Darren: Hello and welcome to Attach Together, the podcast where we explore attachment theory and what it really means for counsellors, psychotherapists and psychologists in practice. Created by the team at Optima, providers of the Level 5 and Level 7 diplomas in attachment-based psychotherapy, So we are back with our dilemma. And this is very related to the conversation we've just been having, Jo. So I'm wondering what you're gonna make of this. ⁓ client who arrives to sessions ⁓ food in hand and sits and eats during the counselling session. Yeah, it's only fairly recently that I came across the term food addiction. And at first that seems counterintuitive because we all need to eat food. ⁓ associate addictions with things that we can do without and us ⁓ Whereas food obviously ⁓ does an awful lot of good, it keeps us ⁓ However, when look at... ⁓ Jo: Mm-hmm. Darren: This podcast is a space to deepen your understanding, reflect on your work and stay connected to the heart of attachment informed practice. food through the lens that you've just described, you could see how a food addiction comes about because it's about self-soothing and not having the internal resources and inner security to meet our own needs. actually, you know, being comforted with food and we even call certain foods comfort foods, don't we? I'm Darren, a counsellor and a touch and base psychotherapist in private practice. Alongside hosting this podcast, I teach on the level five course at Optima. Hopefully that richness of experience comes through in the conversations we have. And a quick note before we begin, our episodes now come with a CPD certificate. If you'd like to access it, simply head to our website For me, it would be sweet stuff. I've got a really sweet tooth. For my husband, it would be crisps or, know, savoury foods. No matter what that is, actually, if you're seeking comfort and you know you can find it in food, then that's gonna be a place that you go to. And thus leads us to disordered eating. That's not an eating disorder. Joining me for the third and final time this season is Jo Oxley, therapist, supervisor and tutor at Optima. Jo, you've chosen for us to explore attachment and food. Where do we begin? ⁓ Jo: that's a really difficult situation, isn't it? ⁓ If a client then asks you ⁓ you mind whether ⁓ they start eating their breakfast ⁓ in the session or if they get their lunch out halfway through a session. Yeah, it's really interesting, it? And I guess, know, we really... ⁓ Darren: in and of itself. Obviously it could lead that way. It could lead to binge eating or bulimia or even go the other way with anorexia. However, actually, I think many people listening to this will recognise that feeling of, ⁓ God, it's a bit of an afternoon slump. I need a bit of sugar as a pick me up. I've, you know, we go straight to food and I've tried really hard as a foster carer to... Jo: ⁓ Well first of all thanks for having me back Darren, it's really lovely to spend some time with you again. Yeah I think when we think about food we often think it's about nutrition or dieting or health and I guess what we're thinking about here is ⁓ eating but from maybe a disordered perspective so disordered eating rather than eating disorders. get curious about what's going on. Now it could be that the client maybe has low blood sugar and the appointment's very early and they've taken children to school and et cetera, et cetera. I perhaps would, say, yeah, okay, if you really do need to eat, then please go ahead. But can we have a conversation about ⁓ what's going on? You know, what's happened that need to have your breakfast? Darren: avoid using food as a reward ⁓ or even as a comfort. But for me myself, it's like, ⁓ I've done really well, let's go for a meal. You know, someone in the family's achieved something or it's a birthday, we'll get a huge birthday cake or it's, you know, someone's feeling poorly. ⁓ okay, we'll send them some brownies in the post. Like food is so... Mm-hmm. Jo: or your lunch in the middle of our session. And then just have a talk about around that as to maybe what we could do in the future, what is going on. But another thing it could be that they're so anxious and if they're using food to soothe, they've brought their self soothing mechanism into the therapy room. So it may be then that you do as a therapist want to work with that. What's it like? What are you feeling before you take them? So when we think about food from an attachment perspective, food carries ⁓ a much deeper story. As a counselor, we'll know that many of our clients' patterns begin long before they had the language to describe what they were feeling, for example. And feeding is one of the earliest relational experiences that we will ever have. So long before those words, there's hunger, there's discomfort. Darren: intrinsically linked with, I've had a dreadful day, ⁓ okay, I'll tell you what, let's get a takeaway, let's not bother cooking tonight, we deserve a treat. Before you know it, food is so wrapped up in our emotions. Jo: Does I have a treat? Mm-hmm. a mouth of that, what are you feeling as you're swallowing it, as you're eating it, what's happening in your body now? And then we could perhaps expand that as to what else could you do rather than just shutting it down and you mustn't bring food into the... So I guess it's a dilemma and I guess it will depend on the comfort as well as the therapist to actually... Mm-hmm, yeah. And that makes sense to me why you're saying that, given what you shared about the experience of the dinner table and your kind of association with food is that nurturing. I guess, you know, certainly from my own experience, I really realized one day I was standing at the fridge with the fridge door open, just staring into the fridge, trying to find something. there's distress and hopefully someone comes along with some nourishment or some warmth and the capacity to soothe that distress. Whether it's the breast or bottle, this moment provides an opportunity for intimate connection. And in that connection, I guess there's that skin to skin contact, that gaze, that touch. And then I started saying to myself, what is it? What's going on here? What's happening for me? And I realized this was my stress response. I felt stressed. So I went to the fridge. I was looking for something to soothe. But I knew myself, if I found something like you say sugary or, you know, maybe that wasn't, it was calorie laden. As soon as I'd eaten that, then the guilt and the shame would start. So. slow it down, really take a back seat and then work with it. I guess that's my feeling, what's your thoughts? the facial expressions and the voice, those little sounds that we make. And that all goes towards creating ⁓ oxytocin, the bonding hormone. Darren: Yeah. Well, it's only on hearing you speak. I tell you what, I'm wondering about ⁓ the client's sense of self-worth and what are they prioritizing above themselves? Why is it that they haven't had time for a meal? And why is it that they maybe aren't using the therapy space as fully as they might? What's the block there? Jo: And that gets stimulated in these interactions between the baby and the caregiver. And I guess if it's all going well, the caregiver and the infant begin to find a rhythm, if you like, in one another through responsiveness and through ⁓ attunement. I think from working with this with clients, it's unpicking what happened at the dinner table. What behavior, what association, what does food mean for this client? What's the story here? Because with any addiction, addiction is ⁓ a solution to a problem. And I always say, Darren: Maybe they're avoiding something, maybe by bringing them meal in that's a distraction. ⁓ And this could well be within their knowledge, but likely not ⁓ their subconscious and ⁓ unaware of what they're doing. And I think I'd be drawn to working with. Jo: how clever our clients are that they come up with or they found a way to survive. ⁓ But like you say Darren, know, it's associated often with a reward, with a treat. And it's about working with our clients to work out how else can you reward yourself? How else can you get that feeling? Because that's short lived, that food. It's a very short lived moment, a bit like alcohol. Darren: their sense of how they prioritise themselves and how they take care of themselves. And really what a counselling session means to them, what are they here for? I think that would be my starting point, but it's a really tricky one. Jo: The other thing that's just sort of, I've just pinged off in my head is, know, when we, when we perhaps work with younger people, the younger person might say, can my mum come in the room or can my dad come in the room, my caregiver come in the room. And if that food represents an attachment figure, then they are literally bringing their attachment figure into the room, aren't they? the ⁓ then begins to organize their sense of safety. When I'm distressed, somebody comes, it feels better, I don't need to be distressed. So ⁓ repeated experiences become internalized, becoming part of the infant's developing expectations about themselves, about relationships, about whether their needs will be picked up. you know, or take in cocaine for example, know, once that high has come, that's it, it's over. What's more beneficial is to work out what the problem is. So for me with the fridge, I'm stressed. I actually don't really need any food. What I need to do perhaps is to go and do some breathing or go for a walk or connect with somebody, have a conversation with someone. I worked with a client very similar to you. Darren: Yeah. Well, especially who made the food? What meal is it? Who prepared it? You know, was it made by mum? Was it made by your husband? You know, like, what does that represent? So yeah, there's a lot to unpick. I think I'd be asking quite a few questions and really sitting and noticing. Jo: noticed, tuned into, will somebody come or do I need to start to manage things on my own? We've talked about, haven't we, in a previous podcast about internal working models. So I think food then becomes a really complex attachment figure, substitute. Yeah. Yeah. There is. Her whole family was a big family and the dinner table when she drew it and described it, it sounded fantastic. It sounded a really warm, nurturing, happy. And what she realized in one or two sessions very, very quickly was the food she was trying to get back to that big family. But her family hadn't left her. She'd moved into her own house and her family weren't readily available, but they were available. Darren: what the answers are and I'm picking it. mean actually what starts off as a ⁓ my word what's going on could be really really fruitful couldn't Yeah back with the puns I can't help it. Jo: Fruitful, very good. Yeah, I think once you put those attachment goggles on and we start to look at things from an attachment lens, then we can see things very differently. And I know in a lot of core training, perhaps the message would be that's not acceptable. But actually, you know, I think we need to be a bit more open minded with that and a bit more broad minded as to what does this represent? What is this behavior telling us? Darren: I can really feel that within even just the short examples that you've given there. That sense of what can be relied on and then what can't. Jo: And so just by bringing that to mind that, you know, when she was looking for that feeling, she could just pick up the phone or she could arrange to go and have a coffee. And that started to be the process. And very, very quickly, she started to shed some of the weight that she was wanting to to get rid of because she no longer using food as a way of soothing this uncomfortable feeling. Yeah and a lot of it is about that early experience of being fed as well. ⁓ You know, has the caregiver made space for the baby to have a good feed? Or is it rushed? Or I don't know, do you remember the film ⁓ Three Men and a Baby? Because we know, don't we, that all behaviour is a form of communication. So if we are curious about what's being communicated or what's being used here to soothe, etc., etc., then I think it could be a really interesting piece of work. Darren: Mm-hmm. Yes, I do. Vaguely. Jo: Poor baby is trying to be fed by three loving but utterly baffled men, adults. Milk's everywhere, there's confusion about what this baby might need and nobody is quite in sync with the baby's rhythm. And whilst it's funny on screen, it actually really shows us something quite profound, I think, about feeding. That it isn't just about food, it is actually about that relationship. Darren: Yeah, good. OK, before we say goodbye, ⁓ Jo, we're recruiting for courses currently that in So it's the level five diploma, ⁓ CPCAB, ⁓ then the level seven. ⁓ Now I have my own hunch, ⁓ where lies with Is there certain ⁓ attachment style that's going to be prone to disordered eating? Jo: It's a really good question. I've never really given this much thought. ⁓ Where I'm tending to lean to straight away is maybe someone who's a bit more avoidant because they're looking for something that they can control and they can get and they can manage themselves rather than going outside to ⁓ find someone else to help them soothe. So that's my gut knee-jerk reaction. What's yours? Darren: Mm-hmm. And the level 7, remind me what does that cover? Jo: So as you rightly say, this really highlights the difference between mechanical feeding, ⁓ IE a baby being propped up and a bottle being propped up with a cushion, as opposed to, you know, the caregiver taking time to hold the baby, to nourish the baby. So, you know, that really starts to get this pattern of, are my needs important? So Level 7 kind of gave birth to itself from the Level 5. Lots of students who had done our Level 5, they were wanting to do more, they were talking about doing clinical supervision or working with couples. ⁓ along with Scoped, obviously, if people want to get ⁓ accreditation, ⁓ I developed the Level 7 to kind of tick a lot of those boxes. So we do a module on ⁓ supervision to be fully qualified with a Diploma in clinical supervision. Darren: It's really interesting because I, working from the basis that actually a secure attachment is going to be far more able to internally resource. So therefore I'm thinking, okay, of the insecure attachments, ⁓ where would that sit? And my mind actually went to a preoccupied attachment style because... ⁓ Jo: ⁓ and that gets linked with food. And I think it can go even ⁓ more kind of deeper than that in terms of, don't know, let's try a little experiment just you and I. Cast your mind back to your memory of the dinner table when you were younger. couples therapy and we cover emotional focus therapy. We cover the Gottman model, the PACT model, as well as an attachment focused couples therapy model. ⁓ satisfy the research element for senior accreditation ⁓ by doing a systematic review. And what that means used systematically. So it's a process. ⁓ Darren: when we're dealing with a child that's anxious, ambivalent, and that's sort of seeking comforts from external... Yeah, I've got a memory. Jo: Mm-hmm. So we can do this with clients as well to try and find out, you know, what is their kind of relationship with food and where did that start? And when I cast my memory back to ⁓ the family dining table, often what we see gets played out is the relational dynamics of the family get played out at the table. Darren: places, actually food is external resource. So although in one way it could be regarded as that independent avoidant, actually in another way. So I'm wondering actually Jo whether this isn't ⁓ about one or another, but how it probably plays out and shows up is or how it develops could be completely different. So ⁓ for preoccupied. Jo: Mmm. review whatever evidence is out there that would answer your research questions. So you came up early with a fantastic question, about food and attachment styles. And so you would pull together loads and loads of research and then you kind of whittle that down to maybe 10 or 11 or 12 papers and then you look at those in depth and from those researches you systematically review that to give yourself a new insight. Darren: It's like you're in my mind, Jo. That's my memory. That is actually my memory. And actually, weirdly, it's my memories of being at my grandma's table and the wider family all being sat around together and the dynamics that then played out and the role that my grandma took in nurturing all of us and showing her care through the food that she gave. adult that could well be ⁓ trying to seek back some of that comfort that they've had a taste of and they're trying to chase that back. But for an avoidant it's not been developed in that way. It's been developed in a, okay well someone isn't there for me but I know what works for me and I'll go and sort myself out. It leads to the same end result but actually the underlying... Jo: Mm-hmm. if you like to, how we might work with that, what it means, et cetera, et cetera. And there's also the fourth module of the level seven is on learning to work with religious trauma. Cause I think that comes into our therapy room far more than we, we realize. And part of that is we teach a little bit of EMDR, it's called a flash technique. So you've got some tools to be able to calm a nervous system and a client doesn't never have to talk about their trauma, but And that's often the case, that care is shown through food. Or we might have at the dinner table, that is a arena if you like, if there's bullying in a family, that will get played out at the table. And then that again can create quite a complex dynamic with food. Food can be like you said, a symbol of care. And that in itself can... Darren: ⁓ triggers and the causalities are completely different and I guess that's where an effective counsellor really needs to be in the client's world rather than making assumptions. Jo: using the flash they can then start to process that trauma. it's kind of a, we wanted it to be an all encompassing course that gets you a level seven, but also qualifies you to be a clinical supervisor, a couples therapist, and be able to read and understand research in a nutshell. Yeah, absolutely. sometimes mean that we develop a disordered eating or unhealthy relationship with food in terms of we might be trying to get something back. Darren: That is furrer and full. And all of that is achieved in much like level five, one academic year, starting September, finished around June or July. And ⁓ yeah, so within two years, in theory, someone could do the level five, then progress to the level seven. And look what you've got at the end of it. I mean, that's a sensational offer. If what we're talking about now has perked your interest in any way, please head to our website, OptimaHealthServices.co.uk. Jo: foods associated with that feeling. Darren: Yeah, that nourishment that comes from food can be wider than just the nutrients itself. It's really loaded in meaning, isn't it, sometimes? And actually, I'm going to take this off in a slightly different direction because there's two things you've said and the thing that's popped in my mind both times, mobile phones. Okay, So ⁓ before we head off the break, ⁓ what's the takeaway? ⁓ God, that's ⁓ pun, not intended, Jo: Take Darren: all of the information you need is on there and you can get in touch and one of us could happily meet and chat with you one-to-one and talk you through the qualification ⁓ but for a huge thank you to everyone for listening and an bigger thank you you Jo for joining us yet again ⁓ baby in caregivers arms, propping the bottle up, are they gazing at the baby or are they gazing at their phone? The family sat at the table, do families now interact at dinner? Or are the youngest children propped up with iPads? I mean, you see this when you go out to dinner, don't you sometimes? know, a family will be sat together and actually, the way that the older members of the family get some peace to eat their dinner, Jo: Mm-hmm. Darren: is ⁓ the one that you'd like people to remember from this conversation that they've listened to? Jo: Mm-hmm. I think therapeutically, when we are with a client who talks about food, maybe we can pick up on some of that yo-yo ⁓ conversation, know, one minute food's a treat, the next minute there's shame. You know, we really need to be thinking about what is this serving? What attachment figure, perhaps, is this food providing for this client? Darren: for another episode. It's been great to have you here. Thank you. Jo: Thanks for having me. Darren: That's it for now and I'll see you next episode. Thanks. or perceived peace is to placate the child with a tablet or a mobile phone or an electronic device of some description and it just spikes through any chance of interaction. Jo: And then to help the client make sense of that story based on their early experiences, perhaps around the dinner table, perhaps around being propped up, perhaps around food being used as a reward, for example. And I think with anything, know, Bowlby says about us becoming storied selves. I think once we can understand the story and the trigger, a like me with the fridge, as soon as I understood it, I no longer go to the fridge, which... Yeah. 100 % and you know, Linda talks about this in her book, Linda Cundy, is Love in a Digital Age. And you just kind of sparked a memory for me. ⁓ We took the two eldest granddaughters out for lunch some weeks ago. ⁓ my said, well, you know, is it a good idea to take them into a pub for lunch? And I said to him, well, how else are they going to learn how to? ⁓ know it's quite a relief for me because ⁓ you know that's something which I didn't want to do really, I didn't want to keep putting food into my body that wasn't going to do me any good and then feel that guilt and that shame so yeah I think that's my takeaway. interact and how to be at a pub or a restaurant. There certainly were no mobile phones. We played games at the table while the food was waiting to come. We did colouring, but we had a thoroughly great time and I think they really enjoyed it too. You often look around families dining together and the majority of people are on the phone. Maybe that's something that we could perhaps Darren: Wonderful, I feel full from that and thoroughly nourished. So thank you very Jo. ⁓ have a break and then we'll be back with our dilemma. Jo: Thank you. doing in another, know, take that deeper. It is a big topic to unpick, yeah. So just coming back then to disordered eating, you know, certainly in my practice with clients, ⁓ I've had clients who struggle with their weight, for example. They yo-yo from one diet to another, and all of the time in this kind of this yo-yoing, there's a... ⁓ Darren: Yes, a big topic to unpick, yeah. Jo: underlying theme that they're having to give up something which is a treat. They're having to deny themselves something and actually that's quite a dichotomy in itself isn't it because if you think that Part of the dieting process is because you're not happy with perhaps, you know, the weight that you're carrying, but in your mind, food is a treat. There's a bit of a, you know, what's this mismatch, isn't there? And doing something ⁓ healthy for our bodies, are you treating our bodies in a healthy way, often is seen as, yes, but to do that, I'm denying myself something, I'm not allowed to treat. yet actually, the treat, if we look at it from a really rational perspective, the treat is treating yourself in a healthy way and being happy with how you are in your body. If we're not happy in our bodies and we feel uncomfortable in our bodies, but it gets really complicated, doesn't it? So going back to the feeling of the table and what you're about your granny nurturing with food, food is then used to try and create that nice feeling. But also on the other side of things, a bit like alcohol is used, food can be used to soothe. So if we can't find another way to soothe, then we might use food as a soother.