When was the last time you, your families, friends, or colleagues attended some form of celebration without marking the event with some kind of food? Imagine any of the major holidays on our country’s calendar being celebrated this year, without food. I will bet the thought of this may sound pretty absurd to you. Has there been a time in the past week, month or year in which you had a difficult or stressful day and decided to treat yourself to a favorite food, a nice dinner at a restaurant or an unhealthy food choice often referred to as “a sinful pleasure”? Even on television and in movies dealing with relationship break-ups, actors are often portrayed curled up on a couch in comfortable clothing, watching movies and feasting on a pint of ice cream. It’s as if the eating of the ice cream was part of a self-care plan to combat sadness and loss. Food and emotions have been closely linked since the beginning of humankind. Many of us sooth our upset emotions with food, and celebrate happiness and love for one another with food.
Food is absolutely essential in providing energy for our bodies to function. When we are at low energy levels, our bodies tell us to do something about it. I know that I personally become irritable and unfocused if I am overly hungry. How often do we follow healthy food habits suggested by our doctors? Despite having an overall balanced diet, I know in my own home, we had a regular tradition called “Junk Food Friday”. Our healthcare providers, nutritionists and fitness professionals often tell us how many calories we need to keep sufficient fuel for our bodies to operate. Yet often we decide to act upon cravings for certain foods and much of them (think of the supersizing phenomenon in the fast food industry or Junk Food Friday in my example). How many times do we exceed what our body really needs because we want to eat what is pleasing to us, or soothe ourselves with food?
Abraham Maslow, a stage theorist in the field of psychology, proposed the following: Food, air, water and shelter are the most basic of all of our needs. When we have these in our lives predictably, we as people can then focus on our needs for safety and security. When we feel nourished, sustained and safe, we, as human beings, can meet our social and familial needs. When our social needs are met, we can then focus on our needs around developing self-esteem, confidence and achievement. Humans who have met their needs to be confident and feel good about themselves can then work on self-actualization or becoming the best possible version of the self. This is illustrated on the right in Maslow’s hierarchy of needs:
As foster parents, you can see how many of these needs are being met in your families and in your homes. A child entering therapeutic foster care is having a very powerful experience. It is often an experience in which these children transition from having few or even none of their basic needs being met in a predictable manner, to having a great many needs met regularly through the opening of your home and through the provision of your loving care. Every time a foster child awakens safe in your temperature-controlled, secure home, with access to food, safe adult supervision and the loving support of new family members, he or she has a greatly improved chance of working on growing up, becoming confident and believing in him or herself. They also can learn how to be kind and nurturing toward others, something very much needed in their future lives as adults, and many as eventual parents themselves.
Many of the children in your care have experienced emotional and physical neglect (as well as other traumas). Their birth families for many possible reasons could not or would not assure regular food for their children. The children in your homes may have been in a frequent state of hunger or may have been left to their own efforts at very young ages to find food. We know the unavailability or denial of adequate food can be experienced as physical neglect. Using my line of thinking at the beginning of this article, like us, kids having food can serve some emotional needs. Food is a very powerful thing in the lives of humans. I propose that in many ways, having food can symbolize having love. In other words, food can be love for many of these children. Many of you may have noticed the children entering your homes feeling anxious about what they get to eat, when they will eat and wondering will they have enough. Some other children may have even raided your refrigerator or cabinets to stash food in hidden areas of their bedrooms. You may also have noticed that after a child has learned to trust you and feels safe in your home, he or she may no longer engage in hoarding or food hiding behavior.
Last month, I wrote about how the method for changing some of the challenging behavior of our kids using rewards and consequences was called a “behavioral approach”. A behavioral approach can utilize very useful techniques to motivate children to develop better, more adaptive behavior, not just in your homes, but in their future as adults abiding by what is reasonable, fair and moral behavior. In behavioral intervention, the actions of youth can result in gaining something or losing something (rewards and consequences). Behavioral intervention feels more like common-sense parenting and is often what we experienced in our youth. Our TFC youth often do not respond as effectively to these techniques and approach.
One of the things I learned working with traumatized children early on in my work at the RTC, was how sensitive they were to the issue of food and how quickly they would escalate into crisis if they perceived any adult as being unfair around providing food. I remember how some of the staff seemed to step on some sort of a landmine when they denied a child a particular food item due to problem behavior. I remember hearing staff members tell children if they did not show respect or did not follow adult directions well enough, the child would be denied a special treat that was offered to the entire group of children. This never went well. Being denied a food item was completely intolerable to many of the children and would send them into a crisis lasting a long amount of time, and sometimes escalating a child to having unsafe behavior. It was a long time ago, and our program and understanding around this issue has expanded greatly. It was clear that withholding food was not the best choice for a consequence. For the children, withholding food was withholding care and love.
As you think about the way things go in your own home, do you ever use food as a reward, or take it away as a consequence? If you have, have you seen any negative effects of this on a child’s face, emotions or in their challenging behavior? What would it be like for you to be at a family gathering and be denied a meal or dessert because the host disliked what you may have said or done? If you have noticed this, would you be willing to change up the equation and take food out of these interactions? Have you noticed that the children in your homes have been drawn to overeating more when stressed? Are they soothing feelings by eating?
Knowing that food is part of celebrating, one thing I have found helpful in a behavioral approach to celebrate a child’s success with improving behavior is to de-emphasize the food aspect and further emphasize the celebration. This would mean talking to a child about going out as a family to celebrate the accomplishment. Being together, talking about being proud and saying encouraging words are the focus, because the effort and behavior change are important for the child. The food or meal would be a part of the celebration and not the focus. This is a subtle difference, but it shifts the event away from the food need and meets the social and familial need more directly. Food, air, water and shelter need to always be a given for children. They should not have to be concerned about whether or not they will get what they need.
I encourage you to give this some thought. Some of the kids in your care take medication that can affect their health (weight, cholesterol). Children on antipsychotic medication my gain more weight as a side effect of the medication. This is compounded when these children are comfort or soothing eaters under stress. Our TFC kids are in perpetual stress just from their early experiences. Add to that, their emotional challenges make day-to-day functioning and navigating relationships very difficult. These are often the youth who return from a stressful day at school and eat excessively in front of the television in the afternoon to decompress. I would be happy to have a conversation with any of you about this topic or any other that may come up in the course of your service to TFC. Our HOPE nurse, Eileen Kavlich talked about healthy eating habits in our May In-Service training session. I know that she may present again on this topic in the coming year. I wish you all a wonderful and peaceful summer. On behalf of the program, I thank you again for your dedicated service to Center for Family Services.
All the best,
Jason Collender, LCSW-C
Director, TFC
Treatment Foster Care