Dietary Counselling

I am a certified member of The Federation of Nutritional Therapy Practitioners

Dietary Counselling

Dietary, or 'Nutrition' Counselling, defined as helping patients identify and manage food and nutrition related issues via long-term councillor relationships, became recognised as part of the accepted scope of dietetic practice in 1996.

The major aim of Nutrition Counselling is the replacement of disordered or unhealthy eating patterns with organised, healthy eating patterns. Nutrition counselling rightfully also includes a focus on weight restoration and monitoring (Herrin, 2003).

Dietary Counselling and Eating Disorders

Dietary Counselling for eating disorders is a specialised approach focused on correcting disordered behaviours and beliefs in the areas of food and exercise.

Dietary Counselling illuminates antecedents of food behaviours, provides nutrition information, supports experimentation with new behaviours and assesses outcomes.

Studies have shown that undernutrition interferes directly with cognitive and emotional function, provides good evidence for the essential need for nutrition counselling in the treatment of eating disorders (Garner, 1997). Research has also concluded that nutrition treatment results in more rapid improvements in overall eating behaviour, a faster reduction in binge frequency and a higher abstinence rate from binge eating than did psychological therapy alone.

Nutrition/ Dietary Counselling is recognised by both the American Psychiatric Association (APA; 2000) and the American Dietetic Association (ADA; 1994) as an essential component in treatment for eating disordered patients. According to the APA practice guideline, nutrition counselling enhances motivation so patients are able to cooperate in the restoration of healthy eating patterns.

Who Can It Help?

People suffering from any disordered eating behaviour including:
Anorexia
Bulimia
Binge Eating Disorder
Compulsive Over Eating
Food Dependancies/ Addictions
Anxiety around social eating
Food/ Eating OCD

People stuck in unhealthy eating patterns resulting in health conditions can also benefit greatly. Examples include:
Overweight
Underweight
Allergies and Intolerances
Low Energy
Trouble with Digestion
Poor Immune System
Blood Sugar Regulation Issues

People simply wanting to change their diet and eating behaviours who feel they would benefit from the advice and support of a qualified nutritional expert.

How I Work

I offer meal planning advice, as well as therapeutic conversations to help overcome the disruptive voices that arise when someone is tackling food issues. I explore current nutrition and dietary behaviours with my clients, identifying areas that could benefit from change. Together, we identify key goals and I provide the necessary support required to achieve them. Any actions we implement are designed to be a guide for life, so that my clients can live flexibly and obsession free, whilst maintaining a balanced diet and healthy weight.

Each session lasts 1 hour. Cost is dependant on personal circumstance. Suggested bracket: 200 NIS / $50

Discounts available for purchasing multiple sessions at once.

* Johanna chooses to keep her rates affordable, having made a personal and professional decision to try and help a larger demographic of people, especially those in the most need who often can't afford to access emotional and psychological support.

Johanna is accredited by the Institute of Health Sciences.

Recently, after posting an article about the treatment of disordered eating behaviours, I received a comment from a fellow mental health practitioner. He suggested that rather than treat obsessive/ compulsive/ addictive behaviours, we should instead just acknowledge that some people are ‘wired problematically’. He suggested that to explore then emotional and psychological issues that manifest alongside and often underpin these behaviours, is ‘unnecessarily intrusive and painful’.
I totally disagree with him on this point and I wanted to share my response with you all! Read below!

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Though some people are potentially neurologically or genetically pre-dispositioned towards obsessive or compulsive behaviours, research has determined that those markers don’t necessarily condemn a person to becoming an addict/ display addictive tendencies. In fact, scientists suggest that it really is a combination of potential pre-disposition, COMBINED with environmental factors, that cause people to struggle with acting out.

This excerpt from the Universih of Utah Genetics Department summarises it quite nicely:
‘Scientists will never find just one single addiction gene. Like most other diseases, addiction vulnerability is a very complex trait. Many factors determine the likelihood that someone will become an addict, including both inherited and environmental factors.’ (https://learn.genetics.utah.edu/content/addiction/genes/)

For other people, there can be no history of addiction in the family and no possible ‘genetic markers’ indicating that they would suffer from obsessive or compulsive patterns themselves. Research in fact suggests that both trauma and poor attachment can be significant factors in the formation of these issues.

If you look at the 12 step model for addiction treatment (which is hugely successful across a multitude of compulsive behaviours from drug addiction to eating disorders, gambling and sex), the suggestion (which is not rooted in any scientific research, but merely on the experiences of addicts who managed to ‘recover’), the suggestion is that there is some sort of ‘malady’ that afflicts the addict, but that a weighty bag of shame, fear, resentment and other painful feelings are also at the root of wanting to act out. The program suggests that a person cannot heal the ‘pre-disposition’ (nor should even worry too much about the fact that they may have it), but that instead they should focus on healing the emotional and psychological narratives that cause them suffering, thus triggering them to want to use. Essentially: they will never heal the predisposition, but they can heal their internal experiences to the extent that they lose the compulsion to act out and can live abstinently.

Trauma expert and physician Gabor Mate, who’s one of the preeminent researchers and clinical practitioners in regards to compulsive/ addictive behaviours, suggests that environment effects brain chemistry and so though someone’s neurology may be altered in a way that implies a greater tendency towards addiction, it was in fact trauma, poor attachment or other environmental factors that bring about the behaviours.

This excerpt sums up his approach nicely:

‘Maté combines his clinical experiences with brain research claiming the source of addiction is in formative brain chemicals. For Maté, the first five years of life (and even the environment in the womb) dictate the likelihood of addiction. He then relates this theoretical point of view to studies connecting stress, abuse and lack of love and attachment to not only life problems (as they have been for some time) but to deficiencies in people's ability to process endorphins and dopamine -- the neurochemicals in our bodies that provide us with both pleasure and pain relief.’(Peel, 2011)

I myself (having worked with addicts and people suffering from eating disorders for ten years now), believe that trauma, fear and shame (and the avoidance/ numbing of these and other feelings), are what lie behind these behaviours. I do believe that there is often a predisposition (though not always, late on-set of these behaviours can occur, after significant trauma/ challenging life events, having never exhibited in any form previously), but that regardless, there are an onslaught of difficult emotions that accompany the desire to act out - and it’s essential these are addressed.

You described exploring the uncomfortable feelings that may arise when a person abstains from acting out on a compulsion as ‘needlessly invasive and painful.’ I disagree. I believe that though it may be painful, within a trusted therapeutic setting, it is not ‘invasive’ - in fact it is the only way to heal what are usually heavy burdens in a person’s life. The very fact that, as you named it: these feelings are ‘painful’; suggests wounding - wounding that deserves to be healed.

On treating and healing these wounds, the discomfort experienced when not ‘numbing’ with certain behaviours, is lessened. The person is then better able to resist the urge to numb or switch off and thus overcome a craving much easier.

If treating disordered eating and addictions consisted as solely labelling someone as ‘wired problematically’ and then letting them continue as they are - people would die.

There are no neurological or chemical ways to ‘re-wire’ people, so even if it was as simple as ‘problematic wiring’, that still leaves people suffering with no suggestions for how to treat them.
Neurology can be changed with psychological and emotional processing, that’s a proven fact (this article explains it well: http://healingtraumacenter.com/neuroplasticity-and-rewiring-the-brain/).
This suggests that seeking emotional/ psychological help, going to therapy etc, is the only current, viable option for addressing and treating the root of the behaviours I discussed in my article. Alongside behavioural change work (I use a lot of CBT and more recently have done some training in DBT), which helps to ‘train’ people to replace one behaviour with another healthier one, the emotional work is essential. All too often a patient simply CANNOT maintain behaviour change without also working on the narratives and emotions that arise when they make those initial changes. The pain and discomfort are just too pervasive.