Intuitive Eating & Trauma's Impact on Food
Intuitive Eating & Trauma's Impact on Food: Speaker Series featuring Lauren Bickford, MS, RDN, LDN (interviewed by Andy Silvagni, APN Lodge's Director of Alumni & Director of Community Relations - Florida)
Andy Silvagni: Lauren Bickford is a Registered Dietitian Nutritionist plus a whole lot of other letters, and I'm going to let her fill you in on what she does.
Lauren Bickford, MS, RDN, LDN: As Andy said, my name is Lauren Bickford; I am a Registered Dietitian Nutritionist and a Certified Intuitive Eating Counselor. And with both of those things, I specialize in behavioral health nutrition. I'm happy to chat a little more with you guys about what that looks like and how it applies to what everyone at APN Lodge is doing.
Andy: Awesome. So let's start here. Is food an addiction or is food not an addiction? How is it tied in connected with addiction? I feel like so many people out there have different opinions, so we're excited to hear where you and your practice kind of sit on that. Tell us, how did you get into this? What was the journey? How did Young Miss Bickford back in Kansas get to being a nutritionist?
Lauren: So spoiler alert, it all started in Kansas. There's no place like home, right? My background in undergrad is in biology, chemistry, and Spanish. So as we're talking about everything today, remember that my foundation is science. I would never do something that is just for the feeling of it. That's a big reason I do what I do, but it's all backed in science. So I take a Health at Every Size lens, and I focus on the relationship with food, coupled with the scientific basis of how that can be beneficial to everyone.
From Kansas in Biology and Spanish, I went up to Boston and got my master's degree in Food and Nutrition Science at Boston University. I did my dietetic internship. Everyone who is a dietitian has to do a clinical internship. The differences between a dietitian and any other nutritionist are that a master's degree is going to be required very soon, everyone has to do an internship, everyone has to sit for a rigorous exam, and everyone has to do continuing education. So there is a lot to it to be a dietitian. Then I became a dietitian at Next Chapter when I was working with Andy.
Mary Allen Kelly is a wonderful dietitian working mostly in the sports nutrition field. But she got connected to Next Chapter, and she's also a BU alum. So she and I got connected while I was still at school. She got me to Florida. I had some family down here already, so it just sort of made sense. I became a dietitian in the world of trauma and addiction and eating disorders, so those have been my foundation from the getgo.
Now, I'm in private practice. My practice is called "The Food Fight RD." I specialize mostly in eating disorders. There is a lot of overlap though between eating disorders, trauma, and substance use. It kind of all works together. And I think we're going to be able to chat a little bit more about the why of that.
Andy: Absolutely. So yeah. As Lauren mentioned there, our Clinical Director, Abe Antine, opened up a men's facility in South Florida in 2015, and I was lucky enough to be with him on that journey. We opened up a small 18-bed facility for men, and we merged with All Points North Lodge last summer. Abe has brought that clinical approach out to All Points North Lodge in Edwards.
Lauren was our dietitian and kitchen coach at Next Chapter. It was cool to witness how the food correlates to substance use and trauma, so subtly, to the point where people might overlook how significant something might be. It may look like, "Oh, they are just soothing through food." But trauma is connected to all process addictions and in food and substance use. So when Laura came on the team, it broadened our scope of what we could treat and how we could treat. She is kind of a jack of all trades. She worked for us for about two years. When we shut down, Lauren went to open her own practice.
Lauren: The Food Fight RD is me, yeah.
Andy: Love it. Lauren got great experience with us. We had this unique population of all-male trauma. Now, she has taken that experience, done well with it, and is helping so many people find that balanced plate. Some people, I've learned from Lauren, want to go to extremes. Lauren is more about finding a balanced plate. So again, Lauren, I'm excited to talk about trauma related to process addictions, but in your specific case, eating. What does that look like - the substance use world and how they view eating disorders and how they treat them versus how you and your team look at them and treat them?
Lauren: Yeah, so, as you mentioned at the very beginning, when it comes to how individuals and clinicians decide their treatment model, we don't all have to agree. That doesn't mean one of us is right, and one of us is wrong. I want to preface with that. But in the model that I use, it all goes back to the origin story of everything. If we think about when we're younger and go through traumas and then get older, a lot of times, both addiction and eating disorders are maladaptive coping mechanisms. I know that's the clinical term. What does that mean? It's using a tool you already had at your disposal in a way that's not the appropriate way to address what's going on. So we have trauma.
Food is the first thing that people are drawn to when they're born. When a baby cries - does it need a diaper change, does it need food, is it tired? What does a baby need? From the time that we're born, food is a soother. It's a coping mechanism. But it's how you utilize it, the relationship you have with food, and the relationship you have with your plate. Often, your plate is a reflection of what's going on around you. If there is so much chaos out here, but you can have control over the food in front of you, that may be your way to have control. But just like with substance use, it's a way that you can have control, but it doesn't actually address the problem. Someone like a dietitian can help you understand your relationship with food while also working with a team. A therapist can help you deal with the outside stuff at the same time so that by the time you go through process work with two people or more, you can have a healthier relationship with the outside world and with your plate.
Andy: Absolutely. So, in your world, how often do you see an eating issue paralleled with a substance use issue or another process addiction? Is this common? Or do you see people focused on "Hey, I just have some eating stuff I need to work through?" Or is it a parallel process that sometimes you see?
Lauren: You know, it's both. And I think, what I observed in my work in the substance use field at Next Chapter, a lot of times, when you deal with one coping mechanism, the underlying ones rise up. So that's one thing. The other thing too is that so often, in early recovery, we get this all-or-nothing attitude of like, "Oh yeah, now I don't need that. Now I'm going to get in shape. Now I'm going to do this. Now I'm going to do that." And it can take food to an extreme as well. This is extreme may look like restriction or a way to eat that eliminates a lot of other types of foods that are totally fine to eat.
You know, I'm an "all foods fit" kind of gal. When we start to restrict those foods, we have a heightened reward for them and heightened desires for them. So it's actually in restriction that we begin to develop a more maladaptive relationship with food itself.
Also, there are predisposing genetic factors for eating disorders. You may have been an individual that had never had any sort of issues around food before. Then you go to this extreme in recovery or this extreme when you're dealing with your trauma. You start to restrict food, or you begin to do things that resemble something more closely to a diet, but then that genetic trigger happens, and now it can spiral and spiral until the problem is an eating disorder versus trauma alone.
Andy: It's behind a lot of these behaviors that can be destructive that we all kind of suffer with. But, we were talking about balanced plates. Can you talk about when you're working with somebody new and the term "diet" comes into people's minds, how people see the term "diet," and what they think? I know, for me, I was talking to you two years ago and said, "Well, I'm cutting all carbs." And you said, "Well, why do you have to cut all carbs?" I said, "I don't know." Can you just educate us a little bit about the balanced plate and the theory you live by?
Lauren: Yeah, for sure. So "the balance." Even that, I use in quotes now. Because even I continue to learn more about how we talk about food. Let me reel it in and put my thoughts together.
When it comes to food, our plate, and how we talk about food, it's been infiltrated by the knowledge the average joe has now about how to "manipulate" your body shape or size with what goes on your plate. And how you change your body shape or size has a lot less to do with your health than your relationship with food does. We know so much more about stress hormones and how those can be triggered and activated when you're in a really restricted place. If you don't have enough fat, your hormones, in general, rely on fat. Your brain's primary fuel source is carbohydrates.
So often, we focus on all of these almost kitschy ways to talk about food. I like to say that if the way you're talking about food is "trendy," it's probably not based in any sort of science. Because if you think about huge influencers, why is that where you're getting your source of information? So I think it can be helpful to check in and pause. "Who am I listening to?" Also, look into a lot of different resources when it comes to who you're listening to - not just dietitians. Not all dietitians practice the way that I practice either. So it really is dependent on you and what your needs are.
But if you're looking at nutrition just for the food itself, and it has nothing to do with your relationship with food or nothing to do with your health, and it's primarily about the size of your body and what that's going to look like a result of what you put on your plate, I challenge you to consider that and look into the why.
Why is it so important for you to change your size? Is that actually going to improve your health? Spoiler alert: we know a lot more now that tells us that size is not as synonymous with health as we once thought. The lens I practice through is "Health At Every Size." If that's a completely new concept for you, check it out. It has a lot to do with why I practice the way I do, especially in the world of eating disorders. I would argue if you're treating eating disorders and not using the Health At Every Size lens, it's probably not a very ethical practice.
Andy: Yeah, that's a good point. Two kinds of hot topics and phrases we hear are intuitive eating and mindful eating. Can you help explain what that looks like, do you practice it? Expound on that for us.
Lauren: Sure, so let's just do intuitive eating. Like I said before, I'm a Certified Intuitive Eating Counselor, so it's the leg I can firmly stand on between the two phrases. Word of warning or caution, intuitive eating is the buzzword of the season and of the wellness world this year. So that means a lot of people are talking about it that don't know much about it. So Evelyn Tribole and Elise Resch, they are the two dietitians who developed the framework.
So it's not a diet, which is awesome because diets are exhausting. It's a way for you to reconnect with your body and stop listening to so much external noise about what you should do. You know, I like to say, you "should" all over yourself. But let's pause on that and get you connected to your hunger and fullness cues, to a positive relationship with food, and to a positive relationship with movement.
As a dietitian, I'm able to chat with people about their exercise and fitness. If they need something more than that, I can recommend a personal trainer rather than me. But being able to recognize the extremes that we can take movement is important as well. "Do you even like it? Why are you doing that movement? What feels good for your body, and what feels good for your life?" Talking about food and movement and even you in general, we can find the foods that work best for you and your body and get you reconnected to that.
A lot of that comes into being connected to your feelings and emotions and even your trauma. If you're super disconnected from what's going on with you emotionally, psychologically, or spiritually, there are many different things that contribute to our wants and needs and how our bodies respond to the outside world. Every single fear and emotion shows up in your body. For some people, a lot of feelings and emotions show up in the same area in their body as their stomach. So, of course, your feelings and emotions are going to impact your food choices.
Taking the intuitive eating framework and applying it specifically to individuals processing their trauma at the same time allows them to stay in their bodies. I always say, "Let's get you in your body." I want to help them stay in their bodies instead of checking out when it gets too much.
Doing the work is a lot. To say that it's easy peasy is not quite accurate. But to form a team that provides you with adequate support to get through the journey, that's what it's all about.
Andy: That's awesome that you mentioned that. At APN Lodge, our philosophy isn't that one size fits all. If you're suffering from addiction - whether it's alcohol, substance use, eating, or gambling, we are custom-curated to meet the client where they're at. Each client has specific needs. Two clients can look similar but have all different issues, and their treatment plan for nutrition and food can be completely different. It's custom. We feel like we have a lot of pride in that because we're going to meet everybody and give them that individual, custom-curated treatment plan. We have so much to offer at APN Lodge. Our clients work with a dietitian, and you're speaking a lot of the same language she is, so that's exciting.
Lastly, talk about how trauma triggers these maladaptive behaviors. We cope in different ways, and food seems like the first way I might learn to cope when I'm seven or eight. If I'm an alcoholic, I can't get to a bottle of Jack Daniels. That hasn't been introduced. The food is right there. How does trauma drive that unhealthy relationship people can have towards food?
Lauren: Right, exactly. To answer that in continuation with what you were already saying, we all develop our relationships with food in a completely unique way depending on the environment we were in, the support that we had or didn't have, the types of food that were available to us, or even any sort of religious or ethical practices related to how you choose, prepare, or consume food. There are so many things unique to every individual that diagnosis is going to look completely different on two different people.
It's crucial to learn from the person who is coming into receive care. We can learn so much from our clients, and we will create an adequate plan for them. But we need to spend some time getting to know the people that we're working with. That's the cool thing. As you mentioned, getting to know the person behind the diagnosis is always a top priority.
I think, sometimes, we tend to treat humans in a less than humane way - based on their diagnosis and with just a textbook. Let's bring the humanity back into how we work with people.
Andy: Awesome, so lastly, before we close up, I know you mentioned "Food Fight." Are you working for another institution too? Can you tell us about that so everybody can do their research and find you?
Lauren: Yeah, so I have a few different ways you can find me. The Food Fight RD is how you can find me, whether across socials or on my website as thefoodfightrd.com. I also work as a recovery coach for eating disorder clients at The Eating Disorder Center. They are based in Maryland, but it's nice because, as a coach, I have a virtual office. Worldwide, no matter where you are located, you can get support for recovery from your eating disorder from one of the coaches at our center.
I also support individuals in the nutrition and dietetics field, whether it's as a student or an intern, so kind of in those early years, under The Food Fight Fam. I serve as a mentor and offer a place for students to connect. A lot of times, we tend to be a little competitive in nature. Being able to have that place to come together and move forward together rather than being so divisive as we're growing and learning is great.
Andy: A lot of Zoom, right? The whole world is Zoom right now.
Lauren: Zoom, zoom, zoom.
Andy: Alright, Lauren, I appreciate it. As we said at the beginning, Lauren and I have known each other for a couple of years. I spent some time out in Colorado at the APN Lodge campus, and I'm now back in South Florida. So it's a great opportunity to catch up with Lauren. We were joking before the call that this is the most professional conversation we've ever had. Usually, after 30 seconds, one of us is busting each other's chops about something. If you knew us and witnessed what we just did for the last few minutes, people would be shocked that we didn't make fun of each other.
Lauren: Yeah, I think people should bring a chair to sit in to watch this if they know us because I'm impressed with us and our professionalism.
Andy: We've grown up. Adulting. Well, for everyone watching, you can find our Speaker Series on apnlodge.com/speakerseries, and it'll be on our social media. I'm sure Lauren will post this on hers. Again, we're excited to connect with professionals that see addiction and maladaptive behaviors through the same lens, and trauma does drive these behaviors. We at APN Lodge, are going to treat that trauma. We're not just trauma-informed, we are trauma-focused.
We treat the wound and get down to when that wound happened. Did it happen at two, did it happen at eight? We're going to address that, not just talk about it. As we said, trauma can show up in many forms, and food is one of them. So we're excited to work with other professionals like Lauren, who are doing the work that we're doing. We're just stoked about it. Again, Lauren, thank you for taking some time out of your busy day and sitting with us. From everybody at All Points North Lodge, we thank you. See you guys soon.
Lauren: Thanks guys!