Food Allergy Counseling

Food Allergy Counseling
Sloane Miller, MFA, MSW, LMSW, Psychotherapist; Specialist in Food Allergy Management, Speaking At Mylan Specialty / EpiPen Event (© Noel Malcolm 2013)

Wednesday, June 03, 2015

Food Allergy Counseling: Your Middle School Aged Child and Worry Versus Vigilance

The fourth and final installment of my middle school aged child* and food allergies blog post series (here are parts onetwo and threeis to give this dynamic that I’ve been exploring a name. 

I think of it thusly: worry versus vigilance.

What we with food allergies need to do is separate worry about a food allergic reaction from practicing vigilance around how to manage food allergy risk whilst living a full, fun life.

This practice is a skill set I use as a food allergic adult and I teach this skill set to my food allergy counseling clients.  

It will be refined over time by the person with food allergies as circumstances and life stages change. For now, I will break it down into its most basic definitions for parents of children with food allergies.**

WORRY
The feeling of worry is based on the “What ifs” scenarios that runs through our minds (“our” refers to the person with food allergy at any age): what if I ate my allergen by mistake, what if that restaurant cook didn’t wash their hands of my allergen before creating my food, what if I didn’t read that label closely and my allergen is hidden in that snack, what if this doorknob has my allergen smeared on it, what if I want to kiss my date and they ate my allergen? 

What if scenarios involve an endless series of questions without an action to get those questions answered adequately. These scenarios may or may not be rational thoughts/concerns but the feeling of anxiety, worry, panic that can set in when the implied question of food allergy risk isn’t answered begins to grow at an alarming rate, resulting in feelings of anxiety that can easily lead to panic. And classic panic attacks can feel very close to anaphylactic reaction. 

VIGILANCE
The practice of vigilance is one of remaining watchful and alert and calmly thinking through a food allergy scenario. I call it “If this, then that”: if I don’t feel safe at this restaurant after communicating my needs clearly, then I won’t eat, if I don’t understand all the ingredients on this label, then I won’t eat it until I can get more information, if I don’t have my emergency medication on my person, then I won’t eat, if I accidentally ingested my allergen, then I will enact my anaphylaxis protocol, if I don’t fully understand my food allergy diagnosis, then I will explore options with my board certified medical health practitioner.

Vigilance is defined as the action or state of keeping careful watch for possible danger or difficulties and taking the necessary action. Remaining vigilant doesn’t mean you aren’t worried or anxious but it does mean that in addition to those feelings you take an active role in calming yourself and taking appropriate steps to stay safe. 

See the difference? Radical, right?

Vigilance gives us agency over our lives with food allergy and risk; constant worry invokes feelings of helplessness and paralysis, with little to no action over our lives with food allergy and risk.

Ask yourself: What is your normal state of being around food allergy risk? Are you constantly worried? Do you feel helpless or out of control? Do you feel prepared? 

Using my previous posts (onetwo and three), explore your child’s fears while giving them hard facts about disease management. Have deeper questions? Ask your board certified pediatrician and/or allergist. Feel overwhelmed and need more support? Consider consulting with a child psychologist, a licensed social worker (like me) or a psychiatrist.

Remember above all, separating worry and vigilance is a process and a practice. There is no perfect. There are good days, better days and days of pure food allergy crapola. That’s okay. Keep going.

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*I'm using Middle School aged children to represent the middle school years 8-12.

** Please note: these posts are also for any tween, teen and/or adult with severe life threatening food allergies and anaphylaxis.



NB: When fears are not managed, children can suffer or withdraw. If you witness troubling behaviors in your child, please have them evaluated by a local child psychologist, social worker or psychiatrist as well as your allergist and your pediatrician.

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Here are parts one, two and three of this blog series on middle school aged children and anxiety around food allergies.


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