Bessel van der Kolk, the brilliant psychologist and author known for his work on post-traumatic stress disorders, defines trauma as “something that overwhelms your coping capacities and confronts you with the thought: “Oh my God, it’s all over, and there’s nothing I can do.”
Trauma is the body’s response to a terrible event. The response may look different for different folk. Sources of trauma may originate from, aside from big events like warfare or environmental disaster, a myriad of experiences early in life, which researchers refer to as ACES, or “Adverse Childhood Experiences.” The list of ACES may include abuse, community violence, neglect, caregiver mental illness, housing instability, or even hunger. A groundbreaking 1995 study from the Centers for Disease Control and Kaiser Permanente found that the more ACES a child experiences, the more likely they are to experience health issues such as diabetes, heart disease, and early death (as well as poor academic performance, substance abuse, and other harmful outcomes). A quarter of the population included in the study (9,500+ individuals) had experienced three or more ACES. The conclusion? Early adversity in life has lasting impacts.
One way in which ACES, and trauma, impact the body is the creation of what is known as “toxic stress.” That is, the excessive or overwhelming stimulation of our body’s stress response. As a persistent background noise in ones’ life, toxic stress can lead to wear and tear on our physical body. For example, when cortisol, the hormone that produces the “fight or flight” response, is sent throughout your body, the natural response is for your metabolism to breakdown its energy stores and dump glucose into your blood stream. When stress is persistent, cortisol is as well. When your cells are perpetually inundated with glucose, the way they transport glucose into the cell for use begins to alter, potentially contributing to outcomes such as diabetes. High cortisol levels impact a developing fetus and can even be transmitted via breast milk as well.
Above: Understanding types of ACES. Below: long-term impact of ACES. Images source: Leah's Pantry "Trauma Basics and the Relationship to Nourishment"
If you’re still reading you might be wondering: what does the incredible coping mechanisms of the human body have to do with food? Truthfully, so much. Food is such an essential part of being alive, defining us as human and woven into most every aspect of our daily life. Consider the ways that the adversity might shape or shift one’s relationship with food, let alone the ways that family food insecurity might directly contribute to an ACES event. Perhaps even more acute, food may be withheld from a child or partner as a form of abuse. When faced with toxic stress, food might present a coping mechanism, which may be tied to feelings of shame. Consider now the ways that food makes us feel safe or content, how it soothes and nurtures us, and how it builds connection. In response to the harm that stress does to our body, food can act as preventative medicine to heal and nourish.
This is where the conversation segues to a suggestion that community gardening and nutrition education is better when it is what some might call “trauma-informed.” Trauma-informed care has been discussed in healthcare and social work settings for some time, and now seems to be entering mainstream dialogue, but what does it mean to be trauma-informed? The CDC defines trauma-informed care not as a singular technique, but guided by six basic principles: safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment and choice, and consideration for cultural, historical, and gender issues.
For how often I hear community groups talk about food-growing projects from a grassroots and asset-driven approach, I’m struck by how often conversations about food-eating messages (either implied or overt) seem counterproductive to this goal and alienating to their audience. Messages about eating fruits and vegetables can run the risk of being overly prescriptive and tone deaf if you don’t approach your audience as co-collaborators and remind yourself that there is plenty you might not know about an individual’s story, and the ways that food is riddled throughout. Telling someone to make sure that half of their plate is vegetables without any nuance or conversation is not only like a temporary Band-Aid to a deeper issue, but when the message mimics the problematic tone of diet culture[1], it can similarly promote patterns of shame and guilt around food.
Heather Brubaker is a former-coworker-turned-friend who works in my community as a registered dietician (RD) and nutrition educator. She shared with me some reflections on trauma-informed nutrition work in a recent conversation we had about SNAP-ed, a federally-funded program that seeks to improve the likelihood that individuals relying on emergency food subsidy in this country make nutritious food choices (even as subsidy programs tend to conflict with this public health goal). SNAP-ed programs are managed at the state level, but generally include a set curriculum on topics that range from using the MyPlate.gov guidelines to fiber.
Heather recently took the set of lessons she teaches and started examining them for the six principles of trauma-informed care. She found that most were lacking. While she can’t change some of the content, Heather shared the ways she wants to change her approach to nutrition education so that it can promote deeper healing as it relates to food and health. Her first priority is with her own attitude. Heather reflected on the ways that she needs to continually divest in her own authority as an educator and recognize the limits around the knowledge she holds. She is learning to carefully consider ways she might create more “safe” spaces when it comes to discussing food and health, so that people might also consider their long-term relationship to food, rather than just walk away with a recipe. Starting with one’s own attitude might seem simple but consider for a second the last time you judged yourself or someone else for what was in their grocery cart, what they were eating or drinking, or how they looked. Again, food and health tend to be topics heavy with shame, the same currency that fuels the diet industry itself.
Image source: Leah's Pantry "Trauma Basics and the Relationship to Nourishment"
While attitude will surely shape the way that one facilitates a lesson or community project, much can be done practically speaking, as well. For example, one of the principles of trauma-informed care is choice. Heather discussed ways that choice might be incorporated into her planning and lesson. She emphasized the importance of allowing lesson participants guide the content that is discussed, allowing her and them to essentially develop a lesson together. I found myself wondering what it might look like for a community garden to incorporate the principle into its planning, or an emergency food distribution as well. Choice brings dignity, but it also provides the opportunity for an individual to reflect on and navigate their own agency.
Sometimes a framework comes along that gives you new perspective and language on a topic that you’ve had glimpses of in the past. That’s how I’ve felt about learning more on what trauma-informed nutrition education might look like. At the forefront of this work is Leah’s Pantry, a San Francisco-based organization that has done a considerable amount of interesting work on the topic. Listening to their webinar on the topic was a goldmine, one of those moments where suddenly your brain makes connections between ideas you’ve been working on, as if everything falls perfectly into place. Leah’s Pantry has several free sessions posted online to watch and a curriculum available for purchase, I highly recommend them.
[1] Diet culture can be defined as a belief system belief system that focuses on and values weight, shape, and size at the expense of holistic health and wellbeing. Meanwhile, studies find that diets typically don’t work to lose weight and only 9% of Americans actually eat the government recommended amount of vegetables.