Relationships with food and their relevance in therapy

One of the most profound connections we have with the world around us is our need for food. Unless we are in exceptionally difficult circumstances, eating is something we do several times a day for almost every day of our lives. This is why the emotional and environmental circumstances that contribute to the development of disordered eating affect individuals and their families in such fundamental ways. While therapists are well used to working with people suffering from eating disorders, an understanding of the broader nature of human relationships with food can be elusive.

It is difficult to see a thing clearly when it is close to the face. Unless something goes radically wrong, we tend to take eating for granted. Yet, each of us has our own individual relationship with food. We learn to regulate our intake in more or less successful ways, and the consequences of our choices become manifested in our bodies. The way we relate to food reflects the way we relate to life in general.

Developments in neuroscience have enabled scientists to establish a connection between food and mental, as well as physical, health (Jacka, 2019). Studies have identified the link between diet and depression, anxiety, ADHD, dementia, schizophrenia (Naidoo, 2020). It is possible now to understand how what we eat can directly affect the chemistry in our brains. We are whole beings, so this fundamental unity of the physical and psychological is likely to be already well understood by therapists. We recognise a whole range of factors contributing to the sense of unease that brings our clients to us. Nevertheless, now that the detailed scientific information connecting mental health with the food items on our plates is out there, it may be interesting to incorporate some of that knowledge into our clinical decision making.

There is growing recognition that microorganisms have an essential role for maintaining brain and body health, notably in the inflammation response that our immune systems make to internal and external threats. As well as being present in the gut to cope with all the peculiar items we ingest as food, microorganisms also contribute to the healing of cuts, burns, grazes and other physical and emotional aggressions from outside (Mayer, 2018). This implies that the garden of microorganisms we cultivate in our bodies influences the emotional atmosphere that pervades our experience in the world. Food is a source of the ‘good’ microorganisms we need, hence the increasing popularity of sauerkraut, kefir and kombucha, fermented foods lauded for their beneficial bacteria.

Similar microorganisms are found in the soil, where they have been providing nutrients for the plants that have nourished humans, and the animals that provide us with meat, since our evolution as a species. Food quality and availability has a social and environmental impact that affects our clients too. Challenges to the supply and distribution of food have in past months become familiar in ways that they never were before, bringing heightened levels of anxiety for many of us and highlighting inequality and injustice.  What does this mean for our work as therapists and health professionals?

The straining food production and distribution system, plus the increase in threats to both mental and physical health that are a consequence of our current lifestyles (Jacka, 2019) provide therapists with a challenge. The way pristine land is being exploited to provide food for animals, plus agricultural practices like monoculture and the use of chemical fertilisers and pesticides mean that the world’s resources are being used up in an unsustainable way, making the provision of our daily food look precarious. In the context of what we already know about climate change, this means that we as a species face a threat to our very existence (Steel, 2020).

Applications to therapy

If, like me, you believe that therapists have a role in supporting clients to deal with social and environmental challenges as well as intrapsychic and inter-personal issues, then you may be interested to integrate some of the following possibilities into your clinical practice.

Incorporating relationships with food into the work.

• Recognising that exploring people’s individual relationships with food can be therapeutically productive, revelatory even.
• Examining the relationships with food that are present in families can shed light on the early relational dynamics our clients have experienced.
• Acknowledging how the different food cultures of particular communities and ethnic groups reflect their common history and geography: the food our ancestors ate has a direct impact on the diet that best suits our bodies now, and the landscape and climate in which they lived had an effect on the type of animals and crops that were available to feed them.
• Identifying the extent to which food culture is shared, or not shared, can bring insight to issues of difference and diversity within the therapeutic relationship.

Doing our own awareness work around these issues is likely to be the most helpful way to prepare for working on them with clients. Maybe journaling in response to the question ‘What is my relationship with food’ could be a good beginning. I found exploring my own experiences around food and eating challenging and it may be like that for you too. Please approach any examination you may decide to undertake with understanding and compassion for what it means to be human. This work can go deep and be fundamental to our sense of who we are.

Identifying relevant sources of information

• Informing ourselves about how specific food items are linked to depression, or anxiety, or any of the other conditions that may be recognised in the ways our clients describe their experiences. I recommend Uma Naidoo’s book for this (see references for details) but there are many other relevant texts available, and I mention some of them on my website.
• Knowing where and how to direct clients to information about food groups, diet and general nutrition, and, where appropriate, how to shop for and prepare simple, healthy meals. There are many books available, but also information on websites and social media that is engaging and informative, and that can be accessed by clients (and us) at no cost.

The place of food in society

• Awareness of a client’s ability to access essential resources like money to buy food. How society shapes this by means of political and economic choice.
• Whether you and your client have similar or different access to these resources and what that means for the work.
• Considering the impact of the type of food most generally available and how it may affect mental health. For example, the prevalence of processed food in supermarkets.

Evolving a way of incorporating new knowledge and understanding

• Thinking about how to integrate this new knowledge and understanding into client work in a way that reflects the theory and philosophy of your therapeutic approach, and the ethical framework to which you adhere. For me, as a Gestalt psychotherapist this has meant building my awareness of how food and eating may be present in the shared field my client and I evolve and noticing when they become figural (the focus of attention) in the rhythm of the dialogue between us. Clients are beginning to seek me out because I have this particular interest and understanding, so food is already in the field from the beginning in those situations.
• Perhaps bringing these matters to supervision, to explore their relevance in your own work.

References

• Carrington, D. (2020) The Guardian Newspaper, 5^th December, p.9.
• Jacka, F. (2019) Brainchanger, Great Britain: Yellow Kite.
• Mayer, E, (2018) The Mind-Gut Connection. USA: Harper Wave.
• Naidoo, U. (2020) The Food Mood Connection. London: Short Books.
• Steel, C. (2020) Sitopia. London: Chatto & Windus.