A food allergy can turn ordinary moments into high-stakes calculations, and the hard part is not always the ingredient. We sit down with Dr Amanda Whitehouse, a licensed psychologist and founder of The Food Allergy Psychologist, to unpack the psychological impact of food allergies on children, parents, and adults who are trying to live safely without shrinking their lives.
We talk about why food allergy anxiety so often gets misunderstood: the very behaviours that keep you safe (label checking, questioning restaurants, advocating at school) can look like “overreacting” to anyone who does not grasp the real-world gaps in labelling and food environments. Amanda explains how chronic fear and hypervigilance build over time, how trauma can come from more than just a severe reaction, and why vicarious trauma can keep the nervous system on constant alert.
From there we get practical, using a nervous system lens to make sense of vagus nerve signalling, stress responses, and why classic mindfulness advice can feel impossible when the body believes danger is near. We also explore the mental health side of oral immunotherapy and other emerging treatments: choice can be calming, but the process can trigger deep fear, guilt, and shame if families are not supported properly.
If you care about food allergy mental health, multidisciplinary care, and evidence-informed ways to feel safer in your own body, this conversation is for you. Subscribe, share with someone who needs it, and leave a review with your biggest takeaway.
Guest Biography
Dr Amanda Whitehouse is a licensed psychologist, food allergy anxiety and trauma specialist, speaker, author, and founder of The Food Allergy Psychologist.
Drawing on both professional expertise and personal experience as a food allergy parent, Amanda has spent more than 14 years helping individuals and families navigate the psychological challenges that accompany food allergy management.
She specialises in trauma-informed care, nervous system regulation, anxiety treatment, and supporting patients through food allergy therapies such as Oral Immunotherapy (OIT).
Amanda is also host of the popular Don't Feed the Fear podcast and author of From Fear to Freedom: A Guide for Navigating Allergy Immunotherapy.
Links
- Website: https://www.thefoodallergypsychologist.com
- LinkedIn: https://www.linkedin.com/in/amanda-desio-whitehouse-phd-4661a0357/
- Podcast: https://www.thefoodallergypsychologist.com/podcast
- Book: https://www.amazon.com/s?k=From+Fear+to+Freedom+A+Guide+for+Navigating+Allergy+Immunotherapy+Amanda+Whitehouse
Subscribe on Substack
Voices in Health and Wellness is published on Substack, as part of The Diagnostician. Every episode lands there with written notes and reflections you won't find in the podcast feed. Free to subscribe.
👉 https://thediagnostician.substack.com/s/voices-in-health-and-wellness
About the podcast
Voices in Health and Wellness features conversations at the intersection of medicine, lifestyle, and human potential, with clinicians, scientists, and thinkers shaping the future of care.
About Dr Andrew Greenland
UK-based medical doctor and founder of Greenland Medical, specialising in Integrative and Functional Medicine. Trained in both conventional and root-cause approaches, Andrew helps people optimise health, performance, and longevity, with a focus on cognitive resilience and healthy ageing.
Listen
Watch
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr Andrew Greenland (00:00):
Welcome back to Voices in Health and
Wellness.
I'm Dr.
Andrew Greenland, and today'sconversation is one I'm
genuinely looking forward tobecause we're exploring a side
of healthcare that often getsoverlooked: the psychological
impact of food allergies.
Joining me today is Dr.
Amanda Whitehouse, a licensedpsychologist, founder of the
Food Allergy Psychologist, hostof the Don't Feed the Fear
(00:20):
podcast, and an expert in foodallergy, anxiety, trauma, and
nervous system regulation.
Amanda has spent more than adecade helping individuals and
families navigate the emotionalburden that comes with food
allergies, something thataffects far more than just
physical health.
So with that, Amanda, I'd loveto welcome you to the show and
thank you very much for joiningus.
Dr Amanda Whitehouse (00:39):
Thank you so much for having me and making
space for such an importantconversation.
Dr Andrew Greenland (00:43):
Well, I'm really looking really looking
forward to it.
So for listeners meeting youfor the first time, can you
share a little bit about yourbackground and what led you into
specializing in food allergypsychology?
Dr Amanda Whitehouse (00:53):
Sure.
So I was a psychologist firstbefore I became a mom, but
showing up in this space, I'malways a food allergy mom first
and foremost.
I can't remove that from anyaspect of who I am or how I
operate in the world.
So I have three kiddos, and myfirst, the oldest who's a teen
now, is the one who has foodallergies.
And I was very early in mypractice when I started managing
(01:14):
that and learning a lot ofthings very quickly and
connecting to a lot of peoplewho were also managing the same
things.
I didn't really have anyintention of making that my
specialization, but it becameclear to me very quickly how
many people, when they found outI was a psychologist, were
asking for support.
And my practice just grew intothat very quickly and filled and
stayed filled for years beforeI started the podcast.
(01:36):
I never even had a website orsocial media, did any marketing
because unfortunately there wasalways a long line of people
more than I could help, whichwas why I decided decided to
start my podcast and to try todo some more work to reach more
than just the people that Icould see individually in my
practice.
Dr Andrew Greenland (01:52):
Fantastic.
So did you set up the practiceand then realize you had a
massive demand?
Or how did you find out aboutthis kind of unmet need out
there?
I'm just really curious.
Dr Amanda Whitehouse (02:01):
Right.
It was it all kind of happenedat the same time, but not
intentionally.
So I was just establishing mypractice at the same time that
we were adjusting.
And so through word of mouth inthe community and being
connected to our local allergyadvocacy group, so many other
parents that I was meeting atthose events were coming to me,
asking for support, spreadingthe word to other moms.
(02:23):
And so then in the community,that just kind of became known
what I was doing.
And so as I said, I neverreally needed to advertise or
make it official, but that'skind of how I became known here
in our community.
And, you know, I would getpeople would spread the word
outside of our area that Iwasn't able to work with because
I'm only licensed here in mystate of New York in the US.
(02:44):
And so it became clear whenpeople were finding me from that
far away, without me puttingthe word out at all about what I
was doing, that there reallywere people searching and
looking for support that thatjust isn't out there.
Dr Andrew Greenland (02:58):
So do you um feel that patients were being
medically supported butemotionally overlooked or not
even medically properlysupported with this?
Dr Amanda Whitehouse (03:06):
Oh, I think there's a wide range
within food allergy, honestly.
Um, you know, we had I'vetalked publicly about some of
our amazing experiences and thensome of our really
disappointing experiences.
And I think this is probablytrue in a lot of areas, but you
have to learn so much so quicklyas a patient.
Um, I think the recognition ofthe emotional support comes
(03:27):
afterward because in thebeginning it's such an emergency
situation of figuring out howto safely feed yourself or your
child.
Um, and else I don't want tomake a broad statement because I
have met so many amazingallergists who I know are giving
really good care.
Um, but I'll talk personally,you know, my first experience
with my first allergist, one ofthe first things she said in the
appointment was factually justincorrect information that I had
(03:51):
just read from a reliablesource.
And so I started things out ina very shaky position in terms
of feeling that I did need tolearn everything and question
the medical support that I wasgetting.
So I think it is out there, andI think it also does take an
educated patient and consumer tolearn to distinguish the
(04:11):
difference because unfortunatelythere are the support isn't
always going to be there or theinformation isn't always gonna
be the best.
But if you're connected andinformed, hopefully you'll find
the good ones who are out there,and there are so many.
Um, and and I don't think it'sfair to expect our providers to
have to provide the emotionalsupport too.
(04:31):
That's not what they're trainedin, they're not trauma
providers, you know, um, and yetthe need is there.
So I would say that yes,there's there's really a need
for the emotional support thatmost of the patients that I have
worked with were not getting.
And the system is not set upfor that.
So that's not on the providers.
That's a lot of work that weneed to do in terms of
establishing connectivity andmultidisciplinary approaches to
(04:54):
identifying and supportingpeople from all angles.
Dr Andrew Greenland (04:58):
Thank you.
Really helpful context.
So, one thing that stood out tome from our earlier
conversation was that yourpractice has essentially stayed
full for 14 years withoutadvertising.
That says, you know, by itself,there's a massive demand for
this.
So, why do you think, you know,all these years that you've
been doing it, it still remainsundisturbed and has been for so
long?
Dr Amanda Whitehouse (05:18):
I think there are probably a lot of
things that go into that.
The most obvious is that duringthe time that I was doing that,
we know the data on foodallergies is that they were just
exploding.
You know, I had my son duringthe time just on the cusp of us
learning that early introductioncan help to reduce the
prevalence of food allergies.
So there were so many kidsduring that phase when they were
(05:38):
we were still being told toavoid the number of allergies,
food allergies was increasing,the multiple food allergies
versus just single foodallergies was increasing during
that time.
And so I think that's probablyone of the biggest factors.
It's just there were more andmore people.
Um, and I think what makes itdifficult is that without really
(05:59):
specific either personalexperience or some introduction,
other than just applying ourpsychological principles and
mental health approaches to foodallergies, it can be really
easy to miss the mark on whatkind of support is actually
needed.
And so, really, really greatproviders who are wonderful at
their cognitive behavioraltechniques can unfortunately not
(06:24):
fully understand the severityof food allergies or still be
susceptible to themisinformation that's out there
or just the lack of informationthat's out there about food
allergies.
And then that shows up in thesession.
So I've had a lot of clientscome to me after working with
other providers, even some thatI know personally who, again,
are really great providers.
But the concept of a lot of thework that we do in therapy is
(06:45):
challenging our thoughts,challenging how we're
approaching things in a waythat's not helpful.
And to sit down a child or aparent who's been diagnosed with
a life-threatening conditionthat can genuinely cause them
significant harm or even deathin extreme cases.
And to challenge that andwhether they're being too
restrictive or whether theyshouldn't be so careful can be
(07:05):
dangerous for them in terms oftheir management and obviously
makes it difficult to buildtrust with them and a sense of
safety in the therapeuticrelationship if you don't
understand the extent to whichpeople actually have to go to
live safely with their foodallergies.
So I think part of that isgetting the information out
outside of our community aboutfood allergies and how severe
(07:28):
they really are.
People still don't understandthat, at least here in the US,
our labeling is still not great.
We still don't have restaurantmenu labeling laws.
We have to do so many thingsthat from the outside look like
anxious behaviors and can easilycross into anxious behaviors
that really, though, areactually just safe management of
the food allergy.
Dr Andrew Greenland (07:49):
Thank you, and touching on that a little
bit more.
I think many people outsidethis world fear hear food
allergy and think primarilyabout physical safety.
But psychologically, what arefamilies actually living with
day to day?
And you've kind of touched onthis a bit already, but I just
want to delve into it a bitmore.
Dr Amanda Whitehouse (08:04):
Right.
It touches on absolutely everypart of life.
So people outside, as you said,think it's just about safety
and it's just about what youeat.
But food is a part of allaspects of our society.
It's how we celebrate, it's howwe mourn, it's how we express
love and affection and support.
And those um ways ofintegrating food to everything
(08:25):
then affect us in every way oflife.
So it affects us at school, itaffects us at work.
Um, when we want to take atrip, when we want a vacation or
do social things, when peoplecome to the point in their life
where they're dating.
Um, you know, I work with somany people in their teen and
young adult years.
The first thing they want totell a prospective date is not,
I can't go here, I can't eatthis, you can't eat this, we or
(08:48):
we can't kiss.
That completely changes thedynamic in relationships.
And that's true, you know, ifI'll speak for myself as a
parent.
I was a brand new parent when Iwas learning all of this.
And I had a great group offriends who are also becoming
new moms too.
None of them had a child withfood allergies, and it very
quickly eroded kind of thatcommunity that I had been able
(09:10):
to build with them because I hadsuch different needs that I
didn't understand yet.
I didn't know how tocommunicate to them.
So of course they couldn'tunderstand what I needed.
Um, and I think that's true inevery scenario, every example we
could give of relationshipdynamics or life experiences,
those things creep in and havean effect that other people
don't see.
Dr Andrew Greenland (09:29):
Thank you.
So, how much chronic fear andhypervigilance do you typically
see in parents and children?
And are you encountering manythat are stuck in this constant
fight or flight state because ofall of this?
Dr Amanda Whitehous (09:40):
Absolutely.
I think the most crucial partfor me in kind of figuring out
how to do this work, becausethere's no framework for it,
there are other people out theredoing it too, but we all kind
of have been figuring out asfiguring it out as we go until
somewhere research just recentlyhas been done.
Um but for me, discovering andlearning about the nervous
system piece was the key tohelping people to get unstuck.
(10:02):
And we talk in terms that arevery black and white about the
nervous system, like you'restuck, you need a reset, you
know.
Um, and it it's not thatsimple, but people really do
develop patterns.
And the more you have to repeata behavior, or the more a
certain topic permeates variousaspects of your life, like we
just talked about, the moreentrenched that pattern becomes.
(10:24):
And it's um it is anxiety, itoften is trauma, and yet it is
logical and it is adaptive basedon the experiences that people
have.
So people come to me feelingreally stuck knowing that they
are too anxious or that it isproblematic, or they're
restricting themselvesthemselves or their child more
(10:45):
than necessary.
And it's this negativeperspective on I'm such a mess,
I'm so anxious.
And I think it's reallyimportant for people to
understand how the nervoussystem works and why it has
developed those responses inorder to work with it and give
it the safety that it needs inorder to move out of that fight
or flight state and be able tofunction in a different way, in
(11:06):
a more balanced way.
Dr Andrew Greenland (11:08):
So, really interesting hearing about your
nervous system lens, which youapproach this through.
So, how um how do traumaticallergy experiences affect the
nervous system in the long term?
Dr Amanda Whitehouse (11:18):
They are so impactful, um, and there's so
much that I think it'simportant for people to
understand about trauma, way toomuch for us to share here.
But um, one of the things thatI think is really important for
people from the outside is tounderstand that trauma is not
just having a dangerousreaction.
(11:39):
You don't have to have alife-threatening rush to the
emergency room and the ambulancereaction to be traumatized.
Um, certainly that can be aterrifying experience for any
parent or patient or child.
Um, but we also have vicarioustrauma by hearing about those
experiences.
We hear from the families whohave lost their loved ones.
(12:02):
They died after an allergicreaction.
That's traumatizing when youknow that you manage the same
thing that resulted in the deathof that person.
Um, when we perceive that weare in danger or have been in
danger, even if it wasn'tfactual or wasn't directly
happening to us, the nervoussystem will still register that
as something that we need to beprotective of.
(12:23):
So the more experiences we havelike that, the more uh
consistent the messages that thenervous system receives that I
need to be on alert.
Here are the things that I needto look out for.
So every time we have one ofthose experiences from the big,
huge, traumatic, scary ones tothe friend that we met that, you
know, the label was wrong onthis food, and they had a
(12:45):
reaction at a restaurant, andmaybe they used their epi and
they were okay, but our nervoussystem logs that as information
and as something that we need tolook out for in the future.
So we have this data bank andall of these little touch points
that are associated with itthat can be so individualized to
each person of what are thesignals of danger, what is my
nervous system looking out for?
(13:06):
And then that keeps the nervoussystem in this state of trying
to always scan and take in allthat information to predict
every possible uh danger thatcould happen to us.
And it's as we discussed, it'severywhere, it's all the time,
it's every scenario.
So for people who are livingwith that, it becomes very
difficult for them to find awindow where that can turn off,
(13:29):
where there aren't then anypieces of information coming in
from the environment that areindicating a possible risk where
they can shift out of thatfight or flight and what we call
call rest and digest.
Um it's no coincidence, right?
We're dealing with foodallergies, and the the natural
restorative state of the body isrest and digesting, digesting
(13:50):
our food, taking nourishment andreplenishing the body.
And um we may not find manypockets of time where we feel
safe to do that.
So it it we don't have anequivalent system that searches
for safety, that looks for um,you know, indications in the
environment that we are safe.
We really have a system that'sum primed to be defensive and to
(14:14):
be vigilant and proactive.
So, in order to do that andcounteract that, we have to make
it a very conscious process anda very aware process that's
intentional instead of thenervous system, which is going
to do its thing automaticallywithout us telling it to do
that.
Dr Andrew Greenland (14:28):
Got it.
Thank you.
And what about the vagus nerveregulation and mindfulness?
How do they kind of fit intorecovery?
Dr Amanda Whitehouse (14:35):
Great question.
I love teaching people aboutthe vagus nerve and the role
that it has where we keeplearning so much more.
Um, but basically, the vagusnerve is the line of
communication between thescanning for information that we
do all comes in through thesenses to the nervous system
through the vagus nerve.
(14:56):
And so the brain is thencommunicating with the vagus
nerve.
Um, I think this the statisticsare about five times every
second, is how often the brainand the vagus nerve are going
back and forth asking, Am Istill safe?
And the vagus nerve assessingthe information that's coming in
through the sensory organs anddetermining if they're safe.
If the vagus nerve picks up onsomething that indicates
possible danger, then it sendsthat signal to the brain that
(15:18):
it's time to shift modes.
And then the vagus nerve passesdown into the body and
communicates with all of thevital organs and all of the
systems that then would prepareus for danger.
So that's what triggers all ofthe fight or flight or anxiety
symptoms that we know (15:33):
the racing heart, the sweating, the
body temperature increase, theuh trembling and the adrenaline
that rushes through our body.
And what people often don'trecognize is what all these
things are being turned on to gointo emergency mode.
There are also things beingturned down in order to preserve
resources.
So, number one is ourdigestion.
(15:54):
And so we are not going todigest our food in an emergency.
Number two is the communicationwith the prefrontal cortex,
which is the area of the brainwhere we do our rational
thinking and our logical problemsolving, all the things that
help us to be calm and make gooddecisions, information-informed
decisions, their blood flow tothat area is literally
(16:16):
restricted during times thatwe're in fight or flight.
So we really are hard onourselves about how we shift
into these modes and can't calmdown.
I can't do mindfulness, I can'tsit and meditate.
My body just won't let me.
And we really have to, I think,sometimes understand the
processes at hand in order toaccess that because everybody
(16:38):
thinks that you're in danger.
And I tell you to sit quietlyand close your eyes and breathe
and not to think any anxiousthoughts, that's going to make
the body feel even less safe.
It's going to make it feel likeit needs to be more protective,
that the danger is not beingrecognized or understood by the
people around it, and then thatit has to amp up even more in
(16:59):
order to be protective.
So accessing mindfulness can bereally difficult.
And I think it starts with thateducational piece and working
with your body where it's at anawareness, not just trying to
force calm, because forcinganything does not create a sense
of safety.
Dr Andrew Greenland (17:14):
Thank you.
So what does a I know there'sgoing to be no typical patient
and every patient is unique intheir way, but what does a
patient journey look like?
Someone who's coming to seeyou, how does it all map out in
terms of what you your approachand how you deliver and work
with a client and how long doesit take?
Like those kind of things.
Dr Amanda Whitehouse (17:31):
Good question.
And you're right, it can varyso much.
But I would say if I had topick the typical, um, it's a lot
of parents bringing theirchildren in when they recognize
that there's a problem.
So that's not to say thatadults with food allergies are
not struggling too, but a lot ofus as adults and as parents
know that we don't put ourselvesfirst.
We we deal with things and wecope longer than we should, but
parents are putting theirchildren first and I think
(17:54):
better able to recognize andprioritize seeking help.
And it's usually something veryspecific.
So following, unfortunately, Iworked with a lot of people
who've had really traumaticexperiences in a school setting
and a restaurant setting, areusually the two biggest examples
of that.
And then the child is showingvery specific withdrawal or
(18:16):
internalizing symptoms wherethey're not wanting to go
places, they don't want to go toschool anymore, they're
clinging to their parents, andall of a sudden they're having
that separation anxiety thatthey had once been through.
And sometimes it's reallyspecific.
It's often very specific tofood.
So the child no longer iseating their lunch at school and
they come home and the wholelunch is uneaten and they just
(18:38):
don't feel safe eating it atschool.
Usually they're not saying thatspecifically.
They're just saying thingslike, I wasn't hungry or I don't
want to go.
Um, and then sometimes it'sreally generalized and it's not
even clear that it's specific tofood or the food allergy.
But as we said, the brain canregister or the nervous system
can register almost anything asa cue of danger.
(18:58):
So it can be any other changeor shift that is not typical for
that child.
So for example, I've workedwith kids who um all of a sudden
didn't want to go visit grandmaanymore.
And grandma's one of theprimary caretakers, and she's
the one who helps to manage theallergy.
And it takes really goodlistening skills to get this out
of kids and get to the bottomof what might have happened to
(19:19):
cause those changes.
But I've seen that examplehappen several times where
either like they maybe saw a jarof peanut butter in grandma's
house and it's not usuallythere, and so suddenly they
didn't feel safe there, or youknow, a change that happened
there that they registered,sometimes not even really
consciously, that cued to them,I'm not safe in that setting, or
(19:39):
with that person or doing thatactivity anymore.
So usually parents noticeparents have a good gut instinct
when something is going on withtheir kiddo, and that's how
they show up to me.
And then we broaden it out sowidely from that specific
concern that they brought in.
Um, and you asked how long itusually takes, and that that can
be very different because it'svery complex.
(20:01):
It's not just the child'sanxiety that's being brought in
for support.
The parent is usually veryintertwined because, of course,
we as parents, no shame to anyother parent out there.
I live it too.
It's anxiety provoking for ustoo.
So a lot of times we have to doour own work in order for the
child to make a shift too.
Dr Andrew Greenland (20:21):
Got it.
This is a real family outing,isn't it, for the for the
obviously the sufferer as wellas the parents and the immediate
family.
Um you mentioned, um, I thinkin your upcoming book, focusing
on the mental in the mentalhealth impact of newer
treatments like oralimmunotherapy, which is a really
fascinating angle because mostconversations focus purely on
the clinical outcome.
What are the psychologicaldynamics that are um emerging
(20:44):
with treatments like oralimmunotherapy?
Dr Amanda Whitehouse (20:46):
Yeah, it is um a very there's a lot of
conflict internally with withfamilies who are being presented
with things and it can presentin a lot of ways.
We would think that it's allgood, right?
There are treatments.
There didn't used to be anytreatments out there, and it's
wonderful.
Choice and control are whatcalm the nervous system.
That's what makes us feelbetter when we're able to have
(21:08):
exert some control or influenceover our decisions.
We research shows that even ifwe don't choose the option, just
having the option improves ourmental health and our wellness.
Um, so you would think that allof these treatments that are
expanding now would be justhands down, not complicated, a
wonderful thing for food allergypatients and families.
(21:28):
However, it's not that simple,of course.
One is access.
You know, I was seeking thesetreatments 12 years ago or so
when they weren't widelyaccessible.
And so I was searching allover, trying to hunt down a
doctor and travel to get them.
It has improved, but it isstill the case that everyone
doesn't have access to this.
(21:49):
In the in the States, there isstill a significant shortage of
allergists, period.
So some people's food allergiesaren't even managed by
specialists, it's through theirprimary care doctor.
So to have someone Providingthese treatments, let alone
multiple ones.
If there's one that you wantand your doctor happens to
provide that one, you'reextremely lucky.
So some people, the conflict isI want to do this and I can't
(22:11):
get access to it.
It's not affordable.
It's too the distance is toofar.
Um, the investment of thetreatments emotionally and
time-wise is a lot too.
So it varies depending on whichoption is chosen, but that is a
really significant umcommitment that people have to
make if they're going to chooseone of those treatments.
(22:32):
And then all of that is kind ofjust still the practical part,
but the mental health side of itis I've been spending X amount
of years, however long that is,for the patient, making sure
that I don't ingest thisallergen, I don't come in
contact with it at all.
And now we have treatments thatrequire the exact opposite.
(22:52):
And as we talked about before,the logical, rational part of
the brain can be verydisconnected from the emotional
fight or flight part of thenervous system and brain.
And even when we know thatthese treatments are effective,
the thought of actually carryingforward with consuming the
allergen is a really, really bigshift to ask for people.
(23:13):
They can want it, they canunderstand it and believe it and
know that it's going to behelpful, and yet the nervous
system will have its responsewhen they're facing something
that has been so scary for themfor many years.
So it's a really complicateddecision-making process for
people.
And as we said before, there'snot a lot of support.
Where is the anxiety level?
(23:46):
How will that impact thetreatment?
But I think we need so muchmore of that.
And so that's why I decided towrite the book because I've
lived it.
And so it has a little bit ofthat.
It has my personal experience,but I've pulled in some really
amazing experts on the topic tohelp to compare the medical
information and options.
And then I gave some exercises.
Everybody's not going to beable to access a food allergy
(24:07):
psychologist, unfortunately.
So there are activities inthere to help people go through
this process, either on theirown or with a therapist who
might not be informed about thisarea, where they can work on
the decision-making process,better understand their
thoughts, address the nervoussystem response, and kind of
tease it out so that they canaccess something if they think
(24:29):
it's a good idea for them.
And the flip side of that isI'm not up here trying to tell
everybody to go out and getallergy treatment.
It might not be right foreverybody.
And I think there's a lot ofpressure and guilt and shame and
all of these difficult emotionsthat come along with every part
of food allergies.
And this is one of them.
So I know a lot of parents whohave not chosen treatment either
out of guilt or shame, orchosen treatment out of pressure
(24:51):
and guilt and shame.
And that is not a good place tomake a decision from, no matter
what the outcome is.
Dr Andrew Greenland (24:58):
Got it.
So what are the um prescribingpractitioners for these
therapies potentially missingwhen introducing these
therapies?
And what would you like them toknow or to take on board from
your experience?
Dr Amanda Whitehouse (25:08):
I would love, my dream would be for all
of them to have systems in placethat at least on a very simple
level are assessing and keepingan eye out for indicators that
people are already strugglingwith anxiety.
I've worked with a lot ofpeople who've pushed forward
with treatment and it didn't gowell because the anxiety was
underlying.
(25:29):
It can be hard to miss.
It's not going to show upprobably in a quick consult with
your allergist how many timesare the, or how many minutes are
they actually in the room withyou?
Um, we're very high-functioninganxious parents and patients.
We survive by having everythingtogether, following all the
rules, staying calm on theoutside when we are struggling
on the inside.
And that's how they look atappointments.
(25:50):
They don't always look likethey're an anxious mess.
The kiddo doesn't always looklike they're super scared and
you know, uncomfortable.
So I would love it if theycould all incorporate some form
of checking in on that andbaseline education for everybody
about what the process would befor any of the treatments in
(26:11):
terms of the social, emotional,mental health part of the
treatment, changing yourperspectives.
What are you committing to, andhow might that impact
relationships and familyroutines and your daily schedule
and things like that thateverybody might not be
thoroughly considering beforethey make the treat make the
treatment decisions?
Dr Andrew Greenland (26:30):
Thank you.
So one of the things thispodcast increasingly explores is
the reality of runninghealthcare practices and
supporting people emotionallyover the long term.
What have you learned over theyears about sustaining yourself
emotionally in this kind of workand avoiding burnout, which is
such a big thing at the momentfor people in this space?
Dr Amanda Whitehouse (26:47):
It is.
And it's tricky.
I I know obviously myperspective will be different
from a lot of your audiencebecause I'm in the mental health
field and not in the medicalfield, but I think there's
probably some similarity.
Um, and for me, really thetoughest part personally is that
I'm doing something every daywith people that touches on the
hardest thing that I've everdealt with in my life.
(27:08):
So I have to be really mindfulabout where I'm at with what's
going on in our family and in mylife and the toll that that's
taking.
Um, I love talking to peopleabout food allergies and helping
them with it.
But when my son has a bump inthe road or a blip in our
allergy management, that can bereally difficult.
And so for me, I have to workin some extra support and things
(27:30):
like that around it.
Luckily, we've been in a goodspot for quite a while.
He's been in maintenance ontreatments for all of his food
allergies for years now, whichwas when I finally felt like now
I have the bandwidth to startthe podcast and try to do some
more outreach because this isn'ttaking so much of me personally
anymore.
Um so for me in mental health,I think that's what it looks
(27:50):
like.
A lot of the people who aredoing work similar to mine also
have that personal experience.
And so I think that is whatmakes us really good at it and
can make it really hard for usthat we have to be mindful of.
Dr Andrew Greenland (28:02):
Thank you.
So thinking about the businessside of running your clinic,
because I think this is animportant thing that
practitioners will appreciate.
Um, you've been doing this fora while.
You've started you'veestablished a very important
niche.
What are the things that aregoing particularly well for you
from a business angle?
Dr Amanda Whitehouse (28:18):
Well, well for me, but not well for the
community that I care about, isthat allergies are still a huge
problem.
I think there is a mentalhealth crisis within the food
allergy community.
I do think awareness isimproving.
We're getting more research onthe topics, we have more options
that we've been talking about.
So what has helped my businessto thrive, unfortunately, is
(28:39):
that there was such a need.
And honestly, I hope I can beput out of business and retire
because we, you know, we don'thave these concerns anymore.
Um, but aside from just theneed that's there, I think in
mental health, really the valueof therapy is in connection and
it's in healing through thatrelationship that you have with
the provider, regardless of whatlens or approach they use.
(29:02):
And so being vulnerable enoughto bring my personal experience
into the room in an appropriateway, in a way that is always,
you know, considering what'ssupportive to the patient or the
client, not because I need totalk about my stress today.
Um, but being show showing upas a human with similar lived
experiences, I think really iswhat has helped my business and
(29:23):
some of the other work that I'vedone to grow because people
want to be seen.
People in the food allergyallergy community often don't
feel that they're understood,that their struggles are valid
or treated as valid by peoplethat they encounter on a regular
basis.
And I think there's a reallydeep need for that.
Dr Andrew Greenland (29:42):
Thank you.
And on the other on the otherside of the coin, what are the
sort of challenges andbottlenecks that are most
impactful to your business atthe moment that you're having to
navigate through?
Dr Amanda Whitehouse (29:53):
Well, I think we all here in the US
could have our complaints aboutour healthcare system.
And I think both with allergymedical care and then with
mental health access is a is abig issue.
Um so I struggle personallywith a lot of the typical
challenges of working withinsurance.
Um, a lot of people are movingoutside of health insurance in
(30:16):
my field.
I don't feel comfortable doingthat because I feel that that
will limit access to people, andI don't only want to serve the
people who financially are ableto seek that out.
Um, so I've had to navigatethat, you know, with especially
recently, a lot of um patienceand a lot of uh focus on what my
(30:40):
goal is and what is reallyimportant to me, my values and
my identity as a provider inorder to tolerate some of those
challenges.
Um, and in general, there'sjust not a lot of access to
mental health care in the US.
There are people who need helpwho aren't able to get it.
There just aren't enoughproviders, um, again, let alone
in my specialty.
(31:00):
So it's a challenge to have somuch work, it's a challenge for
people to access it financially.
And then it's a challenge, youknow, when I can't help
everybody and I want to helpmore people than I can.
Dr Andrew Greenland (31:11):
Thank you.
Now you're a clinic owner, soyou wear probably all the hats.
And what's your biggest timedrain as a clinic operator?
For is it an operational side,the administrative side?
There's there's so muchclinical work that it becomes
overwhelming.
What's your biggest time drain?
Dr Amanda Whitehouse (31:27):
Um there is a lot of paperwork for me in
mental health.
Um, I personally have chosen,and this isn't a judgment of
anyone who has, um, but I'vechosen very carefully which time
savers and which newdevelopments to utilize in my
practice.
Um, I don't outsource mybilling, I do all that myself.
I have not adopted AI practicesinto my note-taking and my
(31:51):
record keeping.
Um, it's still evolving, and Ifeel highly protective of my
clients in that way.
Um, so again, it's not ajudgment of someone who's using
that, um, but I'm finding myselfreally walking a fine line
between things that could helpto streamline that and then
always protecting the privacyand the confidentiality of my
(32:11):
patients and really wanting moreconfidence in some of those
things before I roll them outand wanting them to feel
trusting in every aspect of howI'm operating my business.
Um, I haven't approached itwith many of them because I'm
not doing it.
So the only conversation I'vehad with most of them is just
want to make sure you know youmight hear about these, you
know, AI systems that arerecording your session and
(32:33):
turning it into a note for theprovider.
I'm not using that, but eventhose short conversations where
I'm telling them that I'm notdoing it, people are having a
lot of discomfort with it.
So I am on the conservativeside of those decisions.
Um, and that both researchingand understanding all of those
things and staying on top of thelaws and the require
requirements for myself and thendoing the work that is still
(32:56):
required of me because I'm notopting into them is a pretty
time-consuming process.
Dr Andrew Greenland (33:02):
I hear you.
Um so you talked a lot aboutthe demand for the work that you
do, and with demand continuingto grow, how do you think about
capacity and scaling from theperspective of what you can
deliver and the people that youcan reach?
What are your kind of thoughtsabout reaching more people for
with your work?
Dr Amanda Whitehouse (33:19):
That's a great question.
I think in my field it's sodifficult because it's hard to
scale beyond the one-on-onesessions.
And so the podcast, I think,was a little bit of my um
attempt to do that, but not at abusiness sense.
Um, I've chosen not to monetizethe podcast.
And so that's reaching peopleinformation-wise, but not
necessarily scaling my business.
(33:40):
I would like to get intoworking more with practices, and
this is something that I'mtrying to utilize the book that
I just wrote for working withproviders and reaching more of
their clients.
And I've done some worksupporting allergy clinics and
working with groups of theirpatients and specializing those
to their clinic specifically andhow they operate so that they
(34:02):
can incorporate these thingsthat I know they're not equipped
to do, but that I can show upas a resource for them and
provide some of that incooperation with them to help
improve the care that they'regiving to their clients and to
scale again beyond my one-on-onemodel.
Dr Andrew Greenland (34:19):
Um, if I if you had a magic wand, then you
could fix one thing in thebusiness tomorrow.
What would that be, ifanything?
Dr Amanda Whitehouse (34:25):
Oh, I know you're asking from a business
angle, but my brain can't evengo there because as people can
probably tell, even though I'mI'm the clinic owner and I I
wear all the hats, my heart isjust so much in the work.
So what really would make itall so much easier if I could
wave that magic wand would befor food allergies to be
understood and respected outsideof our food allergy community.
(34:48):
I think that would break down alot of the barriers that we're
facing as a community.
That would improve the mentalhealth of everyone in our
community on so many levels andfor so many reasons.
And I think that would be thebiggest change.
Because my my stress would godown if all of theirs did too,
basically.
Dr Andrew Greenland (35:06):
Sure.
Um, you've mentioned the bookand the podcast.
Just do you want to expand alittle bit on that and tell
people how they can access themand what they would get from
them if they were to tune in orto read?
Dr Amanda Whitehouse (35:16):
Sure.
So the podcast is called Don'tFeed the Fear.
It's on all platforms and it'seasy to find.
And I focus on anxiety andtrauma, but I do that in a lot
of different formats.
So I have guests sometimes havea lot of amazing experts.
I do solo episodes where Ifocus more deeply on mental
health topics, and so I try toshare a lot of good information
(35:36):
in that.
And then I'll hold it up incase people are watching the
video.
Um, the book is called FromFear to Freedom.
It's a guide for navigatingallergy immunotherapy, and um
they can find that anywhere theybuy their books on Amazon.
It's on bookshop.org.
It's available for smallindependent bookstores to order
and libraries if anyone wants toget those resources and
(35:59):
directly through me.
So if there's anyone listeningwho has a practice who wants to
talk about bulk orders toprovide the resource to their
patients, then you can reach outto me.
And I'm everything the foodallergy psychologist makes it
easy to find me.
So my website is the foodallergy psychologist, that's my
um internet handle, and so thatshould make me really easy to
find.
Dr Andrew Greenland (36:20):
Perfect.
Thank you.
Well, put that on the bio pageas well.
Um, thinking about the nextyear or so, what does success
look like for you in your workin the next 12 months?
Where would you like to be?
What would you like to haveachieved?
Dr Amanda Whitehouse (36:30):
I would love to bridge the gap between
um the mental health care andthe medical care that we talked
about early in the com earlierin the conversation.
Um so I'm really excited justtomorrow.
I'm not sure when people willbe listening, but um I'm
traveling to the FAST OITconference in Texas in the
States, which is the group ofproviders who learn and share
(36:52):
how to do immunotherapytreatments together.
And so I get to talk to themabout all of this and these
mental health aspects of notjust food allergy management,
but navigating treatmentdecisions and then doing the
treatment successfully.
And I would love to continuethose conversations and be the
go-between between the patients,between the providers who are
offering this, who I know wanttheir patients to have better
(37:15):
experiences.
I've gotten to meet so many ofthem already, and I I know how
genuine and eager they are tohave the best outcomes for their
patients.
And I think this is another oneof those links that we need to
strengthen.
So I hope I can be a part ofthat.
Dr Andrew Greenland (37:29):
Wonderful.
And finally, if you were tostart this all over again
tomorrow with everything thatyou know, would you do anything
differently?
Dr Amanda Whitehouse (37:37):
I would.
Um, and it you're gonna get apsychologist answer here too,
but it really just would be witha lot more self-compassion.
Um, I think I my own experiencemirrors that of a lot of people
in our community where we'rethrown into something and we
really just have to powerthrough and push through.
And we don't realize untillooking back how hard we pushed
(37:57):
ourselves and and how difficultit was for us.
And so I would love to givethat insight and experience that
I've gained now to myself backthen, both personally as a mom
and business-wise, um, that youknow, to be compassionate, to be
empathetic toward myself aboutall that is on our plates and
how complicated and difficultthis topic is, and to just
(38:20):
accept that I'm not going to beable to fix it all all at once,
but it's still worth movingforward and and making progress
at whatever pace works.
Dr Andrew Greenland (38:30):
Without Amanda, I'd love to thank you so
much for joining me today.
It's been a genuinelyfascinating conversation.
I think you're reallyaddressing one of the most
overlooked gaps in healthcare,helping people feel emotionally
safe while managing real medicalrisk.
So thank you for your insights,thank you for the education,
the information, and the behindthe scenes work of what you do
in the clinic.
It's been a delight.
(38:50):
Thank you so much.
Dr Amanda Whitehouse (38:51):
Thanks so much for having me.
I really appreciate it.
Welcome back to Voices in Health and
Wellness.
I'm Dr.
Andrew Greenland, and today'sconversation is one I'm
genuinely looking forward tobecause we're exploring a side
of healthcare that often getsoverlooked: the psychological
impact of food allergies.
Joining me today is Dr.
Amanda Whitehouse, a licensedpsychologist, founder of the
Food Allergy Psychologist, hostof the Don't Feed the Fear
(00:20):
podcast, and an expert in foodallergy, anxiety, trauma, and
nervous system regulation.
Amanda has spent more than adecade helping individuals and
families navigate the emotionalburden that comes with food
allergies, something thataffects far more than just
physical health.
So with that, Amanda, I'd loveto welcome you to the show and
thank you very much for joiningus.
Dr Amanda Whitehouse (00:39):
Thank you so much for having me and making
space for such an importantconversation.
Dr Andrew Greenland (00:43):
Well, I'm really looking really looking
forward to it.
So for listeners meeting youfor the first time, can you
share a little bit about yourbackground and what led you into
specializing in food allergypsychology?
Dr Amanda Whitehouse (00:53):
Sure.
So I was a psychologist firstbefore I became a mom, but
showing up in this space, I'malways a food allergy mom first
and foremost.
I can't remove that from anyaspect of who I am or how I
operate in the world.
So I have three kiddos, and myfirst, the oldest who's a teen
now, is the one who has foodallergies.
And I was very early in mypractice when I started managing
(01:14):
that and learning a lot ofthings very quickly and
connecting to a lot of peoplewho were also managing the same
things.
I didn't really have anyintention of making that my
specialization, but it becameclear to me very quickly how
many people, when they found outI was a psychologist, were
asking for support.
And my practice just grew intothat very quickly and filled and
stayed filled for years beforeI started the podcast.
(01:36):
I never even had a website orsocial media, did any marketing
because unfortunately there wasalways a long line of people
more than I could help, whichwas why I decided decided to
start my podcast and to try todo some more work to reach more
than just the people that Icould see individually in my
practice.
Dr Andrew Greenland (01:52):
Fantastic.
So did you set up the practiceand then realize you had a
massive demand?
Or how did you find out aboutthis kind of unmet need out
there?
I'm just really curious.
Dr Amanda Whitehouse (02:01):
Right.
It was it all kind of happenedat the same time, but not
intentionally.
So I was just establishing mypractice at the same time that
we were adjusting.
And so through word of mouth inthe community and being
connected to our local allergyadvocacy group, so many other
parents that I was meeting atthose events were coming to me,
asking for support, spreadingthe word to other moms.
(02:23):
And so then in the community,that just kind of became known
what I was doing.
And so as I said, I neverreally needed to advertise or
make it official, but that'skind of how I became known here
in our community.
And, you know, I would getpeople would spread the word
outside of our area that Iwasn't able to work with because
I'm only licensed here in mystate of New York in the US.
(02:44):
And so it became clear whenpeople were finding me from that
far away, without me puttingthe word out at all about what I
was doing, that there reallywere people searching and
looking for support that thatjust isn't out there.
Dr Andrew Greenland (02:58):
So do you um feel that patients were being
medically supported butemotionally overlooked or not
even medically properlysupported with this?
Dr Amanda Whitehouse (03:06):
Oh, I think there's a wide range
within food allergy, honestly.
Um, you know, we had I'vetalked publicly about some of
our amazing experiences and thensome of our really
disappointing experiences.
And I think this is probablytrue in a lot of areas, but you
have to learn so much so quicklyas a patient.
Um, I think the recognition ofthe emotional support comes
(03:27):
afterward because in thebeginning it's such an emergency
situation of figuring out howto safely feed yourself or your
child.
Um, and else I don't want tomake a broad statement because I
have met so many amazingallergists who I know are giving
really good care.
Um, but I'll talk personally,you know, my first experience
with my first allergist, one ofthe first things she said in the
appointment was factually justincorrect information that I had
(03:51):
just read from a reliablesource.
And so I started things out ina very shaky position in terms
of feeling that I did need tolearn everything and question
the medical support that I wasgetting.
So I think it is out there, andI think it also does take an
educated patient and consumer tolearn to distinguish the
(04:11):
difference because unfortunatelythere are the support isn't
always going to be there or theinformation isn't always gonna
be the best.
But if you're connected andinformed, hopefully you'll find
the good ones who are out there,and there are so many.
Um, and and I don't think it'sfair to expect our providers to
have to provide the emotionalsupport too.
(04:31):
That's not what they're trainedin, they're not trauma
providers, you know, um, and yetthe need is there.
So I would say that yes,there's there's really a need
for the emotional support thatmost of the patients that I have
worked with were not getting.
And the system is not set upfor that.
So that's not on the providers.
That's a lot of work that weneed to do in terms of
establishing connectivity andmultidisciplinary approaches to
(04:54):
identifying and supportingpeople from all angles.
Dr Andrew Greenland (04:58):
Thank you.
Really helpful context.
So, one thing that stood out tome from our earlier
conversation was that yourpractice has essentially stayed
full for 14 years withoutadvertising.
That says, you know, by itself,there's a massive demand for
this.
So, why do you think, you know,all these years that you've
been doing it, it still remainsundisturbed and has been for so
long?
Dr Amanda Whitehouse (05:18):
I think there are probably a lot of
things that go into that.
The most obvious is that duringthe time that I was doing that,
we know the data on foodallergies is that they were just
exploding.
You know, I had my son duringthe time just on the cusp of us
learning that early introductioncan help to reduce the
prevalence of food allergies.
So there were so many kidsduring that phase when they were
(05:38):
we were still being told toavoid the number of allergies,
food allergies was increasing,the multiple food allergies
versus just single foodallergies was increasing during
that time.
And so I think that's probablyone of the biggest factors.
It's just there were more andmore people.
Um, and I think what makes itdifficult is that without really
(05:59):
specific either personalexperience or some introduction,
other than just applying ourpsychological principles and
mental health approaches to foodallergies, it can be really
easy to miss the mark on whatkind of support is actually
needed.
And so, really, really greatproviders who are wonderful at
their cognitive behavioraltechniques can unfortunately not
(06:24):
fully understand the severityof food allergies or still be
susceptible to themisinformation that's out there
or just the lack of informationthat's out there about food
allergies.
And then that shows up in thesession.
So I've had a lot of clientscome to me after working with
other providers, even some thatI know personally who, again,
are really great providers.
But the concept of a lot of thework that we do in therapy is
(06:45):
challenging our thoughts,challenging how we're
approaching things in a waythat's not helpful.
And to sit down a child or aparent who's been diagnosed with
a life-threatening conditionthat can genuinely cause them
significant harm or even deathin extreme cases.
And to challenge that andwhether they're being too
restrictive or whether theyshouldn't be so careful can be
(07:05):
dangerous for them in terms oftheir management and obviously
makes it difficult to buildtrust with them and a sense of
safety in the therapeuticrelationship if you don't
understand the extent to whichpeople actually have to go to
live safely with their foodallergies.
So I think part of that isgetting the information out
outside of our community aboutfood allergies and how severe
(07:28):
they really are.
People still don't understandthat, at least here in the US,
our labeling is still not great.
We still don't have restaurantmenu labeling laws.
We have to do so many thingsthat from the outside look like
anxious behaviors and can easilycross into anxious behaviors
that really, though, areactually just safe management of
the food allergy.
Dr Andrew Greenland (07:49):
Thank you, and touching on that a little
bit more.
I think many people outsidethis world fear hear food
allergy and think primarilyabout physical safety.
But psychologically, what arefamilies actually living with
day to day?
And you've kind of touched onthis a bit already, but I just
want to delve into it a bitmore.
Dr Amanda Whitehouse (08:04):
Right.
It touches on absolutely everypart of life.
So people outside, as you said,think it's just about safety
and it's just about what youeat.
But food is a part of allaspects of our society.
It's how we celebrate, it's howwe mourn, it's how we express
love and affection and support.
And those um ways ofintegrating food to everything
(08:25):
then affect us in every way oflife.
So it affects us at school, itaffects us at work.
Um, when we want to take atrip, when we want a vacation or
do social things, when peoplecome to the point in their life
where they're dating.
Um, you know, I work with somany people in their teen and
young adult years.
The first thing they want totell a prospective date is not,
I can't go here, I can't eatthis, you can't eat this, we or
(08:48):
we can't kiss.
That completely changes thedynamic in relationships.
And that's true, you know, ifI'll speak for myself as a
parent.
I was a brand new parent when Iwas learning all of this.
And I had a great group offriends who are also becoming
new moms too.
None of them had a child withfood allergies, and it very
quickly eroded kind of thatcommunity that I had been able
(09:10):
to build with them because I hadsuch different needs that I
didn't understand yet.
I didn't know how tocommunicate to them.
So of course they couldn'tunderstand what I needed.
Um, and I think that's true inevery scenario, every example we
could give of relationshipdynamics or life experiences,
those things creep in and havean effect that other people
don't see.
Dr Andrew Greenland (09:29):
Thank you.
So, how much chronic fear andhypervigilance do you typically
see in parents and children?
And are you encountering manythat are stuck in this constant
fight or flight state because ofall of this?
Dr Amanda Whitehous (09:40):
Absolutely.
I think the most crucial partfor me in kind of figuring out
how to do this work, becausethere's no framework for it,
there are other people out theredoing it too, but we all kind
of have been figuring out asfiguring it out as we go until
somewhere research just recentlyhas been done.
Um but for me, discovering andlearning about the nervous
system piece was the key tohelping people to get unstuck.
(10:02):
And we talk in terms that arevery black and white about the
nervous system, like you'restuck, you need a reset, you
know.
Um, and it it's not thatsimple, but people really do
develop patterns.
And the more you have to repeata behavior, or the more a
certain topic permeates variousaspects of your life, like we
just talked about, the moreentrenched that pattern becomes.
(10:24):
And it's um it is anxiety, itoften is trauma, and yet it is
logical and it is adaptive basedon the experiences that people
have.
So people come to me feelingreally stuck knowing that they
are too anxious or that it isproblematic, or they're
restricting themselvesthemselves or their child more
(10:45):
than necessary.
And it's this negativeperspective on I'm such a mess,
I'm so anxious.
And I think it's reallyimportant for people to
understand how the nervoussystem works and why it has
developed those responses inorder to work with it and give
it the safety that it needs inorder to move out of that fight
or flight state and be able tofunction in a different way, in
(11:06):
a more balanced way.
Dr Andrew Greenland (11:08):
So, really interesting hearing about your
nervous system lens, which youapproach this through.
So, how um how do traumaticallergy experiences affect the
nervous system in the long term?
Dr Amanda Whitehouse (11:18):
They are so impactful, um, and there's so
much that I think it'simportant for people to
understand about trauma, way toomuch for us to share here.
But um, one of the things thatI think is really important for
people from the outside is tounderstand that trauma is not
just having a dangerousreaction.
(11:39):
You don't have to have alife-threatening rush to the
emergency room and the ambulancereaction to be traumatized.
Um, certainly that can be aterrifying experience for any
parent or patient or child.
Um, but we also have vicarioustrauma by hearing about those
experiences.
We hear from the families whohave lost their loved ones.
(12:02):
They died after an allergicreaction.
That's traumatizing when youknow that you manage the same
thing that resulted in the deathof that person.
Um, when we perceive that weare in danger or have been in
danger, even if it wasn'tfactual or wasn't directly
happening to us, the nervoussystem will still register that
as something that we need to beprotective of.
(12:23):
So the more experiences we havelike that, the more uh
consistent the messages that thenervous system receives that I
need to be on alert.
Here are the things that I needto look out for.
So every time we have one ofthose experiences from the big,
huge, traumatic, scary ones tothe friend that we met that, you
know, the label was wrong onthis food, and they had a
(12:45):
reaction at a restaurant, andmaybe they used their epi and
they were okay, but our nervoussystem logs that as information
and as something that we need tolook out for in the future.
So we have this data bank andall of these little touch points
that are associated with itthat can be so individualized to
each person of what are thesignals of danger, what is my
nervous system looking out for?
(13:06):
And then that keeps the nervoussystem in this state of trying
to always scan and take in allthat information to predict
every possible uh danger thatcould happen to us.
And it's as we discussed, it'severywhere, it's all the time,
it's every scenario.
So for people who are livingwith that, it becomes very
difficult for them to find awindow where that can turn off,
(13:29):
where there aren't then anypieces of information coming in
from the environment that areindicating a possible risk where
they can shift out of thatfight or flight and what we call
call rest and digest.
Um it's no coincidence, right?
We're dealing with foodallergies, and the the natural
restorative state of the body isrest and digesting, digesting
(13:50):
our food, taking nourishment andreplenishing the body.
And um we may not find manypockets of time where we feel
safe to do that.
So it it we don't have anequivalent system that searches
for safety, that looks for um,you know, indications in the
environment that we are safe.
We really have a system that'sum primed to be defensive and to
(14:14):
be vigilant and proactive.
So, in order to do that andcounteract that, we have to make
it a very conscious process anda very aware process that's
intentional instead of thenervous system, which is going
to do its thing automaticallywithout us telling it to do
that.
Dr Andrew Greenland (14:28):
Got it.
Thank you.
And what about the vagus nerveregulation and mindfulness?
How do they kind of fit intorecovery?
Dr Amanda Whitehouse (14:35):
Great question.
I love teaching people aboutthe vagus nerve and the role
that it has where we keeplearning so much more.
Um, but basically, the vagusnerve is the line of
communication between thescanning for information that we
do all comes in through thesenses to the nervous system
through the vagus nerve.
(14:56):
And so the brain is thencommunicating with the vagus
nerve.
Um, I think this the statisticsare about five times every
second, is how often the brainand the vagus nerve are going
back and forth asking, Am Istill safe?
And the vagus nerve assessingthe information that's coming in
through the sensory organs anddetermining if they're safe.
If the vagus nerve picks up onsomething that indicates
possible danger, then it sendsthat signal to the brain that
(15:18):
it's time to shift modes.
And then the vagus nerve passesdown into the body and
communicates with all of thevital organs and all of the
systems that then would prepareus for danger.
So that's what triggers all ofthe fight or flight or anxiety
symptoms that we know (15:33):
the racing heart, the sweating, the
body temperature increase, theuh trembling and the adrenaline
that rushes through our body.
And what people often don'trecognize is what all these
things are being turned on to gointo emergency mode.
There are also things beingturned down in order to preserve
resources.
So, number one is ourdigestion.
(15:54):
And so we are not going todigest our food in an emergency.
Number two is the communicationwith the prefrontal cortex,
which is the area of the brainwhere we do our rational
thinking and our logical problemsolving, all the things that
help us to be calm and make gooddecisions, information-informed
decisions, their blood flow tothat area is literally
(16:16):
restricted during times thatwe're in fight or flight.
So we really are hard onourselves about how we shift
into these modes and can't calmdown.
I can't do mindfulness, I can'tsit and meditate.
My body just won't let me.
And we really have to, I think,sometimes understand the
processes at hand in order toaccess that because everybody
(16:38):
thinks that you're in danger.
And I tell you to sit quietlyand close your eyes and breathe
and not to think any anxiousthoughts, that's going to make
the body feel even less safe.
It's going to make it feel likeit needs to be more protective,
that the danger is not beingrecognized or understood by the
people around it, and then thatit has to amp up even more in
(16:59):
order to be protective.
So accessing mindfulness can bereally difficult.
And I think it starts with thateducational piece and working
with your body where it's at anawareness, not just trying to
force calm, because forcinganything does not create a sense
of safety.
Dr Andrew Greenland (17:14):
Thank you.
So what does a I know there'sgoing to be no typical patient
and every patient is unique intheir way, but what does a
patient journey look like?
Someone who's coming to seeyou, how does it all map out in
terms of what you your approachand how you deliver and work
with a client and how long doesit take?
Like those kind of things.
Dr Amanda Whitehouse (17:31):
Good question.
And you're right, it can varyso much.
But I would say if I had topick the typical, um, it's a lot
of parents bringing theirchildren in when they recognize
that there's a problem.
So that's not to say thatadults with food allergies are
not struggling too, but a lot ofus as adults and as parents
know that we don't put ourselvesfirst.
We we deal with things and wecope longer than we should, but
parents are putting theirchildren first and I think
(17:54):
better able to recognize andprioritize seeking help.
And it's usually something veryspecific.
So following, unfortunately, Iworked with a lot of people
who've had really traumaticexperiences in a school setting
and a restaurant setting, areusually the two biggest examples
of that.
And then the child is showingvery specific withdrawal or
(18:16):
internalizing symptoms wherethey're not wanting to go
places, they don't want to go toschool anymore, they're
clinging to their parents, andall of a sudden they're having
that separation anxiety thatthey had once been through.
And sometimes it's reallyspecific.
It's often very specific tofood.
So the child no longer iseating their lunch at school and
they come home and the wholelunch is uneaten and they just
(18:38):
don't feel safe eating it atschool.
Usually they're not saying thatspecifically.
They're just saying thingslike, I wasn't hungry or I don't
want to go.
Um, and then sometimes it'sreally generalized and it's not
even clear that it's specific tofood or the food allergy.
But as we said, the brain canregister or the nervous system
can register almost anything asa cue of danger.
(18:58):
So it can be any other changeor shift that is not typical for
that child.
So for example, I've workedwith kids who um all of a sudden
didn't want to go visit grandmaanymore.
And grandma's one of theprimary caretakers, and she's
the one who helps to manage theallergy.
And it takes really goodlistening skills to get this out
of kids and get to the bottomof what might have happened to
(19:19):
cause those changes.
But I've seen that examplehappen several times where
either like they maybe saw a jarof peanut butter in grandma's
house and it's not usuallythere, and so suddenly they
didn't feel safe there, or youknow, a change that happened
there that they registered,sometimes not even really
consciously, that cued to them,I'm not safe in that setting, or
(19:39):
with that person or doing thatactivity anymore.
So usually parents noticeparents have a good gut instinct
when something is going on withtheir kiddo, and that's how
they show up to me.
And then we broaden it out sowidely from that specific
concern that they brought in.
Um, and you asked how long itusually takes, and that that can
be very different because it'svery complex.
(20:01):
It's not just the child'sanxiety that's being brought in
for support.
The parent is usually veryintertwined because, of course,
we as parents, no shame to anyother parent out there.
I live it too.
It's anxiety provoking for ustoo.
So a lot of times we have to doour own work in order for the
child to make a shift too.
Dr Andrew Greenland (20:21):
Got it.
This is a real family outing,isn't it, for the for the
obviously the sufferer as wellas the parents and the immediate
family.
Um you mentioned, um, I thinkin your upcoming book, focusing
on the mental in the mentalhealth impact of newer
treatments like oralimmunotherapy, which is a really
fascinating angle because mostconversations focus purely on
the clinical outcome.
What are the psychologicaldynamics that are um emerging
(20:44):
with treatments like oralimmunotherapy?
Dr Amanda Whitehouse (20:46):
Yeah, it is um a very there's a lot of
conflict internally with withfamilies who are being presented
with things and it can presentin a lot of ways.
We would think that it's allgood, right?
There are treatments.
There didn't used to be anytreatments out there, and it's
wonderful.
Choice and control are whatcalm the nervous system.
That's what makes us feelbetter when we're able to have
(21:08):
exert some control or influenceover our decisions.
We research shows that even ifwe don't choose the option, just
having the option improves ourmental health and our wellness.
Um, so you would think that allof these treatments that are
expanding now would be justhands down, not complicated, a
wonderful thing for food allergypatients and families.
(21:28):
However, it's not that simple,of course.
One is access.
You know, I was seeking thesetreatments 12 years ago or so
when they weren't widelyaccessible.
And so I was searching allover, trying to hunt down a
doctor and travel to get them.
It has improved, but it isstill the case that everyone
doesn't have access to this.
(21:49):
In the in the States, there isstill a significant shortage of
allergists, period.
So some people's food allergiesaren't even managed by
specialists, it's through theirprimary care doctor.
So to have someone Providingthese treatments, let alone
multiple ones.
If there's one that you wantand your doctor happens to
provide that one, you'reextremely lucky.
So some people, the conflict isI want to do this and I can't
(22:11):
get access to it.
It's not affordable.
It's too the distance is toofar.
Um, the investment of thetreatments emotionally and
time-wise is a lot too.
So it varies depending on whichoption is chosen, but that is a
really significant umcommitment that people have to
make if they're going to chooseone of those treatments.
(22:32):
And then all of that is kind ofjust still the practical part,
but the mental health side of itis I've been spending X amount
of years, however long that is,for the patient, making sure
that I don't ingest thisallergen, I don't come in
contact with it at all.
And now we have treatments thatrequire the exact opposite.
(22:52):
And as we talked about before,the logical, rational part of
the brain can be verydisconnected from the emotional
fight or flight part of thenervous system and brain.
And even when we know thatthese treatments are effective,
the thought of actually carryingforward with consuming the
allergen is a really, really bigshift to ask for people.
(23:13):
They can want it, they canunderstand it and believe it and
know that it's going to behelpful, and yet the nervous
system will have its responsewhen they're facing something
that has been so scary for themfor many years.
So it's a really complicateddecision-making process for
people.
And as we said before, there'snot a lot of support.
Where is the anxiety level?
(23:46):
How will that impact thetreatment?
But I think we need so muchmore of that.
And so that's why I decided towrite the book because I've
lived it.
And so it has a little bit ofthat.
It has my personal experience,but I've pulled in some really
amazing experts on the topic tohelp to compare the medical
information and options.
And then I gave some exercises.
Everybody's not going to beable to access a food allergy
(24:07):
psychologist, unfortunately.
So there are activities inthere to help people go through
this process, either on theirown or with a therapist who
might not be informed about thisarea, where they can work on
the decision-making process,better understand their
thoughts, address the nervoussystem response, and kind of
tease it out so that they canaccess something if they think
(24:29):
it's a good idea for them.
And the flip side of that isI'm not up here trying to tell
everybody to go out and getallergy treatment.
It might not be right foreverybody.
And I think there's a lot ofpressure and guilt and shame and
all of these difficult emotionsthat come along with every part
of food allergies.
And this is one of them.
So I know a lot of parents whohave not chosen treatment either
out of guilt or shame, orchosen treatment out of pressure
(24:51):
and guilt and shame.
And that is not a good place tomake a decision from, no matter
what the outcome is.
Dr Andrew Greenland (24:58):
Got it.
So what are the um prescribingpractitioners for these
therapies potentially missingwhen introducing these
therapies?
And what would you like them toknow or to take on board from
your experience?
Dr Amanda Whitehouse (25:08):
I would love, my dream would be for all
of them to have systems in placethat at least on a very simple
level are assessing and keepingan eye out for indicators that
people are already strugglingwith anxiety.
I've worked with a lot ofpeople who've pushed forward
with treatment and it didn't gowell because the anxiety was
underlying.
(25:29):
It can be hard to miss.
It's not going to show upprobably in a quick consult with
your allergist how many timesare the, or how many minutes are
they actually in the room withyou?
Um, we're very high-functioninganxious parents and patients.
We survive by having everythingtogether, following all the
rules, staying calm on theoutside when we are struggling
on the inside.
And that's how they look atappointments.
(25:50):
They don't always look likethey're an anxious mess.
The kiddo doesn't always looklike they're super scared and
you know, uncomfortable.
So I would love it if theycould all incorporate some form
of checking in on that andbaseline education for everybody
about what the process would befor any of the treatments in
(26:11):
terms of the social, emotional,mental health part of the
treatment, changing yourperspectives.
What are you committing to, andhow might that impact
relationships and familyroutines and your daily schedule
and things like that thateverybody might not be
thoroughly considering beforethey make the treat make the
treatment decisions?
Dr Andrew Greenland (26:30):
Thank you.
So one of the things thispodcast increasingly explores is
the reality of runninghealthcare practices and
supporting people emotionallyover the long term.
What have you learned over theyears about sustaining yourself
emotionally in this kind of workand avoiding burnout, which is
such a big thing at the momentfor people in this space?
Dr Amanda Whitehouse (26:47):
It is.
And it's tricky.
I I know obviously myperspective will be different
from a lot of your audiencebecause I'm in the mental health
field and not in the medicalfield, but I think there's
probably some similarity.
Um, and for me, really thetoughest part personally is that
I'm doing something every daywith people that touches on the
hardest thing that I've everdealt with in my life.
(27:08):
So I have to be really mindfulabout where I'm at with what's
going on in our family and in mylife and the toll that that's
taking.
Um, I love talking to peopleabout food allergies and helping
them with it.
But when my son has a bump inthe road or a blip in our
allergy management, that can bereally difficult.
And so for me, I have to workin some extra support and things
(27:30):
like that around it.
Luckily, we've been in a goodspot for quite a while.
He's been in maintenance ontreatments for all of his food
allergies for years now, whichwas when I finally felt like now
I have the bandwidth to startthe podcast and try to do some
more outreach because this isn'ttaking so much of me personally
anymore.
Um so for me in mental health,I think that's what it looks
(27:50):
like.
A lot of the people who aredoing work similar to mine also
have that personal experience.
And so I think that is whatmakes us really good at it and
can make it really hard for usthat we have to be mindful of.
Dr Andrew Greenland (28:02):
Thank you.
So thinking about the businessside of running your clinic,
because I think this is animportant thing that
practitioners will appreciate.
Um, you've been doing this fora while.
You've started you'veestablished a very important
niche.
What are the things that aregoing particularly well for you
from a business angle?
Dr Amanda Whitehouse (28:18):
Well, well for me, but not well for the
community that I care about, isthat allergies are still a huge
problem.
I think there is a mentalhealth crisis within the food
allergy community.
I do think awareness isimproving.
We're getting more research onthe topics, we have more options
that we've been talking about.
So what has helped my businessto thrive, unfortunately, is
(28:39):
that there was such a need.
And honestly, I hope I can beput out of business and retire
because we, you know, we don'thave these concerns anymore.
Um, but aside from just theneed that's there, I think in
mental health, really the valueof therapy is in connection and
it's in healing through thatrelationship that you have with
the provider, regardless of whatlens or approach they use.
(29:02):
And so being vulnerable enoughto bring my personal experience
into the room in an appropriateway, in a way that is always,
you know, considering what'ssupportive to the patient or the
client, not because I need totalk about my stress today.
Um, but being show showing upas a human with similar lived
experiences, I think really iswhat has helped my business and
(29:23):
some of the other work that I'vedone to grow because people
want to be seen.
People in the food allergyallergy community often don't
feel that they're understood,that their struggles are valid
or treated as valid by peoplethat they encounter on a regular
basis.
And I think there's a reallydeep need for that.
Dr Andrew Greenland (29:42):
Thank you.
And on the other on the otherside of the coin, what are the
sort of challenges andbottlenecks that are most
impactful to your business atthe moment that you're having to
navigate through?
Dr Amanda Whitehouse (29:53):
Well, I think we all here in the US
could have our complaints aboutour healthcare system.
And I think both with allergymedical care and then with
mental health access is a is abig issue.
Um so I struggle personallywith a lot of the typical
challenges of working withinsurance.
Um, a lot of people are movingoutside of health insurance in
(30:16):
my field.
I don't feel comfortable doingthat because I feel that that
will limit access to people, andI don't only want to serve the
people who financially are ableto seek that out.
Um, so I've had to navigatethat, you know, with especially
recently, a lot of um patienceand a lot of uh focus on what my
(30:40):
goal is and what is reallyimportant to me, my values and
my identity as a provider inorder to tolerate some of those
challenges.
Um, and in general, there'sjust not a lot of access to
mental health care in the US.
There are people who need helpwho aren't able to get it.
There just aren't enoughproviders, um, again, let alone
in my specialty.
(31:00):
So it's a challenge to have somuch work, it's a challenge for
people to access it financially.
And then it's a challenge, youknow, when I can't help
everybody and I want to helpmore people than I can.
Dr Andrew Greenland (31:11):
Thank you.
Now you're a clinic owner, soyou wear probably all the hats.
And what's your biggest timedrain as a clinic operator?
For is it an operational side,the administrative side?
There's there's so muchclinical work that it becomes
overwhelming.
What's your biggest time drain?
Dr Amanda Whitehouse (31:27):
Um there is a lot of paperwork for me in
mental health.
Um, I personally have chosen,and this isn't a judgment of
anyone who has, um, but I'vechosen very carefully which time
savers and which newdevelopments to utilize in my
practice.
Um, I don't outsource mybilling, I do all that myself.
I have not adopted AI practicesinto my note-taking and my
(31:51):
record keeping.
Um, it's still evolving, and Ifeel highly protective of my
clients in that way.
Um, so again, it's not ajudgment of someone who's using
that, um, but I'm finding myselfreally walking a fine line
between things that could helpto streamline that and then
always protecting the privacyand the confidentiality of my
(32:11):
patients and really wanting moreconfidence in some of those
things before I roll them outand wanting them to feel
trusting in every aspect of howI'm operating my business.
Um, I haven't approached itwith many of them because I'm
not doing it.
So the only conversation I'vehad with most of them is just
want to make sure you know youmight hear about these, you
know, AI systems that arerecording your session and
(32:33):
turning it into a note for theprovider.
I'm not using that, but eventhose short conversations where
I'm telling them that I'm notdoing it, people are having a
lot of discomfort with it.
So I am on the conservativeside of those decisions.
Um, and that both researchingand understanding all of those
things and staying on top of thelaws and the require
requirements for myself and thendoing the work that is still
(32:56):
required of me because I'm notopting into them is a pretty
time-consuming process.
Dr Andrew Greenland (33:02):
I hear you.
Um so you talked a lot aboutthe demand for the work that you
do, and with demand continuingto grow, how do you think about
capacity and scaling from theperspective of what you can
deliver and the people that youcan reach?
What are your kind of thoughtsabout reaching more people for
with your work?
Dr Amanda Whitehouse (33:19):
That's a great question.
I think in my field it's sodifficult because it's hard to
scale beyond the one-on-onesessions.
And so the podcast, I think,was a little bit of my um
attempt to do that, but not at abusiness sense.
Um, I've chosen not to monetizethe podcast.
And so that's reaching peopleinformation-wise, but not
necessarily scaling my business.
(33:40):
I would like to get intoworking more with practices, and
this is something that I'mtrying to utilize the book that
I just wrote for working withproviders and reaching more of
their clients.
And I've done some worksupporting allergy clinics and
working with groups of theirpatients and specializing those
to their clinic specifically andhow they operate so that they
(34:02):
can incorporate these thingsthat I know they're not equipped
to do, but that I can show upas a resource for them and
provide some of that incooperation with them to help
improve the care that they'regiving to their clients and to
scale again beyond my one-on-onemodel.
Dr Andrew Greenland (34:19):
Um, if I if you had a magic wand, then you
could fix one thing in thebusiness tomorrow.
What would that be, ifanything?
Dr Amanda Whitehouse (34:25):
Oh, I know you're asking from a business
angle, but my brain can't evengo there because as people can
probably tell, even though I'mI'm the clinic owner and I I
wear all the hats, my heart isjust so much in the work.
So what really would make itall so much easier if I could
wave that magic wand would befor food allergies to be
understood and respected outsideof our food allergy community.
(34:48):
I think that would break down alot of the barriers that we're
facing as a community.
That would improve the mentalhealth of everyone in our
community on so many levels andfor so many reasons.
And I think that would be thebiggest change.
Because my my stress would godown if all of theirs did too,
basically.
Dr Andrew Greenland (35:06):
Sure.
Um, you've mentioned the bookand the podcast.
Just do you want to expand alittle bit on that and tell
people how they can access themand what they would get from
them if they were to tune in orto read?
Dr Amanda Whitehouse (35:16):
Sure.
So the podcast is called Don'tFeed the Fear.
It's on all platforms and it'seasy to find.
And I focus on anxiety andtrauma, but I do that in a lot
of different formats.
So I have guests sometimes havea lot of amazing experts.
I do solo episodes where Ifocus more deeply on mental
health topics, and so I try toshare a lot of good information
(35:36):
in that.
And then I'll hold it up incase people are watching the
video.
Um, the book is called FromFear to Freedom.
It's a guide for navigatingallergy immunotherapy, and um
they can find that anywhere theybuy their books on Amazon.
It's on bookshop.org.
It's available for smallindependent bookstores to order
and libraries if anyone wants toget those resources and
(35:59):
directly through me.
So if there's anyone listeningwho has a practice who wants to
talk about bulk orders toprovide the resource to their
patients, then you can reach outto me.
And I'm everything the foodallergy psychologist makes it
easy to find me.
So my website is the foodallergy psychologist, that's my
um internet handle, and so thatshould make me really easy to
find.
Dr Andrew Greenland (36:20):
Perfect.
Thank you.
Well, put that on the bio pageas well.
Um, thinking about the nextyear or so, what does success
look like for you in your workin the next 12 months?
Where would you like to be?
What would you like to haveachieved?
Dr Amanda Whitehouse (36:30):
I would love to bridge the gap between
um the mental health care andthe medical care that we talked
about early in the com earlierin the conversation.
Um so I'm really excited justtomorrow.
I'm not sure when people willbe listening, but um I'm
traveling to the FAST OITconference in Texas in the
States, which is the group ofproviders who learn and share
(36:52):
how to do immunotherapytreatments together.
And so I get to talk to themabout all of this and these
mental health aspects of notjust food allergy management,
but navigating treatmentdecisions and then doing the
treatment successfully.
And I would love to continuethose conversations and be the
go-between between the patients,between the providers who are
offering this, who I know wanttheir patients to have better
(37:15):
experiences.
I've gotten to meet so many ofthem already, and I I know how
genuine and eager they are tohave the best outcomes for their
patients.
And I think this is another oneof those links that we need to
strengthen.
So I hope I can be a part ofthat.
Dr Andrew Greenland (37:29):
Wonderful.
And finally, if you were tostart this all over again
tomorrow with everything thatyou know, would you do anything
differently?
Dr Amanda Whitehouse (37:37):
I would.
Um, and it you're gonna get apsychologist answer here too,
but it really just would be witha lot more self-compassion.
Um, I think I my own experiencemirrors that of a lot of people
in our community where we'rethrown into something and we
really just have to powerthrough and push through.
And we don't realize untillooking back how hard we pushed
(37:57):
ourselves and and how difficultit was for us.
And so I would love to givethat insight and experience that
I've gained now to myself backthen, both personally as a mom
and business-wise, um, that youknow, to be compassionate, to be
empathetic toward myself aboutall that is on our plates and
how complicated and difficultthis topic is, and to just
(38:20):
accept that I'm not going to beable to fix it all all at once,
but it's still worth movingforward and and making progress
at whatever pace works.
Dr Andrew Greenland (38:30):
Without Amanda, I'd love to thank you so
much for joining me today.
It's been a genuinelyfascinating conversation.
I think you're reallyaddressing one of the most
overlooked gaps in healthcare,helping people feel emotionally
safe while managing real medicalrisk.
So thank you for your insights,thank you for the education,
the information, and the behindthe scenes work of what you do
in the clinic.
It's been a delight.
(38:50):
Thank you so much.
Dr Amanda Whitehouse (38:51):
Thanks so much for having me.
I really appreciate it.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
The Joe Rogan Experience
The official podcast of comedian Joe Rogan.