I need to start this post with an apology to Maine DHHS Commissioner Mary Mayhew. In a previous post I referred to her focusing on getting a waiver to restrict the purchase choices to the detriment of promoting SNAP-Ed, a USDA nutritional program designed to empower recipients with resources and knowledge necessary to empower them to make healthy nutritional choices. I linked the post to an article that discussed a recent press conference about the waiver.
I didn’t attend the press conference and was only responding to press coverage, so I was remiss in not knowing that she promoted SNAP-Ed. I apologized in an email to her office, and I am apologizing again now publicly. However, acknowledging my error is quite separate from supporting her office’s justifications for wanting to implement such restrictions.
I can’t, and I won’t.
I’ll never forget what it felt like to be a working parent on food stamps. I was doing my best to support my family and raise responsible children. The idea that I would have been unable to make my own decisions around food, especially for special occasions, is insulting and would have been harmful to my needs at the time.
I take a deep interest in what works in altering behavior because I had to learn to alter mine. The list of behaviors I needed to address that were related to my childhood traumas is long, and I’m still dealing with some.
Among the problematic behaviors was a tendency to deny myself food. It started when I was a really little kid, and it was a constant battle at meal times and, occasionally, at my physicals at the doctors. Decades later, due to instructive cognitive-based therapies (rather than the restrictive or control-based measures attempted when the problem first emerged during my childhood), I learned that denying myself food and refusing to eat was my way of trying to control my body with the only means I had as a child.
It didn’t matter to me then that I was hurting myself. I was in control of my body in some way at a time when it felt like so much of what happened to my body was beyond my control. In therapy, I learned the only thing I can control is myself, my health, and the environment I create around myself, and I needed to do those in positive ways.
I actually had to work to learn to nurture and nourish myself daily. Sadly, I learned those lessons and was working to alter my behavior just in time to find myself in a financially compromised situation and on food stamps. It was all too easy to go without food rather than go to a food bank or ask for help when grocery funds ran low. In other words, it was so easy to fall back on a negative behavior during a time of crisis.
It didn’t matter that I was hurting myself — it was a way to control our financial situation at a time when so many of our circumstances were beyond my control.
After all my years of struggling with under-eating, my heart has always gone out to people who may seem to struggle with food in different ways. Like, what if my issue was overeating and I were obese? Our problems manifest themselves in so many different ways. There but before the grace of God go I.
Further, I’ve worked with and am friends with a number of people who have to work to learn to alter their trauma-related behaviors and symptoms. Over the years I’ve become fairly familiar with something called a “trauma-informed approach” to social services. A 2014 report from the Substance Abuse and Mental Health Services (SAMHSA) speaks to the need for this approach:
Trauma researchers, practitioners and survivors
have recognized that the understanding of trauma and trauma-specific interventions is not sufficient
to optimize outcomes for trauma survivors nor to influence how service systems conduct their business.
A trauma informed approach seeks to avoid inadvertent re-traumatization by service providers.
The report goes on to say that this approach “incorporates key trauma principles into the organizational culture,” including policies, and encourages organizations to apply “the principles of a trauma informed approach to all areas of functioning.” Maine DHHS is cited in the report for having an innovative trauma-informed program, Thrive, geared toward children involved with foster care, which is wonderful.
But adult survivors of childhood trauma require a trauma-informed approach, too, and the SAMSHA report discusses the intention that their framework “be relevant to its federal partners and their state and local system counterparts …” because trauma survivors are present in many service systems. I would argue, as a trauma survivor who also received SNAP benefits, that the SNAP program is one of the service systems in which trauma survivors are present.
I would also argue that placing purchase restrictions on clients who associate their eating issues with trauma is an example of system re-traumatization. And I refuse to accept any documented support for such restrictions that doesn’t include a statement about the efficacy of the measure for trauma survivors and its potential impact on trauma survivors, as well as other subgroups that make up portions of SNAP recipients..
The fifth of the report’s “6 Key Principles of a Trauma Informed Approach” is “Empowerment, Voice, and Choice.” In upholding this principle, “organizations understand the importance of power differentials and ways in which clients, historically, have been diminished in voice and choice and are often recipients of coercive treatment.”
Which brings me back to my story and why I am so hesitant to control other people’s choices around food. I don’t share their demons, and I don’t know what support they’ve received to deal with them. I only know my own, and in my case, there is no restriction, no controlling measure, no negative methodology that would have convinced me that what I was doing to my body was unhealthy and that I needed to stop, either during my childhood or later as an adult.
And I know that restrictions around my purchasing choices when I was dependent on SNAP would have exacerbated my sense of having so little control of our situation. Restricting my decision making would have exacerbated some of my deepest rooted trauma symptoms because of my experiences with “coercive treatment.” I would have felt re-traumatized.
It would have worsened my sense that I was beyond therapy on this one, which was how I felt. I mean, I already knew everything about my under-eating that I needed to know, but there it was again. Granted, it was partially because of our financial situation, but I also knew a big part of the reason was just that it was easy to fall back on old ways in response to crisis.
Knowing something is unhealthy is one thing; stopping it is a different issue entirely.
I had been hearing comments like, “you’re so skinny” or “how do you get that skinny” — none of which registered as helpful. But out of the blue, someone I knew in a professional capacity pulled me aside and asked what was going on. Why wasn’t I eating enough?
The person who asked happened to be a fellow trauma survivor and had enough worries of his own. His sudden directness of his question, the genuine concern, and the compassion behind it came together like a spotlight shining on the path I needed to get back to. I had to ask myself, what was going on? I thought back to things I had learned to do in the past, and I instituted a minimum calorie count.
I pledged to myself to hit that count daily, no matter what it took, and I started to get back on track. And I pledged to address the stressors that were contributing to the regression. I always tear up when I tell that story because the person who stopped me that day has since passed on, but even before he did, my gratitude for that moment always makes me emotional.
That one moment is a beautiful reminder of the power of instructive and rehabilitative measures to alter behavior long-term. My recovery couldn’t exist without them.