Dietary Changes and the Five Stages of Grief (Part 2)
Following on from Part One where I talked about feelings of denial and anger in making major changes to diet and lifestyle, I wanted to continue in Part Two by discussing the final stages of grief – bargaining, depression and acceptance. We tend to associate grief only with really traumatic events like deaths, relationship breakups, or rehabilitating from serious addictions; however, when we have to eliminate certain foods or behaviours from our daily lives we can go through a similar, albeit less marked, grieving process. Hopefully this two part blog post will help to prepare those of you in the early stages of making changes for any negative emotions you may experience en route to acceptance!
For me this was easily the phase that lasted the longest! To an extent I still do it, but in a much less dramatic fashion! When I realised I was stuck in this phase, it marked a real turning point in coming to accept my new lifestyle. The gist is simple: we stick really strictly to our regime for a few days in order to earn a blowout of some kind. We think that if we are strict enough for long enough, we’ll then get away with eating/drinking/doing whatever our trigger is without consequence. As mentioned, I can’t really tolerate dairy, with milk and cream producing the fastest, most lasting and most severe reactions. However, hot chocolate with cream was one of my biggest vices. I adored it. A life without it seemed unliveable. So I would be super strict with myself for a week or two and then order one in a coffee shop, hoping that this time, because I’d been so careful, I’d be able to enjoy it without consequence. And every time I was proven wrong. This would then tie back into the anger phase and would also trigger some depression, yet still I’d keep doing it.
I feel I must stress at this point that a regime undertaken to manage a chronic health problem is very different from one undertaken to lose weight. If you’re trying to lose weight, of course you can have the odd cheat meal. If you have certain types of health conditions, you may similarly be able to cheat without consequence as long as in general you are quite careful. However, for many with chronic health problems, their connection to food intolerances or lifestyle issues is strong and permanent. A well-known example of this of course is Coeliac Disease. Those with Coeliac Disease can’t earn an ordinary sandwich by eating well for a month beforehand – there is simply no way that they can ever enjoy a wheat based meal without consequences, no matter how much they deserve to. I’ve had people encourage me to eat things that make me ill and tell me not to worry about it because I can just burn it off afterwards, or ask me why I can’t just have a blowout day once in a while. I just can’t, because for me my health is absolutely tied in to what I eat, drink and do.
I do still do the bargaining, but just in smaller ways now. I no longer have hot chocolate, or eat pizza, or drink alcohol ever. There are also lots of other things I never eat, which perhaps I will discuss in future blogs. However, once in a while I will have a decaf coffee with just a little cream mixed in. I’d never do it on a daily basis and I try to only do it when I’ve been generally quite healthy beforehand, so in that way I suppose it is a bargain. Similarly, I occasionally have a high quality handmade chocolate, but normally I only eat organic 85% cocoa content and I’d never now buy myself an ordinary chocolate bar. I’ve just spent a week away from home and have had to eat out a few times, so as I write this blog I am definitely not feeling my best after a few days of temptations. However, if I were to write a list of all the things I’d done ‘wrong’ this week, most people would laugh at how trivial they are and I certainly deviate from my ideal regime a lot less often than I used to! I’m fairly certain that most people who’ve had to make dietary changes engage in bargaining to some extent; over time you just learn your lessons and the deviations become smaller and less frequent.
It’s worth mentioning that bargaining also takes place for a while if the changes we are supposed to be making are very intimidating. Someone who needs to eliminate wheat and dairy may first of all just eliminate baked products and milk, hoping that this will be enough and they won’t have to bother with meats containing breadcrumbs, pasta, or cheese. Obviously in an ideal world we’d all know exactly what changes we needed to make and we’d all be strong enough to make them immediately, but major dietary changes rarely work like that. Once you recognise that you engage in bargaining, you’ll be better placed to learn from it and to make better choices in the future. Again, knowing that you can directly influence your own health is very empowering, even if it is also maddening for a while as you make mistakes and take unwise decisions! You don’t need to be perfect all of the time – you just need to be able to look back in X months and realise how much you’ve done right and how much better you’re feeling. That will spur you on to doing more of the good stuff and less of the bad stuff. It will also keep you sane as you figure out all the conflicting advice you’ll discover while you unravel your own individual health mysteries that the books and blogs can’t answer for you!
In this phase we feel really sorry for ourselves and grieve for the old eating habits or lifestyle that we miss. We may think of all the things we can no longer have and the idea of a lifetime stretching before us without our old favourite foods can seem quite bleak. In the beginning before we’ve truly got used to our new lifestyles we can spend a lot of time fluctuating between ‘poor deprived me’ depression when we’re on our wagon and ‘stupid me’ depression when we fall off it. Given that our health problems themselves can also cause us to feel depressed and powerless at times, in those early days when we’re still adapting to a new regime and trying to figure out what we should be doing we can spend a lot of time being very sulky, emotional and despair-filled!
My health problems have been many, various, interlinked and difficult to interpret, so even though I hit my new regime hard, it has required lots of tweaking over the years and I still continue to adapt it as I learn more about myself. Aside from mistakes of ignorance, the sheer enormity of the changes I made meant sticking to the regime was also very difficult for me in the early days. Believe me when I say I have spent many, many nights crying over my stupidity, my weakness and the general unfairness that I have to be so careful – and that in addition to the nights I’ve spent crying at setbacks seemingly out of my control, at the lack of any definitive reason why I am like I am, and at the financial impact my health has had.
I think it’s inevitable really that you will experience depression from time to time, especially for the first couple of years of making changes. With all due respect to my favourite bloggers and nutritionists who have inspired me over the years, sometimes I think they’re guilty of airbrushing their feelings around food a bit. When I was younger and more impressionable, I used to see it as a sign of weakness in myself that I gave in, made mistakes or missed my old foods. This in turn would make me feel even more depressed as I thought, “I bet they never do this!” The thing is, I bet they did. They might not do it now and they might not have done it very many times if their health conditions were strongly enough triggered by their junk food dalliances, but I am almost certain that most of them did mess up and did cry and did feel bad about themselves and their health and their lives.
All I can say is: it gets easier. It really does. It is perfectly okay to make mistakes, it is perfectly okay to feel bad about yourself afterwards, it is perfectly okay to feel really sorry for yourself when everyone around you is eating something you can’t. Stick with it. In time you will make less mistakes, you will forgive yourself more quickly and you will gaze with envy at other people’s plates a lot less often. Focus on what you CAN eat. Focus on what you get right. Focus on what you’re learning and how much better you’re feeling. Understand that grief is a process and you can’t avoid the stages of it entirely, but you can be ready for them and ride them as smoothly as possible. Eventually, buoyed by your progress and armed with the understanding that you have been working through your emotional attachments to food you will reach…
This is where you finally embrace and enjoy your new lifestyle. Though you may still occasionally experience the other stages, they will be infrequent and short lived. You’ll learn new favourite foods, you’ll get excited about vegetables in a way you never thought possible and you’ll love feeling good so much that you’ll hardly miss your old ways. Obviously it’s never going to be entirely easy to go to Frankie and Benny’s, or Starbucks, or a bakery, but your visits to these places will become less frequent and you’ll find that at home (and most of the time when out and about) you never think of relapsing anymore. In my teens I declared that I could give anything up for Lent except bread. Now, in spite of living in a house where bread is consumed, it never ever occurs to me to eat any of it. I will never eat a normal sandwich again (unless there’s a huge cash prize for doing so, which is unlikely!) and I am absolutely fine with that. I’ll probably also never again eat a Crème Egg, or Ben and Jerry’s, or have a hot chocolate with cream, or have a whole glass of wine to myself. None of that makes me sad anymore.
I love the foods I eat and I love the way I feel when I eat well. When I deviate from what I should eat, the way I feel both physically and emotionally is just not worth the momentary pleasure. I’m going on holiday soon. A few years ago I’d have pencilled the week in for loads of ‘treats’. Now, I’m hoping that I won’t have to deviate too much from what I eat at home so that I won’t spend my holiday feeling fat, queasy and emotionally unstable. People often ask me why I don’t go to the doctor so that maybe he could give me something that would mean I could get away with eating more ‘treats’. They ask me if I think I’ll ever be able to eat what I want. They ask me wouldn’t it be nice if once in a while I could just… I no longer want to. I used to say if I was given a week to live, I’d spend it eating all the things I wanted and couldn’t have. Now, I definitely wouldn’t want to waste my last week on earth feeling bloated and rubbish. Maybe if I had 30 minutes left to live I’d stuff down some hot chocolate fudge cake, knowing I’d be gone before any horrible symptoms kicked in. But anything longer than that and I’d keep to my new regime, thank you very much!
Nothing tastes as good as being healthy feels. I love how I feel physically and emotionally when I have a really healthy day – it feels clean and happy and proud. I feel flat of tummy, clear of mind, clean of blood. I feel motivated and bouncy and smug. I don’t just hope I keep to this lifestyle forever – I hope I keep improving it! Once upon a time I viewed these changes as temporary. I was depriving myself of things I enjoyed in the hope that I would recover and could go back to my old ways. Now I feel lucky that I was put in a position where I had to make the changes and love my new lifestyle so much I’d never want to give it up.
However implausible this acceptance might sound to you if you’re in the early stages of learning to manage a health complaint through diet and lifestyle, if you stick with it you will eventually feel the same way yourself. It might take a while and you’ll probably make lots of mistakes along the way, but I’m hoping this blog post might help you to understand and accept your feelings as you move through your own process. I think if I’d known what to expect when I embarked on my own changes I may have got to the acceptance phase sooner. I also think I’d have found comfort in knowing that everyone who went before me did not find it easy and enjoyable.
There is an increasing body of both scientific and anecdotal evidence to support the idea that diet and lifestyle changes can be crucial in managing chronic health conditions such as interstitial cystitis, as well as rheumatoid arthritis, chronic fatigue syndrome, anxiety, depression, premenstrual syndrome, autism, ADHD and many more. In forthcoming blogs as I discuss diet and lifestyle approaches to managing health in more detail, I hope you will find this blog motivating, comforting and relatable.
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