses Resch (Intuitive Eating: A Revolutionary Program That Works,1995), and Rosanna Franklin (You are what your mother eats: maternal intuitive eating and perceptions of child’s eating, Dissertation Defense, Alliant University, 2016) for articulating what the body, psyche, and emotions know as well as providing the research to prove it.
Here are some guidelines for intuitive eating:
- Relying on internal cues for hunger and satiety
- Eat for physiological rather than emotional reasons
- Have no dietary restrictions/unconditional permission to eat
- Practice body size acceptance
I recently had the privilege of sitting on a doctoral candidate’s dissertation committee.• She was researching maternal intuitive eating and how this can prevent children from developing obesity. One title she considered was “You are what your mother eats,” which, though catchy, we decided was just too reinforcing of the already all-too-prevelant “mother guilt.” If you are a mother, you know what I am talking about: you worry about what your child eats, doesn’t eat, how much, in what way, whether it is packaged in BPA free packaging, whether their daily sugar intake is setting them up for future alcoholism…(OK, I may be getting a bit too far into neurosis here, but the point is that moms worry about their kids, and specifically, what their kids eat). So we decided to change the title.
You are (and are not) what your mother eats.
OK, so now that we have put the guilt aside, her research was fascinating! In many ways, it confirmed much of what has already been discovered about intuitive eating. Intuitive eating (1) can be summarized by the following factors:
- relying on internal cues for hunger and satiety
- eating for physiological rather than emotional reasons
- no dietary restrictions/unconditional permission to eat
- body size acceptance
It has been discovered and empirically validated that infants and toddlers have the capacity to self regulate their eating (2), given the right conditions. The right conditions being: provide a wide variety of nutrient dense food, while allowing the child autonomy to choose which of these foods to eat and when they are hungry.
Ellyn Satter’s work summarizes how parents can think about and put into practice modeling/trusting intuitive eating with children, while surrendering battles for control over two-year-olds refusing to eat broccoli in the following way:
The Division of Responsibility for infants:
- The parent is responsible for what.
- The child is responsible for how much (and everything else).
The Division of Responsibility for toddlers through adolescents
- The parent is responsible for what, when, where.
- The child is responsible for how much and whether.
More on Ellyn Satter (and down loadable handouts) here: http://ellynsatterinstitute.org
Two of the most fascinating clinical implications of this candidate’s research were:
- Mothers can learn about how they can indirectly influence their child’s self-regulation via body acceptance messages.
- Body appreciation is a predictor of intuitive eating and Body acceptance messages from mothers predict awareness of the internal feelings and function of the body.
In other words, the more YOU as a mother listen to YOUR OWN body, hunger cues, appreciate and do not criticize your own body, the more this translates to your child(ren).
She found that “controlling feeding practices” such as:
- Pressuring your child to eat,
- Restricting access to certain foods, as a means to decrease the amount of “unhealthy” foods a child consumes, and
- Monitoring food intake, as a means to track the amount of “unhealthy” foods a child consumes. (4)
all have a negative correlation with developing intuitive eating and do not support body appreciation.
Yep, that means NOT saying “you can have dessert if you eat your vegetables,” not pressuring your child to finish what’s on their plate, and stop micromanaging how much sugar your child eats at various birthday parties. I know, it’s hard! I’m on the journey with you, Mama, trusting that at SOME point in his lifetime my child will eat broccoli…or not! And I can model that it is ok either way.
*Congratulations Dr. Rosanna Franklin, PsyD, California School of Professional Psychology, Alliant International University, 2014.
1. Intuitive Eating: A Revolutionary Program That Works, by Evelyn Tribole and Elyses Resch, 1995
2. Birch and Deysher 1985; Matheny, Birch, and Picciano, 1990.
3. Augustus-Horvath & Tylka, 2011; Avalos & Tylka, 2006.
4. Birch et al., 2001.