The Role of Narrative Medicine in Understanding Your Body's Story
Welcome to the Satiated Podcast, where we explore physical and emotional hunger, satiation and healing your relationship with your food and body. I'm your host. Stephanie Mara Fox, your Somatic Nutritional Counselor.
When I was diagnosed with Irritable Bowel Syndrome around the age of 21, I was given no guidance as to what to do to heal. I was told to watch my triggers and manage my stress and that was it. At the time, I was in so much digestive pain and bloating that I thought, no friggin' way am I going to deal with this the rest of my life. So in all of my 20- year-old stubbornness and sticktoitiveness, I started to explore every nutritional avenue I could find. Some nutritional approaches were supportive and some led me down dead ends and fostered a more confusing and harmful relationship with food. I learned an immense amount of information about the gut and discovered how to listen to mine. While I rarely ever get the same kind of debilitating digestive pain and distention as I used to, I still live with a sensitive digestive tract. Something I had to learn on this healing journey was redefining what healing and health meant. My original definition when healing my gut was that I would always have smooth digestion and never have a digestive symptom ever again. Coming to terms with that I will probably always have a sensitive digestive tract based on my genetics and what has been passed down to me freed me up to see my gut as an ally instead of an enemy. I have something in my body that is going to give me such clear messages about what foods, people, and environments resonate with my body and what does not. I now engage in these explorations with those I work with to redefine what things like health, healing, and nutrition all mean.
I'm so excited that I got to chat about all of this and more with Andrea Nayakama today. Andrea is a Functional Medicine Nutritionist and educator, who has led thousands of clients, and now teaches even more coaches and clinicians around the world in a revolution reclaiming ownership of both their own and their clients’ health. As the host of the 15-Minute Matrix Podcast and the founder and former CEO of Functional Nutrition Alliance, Andrea draws on systems biology, mental models, root cause methodology and the therapeutic partnership to offer long-awaited solutions for the rapidly growing chronic illness epidemic. After losing her young husband to a brain tumor in 2002, she discovered a passion for using food as personalized medicine and is now regularly consulted as the nutrition expert for the toughest clinical cases in the practices of many world-renowned doctors. She trains nearly four thousand practitioners each year in her methodologies so that they too can become the last stop for their clients and patients as well as a trusted referral partner for doctors in their area. We chat about the gaps in traditional healthcare, shifting perspective of a healing journey, the misconceptions of nutrition, the basics of a health foundation, understanding the body's signals, the three tiers of nutritional mastery, the role of Narrative Medicine in healing, and supporting the body's natural healing. This episode is not to be missed!
If you're looking for a somatic, trauma, and nervous system lens to heal your relationship with food, come learn about my work called Somatic Eating®. I have two self-paced Somatic Eating® courses or my 3 month live Somatic Eating® Program that will happen again in May 2025. I will leave the links in the show notes to check these out and you can join the waitlist for the next Somatic Eating® Program class. You can also email me at support@stephaniemara.com with any questions or to discuss working with me 1:1. Now, welcome Andrea!
I am really, really, really excited to have you here on the podcast today. You know I was saying earlier, before we press record, that I felt like I've been following your work for ever, and just have been loving what you've been putting out there and where your journey has even taken you. And so I'm just really excited to have you here. And you know, would love to hear a little bit more about your background and how you got into this work and how it's evolved for you.
Andrea Nakayama 05:01
Yeah, thank you, Stephanie. I'm so just touched to hear that and excited to be here talking to you. I love your work as well so big kudos. I kind of feel like I've been in this space for a lot longer than a lot of people, so I joke with one of our mutual friends that like I'm the grandmother of this field. Now, like, not that I'm a grandmother, but could be at some point. So yeah, I started practicing in 2009 and that was several years after my late husband passed away. So I worked in a completely different field. I worked in book publishing, and when my husband was diagnosed with a brain tumor, very suddenly, I was seven weeks pregnant, and we were thrust into the medical system in a way that we had never experienced before. So you know, you've got tubes in you, people are operating on you, a whole different relationship with the system of medical care, and there were so many brilliant things that we got out of that care, but it really brought me face to face with some of the gaps in traditional medical care. We started working with nutrition and all the modifiable lifestyle factors that could influence his health outcomes. He was given six months to live. He ended up living two and a half years. So he died when our only child was 19 months old. That child is almost 24 now. So this is a long time ago, but that really woke me up to a lot of these gaps, and then it just evolved from there. I put myself back through school. I made a huge career change. I left a lucrative and successful career to start a little practice. That practice grew. I was having success in my practice. So people started to look to me and say, What are you doing? What are you doing differently? I didn't really know what I was doing differently, but I was ultimately able to align it with some of the principles and practices of functional medicine, and really identify it as functional nutrition. Started mentoring other practitioners through a school, and it has continued, as you've said, to evolve from the start of my practice in 2009 and the launch of my educational program in 2012 I've now trained over 8500 practitioners in over 68 countries. And I love that work, and I'm ready for a next phase of my own work as well.
Stephanie Mara 07:44
Absolutely. Going back just a second of what you were saying of being the grandmother of this field, I completely agree with that!
Andrea Nakayama 07:53
I feel like Liz Lipsky is like my predecessor. And then I don't know if you're familiar with Liz's work, like she's like the person I look to, and then I'm like, okay, I guess I'm next in line. It's time to let my hair go gray.
Stephanie Mara 08:07
Yeah. I can totally see all of that absolutely, yeah. Like, I really hear you just seeing these gaps in going through the medical industry. And so I'm wondering, like, what were those gaps that started to create the foundation of what you created.
Andrea Nakayama 08:23
Yeah, the first two gaps that I really saw were that people are treated like their diagnosis, and so not only are we as patients over indexing and over identifying with our own diagnoses, but the medical system calls you your diagnosis. You are that diagnosis or that treatment. They may call you by the treatment that you're in to have. So there's a humanity that's really missing in healthcare. So that was gap number one. And then kind of on the flip side of that, it surprised me that it was a very protocol based system, every person with the same diagnosis is treated the same. And so those were the two big gaps that I identified early, early on. This is again, before I was even in the field, I was going wait a minute, what's going on? This doesn't seem right. And then started to really back up and create the story around that. So there are a lot more gaps that I've recognized since then, but those were the initial two.
Stephanie Mara 09:29
Yeah, that's so interesting. I was literally just reflecting before our call. I have a history of healing digestive symptoms on my own healing journey as well. And I was kind of just reflecting on how I still have a sensitive digestive tract like I don't think that's ever gonna fully go away, and how much we get so focused on the healing journey, like you are a person who is healing, rather than I am a person who maybe has healed to a point that I'm meant to heal, and then I'm just a person working with the body that I was born with, and like, where that point happens for people and how do we guide people to maybe you're just a human being and you're still going to struggle with things, regardless of how much like, quote, unquote, healing you've done.
Andrea Nakayama 10:17
Yeah, that's so smart Stephanie, and this really relates to your work in terms of the nervous system and the sympathetic dominance that we go into when we're questing for an answer. And I've seen this so much over the years, and the 1,000s of people I've been able to work with clinically, how there's this fixation on finding the root, doing the test, finding the perfect protocol, and that is not a state of healing at all. And I think as I've aged, I've come to see health as something that can be more flexible, that it isn't a tightrope. It's not about good or bad. It's about being able to breathe into all the factors that allow me to be in my best self, and tuning in as you teach so beautifully, to the different factors that actually influence our feedback mechanisms of how we're feeling and when we're doing too much in any area, we bypass those feedback mechanisms for what's actually working for us.
Stephanie Mara 10:17
Yeah, that's really fascinating, just that you're bringing up that point that even focusing too much on healing can be antithesis to the healing itself.
Andrea Nakayama 11:36
Yes, I know it's kind of funny, because we want to be all better now. We want to be some other version of ourselves, or some dream version of ourselves. And I think what I heard you say so nicely is that it's not acceptance in a way of, oh, this is always the way it's going to be. And that's a funny place, especially as we age as women, because we don't want to just go, oh, whatever, I'm just aging now. We do want to feel our best selves, but I think there's some externalized version of what that is, as opposed to an internalized version of finding that balance between the striving and the being.
Stephanie Mara 12:18
Yeah, I completely agree with that, and I know that something that you have put out there is kind of like, we're missing the mark with nutrition, because that's where a lot of people start to focus on, is like, oh, I must be doing something wrong in my nutrition, and there must be some nutritional protocol I can follow to heal my autoimmune condition or my digestive issues or my binge eating, like I must be doing something wrong with food. And I'd love to hear more of your thoughts on like, how are we missing the mark with nutrition?
Andrea Nakayama 12:48
Somebody wrote me recently on an Instagram post, what's the one thing you think is missing from digestive health care? And I was like, honestly, it's tuning in, and we can't tune in when, again, we're doing so much that we can't tell what makes us feel better and what makes us feel worse. And I think that a lot of where we have to focus our attention and where we're getting nutrition wrong is that it's just a modifiable factor. In functional nutrition, we are focused on the internal body. How do I get my body into its most functional state where it's maybe not functioning at its best for me right now. The thing I always like to remind people is that your body is more functional than it is not. Take a deep breath. You're not broken. You don't need to be fixed. It's really what I see all of these diets, all of these supplements and all these tests validating this idea that there is some right way that we're going to outsource the information about what's wrong with us, and that we are going to find that thing, that route that's going to tell us the answer to everything, and then there's going to be some protocol that's going to tell us exactly what to do. And that goes back to that gap of a very protocol based medical system, and we're all geared towards that. It's the hardest thing with the students I teach to say it's a framework, not a protocol. A protocol is rigid, a framework is flexible, and it allows you, like I was talking about with health, to breathe into where do I need to focus now. So nutrition, to go back to your question is about growth, metabolism and repair. When we are limiting, limiting, limiting, limiting not only are we in that sympathetic dominant state where we might not be able to rest and digest our food, we are also potentially limiting key nutrients that our body might need, which are contributing to other signs, symptoms and even diagnoses that we don't know through the limitations. Now, I'm not opposed to any of the things that I'm talking about. I'm not opposed to healing diets at an appropriate time, if done in the right way, where and right is a funny word, but I just mean a limited time where you're using it for a healing possibility, not rubbing salt in the wound and learning more about your body. I'm certainly not against supplementation. I'm not against testing at the right time, in the right place in the healing process. What I am against is all the things we're doing at once and the narrowing of what we're looking for in our body's ability to heal, and I just want to slow it down for everybody. And I know the physiological complexities I am well versed in all the most challenging chronic health challenges, and yet it's still a slow and steady process, and we might not have to go to the extremes if we focus on some of the core basics that actually allow the body to heal, and they may be different than you think they are.
Stephanie Mara 16:16
Yeah, I really appreciate that reminder of how much on, and I'm calling it a healing journey, which is, like, such a, you know, the way we describe it, other than just like you're just living your life and maybe you're just, like, updating some things in your body, like there's so much focus on the thing that you're trying to heal, which just were, you know, beautifully stating it keeps your body stuck in that sympathetic state of when you're like, I'm healing something, it's sending that cue to the body of, I am in danger,something is not right, rather than focusing on, well, my heart is still beating every day, and my lungs are still taking in oxygen, and I'm still able to get up in the morning even if it's difficult. You know, there's all these things that are still happening in your body, even if things don't feel as smooth as you want them to be.
Andrea Nakayama 17:05
Yeah, I think one of the things that really taught me this lesson was working with people who have a lot of fear about what information outside of them is going to tell them about their body. So they're already thinking, I'm going to learn something that tells me something is wrong with me. So every test, every appointment, every time they're going to somebody, there's this fear. We know about the white coat syndrome with blood pressure, but it comes up in all different ways, and that's what really shifted my mindset about how I even look at serum labs. I'm just talking about the regular old labs that we can get from our blood, not these fancy functional labs, which I have a lot of feelings about. But serum labs can tell us a lot about our gross body functions, and if our gross, broad body functions aren't dialed in, then, yeah, everything else that we're testing for or looking for is going to be off. But I realized in working with certain patient populations that that fear is something that needed to be held so I could remind them of how functional their body is, and I would do that in looking at their labs, creating a chart and making all this green. Look at all the green, the green means you are not only looking awesome from a pathological lens, what your doctor, your conventional doctor, might look at, but you are looking brilliant from my lens, which is even more narrow and anchoring first and foremost on that. And I'm saying that to you because I think we forget to do that. We get our labs back, and we are looking for the red areas. What's wrong with me? What do I do to fix that? And we forget, wait a minute, look what's working. Looks at what's working over time. Look how good I'm doing at taking care of myself. And is there some little thing I want to work on here? Let me focus on the small thing I can shift, as opposed to always treating ourselves like we're broken.
Stephanie Mara 19:22
Oh my gosh. I love that. And that's sending a cue of safety to your body. Like, look how much safety cues we can take in from all this green and all these things that are working well, rather than continuing to send this cue of threat to the body that there's all these things that are in the red and aren't working well, you know? And then sometimes this becomes that, I don't like the term self fulfilling prophecy, but because it's your body is doing exactly what it's meant to be doing when it feels like it's in danger. And so it's not that it's self fulfilling, that you are doing something wrong. It's just when it picks up something that it perceives as threatening. Of course, it's going to turn on your sympathetic nervous system that is going to start a cascade of different bodily reactions that then you feel like everything is wrong and you must be doing it, rather than your body is doing what it's meant to do when it feels like it needs to protect you and fight for its survival.
Andrea Nakayama 19:27
Totally. Yes, I love the somatic perspective you overlay. You know, that's not my expertise as much to think but I love how you're talking about it as that threat and the response that happens to a threat that we are imposing on ourselves. And for me, I'm thinking about it as this baseline rest and relaxation that allows us to take a deep breath and think, where's the next thing I'm going to focus on? I can't tell you how many times I see people who are struggling with energy and fatigue and they're looking for whether it's some kind of infection or Epstein Barr Virus or mold, or it's a mycotoxin, or it's Lyme disease, or why are they so tired? And I look at their serum labs and ask the simple question, are you hydrating enough? And they'll just stop and say, "Why do you ask that? Because no, I don't." And I'll be like, okay, I can tell in your red blood cell function that you're dehydrated. I don't know if this is a pattern, but it reminds me to ask you, and hydration pumps your blood. Your blood pumps to your heart. It pumps to your brain. Let's try to increase your water intake and see if that impacts your energy and your fatigue, and it's these things that we overlook that are actually simple and fortifying and not that over striving, that then give people that feedback loop of just sitting in that place of listening in and understanding that starts to take us out of that threat that we are broken, there's something wrong with us. We have to find out what it is, then we have to do the protocol. What's it going to be? I'm keeping looking for doctors. I mean, just saying it makes me feel stressed out so but that's what people that's what everybody is going through right now.
Stephanie Mara 22:20
Oh yeah, I was feeling it too. I'm like, yeah, just like the speed of stress that happens. I know we share a fellow colleague, Michelle Shapiro, that I'm reminded of a post that she put out on Instagram, of, like, are you doing these first, like, sunlight. Are you getting outside? Are you drinking enough water? Are you connecting enough with other people and we forget, just like the simple basics of have I laid the foundation of what helps my human body thrive, and if one of those pieces isn't there or isn't happening enough, can I actually start with the things that are completely for free before I start doing all of these tests and then freaking myself out that there's something horribly wrong with me.
Andrea Nakayama 23:05
Exactly, and I'm going to speak now to all those who have chronic, unresolved issues, because that is my area of expertise. And there's a three tier system that I've built that is the three tiers to nutrition mastery. I actually think of it as the three tiers of epigenetic mastery. Tier one are the non negotiables. Tier Two is deficiency to sufficiency. Tier three is dismantling the dysfunction. What we're talking about in this striving is dismantling the dysfunction and that's what our conventional medicine practices do. They go right for the dysfunction. Unfortunately, that's what functional medicine has started to do as well. What is the name of this thing and how do I address it? I want to tell everybody, just like we're talking about, you can dismantle the dysfunction by working on tier one and tier two. It's just the soil that nourishes the terrain, as opposed to target practice for the terrain. If we have a severe medical condition, we usually have to do both. If I'm not telling you that, like you can just work on the soil that your cancer is growing in. You might need to go through your medical treatments and work on the soil, which is what we did with my husband's situation. So tier one those non negotiables, my non negotiables for you, are sleep, poop and blood sugar balance. If those are not dialed in, then we're going to have all different sorts of challenges that show up as the expression of those imbalances. So if that's where we're focusing, and we need to hydrate, to have better poop, or we need to eat more fiber, whatever it is, we start to watch what I don't mean like a poop test. I mean like just what we leave behind. We start to think about that sleep is such a huge huge factor that is impacting both ghrelin and leptin. So if we are overlooking these factors that are base, they are core basics, we are going to have the other issues, and we're going to keep staying in that striving place. So my non negotiable is our sleep, poop and blood sugar balance. But by working with you, I begin to understand what are your non negotiables? You already know some of them in functional medicine, we call them your mediators, what makes you feel better, what makes you feel worse, and that becomes part of our tool kit. Ultimately, I see my job as somebody who helps you gain more of your non negotiables. Once you know your non negotiables, what makes me feel better? What makes me feel worse? You have more agency in your health, and you're not constantly outsourcing it. And I just want to say tier two, those deficiencies that can be in self love, it can be in joy, it can be a movement, it can be in laughter, it can be in intimacy. It can be in all these things. It's not just a deficiency of vitamin D or, you know, deficiency in, you know, methylation nutrients like these things that people chase after. There's a whole bucket of things that, like you said, are free and in our own pockets to be able to say, I'm going to work with X.
Stephanie Mara 26:35
Yeah, thank you for bringing in just all of those many different layers. I feel like it's actually been coming up a lot more in my sessions lately of I'm working more in the realm of food behaviors around, you know, binge eating and restricting and emotional eating and chronic dieting, and that there's so many self regulating things that people are trying to do like I've seen it also in somatics as well, that it's starting to go down that same path of like a fix for what's going on for you, rather than a how do I learn to live from my body, from the inside out, rather than the outside in. But what I've been exploring a lot of what you're also referencing is more like, where is there more coregulation that's happening in your life, through community, through laughter, through are you getting out and connecting with nature enough? Ya know, and these things that when we're looking at it as something to be fixed, are often forgot, of like, what's the supplement? What's the diet? What's the thing that I need to be doing, rather than, like, how do I facilitate how I want to feel in my body through setting those foundations of what just helps my body thrive. And that's not always just doing things all on your own.
Andrea Nakayama 27:51
Exactly, and it's also, I think, not doing things that we think we're supposed to do. And I've been experiencing this myself lately, in that I'm accustomed to my morning routine as an example. I love my morning routine. I wake up early at five, I stretch, I do some resistant training, I meditate, I pull some tarot cards, kind of set my intention for the day. I drink my water. I do all my things. Lately, I don't want to. I don't want to, and I've been fighting myself because I want to pat myself on the back for doing the things that I know are beneficial to the stress that I have in a day, carrying a business that's very active, while moving my work forward in a new direction. I'm busy. There's a lot of stress. And I think like, well, that's a good way. Those are good things to start my day. But lately I want to wake up, make a cup of tea and get back in bed and write, and I had to go through a little transition with myself to allow myself, to give myself permission that in this season right now of my life, I may need to find another time for the resistance training, and I may need to find another time for the five minutes of meditation. It's not like those things were long in my morning, but it was this routine that I was like, good girl, you got it. You're taking care of the stress. That's not what my body wants right now, and I think, like, what feels healthiest to me is that ability to just listen to that cue. It took me a minute to say, like, okay, the alarm is going to go off at five, and I'm allowed to make a cup of tea and get back in bed. The other stuff will happen. And it sounds simple, but I think like those are the cues that we bypass when we look outside of ourselves for the right way or the right patterns. As opposed to letting that message come through.
Stephanie Mara 30:05
Yeah, thank you for sharing that experience. I've seen that a lot just with nutrition in that when someone finds something that works for them, that they're doing it and they're doing it and it works for months, and they're like, oh my gosh, I finally found something that makes me feel like grounded and connected and thriving and energetic and all these things, and then suddenly it stops working, and they try even harder to make it work again, rather than what I like to explore with people is inviting in curiosity, of like, what is your body trying to tell you? It's not that you are doing something wrong, but that your body is telling you it's ready for something else. Maybe it got enough of the nutrients that you've been feeding it over and over and over again. It needs a different routine. It needs a different pace. It needs different foods, and that it's not something to fix, but actually just to listen to. And I get that. I go through those periods too, where at first I'm like, wait, what? No, let's just try it again. Are you sure this isn't working for us? I keep trying to, like, make it work again. I'm like, okay, no, this just doesn't work for me anymore and something, my body's asking for something different now.
Andrea Nakayama 31:12
Yes. I think that that is, you know, to get into this realm of Narrative Medicine, and what Narrative Medicine is as a academic pursuit, as a pedagogical term, and then also where I'm trying to bring it into the personal practice, is that ability to embrace active listening. So Narrative Medicine from a practitioner perspective, is about the practitioner being able to stop and listen and hear and not be sitting with the protocol in our mind while we're sitting with a client or patient. It's the practice of engaging with the humanities to remind us as providers of humanity. Because oftentimes in healthcare today, we've gotten so into what I said earlier, this person is their diagnosis. This is the protocol for that diagnosis, that that's where we are. The first thing I have to really drum into my students, especially nurses, who are coming from a very protocol based background. It doesn't matter if somebody's coming to you that you know about their diagnosis. That's not the point you are there to learn about them. If you think you know the answers before you've met with the person, you've left functional at the door, you're not practicing functionally, because you don't understand who it is that you're talking to. So it's why I love Narrative Medicine, which is a very small and very young practice that was born at a Columbia University that really does sit in this place of active reading, active listening, what do we feel, perceive, know, when we slow down and take ego out of the picture? And what I would love to do in my realm as a functional medicine nutritionist, embracing this is not just teach that practice, and remind practitioners of that, but give this back to the patient, to be able to tune in actively listen to themselves, which I think is a very somatic practice, even though that wouldn't be the language that I would have put to it. It's that active listening and tuning in to what our body is telling us in any one moment. And that's what I love about it. It's a slow down. It's a what moves me. It's a why is that impacting me? Why am I triggered what's happening in this moment? And how do I just listen before acting?
Stephanie Mara 34:03
Oh my gosh, my brain's going in like a million different directions. I love all of this. So the first thing that comes up for me is also, just like all the research that's been done on how the beliefs of your practitioner on your ability to heal actually affects your healing. What I really hear in that is also that it's just as important as the practitioner to meet whoever they're working with in a space of safety, of empathy, of curiosity, of compassion, of saying I want to get to know who you are as a person, and you are not this diagnosis that you're coming to me to work on like when people come to me and say, well, I'm a binge eater. I'm like, no binge eating is not your identity. That is not a part of your character. It has maybe been a coping mechanism that has helped you for a million different reasons, but it is not who you are. It is just something that you are navigating as a whole complete human being. And so that's the first thing that comes up for me when I hear that, is that practitioners have to start to be curious within themselves. How am I meeting this person in front of me, and am I facilitating a space for this person to heal?
Andrea Nakayama 35:12
Yes, and I think that if I go back to this notion of frameworks, you know, I'm a super framework person, not no protocol, all frameworks. And I talked about the three tiers, there's two others that I really anchor on, but one of those is the functional nutrition matrix, which is modeled after the functional medicine matrix, but a little nuanced for the work that I do as a functional medicine nutritionist and those I train, but it's divided into three categories, and those categories are the story, the soup, and the skill. The soup is the systems biology, and that's the part that I know we often like to geek out on what's impacting the gut brain response. How about my hormones? What do I do with my detoxification, my environmental stressors? Everybody wants to geek out on those. And I love those too. I love seeing the soup, the blend of how systems biology impacts each other. Nothing exists in isolation, the binge eating, the Hashimotos, the IBS, none of it exists in isolation. We also like to then focus on the skill. So I said the story, the soup and the skill. The soup is the systems biology. The skill are the protocols, the things we do, the sleep and relaxation, the exercise and movement, the nutrition and hydration, the stress and resilience, all the things that are the to do's and again, I saw as I was moving through my career in functional nutrition, that we're anchored on those things, and we've kind of left the story behind, when, in fact, the story and the skill are what inform the system's biology. They flank the body. And if we don't spend time on the story, we miss the opportunity to see the person who's actually wanting resolution, wanting help, and so for me, giving people back their story in really indirect ways to begin to have the muscle to feel themselves again, as opposed to handing it all over, is just a beautiful opportunity, and when I see it in action, I'm like, yeah, this is the richness of that healing journey. It's not your polymorphisms and your supplemental regime. It's this is who you are, and understanding that allows for that therapeutic partnership that you're talking about to really be activated.
Stephanie Mara 37:52
Yeah, what that makes me think of is like when I'm first starting to work with someone, yeah, I want to hear a piece of I like to call it their body story. What has their body lived through? Because if I just look at, oh, you're coming to me for binge eating, then I don't get the context and like you were saying before, the soil that that binge eating got created out of, that there's wisdom to the body creating that symptom, that habit, that pattern, that impulse, it takes it away from, like, oh, how is this actually information of there's, there's a whole bunch of other things in your history that we get to look at, not just what you're coming to me that you feel like you've been told is the thing that needs to be fixed.
Andrea Nakayama 38:37
That's so true. And binge eating is such a good example. You know, I can use other examples of where people will say, I've always been constipated or I've never slept well. And my question isn't going to be, let's work on your sleep, melatonin, magnesium, what do we need to do? It's going to be, when's the first time you remember not sleeping well? Take me back to how that was a realization. Because what does that always mean? I've had the most beautiful stories. I'll share one from a woman in her 70s who said to me, I've never slept well, you know, dealing with a CPAP, I've always had problems sleeping. Take me back to the first time you remember that being the case, and she sent me a photograph of her childhood home, and she said, the window in the front is my room. It also had a window on the side of the house, and that window looked out on the neighbor's house, and there was no shade on that window sill. And there was never anything nefarious that happened, but the fact that somebody could look in my window when I was sleeping kept me in this awake state, and I would cry out for my parents, and they would come and comfort me, but I could never fully relax to let myself fall asleep without the awareness that somebody could be looking in. She had never even thought of that story until I asked her take me back to the first time you remember not sleeping well. And then, as I'm sure you know, like she's trained her body into that awake state as a protective mechanism, because it felt like there was a threat, even though there wasn't one. And that has led her to this place where she can't relax into sleep, and then what she was able to recognize is that's how I also feel in the passenger seat of a car, because she doesn't have control. And so that lack of feeling, I can control how I feel, and I can come into a full state of relaxation that then gives us something to work with, because I know an aspect of what's not allowing her to sleep, as opposed to putting a solution on it that is trying different things, and it just creates so much texture into the therapeutic partnership. And as you were saying before, so much trust, because we just got into knowing each other in a deeper way that allows for her healing to occur in a whole new and nuanced way.
Stephanie Mara 41:30
I love that example, because what you were referencing if you just started giving her all sorts of nutritional support for sleep that doesn't address that she doesn't feel safe to rest and go to sleep, and so that's where what you were talking about, even at the beginning of our chat, of like, all these protocols and all these supplements and all the nutritional dietary strategies sometimes aren't addressing some of the things that actually need to be focused on, I'm gonna say first before maybe the yes the base that that needs to be addressed so that something else can change.
Andrea Nakayama 42:10
Yes, and I think that this happens a lot with hunger and satiety as well, like we're going to the magic sprinkle hormones, even with sex hormone issues that are all the rage these days in terms of like menopause issues and symptoms, and I'm happy that that is actually happening out there, but they're all very protocol based. They're all very fixed, something that's broken, and they're not dealing with the base support that the body needs to be able to manage the change. It's not going to come from bioidentical hormones alone, and I am not against bioidentical hormones, but if your body can't metabolize hormones and you're constipated, you are not actually helping your body with those interventions. And I think those are good examples of where we layer on and sometimes create more issues. We have a lot of finger wagging that happens around the realm of polypharmacy, where somebody's taking a pharmaceutical and then they have to take another pharmaceutical to offset the side effects of that pharmaceutical, I am sorry to say we are doing the same thing in holistic, integrative and functional care, when we are not taking the time to appreciate and understand that base story and what the body needs to come into its healing potential, which is why I'm so happy people like you are doing the work that you're doing, because it brings into that therapeutic relationship with the self that listening in and that understanding and that self awareness, as opposed to that quick fix seeking that really drives us into that layering.
Stephanie Mara 44:08
Yeah, it makes me just recall an experience that I had, I've shared openly here, that I got long covid, and it took me about two years to heal, and saw a lot of different practitioners during that time, did a lot of just playful experimentation on myself, which just as a reminder, like, sometimes, like we know what's best for us and how different things land in our body, if we're listening to our body's feedback. And at one point, I did end up going to the long covid clinic at Yale and just kind of seeing, did they have anything else to offer me or suggestions, or what are they seeing. And I feel lucky to have a doctor that reminded me he said, your body wants to heal. And it was really refreshing to just hear that, because I was like, ready to, like, come in with like, my like defenses up, like, okay, I'm gonna speak up for myself if I need to, and just that reminder that, like this is your body's tendency is toward healing. This is what it wants to do, and it's going to do that, and let's just support it in doing what it naturally knows how to do.
Andrea Nakayama 45:13
Yes, and having somebody who can reflect that for you, as that physician did for you, as you do for clients. I think that holding space for ourselves, being able to understand where our narratives may be a little messy, right? They may not be linear, they may not be telling us what we need to hear at any one moment. And I think that the act of being listened to, being heard, and holding space for another, it can happen in as little as five minutes where that reflection is happening. And I really believe we can do it for ourselves in ways as you were doing. Let me see the different things that can work for me. Let me try all these things. What helps me feel better? What makes me feel worse? Where do I still need help navigating this? That's the dance, I think. That is the healing journey that we're talking about when it's chronic when it's something like long covid, and it's not easily resolved and there aren't easy answers. Long covid taught us a lot about what people with chronic illness have been experiencing for a very long time, that our medical system does not know what to do with chronic illnesses. They need a different kind of approach. And I worry going back to this like, where are we doing nutrition all wrong? Where are we doing functional all wrong? I worry that we're still applying conventional thinking to chronic care issues that take a multi factorial approach to care, because they are multi factorial issues.
Stephanie Mara 47:13
Yeah, as strange as this is going to sound with where I'm at now, going through it was obviously had its highs and its lows, but I'm grateful that I went through that experience, because I understand the body so much more now. And like, how many layers it does take. I'm gonna, instead of, rather than saying, like, heal, but just come back to, like, a homeostasis and equilibrium of what feels like me and the me that I know myself to be and that it did take time, and how often when we continue to be fed these protocols, even like I'm so grateful you're pointing out that even it happens in functional medicine and nutrition as well, and that when we're fed that we still continue to see there's something I could be doing or something that needs to be fixed, rather than I'm still here. I'm still living, and I'm going to do the best I can every single day with where I'm at now, to show up for myself, rather than continuing to focus on some end point that may not even exist.
Andrea Nakayama 48:15
Yes, exactly. And I think if we can just pause and know our own non negotiables. What are your non negotiables? That's our starting place. If we know I feel better when, I feel worse when, and I don't mean some state of perfection. So if you're saying to yourself, I feel better when I intermittent fast and eat an autoimmune paleo diet, but it causes me a lot of stress because it's expensive and I can't eat out with my husband, and whatever it is that's not a it makes me feel better. There's aspects of it that you can tease out. What about that? But that's where you might need help figuring out what pieces of the puzzle and why, but I think we all have some good indicators for ourselves of the things that make us feel better. And it may be going to a dance class, it may be cuddling up and reading a book every evening for a certain time. There's so many things that, if we go back to our core selves, like, who were we when we were younger, and what gave us hope and made us hopeful and excited, that we can bring back into our lives, no matter what age we are, and start to nourish ourselves. That too is about growth, metabolism and repair, and we forget that we can pull on different resources to support ourselves, between our medical visits, between our healthcare visits, and all the places that we are our own provider.
Stephanie Mara 49:57
Yeah. Well, I always like to wrap up with a little baby step that some individuals listening to this can take forth and move forward with. You just gave a really good one. But I'm curious if there was anything else you would add on to that.
Andrea Nakayama 50:12
Yeah. I mean, if we go back to that sleep, poop and blood sugar balance. Another one of my ways of thinking about that with blood sugar balance, because that can feel really daunting for folks, and they feel like they need a continuous glucose monitor, and they're not going to get both. All I like to say with that is there's three principles for me, because I don't subscribe to any one dietary theory ever for any one person, but there are three principles, and they are fat, fiber and protein with every meal or snack. Eat the rainbow when you can, because it's going to help you with that fiber and a lot of your nutrients. But the third one relates to what we were talking about, which is why I wanted to bring us there, which is, know your yes, no, maybe list, and if you're confused with that, that's what you can bring forward to someone. I feel like I feel good when I eat these things. I know I have diarrhea or migraines when I eat these things, and I'm just not sure about these things or these things cause me to want to eat them and not stop eating any of those things. If we can step back and look at that, that really does help us to know a little bit more and be able to communicate for ourselves. I also just want to recognize that that might be something that people don't feel comfortable doing on their own for a variety of reasons, but it's a great exercise to bring forward with somebody you're working with, to be able to say, I can't figure out what makes me feel better, what makes me feel worse. I know this might be a trigger for me, and this isn't, and I'm I'm stuck, and that conversation in itself is a great way to recognize and invite the kind of conversation that's going to help you get more tuned in to the symbiosis, as I like to call it, where the food meets the physiology. And when we can't tell that, might be a really important starting point.
Stephanie Mara 52:23
Yeah, and I appreciate that you brought in both. Because for those who are listening that feel ready to make those lists for themselves and have maybe done a lot of somatic work and are able to identify their yes, no's, and maybe's, really great to write that down, and then for those who maybe aren't there yet aren't quite clear about what that feels like, yeah, like we've been talking about all along sometimes this is that coregulation with another practitioner. Sometimes it is feeling held and heard and seen by someone else that you can work with that helps you create that list. So I feel like that speaks to everyone, depending upon where they're at.
Andrea Nakayama 52:59
Yeah. And I just want to say one more thing, and that, like sometimes we can't even talk about food yet, and it might just be talking about how your body feels when it's most relaxed, or when you have, it might be poop. It might be talking about poop before you're talking about food. So I just want to give all the permission to start where you are and recognize there is no one protocol. There is no right one way, and raising your hand and getting help with tuning in, that's the advice. Tune in and get help where you need to.
Stephanie Mara 53:32
Yeah, that's such an important nuance that you're bringing in of it doesn't have to be yes, no's and maybe's with food. It could be like ya know whatbubble baths are not for me, but going out for a cup of coffee with a friend, that's a go.
Andrea Nakayama 53:44
Exactly, exactly.
Stephanie Mara 53:46
Yeah. Well, thank you so much for being here and just sharing all of your wisdom today. I absolutely loved this conversation, and I feel just loving our time that we got to spend together today and to get to know you more, and would love to share with people who are listening, how can they keep in touch with you and your work and find you?
Andrea Nakayama 54:05
Thank you. Yes, it was such a treat to spend time with you as well, Stephanie and you can always find me at andreanakayama.com on the web, on the gram, all the places Andrea Nakayama and at andreannakayama.com you can find your way back to the Functional Nutrition Alliance, where I train practitioners, but you'll also see the Narrative Medicine workshops that I'm aiming to do quarterly. Those are free opportunities for people to go, what is this? How do I feel into this? And to read some more about how we get out of this mindset of the quick fix and into that more embodied experience of thinking about our healing journeys as we've been calling it, and maybe a new and refreshed way.
Stephanie Mara 54:51
Yeah, your work is so needed in the world, so just thank you for what you're doing. I will put all of those links in the show notes and just appreciate how you continue to share your passion for this work and making sure that people, you know, get what they're looking for out of what we've been calling a healing journey, but in a way that feels realistic and also hopeful and embodied.
Andrea Nakayama 55:14
Yes, thank you so much. I appreciate that, and appreciate you and all you're doing as well.
Stephanie Mara 55:20
Yeah, well, to everyone listening. If you have any questions, as always, reach out. I will put both of our contact information in the show notes, and I hope you all have a satiating rest of your day. Bye!
Keep in touch with Andrea:
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