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"Eating disorders are on the rise in Jewish communities" on WBEZ 91.5
 
 
Neurologically based Interventions for Eating and Feeding Dysfunctions, Picky Eating Syndrome, Sensory Integration Disorder, and other Processing Disorders

By Abigail Natenshon, MA, LCSW, GCFP

The era of the brain
The early twenty-first century has been called the "era of the brain," having produced genetic research and developed new forms of brain research and neurological imaging (PET scans) that have given rise to the science of neurobiology and neuropsychiatry; both have been instrumental in changing the face of eating disorders and psychology. The notion that the brain is hard-wired with an inborn and unchanging learning potential has become obsolete with the emerging recognition of the brain's limitless capacity to learn, grow, and change throughout the human life span. "Neuro-plasticity," the ability of the brain to change and reorganize itself by rewiring neuro-pathways, is at its peak of potency during infancy and the early years of childhood when the brain is most malleable and fertile for change.



Picky eating syndrome or selective eating
Some forms of resistance to eating are the result of simple food preferences, which may change in time and through life experience; others may result from physical trauma such as choking, or other organic or gastroenterological problems that require diagnosis and treatment by medical doctors. In the case of picky eating syndrome, dysfunctional eaters are all too frequently evaluated by pediatricians and released with ‘a clean bill of health’ for having normal blood tests, a normal BMI, and no physiological abnormalities. Physicians typically advise parents to ignore the problem and wait till the child outgrows it; in a case such as this, parents would be wise to seek a diagnosis and professional help elsewhere. When a condition is neurologically or biologically based, as it may be in some cases of picky eating syndrome/ selective eating disorder, it will not be remediated without exposure to various traditional forms of treatment, such as occupational and speech therapies, as well as non-traditional forms of treatment, such as neurologically- based holistic interventions. Our ever-increasing knowledge of the brain, neuroscience, and the plethora of holistic interventions available today have created a new frontier for healing these complex and integrative problems, offering innovative opportunities and hope for change in afflicted children and adults.



Selective Eating Disorder have their origins in neurobiology
Premature infants who start out life in an incubator and/or with a feeding tube may develop feeding disorders, stemming from an aversion to certain sensations in the mouth and possibly resulting in problems with sucking and chewing. Children with picky eating syndrome (also known as selective eating disorder or food neo-phobia) frequently suffer from co-occurring sensory integration disorder, a neurological condition marked by difficulty tolerating certain sensations, i.e. the brightness of lights, the loudness of sounds, the feel of different textures on the skin or in the mouth, and certain smells and tastes that arouse an extreme aversion, resulting in gagging or vomiting. Variations of a specific tasting gene (dubbed TAS2R38) have shown up in “sensitive tasters,” who report that for them, vegetables take on an intolerable metallic taste, revealing the probability that picky eating syndrome is a genetically and biologically-based condition. In further questioning the correlation between certain forms of dysfunctional eating and neurological processing, it is noteworthy that in some cases, both sensory integration disorders and picky eating syndrome are likely to co-occur within the autism spectrum.



Innovative approaches to stimulating neuro-plastic brain changes
The development of intelligence has been defined as a combination of sensory integration and life experience, with genetics a less defining factor. The brain is a dynamic learning machine, and there are many ways to encourage the function of new learning. Research has shown that various brain parts and functions can be enlisted to facilitate structural change and enhance functioning of other parts of the brain. Therapies directly impacting the brain and neurological function can be instrumental in reorganizing and/or creating new neuro-pathways to take the place of damaged, non- existing or dysfunctional ones. Dr. Moshe Feldenkrais understood that the brain learns through movement, declaring movement to be “the language of the brain." (3) According to Dr. Norman Doidge, practicing novel behaviors, with attention, evokes electrical/ chemical movement along the brain's neuro-pathways, which he describes as ‘learning from the outside in.’ Non-traditional holistic interventions provide somatic learning from the ‘outside in.’ Doidge describes neurological movement that comes from changes in cognition, thoughts and feelings as ‘learning from the inside out.’(2)

The mind, brain and body are not separate entities, disconnected one from the other; they are a unified and integrated whole. Bodily-based interventions, such as the Feldenkrais Method©, the Anat Baniel Method©, (1) sensory perception diagnostics and treatment, the Masgutova technique, cranial-sacral therapy and various forms of energy work can offer profound and lasting effects on the brain’s neurological organization. As invaluable resources that are not yet universally understood or accepted for their potential to remediate neurological dysfunction in the ever-developing brain, techniques such as these provide non-verbal, somatically-based self education that can be effective for individuals of all ages, particularly for those with youthful brains that are most highly receptive to change.



The role of parents
By recognizing that the cause of picky eating syndrome and food neo-phobia lies at least principally in biology (or "nature"), and that therefore, these genetic and biochemically- based problems are typically predetermined at the moment of conception, parents are given the permission they need to stop flagellating themselves with guilt feelings for being somehow to blame for causing feeding dysfunctions in their children. Parents need to learn that they are not responsible for creating these problems, by feeding their child "unhealthfully,” by failing to find effective professional care sooner, or by their own sense of helplessness and despondency in not knowing how to understand, diagnose and handle their child and these dysfunctions on a daily basis. Having said that, when parents are without proper coaching and guidance, even the best intentioned of them may ultimately, inadvertently, reinforce a child’s unhealthy eating behaviors around meal times rather than diminishing them. (a function of “nurture”) Parents need professional assistance with these many-faceted problems… emotionally, cognitively and behaviorally… if they are to affect positive change in their child. They need to learn how broad-based these problems can be, how significantly they bear on the quality of a child’s current and future health, social adjustment, and development of self-esteem. A selective eating disorder typically limits far more than one’s capacity to tolerate variety or novelty with regard to food and eating; typically suffering from co-occurring anxiety, the picky eater’s eating dysfunction becomes a metaphor for that individual’s adjustment difficulties in facing and managing other forms of risk, change, uncertainty and unpredictability as they naturally occur in all life spheres.


Case Study
The young man in question was entering his teenage years. As an allergic child and a picky eater, he displayed diverse symptoms of sensory integration disorder throughout his life. As a young boy, he had problems tolerating most foods, haircuts, dentist visits, dark movie theaters, and tags against his skin, etc. As a child in school, he displayed perceptual processing problems that showed up in his dislike for reading, difficulty with reading comprehension, making eye contact with others, and doing his homework without procrastinating. Still, his teachers enjoyed this young man for his kindness and genuine commitment to learning.

His bright and capable parents did everything in their power to facilitate their son's normal growth and development throughout his childhood, providing help through speech therapy, occupational therapy, academic tutors, and consults with doctors, psychotherapists, teachers, etc. All of these efforts were described as somewhat helpful some of the time, though none eradicated or significantly changed his picky eating habits and nutritional deficits.

Might this young man’s problems have originated in genetic meshing, a problematic birthing process, or possibly in utero through the formation of neuro-pathways that affect brain function processing? These questions will remain unanswered; however, discovering the origins of these integrative problems is less significant than discovering innovative ways to remediate them. He and his mother took advantage of referrals… to a family psychotherapist to handle problematic family system interactions around mealtimes; to a Feldenkrais therapist to reintegrate his neurological functioning; to a developmental optometrist to diagnose his brain’s capacity to perceive accurately, and to a psychopharmacologist to manage the boy’s anxiety about his health, his fears of foods, limiting his opportunities for social interactions with peers around food and eating. The services made available to him needed to be as integrative as were his presenting problems; his healing, a non-linear and generally unpredictable process over time that entailed intermittent progress and regression, would be integrative as well. Through the healing process, he began to gain self-awareness and self-acceptance that allowed him to more easily forgive himself for behaviors that he’d felt were shameful. Through these interventions, he had begun to discover hope, as well as a reduction of anxiety, giving rise to a sense of his own empowerment and to increasingly strengthening self- esteem. He had also began to introduce a few new foods into his eating repertoire, more consistently.

At any age, a person can benefit from seeking to access brain structure and function and reorganize the central nervous system in ‘fixing what is broken.’ A most important challenge for the practitioner is to inspire a sense of the possible, motivating the client’s determination and courage to continue seeking optimal health and problem solutions despite their elusiveness at times.

 


Finding the health care you need for your child

As an integrationist, the parent of a child with special needs, a psychotherapist and author with an expertise in the specialty in the treatment of eating disorders and dysfunctions, and as a Guild Certified Feldenkrais Practitioner with Masters level training in work with children through the Anat Baniel Method based on the work of Moshe Feldenkrais, I am uniquely prepared to offer guidance through consultation to parents and families or professionals in search of appropriate and specialized care for children who might benefit from non-traditional neurological interventions.

The services I offer include assessing the needs of the eating dysfunctional child, followed by referrals to somatic practitioners, including those who specialize in resources such as the Feldenkrais Method and Anat Baniel Method, cranial sacral and other forms of energy work, and the various cognitive, perceptual and sensory integration therapies that impact the structure and functioning of the brain, optimizing a child’s capacity to learn, to change, and to grow. All of the above mentioned integrative techniques directly

 

Abigail Natenshon, MA, LCSW, GCFP

Copyright 2014

Abigail H. Natenshon may be contacted through her web sites
www.abigailnatenshon.com
www.treatingeatingdisorders.com
www.empoweredkidz.com

 

Article References;

1. Baniel, A. (2009) Kids Beyond Limits; The Anat Baniel Method for Awakening the Brain and Transforming the Life of Your Child With Special Needs. Perigee, New York

2. Doidge, N. (2007). The brain that changes itself: Stories of personal triumph from the frontiers of brain science. New York: Viking.

3. Feldenkrais, M. (1972) Awareness Through Movement Harper and Row, New York

 

Further Reading Suggestions

Fraker, C., Walbert, L., Cox, S., Fishbein, M., & Barker, S. C. (2007). Food chaining: The proven 6-step plan to stop picky eating, solve feeding problems, and expand your child's diet. New York: Marlow and Co.

Lask , B. Bryant-Waugh, R.(2013) 'Eating Disorders in Childhood and Adolescence', 4th edition
UK and USA: Routledge,

Natenshon, A. (2009) Doing What Works: An Integrative System for the Treatment of Eating Disorders from Diagnosis to Recovery; Washington, D.C. NASW Press

Natenshon, A. (1999) When Your Child Has an Eating Disorder: A Step-by-Step Workbook for Parents and Other Caregivers; California, Jossey-Bass

 
       
 
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