As more people change their diets, nutritionists might become the new therapists
At least twice a month, and more if my life is skidding into crisis, I sit on a couch in a sunny, incense-scented office (or call in for a phone session from home) and tell my doctor all. I tell him when I'm feeling anxious or depressed, when my boyfriend and I have argued, when I've lost it with my mother. I tell him when I'm feeling stuck in a piece of writing, that I'm trying to create better boundaries for myself, that I want to make more money. I tell him when I've been staying up too late, and that I loathe any day that I have to wake up early. I tell him nearly every last thing I consume, from verboten sweets to approved-of supplements. After a bad breakup several years ago, I confessed to him that I was indulging in the odd cigarette, and that I'd occasionally smoked an herb less legal than tobacco. Surely by now, you're thinking, She's talking about her shrink. But you would be wrong. I'm talking about my homeopath.
Acupuncturists, Herbalists, and Naturopaths, Oh My!
I'm not the only one with an alternative health practitioner who has become her de facto therapist. If you've gone to a dinner party lately or shared a meal with a friend, the topic of food has likely dominated the conversation-not only the food being ordered, served or eaten, but also the food not being eaten. It seems like nearly everyone is dabbling in an elimination diet of some kind-gluten-free, sugar-free, wheat-free, dairy-free, a detox or a cleanse-for reasons of health or weight loss. Because these regimens tend to be administered by professionals who require regular visits, clients frequently develop a therapy-like relationship with their practitioner, telling him or her far more than how many calories they've consumed. "I don't see a shrink but I feel like she's become like my shrink," says a 30-something publishing professional, whom we'll call "Fiona," about her relationship with her nutritionist, New York City-based Keri Glassman. (Names and identifying characteristics have been changed at the subjects' request.) "She knows so much about me: She knows how I sleep, if I take a bath before bed, she knows so much."
Clients often come to view their healer or nutritionist as a guru of sorts and talk about him or her (and the ostensibly life-altering diet being touted) in the reverential, mildly obsessed way inhabitants of a bygone era nattered on about their analysts and analysis. "It's now very chic to have to see your acupuncturist or herbalist or naturopath," says Dr. Joy Jacobs, a clinical psychologist and assistant clinical professor at the University of California, San Diego, School of Medicine who specializes in eating disorders, weight management and healthy lifestyles. It's as though we've taken our anxieties about all the things we can't control (money, illness, other people-to name a few) and channeled them into an area we can control: what we put in our mouths. Indeed, for reasons cultural, social and practical, the healer has become the new shrink, and dieting the new therapy.
"That's just normal, that you become part therapist to your patients. That's just part of what happens," says Dr. Frank Lipman, a doctor of integrative medicine whose New York City practice, Eleven Eleven Wellness Center, counts Gwyneth Paltrow, Kyra Sedgwick and Maggie Gyllenhaal among its clients. "You can't separate emotional, psychological health from physical health-it's all part of the same thing. You're not happy in your relationship or you're having a problem at work, it often presents physically." In other words, according to this holistic point of view, because the mind and body are so entwined, trying to get to the root of physical problems-whether a serious health matter or those last few clingy pounds-can mean a necessary confrontation with emotional ones.
"People come, they usually think, to deal with weight issues," says Miami Beach psychotherapist and doctor of holistic nutrition Dr. Etti Orya, who simply goes by Dr. Etti (though people also call her "The Juice Goddess"). But once her clients start fasting, she explains, they frequently find themselves flooded with feelings: "Everything comes up. [One's] relationship with food, relationship with one's self, relationships with your family, your loved ones, your children, everything." Anyone who has ever found themselves inexplicably bawling midway through a juice fast knows exactly what she's talking about.
Debunking the Mind-Body Connection
But if the mind-body connection seems too woo-woo to you, it's likely still obvious why talking about one's diet would lead to confessing about one's life. For starters, how and what we eat is clearly determined, to a great extent, by the way we live. If you work from home and have time to prepare a meal for yourself, you're likely going to make healthier choices than if you're forced to wolf down your lunch at your desk while your boss hollers in the background. Likewise, a late-night carouser who comes home with the munchies is going to eat differently than a more regimented, early-to-bed soul. "I ask myself, Am I looking at a person that is in this position because they're an obsessive-compulsive eater or are they eating because of stress?" says David Allen, a Woodland Hills, California, nutritionist whose services are so in demand he recently created a concierge package that includes texting, e-mailing and round-the-clock availability, even on the weekends. "What's going on in their lives? Are they going through divorce? Did they get a job that's so stressful they don't eat for nine hours? Do they sit there and eat the last two hours before going to bed? Are they emotional eaters? What's driving their habits?"
To address such questions, most healers and nutritionists require that their clients fill out a comprehensive initial questionnaire that asks not only about their diet but also their lifestyle-which, of course, leads back to diet. Allen says he gives new prospects "a huge packet" composed of "every question known to man, from sex drive to everything you can think of. I know everything about them: If their poo is green, you know I know it." Says Latham Thomas, a wellness and birth coach who offers clients nutritional support and yoga instruction: "I'll ask about stress, about their job, what it is they're excited about, what's new and good in their life, what they have anxiety about, what they're stewing about now. It starts casual, but it gives me an entry point and it leads to something deeper." Fiona, the publishing executive, recalls a similar initial experience with Glassman: "We started going through all the usual things-parents, health history, my eating habits, my sleeping habits-but ended up talking about who you're dating, and are you up all night? Do you do drugs? Do you smoke cigarettes? How much are you drinking? You have to tell her everything." And why not? What is there left to hide from someone who knows the vicissitudes of your libido and the frequency with which you visit the bathroom?
It may also be that coming clean about one's problems is a way of justifying unhealthy habits. "It's like, 'I didn't really start exercising yet, and here's why.' You're explaining why you haven't taken care of yourself," says an art director in her late thirties (let's call her "Agnes") who saw a nutritionist to shed her post-baby weight. Suffice it to say, when it comes to food-when it comes to most things-our behavior stems from our deep emotional selves. We eat to celebrate our professional victories, to calm our anxiety at social functions, to assuage the pain of a breakup.
"The reality is that the reasons people are making poor food choices have very little to do with hunger," says Tanya Zuckerbrot, a New York City dietitian whose high-fiber "F-Factor" diet is followed by a passel of high-powered types. "They're usually reacting to an emotion. They're bored, they're sad, they're lonely, they're frustrated. I uncover during sessions what leads to those emotions. That's where people really share the personal side of their lives." She sounds uncannily like a traditional psychotherapist. As does Glassman: "If you don't know what's going on in someone's life, it's very difficult for you to understand, say, why they are eating late at night. If they're stressed that their teenage son is out doing drugs…I can't tell that person, 'Well, you just have to put the food away.' Instead, we have to deal with the underlying problem." And so, relationships, parenting, important rites of passage and significant life struggles all get discussed. "You'd be surprised how many boxes of tissues I go through," Zuckerbrot tells me.
Yet I have a hunch that people are opening up to naturopaths and nutritionists for a simple, very human reason. Given how busy our lives are, it's not uncommon to go days without a single person inquiring, with genuine curiosity, how we are. So when someone, even if it's someone we're paying, focuses on us, rapt and ready to listen, we unfurl and maybe come a little bit undone. Agnes, the art director, remembers breaking down in tears during the first couple of visits to her nutritionist: "I got in and he was like, 'Hi! What can I do for you? What's going on?' And for some reason, it was like the first time since I'd had the baby that I actually took time-besides a manicure or something stupid-for me. So I just kind of let everything come out. I told him about my life, what my last year was about...I remember coming back to the office and saying to a colleague, 'Holy shit, I don't know what happened. I just cried in that guy's office.' "
Is a Nutritionist Right For You?
Since those of us who treat our alternative health practitioners as shrinks have someone to talk to on an almost weekly basis, it can often seem to us like the space in our lives for a therapist has been filled. What's more, we have someone to spill to without ever having to admit a need for a trained professional who would force us to wade into the muck of our darker emotions. But is therapy therapy under any guise? Many clients I interviewed remarked that when their healer began playing the therapist-when he or she assumed the role the client had put him or her in by gushing-they felt annoyed. It was like revealing too much to a friend and then feeling like you want to avoid her. "He started bothering me when he started to have opinions on my family and stuff," says Agnes. "I was like, 'Why are you judging my husband?' I just kind of wanted him to listen. I didn't want him to give opinions."
"Mark," a 33-year-old New York City publicist for several art galleries, says his "very personal" two-and-a-half-year relationship with a weight-loss consultant ("after I lost the weight I still kept seeing her for a like a year") "soured," because, as he puts it, "I was gaining all the weight back, and she felt like I wasn't dealing with things in my life that were making me unhappy but I didn't want to deal with them in her way."
For the self-directed, results-oriented person who doesn't want to talk desultorily, the naturopathic approach may in fact be preferable. Kerri Axelrod, a former political communications director who is currently a holistic health coach in Boston, stopped seeing her psychotherapist because, in her words, "I felt like I wasn't getting anywhere. I wanted to be much more goal-oriented, to have someone hold me accountable for what I wanted to achieve in my life." She currently sees a health coach; together, they map out her goals in six-month intervals. "We talk about everything from food to the income I want to be generating to relationships in my life and how they're going," she says.
Dr. Etti, a former marriage and family therapist who no longer provides talk therapy because she "didn't find it effective," believes that ministering to the physical self opens up a quick route to the soul. (If the problem is purely physical, a nutritionist is probably the way to go.) "The Freudian point of view of looking through the past and finding the issue takes so much time," she says. "It's like, 'Why did my mother say this?' Who cares why?! Snap out of it, and really deal with the issues today and how you can change them."
She pinpoints the appeal of following a food- and-wellness-centric regimen: You leave with a plan, and before long you see and feel results. After all, changes to our bodies, like weight loss, are far more tangible than changes in our minds-and the former can have a profound effect on the latter. I've been in traditional talk therapy, off and on, for 15 years. Have I fixed or improved upon any of the problems and obsessions to which I always return? Marginally. Yet when I do a juice fast or stick to a healthy diet, it's not long before I feel like an entirely new me.
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