Dale Johnson: This week on the podcast, I have with me Hannah Carter. She serves as the executive administrative assistant to the provost at the Southern Baptist Theological Seminary, and as an adjunct instructor of biblical counseling at Boise College in Louisville, Kentucky. She received a Master of Divinity from Southern Seminary and has been counseling and discipling women for over thirteen years. Hannah has been a certified member of ACBC since 2011. Prior to coming to Louisville, Kentucky, she served as a missionary to an unreached people group in Central Asia for nearly five years. Hannah, it is so good to have you on the podcast today and to talk about a really tough topic. And so, I’m looking forward to the discussion. So, welcome to the podcast.
Hannah Carter: Thank you. It’s great to be here today, thanks.
Dale Johnson: Now we’re talking about this issue of eating disorders. And this is certainly a problem, and it seems to have a cycle where it grows in popularity or dominance within a culture, and then it sort of takes a backseat to maybe other issues, and then it comes out again. We see this obviously a lot with young teen girls, but it’s not exclusive to young teen girls. So, we want to approach this today, if we can. The Bible speaks a lot about eating in and of itself, and so the Bible is not blinded to how we should think about eating and how we should approach this issue of eating. I want to start with maybe describing a little bit about what the Bible describes relative to eating: How we are called to eat? What’s our purpose in eating? What are some of the things that can go wrong, even as we think about that purpose that God has given us in the Word?
Hannah Carter: Yeah. So, as we think about different passages in Scripture, in 1 Corinthians 10 and then in 2 Timothy, we learn that God calls us to eat for His glory. But we also eat because we need nourishment, and He’s provided those essential nutrients on Earth for us to have. It also expresses that we are dependent people. We are dependent on food and God has provided us food, so that we can be sustained and have strength—not only to just live, but to serve His church and His kingdom. And so food is really important. God also calls us to eat in moderation and to hold closely to just taking pleasure in the good things that He’s given us.
Dale Johnson: Man, I love that. I love the way you frame it. First, we have to talk about, you know, what I call a theological idea. We start with what God intends for a given thing, like food. And food in and of itself is a good thing. He’s given it to us to sustain ourselves. There’s not a whole lot more mundane thing that we do, maybe rather than walking, sleeping, or breathing, that we do besides eating. Eating is very mundane, yet the Scriptures tell us that we’re to eat to the glory of God. We’re to give ourselves in seeking nourishment and eating, for the glory of the Lord. And if we think about it, the way you just framed it, we’re not starting with the problem itself, we’re starting with God’s purpose of it. And that really helps us to frame what we can see going wrong, when we don’t glorify God in our eating. So, I want you to start talking about what are some of the particular things that go wrong when we’re not eating for the glory of God, or not eating for the purpose of nourishment. We’re not self-controlled in our eating. A lot of people, obviously, think about anorexia or bulimia, but we also have the issue of obesity. So, we got problems on both ends of the spectrum here. So, I want you to explore some of these things that can go wrong when we don’t think about eating to the glory of God.
Hannah Carter: Yes. So, food, like many other things in our life, can be used as a vehicle to sort out problems of life. We can either turn to it, or we turn away from it to deal with pressures and difficulties. And when we’re not eating as God has called us to in an ordered way, it becomes disordered. We’re disordered in thinking we need to have a certain appearance, or we need to restrict certain foods, or we need to eat enough to be comforted. And so, that’s when you start seeing the overly restrictive type-eating which our culture deems as anorexia. And then, you have others that are unrestrained eating, which is more bulimia, or binge-eating, kind of gluttony-type eating disorders. Again, these are disordered ways of eating, but it’s not a disease per se. It is a disordered way of thinking about yourself, thinking about food, thinking about God and His provision. And so, therefore, as we’re trying to deal from our heart, with all problems in the world, we are looking at food in particular, in the way we’re taking it in, or needing to control, and so forth. And it can get difficult. And so that’s why we’re seeing all these common problems. And actually, since COVID, I think there’s been an uptick in a lot of what I’m seeing and hearing from the teenage side, and so forth, struggling in this area.
Dale Johnson: Now, I like the way you frame it to describe these problems as disorders, and we would say—yes, there are disorders in the patterns of our eating and the choices that we make relative to eating, and certainly the consequences that has. But in order to understand something as a disorder, we have to have an orderly way of thinking, and that’s why we framed it the way that we did, right? So, we start with God’s order, process, and purpose for eating. And then, we think about it in terms of now, we can frame what we see as being disorders from that. The reason that’s important—and I want our listeners to pay attention to how Hannah’s framing is—The reason that’s critical is because you will miss-associate the problem, if you start there. You will miss-define the problem, if you start there. You have to frame it first in: What does God say is orderly? Okay, now let’s consider what we can see and observe with our eyes as being a disorder, of how we should approach this issue of eating. But you mentioned that there are common problems. And we talked about the spectrum of what that could look like in the lack of self-control or being unbelievably controlled and, you know, not eating for the purpose of nourishment. We can see all kinds of health effect that come with those types of things. But there are some common denominators here, Hannah. So, what I want you to do is help us to see what are some of those things that these types of sinful responses to eating have in common?
Hannah Carter: Yeah, so with those struggling with—and I’ll just use the familiar terms—the anorexia, or bulimia and binge-eating are all having a common understanding of needing to control their food or weight. There’s also another common denominator of just taking extreme measures to control that weight. Sometimes it’s obsessing over-exercise, because they know they need to eat, or they’re being told to eat, but they don’t want to keep that weight on. And then for bulimia, they’ll eat a lot but then in order to control it, they’ll purge. And then, also with these different eating disorders, there are complicating factors. Some will turn to cutting as another way of releasing difficulties in their life. Some will also maybe take some medication. And all of them have been struggling with fear, that I’ve counseled. And so there are multiple things that also complicate, not just the physical eating part of what’s going on in all that. And again, there’s a common skewed view about themselves, about food, about portions, about their body, and even about God, and how He is and their relationship with Him. Or if they don’t have a relationship with Him, then in their own understanding of who He is, in the mist of all that.
Dale Johnson: Yeah, well said. I think, you know, the commonality that we see here is it points to the story the Bible describes—Which is that there are roots of sin and desire on the inside. But then, they manifest themselves in a lot of different ways, like where we were talking about the lack of self-control in the aspect of obesity. Or you know, the overindulgence in self-control, trying to control every aspect, relative to exercise, intake, and that sort of thing. Now, some of this can sound overwhelming to people, right? You described some complicating factors. You described a little bit about some of the consequences relative to a person’s health. And often times we may not find out about these eating disorders until there are some sort of visible consequences that are happening. So, this can be scary to people when they see a need, and they want to help, but they’re hearing all these things. They don’t know what to do. But where do we begin, when we approach someone who’s struggling with issues like this? And listen, I don’t want to make too much of, “Oh, this is so hard on the counselor”, what this person is going through. Their life (of the counselee) is really, really difficult. But there are some things that we as counselors need to sort out in order to help them. Well, so how do you start counseling when someone who comes to you with, with these types of issues with eating?
Hannah Carter: Usually, I’ll have a form that they’ve completed and it gives me some information. And so if I’ve noticed that’s been a struggle in the past or currently a struggle, I will honestly treat it like no other counselee. I will treat them the same. In a sense of, I’m still gathering all the information that I can from the past, present, future, and ongoing things that they’re dealing with. I’m really trying to grasp an understanding of their perspective on what’s going on, how they kind of got there, different things in their life that had kind of maybe contributed to where they’re at. I’m learning also, how they’re interpreting things. Again, I’m not giving counsel just yet. I’m really grabbing all that I can from them. Because what I’m doing is showing compassion. I’m showing that I want to gain their trust. I’m showing that I don’t know them well, and I need to know them well in order to give them help. And so, again, I’m not coming with a presumption, but really hearing them, because with every person that I’ve counseled, this particular problem has been different. They’ve come from different angles. They’ve come from different paths. And so, therefore, their thoughts, and their beliefs about those things are different, and you want to help individually with those things.
Again, just thinking through, in showing compassion and care, I’m remembering that it is difficult at times. I think even parents and friends that may relate with this counselee in particular maybe get angry in dealing with a problem like eating and being restrictive. Or there’s a shame there, there’s a stubbornness, there’s resistant to hear truth, there’s fear—I’m trying to draw it all out, as Proverbs says, “A man of understanding will draw another person out.” And so I’m trying to get it out, but also not respond in anger or stubbornness back, but really trying to be patient with them. Another big thing that I also try to learn is what immediate thing needs to be dealt with. So, in a sense: Are they seeing a doctor right now? Or where are they at with their weight? Are they kind of on the edge? Or have they just come from a treatment facility? Or do they need to go to the hospital? Like there are all kinds of ranges, and you want to know what’s going on there, in order to really help from that, if they’re cutting, along with some of those things. Again, I’m going to deal with that as I see with wisdom and so forth. If it’s very serious, you never want to play around with it. And you do, we do need to utilize the hospital and doctors in this area, and your area to help with that.
But the next thing, I’ll also do is try to listen to their heart, try to understand their thoughts and beliefs going on. So you’re getting a doctor. You’re helping from the physical side, but you’re also trying to get down to the heart. A lot of times I will hear from someone struggling that they’re just wanting control, but I don’t just take it out what they’re saying at face value, because often control has different forms there. And so, I’ll ask them all: What would the control give you? Why is that so important to you? Sometimes counselees are coming from a difficult background in their life, or in their home life there are difficult things going on, and so they’re just alone. They’re wanting to be loved. They’re wanting to be seen. And so maybe they’re wanting love in a deeper way. And so on the outside, it looks like control. So therefore, they’re not necessarily just wanting control, they’re using control to get to being loved and to belong. Yeah, so you just want to kind of break those things down for them, to help them to see that.
And lastly, you’re giving them hope—you cannot do this enough. The Lord God is the God of all hope. And so we need to repeatedly and consistently teach the counselees that are dealing with eating to have hope, and help them know that change is possible. So, I’ll at some point in our counseling time talk through: What does that look like? And really get very specific there, because ultimately I’m not just trying to help them learn how to eat better and eat for the glory of God. I want them to have a deep relationship with the Lord, and that’s what my end goal is: That they will not just live for the Lord, but live with Him, and know Him, and treasure Him above all things.
Dale Johnson: Yeah, I love that, Hannah. And we’re running a little low on time, but I want to highlight several things that you said in this last answer, and I want to ask you to come back. I think it will be good for us to continue this discussion because obviously, there’s a whole lot to say in this particular area. I really appreciate the way that you nuance on some of this in the final answer that you gave. I want to highlight three particular things that I think were really important. The first thing is the pace—sometimes we need to slow down, and you’re gathering information. There’s very important information. I describe this to my students sort of similar to what you were doing. Although you have a blanket issue like an eating disorder, anxiety, or whatever the case might be—every person that walks in the door that has that particular issue, it’s not exactly the same. It never presents exactly the same. Yes, underlying issues are very similar, but each person presents distinct variables that brought them to this particular place, at this particular time. And when you’re generic in the way that you understand something, in how you gather data, and how you understand the person, then you’re going to give generic counsel. And that will rarely be received well. So, if we can understand the variables, Then I’m using the language that’s very appropriate to their life. And I’m taking very appropriate passages and applying that to the language that has built the variables in their life, that’s brought them into the room at this particular time. That’s a critical step, and I think you explain that part very, very well.
The other thing that I would mention is the way you described triage. You’re triaging to say, “okay, like what brought them to me today? Did they just come out of a treatment facility?” Well, okay, I need to approach them in sort of maintenance, ‘Let’s make sure that we’re moving in a good direction’ way. Maybe, as I’ve had encounters with young ladies, they were brought to me by referral from a physician who is very concerned about where they were. And we were sort of in an emergency type state. We needed to get help very very quickly. And what are we going to do here? So you need to triage to see: Where are they? What’s appropriate right now? We can talk about a long-term plan, but you have to triage, sort of, where they are: What are the presenting factors? What does their health look? Like, are they seeing some of the consequences? Very wise, all the things that you described. So I want you to, if you will, come back and let’s chat about this a little bit more, on this issue of eating disorders. Because again, there’s so much for us to talk about. Maybe we can continue this discussion on how we approach these types of problems, as we move through the counseling process, now that we have a good understanding of how we would approach it on the front end. So, Hannah, thanks for being with me today, and I look forward to maybe discussing this with you in the future.
Hannah Carter: Thank you. I’ll be glad to.
