Trauma and Nutrition: The FST Nutrition Strategy
Why is Nutrition Not Typically Part of Trauma Treatment?
Despite the advances of nutritional therapy over the last 30 years, there is often limited to no inclusion of nutrition as part of the trauma treatment for children and families with PTSD.
However, diet and nutrition can serve as powerful tools to influence change in both the body and brain of a child and/or family member experiencing trauma.
Why Nutrition and Trauma Matter:
THE TOP THREE REASONS
- In trauma treatment, a medicated brain change is tried first before attempting a nutritional brain change. In other words, therapists often move past nutrition and quickly on to psychotropic medications with the traumatized child.
- Based on neuroplasticity research, the brain is continually adapting and rewiring itself. Therefore, proper nutrition is a crucial ingredient to repair our neural pathways and heal the traumatized mind. Neurons that fire together, wire together.
- The trauma therapist is not expected to be a trained nutritionist but still can introduce and incorporate nutrition into treatment when needed or self-refer to a local nutritionist.
In his book, Mental Health for the Whole Child, Dr. Scott Shannon, a top child psychiatrist, concluded:
“We must try nutritional brain change first with a traumatized child before trying a medicated brain change.”
Fifteen-year-old Travis came into treatment heavily medicated for both anxiety and depression. He experienced only mild improvement, which was compromised by the simultaneous onset of severe side effects, including dizziness, fatigue, dry mouth, and insomnia. The medication was regularly changed and dosages adjusted in a futile effort to reach some balance between benefits and side effects. Prior treatment did not include any nutritional analysis or consideration before medication.
After the nutritional balance was achieved through a change in diet, the turnaround was remarkable. Travis was able to be weaned off all psychotropics and had no further side effects. He was also clear and more workable in therapy because, as his mom stated, “He no longer had to work as hard to keep it all together.” Travis’s sleep became steady, and his mood became calm and peaceful.
Please Note: I am not disavowing the use of psychotropics on a case by case basis. These drugs are a quick pathway to symptom alleviation and can stabilize a patient. However, medication is often the first and only go to option while nutrition is overlooked. That is the problem in a nutshell.
3 Steps of the FST Nutritional Technique
The FST Family Systems Trauma model developed a three-step strategy to guide the trauma specialist in how to introduce and execute the FST Nutritional Technique:
- Step 1: Why Nutrition and Trauma Introduction
- Step 2: A Nutritional Self-Assessment
- Step 3: A Nutritional Contract if Needed
See chapter 7 of Treating the Traumatized Child: A Step-by-Step Family Systems Approach for a detailed explanation of these steps as well as case studies and sample nutritional contracts.
Step 1: Why a Nutritional and Trauma Introduction
The following statement is merely a suggestion of how you can introduce the value of nutrition into your overall treatment. You may adapt it accordingly:
The latest research shows a direct link between proper nutrition and its healing effects on the traumatized brain for both you and your child. However, every brain, just like every car, needs proper gasoline.
If you put diesel gasoline in a car that requires unleaded, the engine will break down. In the same way, if you feed your brain with processed sugar, bad carbs, and not enough water or vitamins, you can starve it to death.
Our brain needs the right “gasoline” to rewire itself properly. Therefore, before we move into rewiring through the use of what we call “wound playbooks,” we must first make sure you have the proper fuel to feed both your body and your brain. Let me pause here and ask each of you to comment on or ask questions about what I just said.
This introductory statement will elicit rich conversation and debate. It will range from wholehearted argument to denial or defensiveness. Since the typical diet is often high in sugar and saturated fats, children and teenagers, even sometimes parents, may vehemently resist such a change. When this happens, the FST therapist needs to consider Step 3: A Nutritional Contract to Jump-Start the Process
Therefore, keep in mind that family members may agree in theory, but when it comes to actual change—a battle between the therapist and family may ensue.
It is essential not to use the word “diet.” It has a very negative connotation today. Instead, use the phrase “nutritional plan.” This reframe is invaluable in getting the child or family system to accept change in this area.
Step 2: A Nutritional Self-Assessment
After the initial discussion of the pros and cons of proper nutrition, the FST therapist will use the Basic Dietary Guidelines Handout to assess for appropriate nutrition. The questions for this handout are adapted with permission from “Dr. Shannon’s Basic Dietary Guidelines for All Children” in the book Parenting the Whole Child.
This self-assessment resource and others for the FST Model are located in the Resource Library within the FST Membership program.
Basic Dietary Guidelines for Good Nutrition to Feed and Rewire Your Brain
According to Dr. Shannon’s research, there are six key ingredients to brain growth:
- Energy (fat and carbohydrates)
- Vitamins (fat and water soluble)
- Trace elements
The FST therapist will present this list to the family along with the self-assessment. If the overall self-report is a total score of between 8 and 16 points within these six areas, poor nutrition is indicated. The FST therapist can then recommend a self-referral to a local nutritionist that they work with and create what is called an FST Nutritional Plan Contract with the family to create a new diet in the child’s life.
Step 3: A Nutritional Contract
If the decision is made to move forward on improving the child’s nutrition, follow these steps:
- The FST therapist must find out whether other family members will also agree to improve their nutritional intake within the six key ingredients to brain growth.
- The likelihood that the child or teen will be compliant or enthusiastic with dietary changes is low.
- Instead, just as with discipline, the FST therapist might need to use what we call a nutritional behavioral modification contract.
- In the contract, privileges that the child receives or takes for granted are tied to eating what is served. For younger children, one can link good eating to the opportunity of using electronics or watching television. For adolescents, a healthful diet can be tied to the privilege of seeing friends or going out on the weekend.
Examples of these types of contracts are in the Resource Library within the FST Membership program.
FST Trauma Therapists who actively pursue this nutritional technique will see considerable changes in the child or family member who is traumatized. The use of drug therapy can be helpful because it can quickly alleviate the child’s traumatic symptoms (i.e., depression or anxiety) and provide an immediate break for the overwhelmed parent.
But psychotropic drugs only treat the symptoms of the trauma. Furthermore, using medication without nutrition can delay treatment of the root causes of the child’s trauma.
Combining the FST Nutritional Playbooks with better nutrition will work together to rewire the child’s traumatized brain. In turn, the child will be more workable in treatment and able to receive new information and ideas to change. We all have experienced the differences in the way we look, feel, and sleep with a balanced diet of fruits and vegetables vs. one with high sugars and carbs.
A Success Path to Become a Family Trauma Expert
About the Author
Scott P. Sells, Ph.D., MSW, LCSW, LMFT, is the author of three books, Treating the Tough Adolescent: A Family-Based, Step-by-Step Guide (1998), Parenting Your Out-of-Control Teenager: 7 Steps to Reestablish Authority and Reclaim Love (2001), and Treating the Traumatized Child: A Step-by-Step Family Systems Approach (2017). He can be contacted at firstname.lastname@example.org or through LinkedIn and Facebook.