Do you have clients who use food to self-medicate?

Do you have clients who use food to self-medicate?

Not long ago, I had a sudden lightbulb moment during a session with a client. I’ve had several interesting insights working with Morag, which I think are to do with her openness and her determination to find things that work for her.

In this particular session we were talking about her love of chocolate and specifically, how much chocolate she eats when she is feeling down. At the time, there was a lot of difficult stuff going on in her life and she couldn’t get support from her friends because the issues she was facing were things they didn’t understand.

Food can be a bit of a blunt instrument

The chocolate eating had, in Morag’s view, become a problem because once she started, she kept going. It wasn’t exactly a binge but it certainly felt out of control. Morag told me that she didn’t want to give up chocolate altogether, as when she tried that before it back-fired and led her to abandon the diet she was on at the time.

As we talked about what the chocolate was doing for her, she said it dulled unpleasant emotions. I asked her whether it was acting a bit like an anaesthetic, and as I asked the question I realised something I hadn’t thought of before….

…that when you use chocolate as medicine, maybe it could help to think of it being a bit like paracetamol.

Medicine is administered by dose and timing

What occurred to me was that if Morag was using the chocolate to self-medicate (as many clients have done in the past) then titrating the dose and the timing would be key.

I suggested to Morag that maybe she could think of chocolate rather like using paracetamol. In other words, it has a specific helpful purpose when you need it, and that planning how much and when might be more effective than dosing yourself up willy-nilly.

Morag liked this analogy, and decided to try it out.

Chocolate-as-paracetemol

When we next met, a month later, Morag said that the paracetamol analogy had been an eye-opener. It meant that she thought in advance about when she would be likely to want a dose of medicinal chocolate, which made her feel more prepared. She portioned out the dose of chocolate that would help but not leave her feeling sick and full of regret (which is what had been happening previously when she’d used chocolate to self-soothe).

Morag told me there had been an additional unexpected benefit of the paracetamol analogy. It empowered her to make a health-enhancing decision about dealing with low mood whenever she found herself feeling down. She started to see having a planned dose of chocolate as one option available to her when she felt down. The other options were to use a non-food means of dealing with the difficult emotions, or to eat chocolate as she used to without thinking about ‘dose’ and timing.

I suggested that she see the three options as all effective ways of dealing with feeling down, without feeling that she had failed if she opted to eat chocolate in the way she used to. The fact that she had other options (medicinal dose of chocolate or non-food strategies) gave her a greater sense of self-control.

The value of re-framing

What had happened for Morag was essentially that re-framing how she thought about using chocolate to deal with difficult feelings put her back in the driving seat. Rather than hoping that the next time she felt down she could resist eating, she could now remind herself of her three options and take an active decision about which to follow right now. Just to remind you, the three options were

  • to eat the comforting food as she used to do
  • to use the non-food techniques for Emotional Eating we had already worked on
  • to medicate her feelings with a dose of chocolate and space out the doses like she would if this were paracetamol for physical pain

In some countries, Smarties come in blister packs!

I was amused to see a post on twitter by Dr Aimee Pink, an academic psychologist who studies the psychology of nutrition and appetite. Aimee is currently working in Singapore and posted the photo at the top of this article. In the post she asked, “Singapore, why are your Smarties packaged like drugs?”

I’ve never seen anything like this before, but after my experience working with Morag, I wondered whether sweets in blister packs could actually be quite helpful. As far as I know they aren’t available in the UK. Do let me know if can buy sweets like this where you live!

This is simply a clinical insight I stumbled upon

This idea of using dose and timing in relation to self-medicating with food isn’t something I have discovered through research – it simply came up in the session with Morag. I don’t know how many people it might be useful for, as I haven’t yet offered this idea to other clients as it hasn’t been relevant.

I’m writing about it here in case it’s something you might find useful with one of your clients at some point. A simple idea can sometimes give a client a handle on what they are doing, in a way that helps them make positive change.

There is plenty of research on Emotional Eating

Although this paracetamol analogy isn’t evidence-based, there is plenty of research on the development of Emotional Eating, and on techniques that help people reduce their reliance on food to deal with difficult feelings.

The issue of Emotional Eating is something I’ve been asked for training on many times, so I’ve developed a Masterclass for professionals of all backgrounds whose work involves helping people change how they eat.

If you want to learn more about the science behind understanding Emotional Eating, and effective strategies that you can use with your clients, you are welcome to sign up to the Masterclass on Emotional Eating.

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Photo by kind permission from Dr Aimee Pink

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