Food and Mental Health

A Guide for Health Professionals

Gerrie Hughes

• Verlag: Routledge
• Jahr: 2021
• ISBN:
  9781000484502
• Auflage: 1
• Thema: Psychologie
• Thema: Santé mentale en psychologie

Written by an experienced psychotherapist, this book provides professionals in the fields of health and wellbeing with a guide to human relationships with food, and their impact on mental health. Acknowledging how food choices profoundly effect a person's experience in the world, Gerrie Hughes offers knowledge and support around how to understand and negotiate the relationship between food and mind. Chapters offers facts, information and theories on key topics such as self-image, 'good' nutrition, sustainability and rituals. Each chapter uses vignettes, case studies and reflective activities to stimulate thought about the reader's own assumptions and experience and offer approaches to how they might use their expertise with the people with whom they work. Providing an accessible and easy to read guide into the role food plays in our lives, this book will be of interest to a range of healthcare practitioners, including mental health nurses, occupational therapists, psychotherapists, and counsellors.

1 Appetizer

A taste of what is coming next

DOI: 10.4324/9781003172161-2

Introduction

The words we use about food are the same ones we use about life: abundance, hunger, appetite, taste, disgust, satisfaction and more. Food is, literally, essential for life, but our relationships with it, both individually and collectively, can become problematic. When they do, the result is disease, distress and strain on services. We are accustomed to making the link between what and how we eat and our physical health but, currently, researchers are recognizing the link between food and mental health.

Thinking about it, this seems obvious – we are whole people, not just the sum of our parts. We are also fundamentally interconnected with our environments. Eating (along with breathing) is one of the basic ways that this relatedness is experienced. Sometimes I think this deep interdependence is difficult to perceive, like when an object is so close to your face it can’t be seen properly. This lack of clarity means we go along with ideas that, if we could let ourselves accept the reality of them, would dismay us.

As individuals, we make food choices that we know, at some level, do not really nourish our bodies. Like when I slather butter on pieces of white bread (albeit home-made organic sourdough) to make a sandwich for lunch because I’m hungry, tired and having to process everything that happened with my work that morning. I have beautiful organic lettuce in my fridge, and the wherewithal to make a healthy salad. But what I’m hungry for at that moment is comfort, and my body remembers my grandmother giving me butter on everything. Our bodies and minds need nourishment on many different levels and, I suppose, there is something helpful for me in at least being able to bring my choices into awareness, even if I still make the ‘bad’ ones.

This dissonance also happens for us as a society. In Britain, we seem to have arrived at a position where what food needs most to be is cheap. Never mind if it means that people or animals are exploited to produce it, or if potentially harmful fertilizers or pesticides are involved, or if it only tastes reasonable because it contains a lot of sugar or salt, so long as it is at the lowest price compared with competitors. I understand that the beneficial intention behind this approach is to avoid those on low incomes having to go hungry, but then I wonder about what it takes for people to be truly nourished.

Setting out the table

What can we do?

This book is offered as a guide for professionals whose role is to facilitate others to understand their relationship with the world and to support them in making that relationship as satisfying as possible – which means, from my point of view, satisfying for both individual and world. I don’t think just satisfying one side of the relationship is sustainable anymore. You may be a therapist, doctor, nurse, teacher, sports coach or a parent wanting to help your family build satisfying relationships with food for the future (remembering, though, that this book focuses on working with adults). You may have noticed that your patients, clients, students or family are involved in challenging negotiations with their diet and their physical and mental health. In this work, I’m attempting to identify and describe areas of experience that may be relevant for us all, whichever side of the ‘helping’ relationship we are on at a particular time. To this exploration, you will, I hope, feel able to bring your own experience, expertise and preferences. For ease of expression, from now on I will talk about ‘professionals’, hoping to encompass all the disciplines that this kind of material would interest, and ‘client’, which means anyone to whom we have a contractual commitment or responsibility.

Why I wrote the book

There is something daring about offering a book to a multi-disciplinary readership. Inevitably, there is a risk that readers will have far greater expertise than I do in neuroscience, physiology, nutrition and many other fields. The expertise I do claim for myself comes from having worked with people for 30 years as a Gestalt psychotherapist, with the aim of making lives that are more satisfying for all of us. Counsellors and psychotherapists may not know everything about how to provide effective support in every context but being and working in relationship with others is the discipline we practise; it is where our training and professional development is focused and what our accrediting organizations assess.

When I wrote my previous book, ‘Competence and Self-care in Counselling and Psychotherapy’, which was published by Routledge in 2014, it was designed directly for my own profession. Yet, when I had finished it, I realized it could be useful to anyone who works with others: managers, teachers, social workers, HR and sales professionals, for example. Most jobs require that people work with others, whether as leaders, facilitators, or colleagues or with customers. My focus in that book turned out to be too narrow and it feels important to focus on a wider readership this time. Besides, it seems to me that the traditional boundaries between disciplines and, indeed, art and science are no longer relevant or practical and that people must be versatile and open to learning across subject boundaries throughout their lifetimes.

If you had told me ten years ago that I would be researching and writing about the brain, I would have been horrified. Yet, when the neuroscientists started discovering the link between mirror neurons and empathy, I felt like science was ‘proving’ something I already knew as a therapist. A similar thing happened when I started to read about the work of scientists linking mental health and diet. The findings were in tune with my subjective experience as a person who eats, who shops and cooks for myself and my friends and family, and who also works with others around their relationship with food.

Difficulties and delights around food have been a major issue in my own life. They have also figured very largely in my work with clients. This seems like the right time to bring together what I have learned.

Words and meaning

Before going any further, I would like to clarify something about the terms I use and what underlies my approach. To begin with, some terms. You may not define these words in the same way because of your own professional training or personal preference, and I don’t think that matters particularly. But it seems important to me to be clear about what I mean when I use them.

• Brain. This is the organ that dwells in our skulls – the physical, cellular matter.
• Gut. Following the outcomes of research in the late twentieth century, deeper understanding of the significance of microorganisms present in the gut and the connection between brain and gut via the vagus nerve, has led to new thinking about how human beings operate internally and also how we engage with our environments. The gut microbiome is a garden of organisms that are not us, but that co-exist intimately within our digestive tracts to help us assimilate what we take in (and not only food) (Mayer, 2016).
• Mind. The subjective experience of the operation of the brain and gut plus, for me, the experience of the body, a lot of which, like the movement of blood, is out of awareness. The physical body is in constant exchange with the environment, breathing and sensing, held by gravity. Tim Parks expresses this beautifully in his book ‘Out of my Head’ (Parks, 2018), in which he describes his journeys as a layperson into some of the current scientific beliefs about the brain and consciousness. For him, ‘mind is the happening of body and environment together’ (p. 33).
• Psychological. Matters concerned with my rational, cognitive experience of being. Some definitions (including the one I just looked up on Wikipedia) include emotional experience in them. While I know we are whole beings, and that to attempt to dismantle us into constituent parts diminishes our nature, for the purposes of this exploration I would like to be able to differentiate the mental and emotional aspects of our engagement with the world so as to understand them better.
• Emotional. My embodied, intuitive experience of being, where rationality is irrelevant.
• Senses. The conduits through which I experience being in the world. These are, of course, sight, hearing, touch, taste, smell, plus the proprioceptive sense of what I am experiencing in my body.
• Self. My experience of body and mind interrelating with other beings and the world over time, and in this present time and place. By this, I mean the personal history that has made me what I am today, plus how the person I am now influences the possibilities available to me in the current moment and, importantly, the potential I have to learn, grow and change for the future.

Food and mental health

There is a range of areas of human experience around which food and our brains, bodies and minds are connected. Here is a brief overview of the areas I will be exploring in the following chapters.

Food and the brain

Sloshing around the brain is a cerebral fluid, composed of water and fats, that protects the precious structures, delivers nutrients and washes away waste. The brain needs food in order to keep working and glucose is its only form of sustenance. In fact, the brain takes 20% of the body’s glucose supplies, although it is only 2% of its weight (Carter, 2019). This glucose comes from the food we eat that contains sugar and starch, found in fruit, vegetables and grains. These carbohydrates can be divided into two types, simple and complex. Simple carbohydrates, refined sugar, for example, are quickly processed by the digestive system and provide an immediate burst of energy, but the available energy soon drops, and the body begins to crave for another sugar hit. In contrast, complex carbs, like potatoes and other vegetables, fruit, brown rice and grains, are more steadily processed by the body and so provide a more sustained form of energy. People often call this difference in processing ‘GI’ (glycaemic index). The fast processors are high GI and the slow are low. Consistent, steady supplies of energy are important for the body, but for the brain, they are essential. The brain reacts to lack of glucose in the same way that it reacts to lack of oxygen (Carter, 2019).

The processing cells of the brain are called neurons. They resemble straggly stars with branched points. One of the points is longer and thicker than the others, reaching out into a web of connection with other neurons. This is an axion. Along the axion, there are points called synapses, small gaps between the neurons which are the areas of communication between them. One of the ways they communicate is by chemicals called neurotransmitters. There are many different types of neurotransmitters that tend to excite or inhibit (send or block) nerve impulses. Familiar examples include serotonin, dopamine and noradrenaline (Carter, 2019). The raw materials to manufacture neurotransmitters come from the food we eat.

Serotonin is a neurotransmitter that is connected with mood, appetite and sleep and so is important for general wellbeing. It is produced from tryptophan, an amino acid that is found in protein sources of food like meat, fish and grains (more about food groups will be found in Chapter 2). However, in order to cross the blood-brain barrier, which protects the brain from any toxins that might be circulating in the blood, the presence of carbohydrate (from vegetables, grains, etc.) is necessary. Once across the barrier, folic acid, vitamin B₆, biotin (another kind of B vitamin) and zinc are all essential for the final transformation into serotonin (Geary, 2001). Folic acid comes from vegetables and the other nutrients come from meat and eggs (Leyse-Wallace, 2008).

Depression, anxiety, schizophrenia, autism, Alzheimer’s disease and Parkinson’s disease have all been connected with dietary deficiencies. Scientists are currently conducting research programmes that build a solid evidence base for identifying nutrients that benefit the brain and substances that are detrimental. For example, Professor Felice Jacka, a groundbreaking researcher in the field (https://foodandmoodcentre.com.au), offers a thorough and accessible overview of the current internat...