Food Allergy and Your Kiddo
If you are a parent of a food allergy kid, then this is the podcast for you! Join food allergy experts - board-certified allergist Dr. Alice Hoyt, MD, FAAAAI, and food allergy mama Pam Lestage, MBA - as they dive into all things food allergy. Hear interviews with world-renown allergists as well as food allergy advocates and food allergy families, just like yours. This podcast will answer many of your food allergy questions and provide you with strategies to make your life and your family's life ones of LESS STRESS and MORE JOY.
Food Allergy and Your Kiddo
Tamara Hubbard Shares Strategies on Navigating Food Allergy Anxiety
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In this episode, Dr. Alice Hoyt interviews Tamara Hubbard about her new book, 'May Contain Anxiety,' which addresses the challenges of parenting children with food allergies. They discuss the emotional journey of writing the book, the realities of food allergy-related anxiety, and practical strategies for parents to manage their fears while fostering resilience in their children. The conversation emphasizes the importance of communication with allergists, understanding values in parenting, and recognizing unhelpful approaches to anxiety. Tamara shares insights from her clinical experience and personal journey, providing valuable resources for families navigating food allergies.
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Hello and welcome to Food Allergy and your Kiddo. I'm your host, dr Alice Hoyt. Very excited to have my friend and colleague, tamara Hubbard here today to talk about her amazing new book May Contain Anxiety Managing the Overwhelm of Parenting Children with Food Allergies. Tamara, welcome back to the podcast, my friend.
Speaker 2:Thank you so much for having me. I always say yes and love coming to chat with you on this podcast.
Speaker 1:Thank you so much. It's a pleasure to have you and I think you know. Thinking back to the first time you were on the podcast, I'm pretty sure I just kind of like cold emailed you because I saw like the amazing work you were doing. This was a few years ago too. Oh my gosh, she needs to come on the podcast. I'm pretty sure that's how our friendship began.
Speaker 2:That sounds great to me and I'm glad you did that. I I've done that. I share. I don't know if I share in the back of the book and the acknowledgements, but I I did that for to an author and that helped give me the courage to write this book. So I'm all for reaching out to somebody you admire their work. That's very cool and making a new friend. I'm so glad you reached out.
Speaker 1:I know because we have become friends and it's been really nice because I feel like, even though I haven't read the whole book, our friendship has grown as you've been writing the book.
Speaker 2:You went along for the ride of the writing of the book.
Speaker 1:Yes, yes, yes, it was a great ride, and now to actually like hold it in my hands is very cool, and so, preparing for our interview, it was fun to just really kind of bounce around the book and find all the amazing like very tactical, very I don't know, sometimes when I think about anxiety kind of help books and things like that in my mind I don't know, sometimes when I think about anxiety kind of help books and things like that in my mind I'm first thinking like is this going to be very abstract? But this is not abstract. This has so much very good concrete content in it. It's well referenced and it really I mean it comes back to your training, your licensed clinical professional counselor, family therapist. You provide very evidence-based medicine or counseling and you've been doing this for many years, and so I want to start our interview today with an excerpt from your book that I think gives insight as to why you wrote the book and part of your journey, and then I'll ask you to opine. So this is from your introduction.
Speaker 1:Are you wondering how I made the transition from letting the overwhelm of parenting a child with allergies derail me to now writing a therapeutic book for allergy parents? Here's the rest of my story about my entrance into the allergy parenting club Love it. In the very moment I decided it was time to become the parent I wanted to be, rather than the one my allergy anxiety was pushing me to become. Somewhere along the way, my goal of just getting through each day as an allergy parent became a goal to teach my son that he could be resilient with a food allergy, even at a young age, I couldn't imagine our family living in fear our whole lives, but I knew that if I wanted my son to learn how to be resilient, it was up to me to pave the way first. While living with a food allergy was scary, I needed to teach myself and then my son how to find a workable balance between seeking safety to avoid reactions and enjoying life's experiences. It was my job as the parent to help us both work toward accepting, adjusting and adapting to this new reality.
Speaker 1:Beautiful Tamara, it's very raw. It shows a lot of who you are, a lot of where you were at one point in your allergy journey. Because I know a lot of people are going to think oh well, you know she's a therapist, she has, you know, all these skills, she's got it all under control. But to read that out loud and hear where you felt you were in your journey many moons ago to now where you are, and that you took that knowledge, your expertise as a clinician, but also your life experiences, to create something to help other parents, is very beautiful. So what are you thinking as you're hearing those words?
Speaker 2:I'm thinking who wrote that. That's great. It's kind of an out-of-body experience to hear somebody read your words that you, you know, very vulnerably shared, and that's exactly what it is right, I might be and I am a licensed clinician who does this work, who helps other families, but I'm just a human being. I'm just a mom who has a child with a food allergy. So at the core of all this, I intimately, like you said, understand what families are going through each and every day, and that has really helped shape me as a clinician doing this work. Everything's based in I always like to say this part too everything I do is based in evidence and clinical grounding, right, so I lean into my clinical training. So I lean into my clinical training. But that everyday living of living with food allergies and parenting a child with food allergies absolutely informs my work and helps me connect with those I'm working with and hopefully helps me connect with the people who are reading the book too.
Speaker 1:And I like to ask our guests how did you get into this work and what is your experience that really motivated you to serve this population? The food allergy parent population.
Speaker 2:Yeah, so I mean simply stated it was. My younger son was diagnosed with a food allergy and we don't have food allergies in our family, so I wasn't very familiar. I knew kids in my older son's preschool class who had food allergies and so I was loosely aware that they existed. But I didn't do this work. Early on in my career I started off again. I'm a trained family therapist so I've done couples counseling and family therapy. But I started in substance abuse work with teenagers and then I did inpatient work and community mental health and finally private practice. But it was my son's diagnosis, living through it, knowing how it felt as a parent, how overwhelmed and anxious I felt in those early years and still do, during different transitional changes. That doesn't go away. I'm still the human parent going through this too. And then I realized that there was a gap in resources out there for those living with us families, individuals and parents.
Speaker 2:And so I started writing blog articles on thefoodallergycouncilcom. That's quickly snowballed into people reaching out all over the country saying I know you're a therapist, Can I work with you? And unfortunately, due to licensing laws, I can only work with those in the states in which I'm licensed.
Speaker 2:So that was very limited, started reaching out to other therapists, thinking that there have to be more people doing this work or who want to do this work.
Speaker 2:One thing led to another that led to the Academy for Allergy Counseling and its therapist directory to kind of grow this niche and broaden how many of us are doing this work so that we can help families. And then somebody, a friend of mine, said to me you should write a book and I went, oh, how hard could that be? And then I realized how hard it was. So I still persevered through all of that hard book writing stuff years of it, because I felt like what I had to say needed to be out there in the masses. And it's really, you know, psychologists and licensed clinicians who aren't trained in marriage and family therapy. We all do the same work, but we might look at it a little differently. So I felt that my background in marriage and family therapy really could serve in a different way, and so that's why this book is written with that in mind, that I am a family therapist and my guidance is coming from that point of view.
Speaker 1:That is so cool and you know, when I was preparing for this interview and kind of poking around your book I feel like you know we've become closer friends through your writing of your book and hearing you talk about the different parts of the book has been like I kind of feel like it's like deja vu when I'm looking at some of it. It's like deja vu when I'm looking at some of it, but I would hear bits and pieces and we would have conversations about some parts of it. So I really want to dive in and for our audio listeners, I'm flipping through the book right now. If you're watching on YouTube, you're seeing me flip through the book. But I want to read out the names of the chapters so that families can really see that. Our parents can really hear what is in this book. It's really great stuff.
Speaker 1:So exploring unhelpful allergy parenting narratives man, you just dive right in there. Huh, I can imagine common allergy parenting traps. That's so good. Setting developmentally focused allergy parenting goals I love this. We could do a whole series on that, tamara. Responding differently to anxious thoughts F focusing on all that matters, not just allergy safety. Developing flexible perspectives on allergy parenting and putting your balanced, mindful allergy parenting plan into action. So how did you come to really settle out on addressing these issues and I mean, I just feel like you know a ton in this space and so to kind of take everything out of your head and put it onto paper, what were some of your priorities in reaching your audience, our audience of food allergy parents?
Speaker 2:You know and I think every author would say this that there's probably so much more we could have put into our book or our work. There's certainly, as I'm reading it, going oh, I wish I would have added that or that, but like the book could have been a million pages long, to your point, any of us could write forever on this stuff. But my goal with this book was to not just validate the very real anxious feelings that parents often have and the overwhelm they feel, but to offer some practical guidance and then to help them understand what was behind that anxiety and overwhelm. We all talk about the anxiety and overwhelm, about the fear of our child dying. Of course that's the big fear, right? An allergic reaction, an anaphylactic reaction and ultimately death. And so that is.
Speaker 2:You know in a nutshell, no pun intended, what fear is about. But there's more to that fear and anxiety that keeps us from parenting the way we want to. That can impact our child's development. It can impact their own internal narratives about what it means to live with a food allergy and exist in this world with food allergies. So my goal was to really provide sort of all the stuff behind the anxiety and overwhelm, beyond just hey, we're afraid of our child having an allergic reaction and dying and we're giving some guidance for how to walk through that, how to think of it differently and ultimately create a different relationship with our food allergy anxiety, so that we could parent the way we want to and not parent on autopilot anxiety autopilot.
Speaker 1:Right, and so you know, for our listeners, the likelihood of a child dying of anaphylaxis is incredibly low. It's incredibly unlikely, but we all know that it happens. The gravity and the tragedy, if it were to happen, can be overwhelming.
Speaker 2:And how I address that in the book. Because, again, I'm very careful in this book not to step into the medical world. I'm not a doctor, I'm a therapist and so I can speak on all of that. I'm educated, I'm licensed, I'm an expert in that space, but I don't ever want to talk about the medical aspects because I'm not a doctor.
Speaker 2:So how I address that is yes, while the statistics might be low and I put that in the book the statistics, the fear and anxiety tells us it's much bigger and makes us feel like it's much more of a higher number, and nobody wants to be that statistic. So that's kind of how I address it is yes, I need you to know that it's low, but I understand where that anxiety is coming from, so let's address that, and a lot of the guidance in the book comes from me. But I understand where that anxiety is coming from, so let's address that. And a lot of the guidance in the book comes from me. But also is to help families go back to their allergist or allergy care team and ask really important questions that likely haven't been asked or discussed in previous sessions. So it's not just I'm giving you guidance on how to manage anxiety, or what's behind all of the overwhelming anxiety, but it's like have you had these important conversations that are quality of life enhancing, conversations that need you to be having?
Speaker 1:Right, we talk about that often in our carpool to pick up children discussions about the patient experiences that we see and how just upsetting it can be when a family doesn't have that evidence-based information, doesn't have answers to their food allergy questions that are impacting their lives so much that, you're exactly right, in many cases only the allergist can provide that information, because all of our children deserve that very personalized approach to their food allergy care.
Speaker 1:And so you know, you can go on and read about the symptoms of anaphylaxis and when to use an autoinjector. And then we haven't even really kind of broached the other food allergies. You know eosinophilic esophagitis, fpi, how those can present and the anxiety and food avoidance and all these things and just how important it is to have good information from your allergist and bring your questions, write down your questions on paper and bring them to your allergist and say these are the questions, because I know when I go to the doctor sometimes like my mind just kind of goes blank and it's just like I could put the questions in my notes app on my phone. But then I'm like fumbling around with my phone and like anytime, like I could put the questions in my notes app on my phone. But then I'm like fumbling around with my phone and like anytime, like you know, you're looking at your phone and somebody else is like okay, well, I guess they're looking. You know what I mean. Like it's just so much easier just to have it written down on paper.
Speaker 2:Well, and sometimes you need to digest what you've heard, yeah, and then you come up with new questions or curiosities. You know I tell families anytime. Excellent point A million percent.
Speaker 1:Especially when you're getting a new diagnosis, like as soon as you're told your child has something, your mind goes like where? And so then you're missing. What 40% of the rest? That's totally like arbitrary number, but that's just what I feel is like you're missing.
Speaker 2:Well then, there's so much to cover. There's so much to cover that initially like so, if we're talking about that initial diagnosis, it is overwhelming a lot of times because you're getting the information to help you just sort of live with this food allergy and learn about it. And then you get into the actual living and then you're like well, how do I deal with this? How do I navigate this? Am I telling me this is unsafe? Is it unsafe, right?
Speaker 2:The way that I talk about it in the book is our anxious minds want us to think risk is all or nothing. It's either completely risky and we should avoid it, or there's some kind of like place where nothing is risky. Right and sure, we could keep our kids home in a bubble and really kind of lower that risk to as small as we can. But there's risk in everything we do, unfortunately, and there's a lack of certainty in everything we do. So the way I talk about it is learning how to determine and this comes from guidance from the allergist and allergy care team what is safe to do with your food allergy, what is safe enough meaning there's some risk, but it's a small level of risk or it's a level of risk I'm okay with taking for the quality of life experience I'm having, or it's just not safe.
Speaker 1:So, this is so interesting because you and I were talking about this the other day, because I land patients in a. This is either safe for your child or this is not safe, and so I don't. So I don't hedge in the safe enough, because it's either going to be safe, a safe activity or, in the case of this, is probably the biggest one. I hear about a kiddo who's allergic to peanuts and can they eat foods that are fried in highly refined peanut oil, and highly refined peanut oil does not contain peanut protein and so it is safe. For kids who have an IgE mediated anaphylactic peanut allergy, it is safe, whereas some people might feel like, oh well, it contains peanut, but I guess it's safe enough.
Speaker 1:But I feel like my job as the allergist is to be very clear on what's a safe activity and what's not safe, and the same activity could be safe or not safe depending on how it's approached.
Speaker 1:The thing that comes to my mind would be dining out. You know, it can be very safe to go out to a restaurant having food allergies, if you do it properly, if you follow some certain strategies where communication is the biggest of those strategies. Right, and that could be a whole nother podcast, but it could also be done in a way that's not safe and ultimately having these discussions with your allergist, but then also navigating the anxiety that comes along from these day in, day out decisions, because, ultimately, how many times a day is a child eating and that's the number of times a day of a potential risk of a reaction if good strategies aren't implemented. And then thinking about that, and so that's why I love your book, because first of all, it validates that families can and do have food allergy-associated anxiety, but then it does. It's very practical and I want to ask you how and I probably should ask this in the very beginning how do you define food allergy-related anxiety?
Speaker 2:You know I mean the clinical research definition is really an anxiety that is focused on something pertaining to living with a food allergy, and it's oftentimes focused more specifically on things such as the fear of an allergic reaction.
Speaker 2:It could include needle phobia when we go to appointments, right? It's different than generalized anxiety, where we're anxious about a number of things across a number of domains and it's not just sort of one theme, although allergy anxiety could give way to being much more anxious about a lot of things. But it's usually tied to that fear of staying safe and an allergic reaction and something bad happening. And there's even a new construct that Melissa Engel put out recently I was just reading an article that she's proposing this construct of food allergy, food allergy, social anxiety right. So it's sort of like an extension of that, where we see social anxiety focused on the food allergy piece, right? So it really is just that it's specific about food allergy and it's not just the person with the food allergy who can feel this, of course, it's parents, it's families, it's caregivers, it's you know, we can be anxious about the food allergy.
Speaker 1:And transfer that and transfer that. Yeah, yeah, I want to talk more about values, because in Chapter 5, you really dive into what values are and what they're not and this is a chapter focusing on all that matters, not just allergy safety and this comes back to what is safe, what's not safe, managing the food, allergy anxiety and talk some about values. You have a really nice list of what values are and why is it really important to kind of solidify what your values are?
Speaker 2:Yeah, so this comes from the acceptance and commitment therapy, or ACT theory. So a couple of the later chapters are a lot more sort of grounded in therapy theory, so to speak. And so, in ACT, values are I call them sort of our guiding stars, our North Stars, our GPS coordinates right? They're the things we want to embody. They help us live the way we want to. They help us teach our kids, you know, how to live, the characteristics to have, so it might be like to be somebody who's loving, somebody who's adventurous, who learns to be independent, who's responsible, who's trustworthy, right? Those are examples of values, just a short sample of values.
Speaker 2:There's a long, long list of values, and so what I found is that families, of course, understandably so who manage food allergies are really focused on the value of safety and protection, because, of course, they are right. However, what often happens because we're seeking control and we want to, you know, respond to our anxiety by seeking that control and calming the fear we feel we tend to only focus on safety and protection, that value, and when we do that, we then push away oftentimes other values that are important, that we want our kids to develop, that we want to live by, that are important for us, so, for example, the adventure, the value of being adventurous. You know traveling that feels very hard, so we stopped doing that because of safety reasons, and so my point in that chapter and throughout the book is that safety and protection is absolutely going to stay a top value, if not the top value. With allergy families, however, we can focus on multiple values at once, and I'm encouraging parents to do that, and that's what that chapter title is about.
Speaker 1:That's so good. And you have in here pause and reflect. That's so good. And you have in here, pause and reflect, clarifying your values, and I think it's wonderful to have parents sit and think your parenting values, your family values, why focusing only on the value of safety can be problematic. It can lead to values conflicts, imbalances, reinforce unhelpful approaches to anxious-related, anxious-allergy-related thoughts. This is all so good, tamara. Let's talk about some of those unhelpful approaches to anxiety, allergy-related thoughts. What are some of the common ones that you see?
Speaker 2:Well, I think the biggest one is just believing everything our anxious mind tells us to be true, right? So if we have an anxious thought about something being unsafe, we tend to automatically believe that, because our mind boils it down of this is helping us do in the book is recognizing that it's understandable to feel anxious, that we are going to have anxious thoughts, but that we need to See them, approach them, be more curious about them. And one of the things that I encourage people to remember is that anxiety isn't just there because something is unsafe. That's one possibility. Anxiety can also show up if something is new, unknown. We don't know the outcome, we've never done it.
Speaker 2:So when you think about first starting to go out to a restaurant or traveling those first few times, you're going to feel really anxious. Your mind might convince you it's because it's not safe and that is a possibility. But if you've talked with your allergist and you've worked through and you've communicated, it's probably safe or safe enough. Again, I'm not 100% risk-free, I know that's the difference. When you were talking about that, I was like, again, I'm not 100% risk-free, I know that's the difference. When you were talking about that, I was like, well, that's the medical point of view. And again it does boil down to it's like collaborative decision-making.
Speaker 2:Yes, it is.
Speaker 1:It does boil down to Well, it's not all black and white, right and how one kiddo with the same exact food allergies, the same exact age is managed medically, from a mental health standpoint, socially, can be different from a different child. It often is very different because our children are different. We as parents are different. We have different values, as you talk about in your book.
Speaker 2:Well, and that's why I think it's important that middle category of safe enough is yeah, ultimately, we want allergists and allergy care teams to tell you what's safe and not safe, but I don't want people living in the all or nothing space. There's cognitive distortions that get us caught up and then we're stuck and then we're not taking values, aligned actions and our quality of life decreases. I need people to and I bring it up in the book have a little more flexibility, even though our anxiety tells us to be more rigid, and so that little middle space helps us recognize that some things are not going to be 100% risk-free, but they're still worth doing and they're safe enough to be doing, deemed by our medical team.
Speaker 1:I love and I love that we can ultimately like I think ultimately we agree on how we're approaching patients.
Speaker 1:We have some disagreement in some of the approach here and I think where a lot of that comes from is the education one should receive from their allergist. We talk all the time about healthcare and how healthcare has gone to a place that doesn't always have the patient's best interests and where I hear from my colleagues about having to see more and more patients, which we love seeing patients, but in less amount of time. And when you have to counsel a family on how to use an epinephrine auto-injector, the life-saving medication, you have a finite amount of time. You can choose that. Or you can choose talking about eating at a restaurant, even though eating at a restaurant is super important and super important for quality of life.
Speaker 1:If you have finite amount of time, then of course the life-saving medication, those types of more medical topics, are going to get more time. And yeah, in chapter four that chapter before the focusing on, all that matters is the responding differently to anxious thoughts. There's so much good, good stuff in this book, tamara, as we're kind of wrapping up here, what have I not kind of? I mean, there's so much. I haven't discussed what's some of your favorite parts about the book.
Speaker 2:You know, one of the chapters I focus on, it's a phrase that I coined, it's called allergy parenting traps, and so these are behaviors or behavioral patterns that we engage in as parents and caregivers that are in service of keeping our child safe, and they do keep our child safe, but they also so in the short term. They are effective in that way, but in the long term they tend to cause more challenges or become problematic, right. So things like comparing ourselves to other families and how they manage their food allergies, like over avoidance, beyond what's medically necessary, over functioning for our child, because it's a way to keep our anxiety calmed.
Speaker 2:But yet our child isn't learning how to manage age appropriately and that becomes a problem as they get older Resentment trap, the burnout trap. So that's another important chapter, as I described in the beginning of the book, of the things behind the anxiety and overwhelm we feel that I think parents are going to resonate with and go oh, yeah, okay.
Speaker 1:Absolutely, absolutely. Wow. I'm just kind of like flipping through right now. I'm like I should ask about that, but this interview could literally go on for five hours.
Speaker 2:I'm sure it could Plus, we can talk for hours.
Speaker 1:That helps. So we're just going to have to have you back on the show, my friend. The book will be out you can preorder now. May contain anxiety managing the overwhelm of parenting children with food allergy anxiety children with food allergies.
Speaker 2:Who may have food allergy anxiety too?
Speaker 1:yes, who may have it too right, especially if we, as parents, are not managing ours? Where can they get this exceptional book, tamara?
Speaker 2:Yeah, so pretty much anywhere books are sold. They can find more information about it on my website, wwwfoodallergycounselorcom. Backslash book. It's available as of September 30th here in North America a little bit later in other countries because of distribution, but it'll be available in paperback, hardcover, e-booker, kindle and audio book as well, published by Johns Hopkins, yep, and then the audio book is published by Dreamscape or RB Media. Yeah, Awesome.
Speaker 1:Well done, my friend, and thank you not just for coming on here but creating such an excellent resource for our listeners, for my patients, my patients' parents, really for the entire G-food allergy Allergy community. Thank you.
Speaker 2:Thank you. I appreciate you having me on to talk about it.
Speaker 1:Thanks so much for tuning in. Remember I'm an allergist, but I'm not your allergist. So talk with your allergist about what you learned today. Like subscribe, share this with your friends and go to foodallergyandyourkiddocom where you can join our newsletter. God bless you and God bless your family.