Listening to our clients' verbal messages - what's the buzz?
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Issue 9
August 2014

Talk Talk Talk!
Tuning into our Clients Part 3


Welcome to the new mobile friendly Practice Pavestones! The new format should make reading Pavestones on your hand-held device much easier. The side bar hasn't disappeared - it is now in a handy strip after the editorial section.

I'd like to extend a big WELCOME to all of the new subscribers from New Zealand who have joined this month - great to have you on board! I'd love to travel to New Zealand with my counselling skills training so please let me know if you are interested.

Speaking of.......the closing date is looming for registering for The Essential Counselling Skills Workshop in Sydney. See the Special Announcement box up next.........I have been working hard putting the finishing touches on the training content and have added a section on working with clients' emotions and our professional boundaries. If you miss out on getting a place in the workshop this time around please leave your email on the waiting list via the training registration portal. 

This issue is continuing on our theme of 'tuning into our clients'. Issue 8 featured tuning into our clients' body language and gave some neat examples of how this might enhance our practice of eating behaviour counselling. If you'd like to revise this issue have a look here. Issue 9 is all about our clients' verbal messages. This subject material could fill a book so I hope you enjoy this 'toe dip' into what will feature in many Pavestones to come!

As always if you are short on time scroll down to the Pavestone at the end..........happy reading!

The Essential Counselling Skills Workshop for APDs

This is the only counselling skills training for post graduate Dietitians in Australia run by a dual qualified APD and Psychotherapist/Counsellor.

Registrations close September 9.

The workshop will be held in Sydney on October 9 & 10 in Sydney.

For REGISTRATION and more info please click HERE

Numbers will be limited to ensure a quality, highly experiential learning format. The workshop will offer attendees unique experiences in reflective inquiry and practical skill development. It will also be lots of fun! 

There will be opportunities to join small group supervision as a follow on from the workshop to receive ongoing support for the integration of your learning and skills.

If you have any questions don't hesitate to email me.  

'Mankind's greatest achievements have come about by talking, and its greatest failures by not talking....... Our greatest hopes could become reality in the future....... the possibilities are unbounded. All we need to do is make sure we keep talking.”
Dr Stephen Hawking

'Two men are standing at the foot of a giant skyscraper gazing up in awe.
“What does it take to build something like that?” marvels one.
“Oh, about a million conversations,” replies the other.

 Adrian van den Bok Psychotherapist, Trainer, Supervisor

When we think of 'tuning into our clients', our most obvious attention point is our clients' verbal messages i.e. - what they are actually saying to us in words. Particularly for our objective data collection as health professionals, understanding our clients' verbal messages is essential.

When we are listening to our clients talk, it can be useful to consider these three areas of experience that our clients may be verbally describing:
  1. What they are thinking
  2. How they are feeling
  3. What they are doing
As Dietitians, our training tends to focus on recording and analysing very specific aspects of data within the frame of what the client is doing. For example - when do you eat?, what do you eat?, what is your body doing? (symptoms, bloods etc) what medication do you take?...doing doing doing doing.........

This data is often very important, particularly when we are new to the work. Typically we need this data to assess aspects of nutritional quality, nutrients, metabolic response and how the human body seeking our assistance is operating. 

So what's the problem with honing in like this on the 'doing data' ? Well, when it comes to working with eating behaviors it often misses the point... it's linear's reductionistic. That is, this sort of tuning in, on its own, simplifies a complex phenomenon to the point of minimising, obscuring or distorting it. This 'doing data' is the data aligned with :

........and it brings on an Intergalactic-Face-Palm (IFP)

As a new graduate, I found the task of client assessment quite a daunting one. 'So much data!!' I remember thinking to myself. Looking back I think I was overwhelmed by all of the 'other stuff' my channels were picking up on. The 'other stuff' that was in the phenomenon of eating - my clients' thinking, feeling and other aspects of how they ate not just what and when. I had no collection centre for this 'other stuff' - and no way of fitting it into my advice which at that stage was pretty much limited to 'eat less, move more'.

I responded to this overwhelm like any other conscientious person with a penchant for anxiety - I engaged hyper-focus!

To do this I had to put 'brain blinkers' on.

I became a food data collection machine. Machine was the operative word. I had my structures for what I needed to ask my client and what I needed to attend to in their verbal messages. Enter at point A, exit at point B, do not deviate. I remember doing a mock interview on internship with a fellow student role-playing a client. At the end of my data collection she said to me "Wow, Tara, you didn't miss a thing!'. Man was she wrong! We both were. I really had no idea:
..... how this client ate,
.......what she felt while eating,
.........what she thought about her eating,
.......or what she thought before she ate,
...........or what she felt about her eating,
.........or what it felt like for her to be giving me all this data in the first place!

The verbal messages I attended to created a picture like this:

.....................a black and white orderly food data picture

The problem is, that what the client was experiencing was probably more like this:

.............a vibrant messy mish-mash of dynamic human experience. 

This issue with our data collection is a classic demonstration of left brain/right brain split. In the last couple of issues we have explored a definition of Active Listening being the application of our 'whole-hearted attention'. I wonder if an addit to this definition might include the application of our 'whole-brain attention'.
Let's have a look at a sample dialogue featuring the verbal messages we might tune in to, to really 'colour-in' our understanding of this client's eating experience:
Dialogue                             Tuning into the Verbal Message                                                                          

Client: 'For lunch I have 'light' crackers with a smear of low fat cottage cheese and grated carrot'
Doing - food choice
(In my 'brain-blinker' days this is where
my lunch inquiry would have
chased a data rabbit down its hole
e.g.- how many crackers? what size carrot?
what brand cheese? etc etc Cue IFP!)

Dietitian: 'Can you tell me a little about your thinking there? What gets you choosing that?'

Client: 'Well it's low cal - low cal means GOOD'

Thinking - good/bad food dichotomy
Doing - likely disembodied when choosing food
(no mention of hunger or preferences)

Dietitian: 'Uhu. Sure is low cal. Do you enjoy it?'

Client: 'Ha! What's enjoyment got to do with it!! No I don't. Tastes like cardboard.'

Thinking - weight loss is more important than taste
Doing - experiencing dissatisfying meal

Dietitian: How do you feel after your lunch?

Client: 'Virtuous!..and bored..... but Virtuous!'

Feeling - conflicted: proud of effort
but unstimulated and dissatisfied

Dietitian: '.......Righto - makes sense - you've chosen something 'good' but it hasn't been tasty. What happens next?'

Client: 'Well, this is when it starts to get tricky. I've been so good till now but about 2pm the bikkie bin starts calling my name. It drives me nuts. "Don't do it stupid - you know where this all ends!" I say to myself. I keep myself distracted but eventually it cracks me. I start with one, then two,  then well ...... it's just miserable 'I've blown it' I think to thing I'm out of control....bikkie bin on my lap, in front of the computer'

Doing - resisting, distracting, then eating rapidly likely in
large quantities in front of computer, disembodied eating

Feeling - Self critical, miserable, tempted, overwhelmed
Thinking - Harsh, self- critical, demotivated
 'Abstinence-Violation Thinking'

Dietitian: 'Ahhh gee that sounds tough.  I get the sense that some of that dis-ease is with you just now, as you talk about it with me?' 

Client: 'Yeah It's the pits. I really don't know what to do about all of this. I feel foolish telling you too. Like you're thinking 'just don't eat the biscuits you idiot'.. 

Doing - contacting present moment experience (introspection)
Thinking - (Projecting her thoughts onto Dietitian) 
Harsh, self -critical

Feeling - somewhat hopeless, lost, foolish

Dietitian: 'Wow it gets you so tough on yourself this thinking! I can hear how hopeless this situation leaves you feeling. You've really helped me to understand what happens for you - the way you've described it all - and I think there's lots we can do here together to understand more clearly what goes on and find a way through it all.'

Client: 'well.......OK - .....I guess it's good to hear I'm not a lost cause'

Doing -  contemplating
Feeling - tentatively hopeful

For those of you new to data collection for assessing the experience of eating and eating behaviours, an Eating Awareness Journal can be an excellent starting point to grease the wheels of thinking this way. Dr Rick Kausman provides great template on his website You can access the journal directly Here. To do this you need to sign up to his mail list - I highly recommend ALL of Rick's mail outs.

The soundtrack for this issue is the beautifully haunting 'Say Something' by A Great Big World. It leans right into the need we have has humans to connect by speaking. Definitely a little sentimental for the type of talking we have explored in Issue 9, it is still a lovely invitation to close your eyes for a couple of minutes and enjoy Here.

Issue 9 Pavestone: Tuning into Our Clients' Verbal Messages

Nutrition is a science. Eating is a behaviour.

Behaviour change is difficult.

Active Listening is a fundamental skill, core to the process of understanding our client's experience, inviting their trust and building the helping alliance

Active Listening is only possible when we truly attend to our clients. Attending may be thought of as our 'whole-hearted' attention

When we attend to our clients we pay attention to both their verbal and non-verbal messages, our own embodied resonances and our thinking processes.

Verbal messages can be considered as describing 'thinking', 'doing' and 'feeling' data.

For a fully 'coloured-in' picture of our client's eating experience we need to evoke and attend to verbal messages that describe not just 'doing' but 'thinking' and 'feeling' around food and eating


Suggestions for Reflection

How did my training influence the content I habitually focus on in my clients' verbal messages?

How has my work experience broadened my focus and what influence has this had on my capacity to develop working alliances with my clients?

What content areas remain challenging for me to attend to in my clients' verbal messages? How could I develop my confidence in these areas?


I'd love to hear your thoughts, curiosities, insights. Please email me to let me know.

Enjoy experimenting!
Keep reflecting!

Archives of Previous Newsletters

Full collection Issues 1-8 available HERE

Dr Anita Johnston
I was so fortunate to meet Dr Anita Johnston at the EATFED Conference this month. 
Dr Johnston is the Clinical Director and Founder of the Ai Pono Maui Treatment Centre for Eating Disorders in Hawaii, Clinical Psychologist, International Speaker, Trainer and Story Teller. Her work on the metaphors of eating is a perfect match for this newsletter issue.
Anita is one of a kind. Her passion and mastery of her subject material left me inspired to be the best practitioner I can be. If you ever get the chance to hear her speak - DO IT! Her website is full of great information and links to her book "Eating by The Light of the Moon' . Have a look Here

New Book on Understanding Disordered Eating
Evonne Englezos and Sue Paton Directors of the EATFED Program in Sydney have launched their new book on understanding disordered eating 'To Eat or Not To Eat'. You can purchase the book and learn more about their innovative IOP program on their website HERE
Feeling a bit overwhelmed?
Ever thought about Supervision? ..........or up-skilling with some counselling skills training?
One of the most effective ways to enhance your learning and adoption of new skills is to receive supervision/mentoring for your work. If you would like to learn more about this you are welcome to have a look at my my service. Why not consider sharing supervision with a colleague and practice together between sessions?
Don't forget to consider my training - registrations close September 9 for this round.
About Tara MacGregor
Tara MacGregor is a dual qualified Accredited Practising Dietitian and Counsellor & Psychotherapist in private practice. Graduating from Sydney University in 1991 she has worked in a broad spectrum of clinical areas in public and private hospitals until specialising in disordered eating in 2004. Tara works exclusively in the non-diet paradigm and is passionate about teaching and promoting the Health At Every Size (R) philosophy. Tara provides skills training and mentoring in the form of clinical supervision for Dietitians and enjoys tremendously the exciting opportunities, insights and growth this offers both herself and supervisees.

Make an enquiry about supervision and mentoring with Tara

Make an enquiry about supervision and mentoring with Tara

Tara MacGregor PACFA Reg. 21520 BSc MSc H.Nut & Diet. G.Dip Couns

Counsellor & Psychotherapist Accredited Practising Dietitian

Suite 3, 780a Pacific Highway Gordon NSW 2072
M 0459 991 788
Copyright © 2014 Tara MacGregor, All rights reserved.

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