You’re finally here. Months or even years of contemplation and you’ve made the brave step towards calling a therapist and making an appointment. For the chronically cynical, who either don’t believe in therapy, or who perhaps have previously been disappointed with their counseling experience, consider these questions: Would you train for a 5k with a fractured ankle? Attempt a marinara sauce without garlic or tomatoes? Well of course not, you say…and I believe that you mean it. Dear Reader, I believe you have good intentions, and want to start your therapeutic relationship off with your best foot forward…really hit the ground running. Maybe you’ve even done a little prep work, read The Untethered Soul or, The Body Keeps the Score.  Perhaps you recently went to a yoga class, and started drinking mushroom coffee. You’re using words like “boundaries” and “triangulation”, and for that, I applaud you. And.

There is so much more to it than that.

Usually, clients have spent some time reflecting on what exactly they would like to work on in therapy. Seasoned pros are usually more realistic, as they understand the process of establishing a therapeutic bond, working on small, manageable goals, and, ultimately, saying yes to the process instead of an end goal. Some newbies however, may arrive bursting with hope and vigor with a wish list of goals that would make even Johanna Gaines on Fixer Upper take pause and say, “I think we can add shiplap to the entire first floor, build an outdoor pergola that connects to the cottage garden, revamp the kitchen and add some farmhouse charm, but the four-hundred-year-old hand-sewn barn beams harvested from a historic chapel in New England might be outside the budget...”

One of the many initial questions I would often ask clients was, “what are you eating?” I am still a firm believer in the idea that a client can tell me what and how they are eating, and I’ll have at least a basic framework for what might be going on. Even more insight is gathered if they can communicate their feelings about food or early memories of food.

Taste is emotional. And also, evolution driven. The sensations that we experience today helped protect our ancestors from consuming things that might make them sick, and draw them towards foods rich in nutrients.  “A bitter or sour taste was an indication of poisonous inedible plants or of rotting protein-rich food. The tastes sweet and salty, on the other hand, are often a sign of food rich in nutrients” (Ann Kyle, 2015). Sadly, the science behind food often becomes background noise… possibly drowned out by all the Girl Dinner videos on Tik Tok?

Those of us that are privileged enough because of where we are born, what we look like, or a variety of other reasons, to be able to playfully experiment with our groceries can choose to become culinary artists. The world is our kitchen, and if you are like me, you want to leave no oyster un-shucked, balsamic un-drizzled, or chip without dip. These days though, it seems like everyone with tastes more exotic than a vanilla cupcake has the right to call themselves a foodie. “I’m obsessed with food” they declare at parties as they pull up their latest Instagram post with hashtags like #foodie, #foodstagram, and #foodphotography. As with the show The Office, people use a general, blasé, nonchalant interest in what they cram in their pie hole as a defining pillar of their personality. And by the way, The Office is a great show. The ingredients that we chose to incorporate into our meals help us tell stories, create meaning, and explore our cultural identities. What we put into our mouths has been, and continues to be, first and foremost about survival. For too many, it is still exclusively about survival. According to The World Food Programme, “In just two years, the number of people facing, or at risk of, acute food insecurity increased from 135 million in 53 countries pre-pandemic, to 345 million in 79 countries in 2023”

While there are 5 Tastes (sweet, sour, salty, bitter, and my favorite, savory or Umami) I’d like to zoom in on the relationship between salty and sweet for a moment. Both necessary components of our palette that define how we interpret foods. When salt is added to a sweet recipe, it enhances it, often intensifying the sweetness. The same is true for salty things. A pinch of sugar can intensify what makes a salty snack so delicious. The experience of tasting something is incredibly complex and requires a lot of effort from our brain to interpret what we are experiencing. Feelings about food drive our behavior, and ultimately, the choices we make. Like many clinicians I have always chanted “Gut health equals brain health!” like a crunchy drill sergeant with a diffuser who desperately wants you to work on your microbiome. The idea that what we consume has a psychiatric impact on our brain is slowly becoming mainstream. I don’t mean hipsters with man-buns touting kombucha at your local farmers market, I mean bona-fide sciency terms like dopamine and serotonin. “Since about 95% of your serotonin is produced in your gastrointestinal tract, and your gastrointestinal tract is lined with a hundred million nerve cells, or neurons, it makes sense that the inner workings of your digestive system don't just help you digest food, but also guide your emotions” (Harvard Health, 2022).  When our neurotransmitters are not functioning properly, trouble sleeping, and feelings of anxiety and depression are more likely. Studies have compared "traditional" diets, like the Mediterranean diet and the traditional Japanese diet, to a typical "Western" diet and have shown that the risk of depression is 25% to 35% lower in those who eat a traditional diet. Scientists account for this difference because these traditional diets tend to be high in vegetables, fruits, unprocessed grains, and fish and seafood, and to contain only modest amounts of lean meats and dairy. They are also void of processed and refined foods and sugars, which are staples of the "Western" dietary pattern. In addition, many of these unprocessed foods are fermented, and therefore act as natural probiotics (Harvard Health, 2022).

What pearls of wisdom can we acquire from all this data? (And, to be fair, there is A LOT of it. Much of it conflicting information). Almost anyone with any nutritional authority will tell you that you should care about your gut health. Any therapist worth their salt should ask you about what you are eating. And, if you really give a damn about getting down to business in therapy, then you should care about these things too. This important work can be expensive. It is time consuming. And, it can bring up a host of other things. You owe it to yourself, and your therapist, to give yourself the opportunity to explore this journey without unnecessary roadblocks.  To be clear, I am in no way hyping up any particular diet. I have no loyalty to any one way of eating. I am not an expert on matters of nutrition. Throughout my years in the mental health field, I have acquired only a mediocre understanding at best, of how our gut is connected to our brain. I offer the same concentration of validity as one might expect from a morning talk show host. Generally helpful and well-meaning but let’s bring in the real experts and do a segment on them. Consider this an announcement from your friendly neighborhood therapist. Your odds at therapeutic success will be higher if you make your gut health a priority. And for goodness sakes, stop sabotaging therapy. More to follow. 

For a real expert on matters of nutrition, check out our holistic dietician, Kate!