Psychobabble with Laura Thomas PhD

Intuitive eating expert explains how to improve your relationship with food and your body, why there's nothing 'wrong' with emotional eating and the importance of self-compassion.

I’m so excited to introduce my first Psychobabble chat with Laura Thomas PhD. Laura is a Registered Nutritionist specialising in anti-diet nutrition and responsive feeding who writes the Substack Newsletter Can I Have Another Snack?. Her work on food and body image has completely changed my life, in terms of my own relationship with food, disordered eating and my body.

It was an honour to speak to her about emotional eating, the importance of getting angry so we can stop blaming ourselves, how childhood shapes how you learn to eat and relate to your body, and what Laura herself does to look after her mental health (look out for possibly the world’s most therapisty-comment where I somehow link swimming to being in the womb…Freud would be proud).

Annie: The work that you do is very much in the realm of psychology and mental health. So I just want to start by asking what is the most effective practice in helping people heal their relationship with food?

Laura: There are maybe two answers here, depending on how you want to frame it. I think the concept that feels most important when healing our relationship with food is probably self-compassion. I find that that's often really low in folks that I'm working with.

It feels really important to be able to forgive yourself and to be able to externalize any blame and shame that inevitably comes up as the result of becoming aware of how messed up it is to live in diet culture and all the related systems of oppression, anti-fatness, white supremacy, capitalism. Once we start interrogating diet culture, we inevitably bump up against these other systems, and there can be this thought, why didn't I see this? What can I do? I need to do more.

We need to get in touch with self-compassion and be able to take a step back and say, I wonder why my relationship with food is so difficult? Look at the sea that we're swimming in. If we don't have that baseline level of self-compassion and flex that muscle regularly, then I think the whole process can feel so much more difficult.

I also think it’s important to be able to name these external systems that have such a bearing on how we move through the world and be able to externalize the problem. There's not something defective within me, but I have been told that I am defective. I have been told that there's something wrong with my body, that I need to eat a particular way in order to be worthy, in order to be valuable, in order to be loved. And so if we can redirect that blame, that shame, that anger outwards towards the systems of oppression that are making it so difficult for us to move through the world, then I think that goes a really long way.

Annie: It reminds me of something called The Moral Defence. As a kid, it’s a survival mechanism to blame ourselves for the things that happen, rather than our parents, because it’s scary to believe our parents are anything less than perfect when they’re the ones responsible for keeping us alive. So, all the blame and anger gets turned on ourselves because it's safer to think that we’re the problem than to see our parents as flawed.

An important part of therapy is helping people to shift the blame and anger away from themselves, which is what you've done for the anti-diet community - help people turn the internalised anger onto the external systems which most of us don't realize are at the root of the problem. Getting in touch with that anger, especially in my own relationship with food, was such a huge transformative tool in shifting the blame off myself. Processing childhood in this way is a big part of the work of therapy for me, how important do you think it is for healing your relationship with food and your body?

Laura: I have to work with people in the here and now. in terms of helping support them develop practical skills around eating, but a huge part of my work is in helping people understand their early experiences and the genesis of some of their difficulties around food.

It's really interesting to have people explore their relationship with food as they were growing up. What were the messages around food and around bodies in the house? Were their parents dieting? Did their siblings have a different body shape or size or have a different appetite, and where was it controlled and where was it praised or celebrated?  There's an obvious gender difference that can be at play, but all of these other factors too.

One activity that I will get clients to do is to make a timeline of those things and to get it all out and write it down. Just the process of going through that can be cathartic. Often, people come to me saying they've never explored this, they've never had a space to talk about these things. Even people who have been through long-term therapy, if that therapist isn't well versed in looking for a difficult relationship with food, if they haven't done any intuitive eating training, then sometimes they just don't pick up on these things. Sometimes I'm the first person who has held space for that, so you can imagine a lot of tears are inevitable. 

Annie: I wonder how much therapy is actually perpetuating diet culture – suggesting that emotional eating is a ‘bad’ thing. In psychoanalytic thinking, everything is about your childhood, we're taught that people are using food to soothe and that’s seen as a negative thing because there's something unsoothed within you. I'm really interested to hear what your thoughts are on that?

Laura: I would frame it slightly differently. I agree with the idea that we use food to soothe ourselves. Where it falls apart from me is the pathologizing of this. If we look at infants, food and appetite are innately linked to being soothed. So if you have a crying baby, you think of food, wind, nappy. Or maybe they need a cuddle? This means that from a very young age, food is used to soothe our emotions. If you look at humans as a whole, if you look at it through our culture and our history, every celebration or commiseration is associated with food. If you have a breakup, your friend goes and get some ice cream. If you go to a wedding, or a big celebration, there's cake. If there's a funeral, there are always finger sandwiches. There's always food because it's such a human thing to turn to, something that can bring us joy and comfort and can help us soothe.

Interestingly, there's some evidence that shows that adults can help children co-regulate through the use of food. What I mean by that is taking the time to sit down and have a slice of cake with your toddler or your pre-schooler or your school-age child who is a little bit anxious or a little bit worried about something. It can be part of that overall piece of role-modeling co-regulation.

In the conversation around ‘emotional eating’, we are encouraged to completely detach our emotions from eating. But we're humans, we always have emotions. We can't turn our emotions off. From that perspective, all eating is emotional eating. However, I also appreciate that sometimes eating can be a really distressing experience for people who have eating disorders in particular. It can be really upsetting and we may be eating in a way that feels chaotic or out of control or some might even label it as food addiction. 

I don't want to dismiss people who have that experience with food, but something that I ask my clients to gently interrogate is the idea of ‘emotional overeating’ by inviting them to think about what purpose or what function food has served for you, where has it maybe been a helpful coping tool, where has it maybe been the only thing that's been available to you? 

Maybe that has kept you safe in some way, which can be a really difficult thing to orient your brain to - thinking about something that you've had a really challenging experience with as actually having been helpful in some way. It comes back to that self-compassion piece. If we can think that turning to food or equally turning away from food is something really wise that my body has done to keep me safe and bring that lens of self-compassion to it, we can start to think of emotional eating in a less pathological way. I think of it as an onion and starting with that piece around - what has food done to help me or keep me safe in some way? 

Annie: It reminds me of a theory by a psychologist called HeinzKohut about self-objects. A self-object is an internalized representation of a parent, which we develop by having supportive and empathetic parents Then we have this kind of inner loving self that helps us to feel whole and good about ourselves. If we don’t have parents who are able to do that, self-object isn’t formed, or they’re lacking, and substances can make up for this deficit, whether that's some form of addiction or food. It's really important to respect that food has been a replacement caregiver for some people, rather than try to dismantle that and make them feel what they're doing when that's been such an important way that they've regulated themselves. 

I can see how important self-compassion is as a thread through your work. There are a lot of people who really struggle to be kind to themselves because of trauma, because they've been criticized a lot as a kid, or never had that nurturing voice. Do you find anything that works best with those people? 

Laura: I think it's really important to say that you can't self-compassion your way out of an abusive relationship or you can't self-compassion your way out of the cost of living crisis. It's not saying that you should just have a positive attitude and everything will be fine, but it's helping you externalize blame or shame about situations that you might otherwise internalize.

For those people who really struggle with self-compassion, in my workbook, How to Just Eat It, I have a whole chapter at the beginning, which is what I call your intuitively eating toolkit. It’s a collection of tools based on Acceptance and Commitment Therapy that is intended to be a pick and mix of things that feel most supportive for you.  It does include self-compassion, and it includes a couple of other tools too. If self-compassion isn't accessible to someone in that moment, if it doesn’t feel authentic or it feels really hard to practice, then there are other things that they can connect with and see if they help a little bit better. I think of it always as an ongoing practice as well. You might come to it, practice it for a bit, put it down, go to something else, and then come back to it. Something I've found to be quite effective when working with folks is identifying the voice of the inner critic which can sometimes be a little easier to get in touch with.

Often in the context of food and eating, the inner critic is similar to the food police voice. Always berating you, always judging, always trying to bargain and negotiate about the ‘healthiest’ food or how much to eat, or if you're eating too many carbs that day. What I will sometimes encourage clients to do is to just keep a couple of notes on their phone of how often this voice is coming up and how aggressive and how angry and how bullying it is. I think sometimes when people can see all of that in front of them, see the way that they're talking to themselves, it becomes clearer to identify that voice and start to gently push back on it or start to notice when another voice is talking, maybe a more nurturing, a more compassionate, a kinder voice. 

Annie: The work you do seems to touch on really painful areas for people. How does that affect you and what you do for your own mental health?

Laura: It can be quite a lot to hold sometimes, particularly if I'm working with people who have clinical eating disorders.  I've noticed since becoming a parent, that my own capacity for holding other people's stuff has become reduced. And I think that's part and parcel of having a small child who needs a lot from me. So I've actually reduced my client load at the moment, and I'm focusing more on writing in the hopes that I can convey some of these ideas, but without it taking so much from me.

I also have good supervision (where you meet regularly with another, usually more experienced, professional to discuss your clients and other professional issues to help you think about your cases and give a different perspective to your work), which is an essential when you're in a relationship with people; we need to be able to think about and have a place to process what's going on, what's coming up for me, what's coming up for them. Supervision is invaluable, as well as my own therapy, and I've been really privileged to have long-term therapy.

Something else that has been helpful for me is swimming. I'm really lucky that I have a lido basically on my doorstep so I can go be there and back within an hour. It might not be this whole glamorous morning routine or bedtime routine that we're told we should build, but there is something about swimming outside that helps me get back into my body. I find the water is very holding and containing, especially if I've got anything coming up around my body, I can go to the water and it will hold me.

Annie: This might be the most psychoanalytic thing I've ever said, but it makes me think that swimming is soothing because it's similar to being in the womb and you're suspended in water, it's so holding that you're almost light. As a mother, you're taking care of your child, and then you're taking these breaks to go and take care of your inner child in the womb just for an hour.

Laura: And to get even more psychoanalytic, I started swimming when I was pregnant. That was something I felt held both of us, because I was pregnant at the beginning of the pandemic, so I actually had to stop swimming at some point. But as the world around us was getting more and more chaotic that was somewhere that felt safe and contained.

Annie: Well thanks so much for chatting with me. I just want to say you were a huge part of me getting over my own eating disorder. The work you do is really brave, and it completely changed my life, so thank you.

Laura: That's really kind of you to say.