Tuesday, February 1, 2011

Lessons from the Tiger Mom

A Nutritionist's View on Achieving Success

Twice last week I was accused of acting like a Tiger Mom. Interestingly, the accusers were not my own flesh and blood. Rather, they were two patients, independently, who described my Tigress-like approach in my sessions with them.

Unaware of the Tiger Mom associations, evolved from Amy Chua’s book “Battle Hymn of the Tiger Mother”? Briefly, this Yale Law school professor recently published her memoir on parenting, Chinese parenting, focused on tough love strategies and exceptionally high standards. She writes that “an A- is a bad grade”, and has been known to reject her young daughter’s homemade birthday card, saying “I deserve better than this” throwing it back at her child. She states:

"Chinese parents can do things that would seem unimaginable — even legally actionable — to Westerners. Chinese mothers can say to their daughters, "Hey fatty — lose some weight." By contrast, Western parents have to tiptoe around the issue, talking in terms of "health" and never ever mentioning the f-word, and their kids still end up in therapy for eating disorders and negative self-image. ... "

While I admit to having not yet read the book, it certainly appears that success is measured by how things appear on the outside (such as mastering a musical instrument to perform at Carnegie Hall, as her daughter did at 14). Happiness, and psychological health, however, apparently are of no concern.

Now back to my patients. Neither Jane nor Dana was called names in our sessions. And my focus was hardly limited to external measures of progress, such as weight, for instance. Yet their descriptions of my counseling approach I could only translate as “Tiger”.  And rightfully so.

A literal “Ouch” was uttered, as I strongly linked Dana’s recent eating disordered slip with the very destructive pattern she sees in her mother. I very directly pointed out the inconsistencies between what she stated she wanted to achieve and her unhealthy behaviors. After much time working together, this grade was substandard and for eating disorder recovery, simply unacceptable. I told her I had come to expect better from her. And strict limits were set regarding behaviors that impacted her safety and the safety of those in her care. While her behavior is her choice, I could not support working together unless some clear limits were established, including accountability for medical stability.

As for Jane, who has been working with me for more than a year, she casually described (to an Intern sitting in on our session) my lack of warmth and fuzziness at our initial meeting. Perhaps she even mentioned distant? Can’t remember, or simply blocking it out. But over time, she reported, she saw another side of me. Let’s call it the Koala Mom side.

The Koala Mom, so beautifully and lovingly described by Dr. Amy ( is warm, fuzzy and supportive. She trusts her offspring have the competence and wisdom to do the right thing, to have good judgment, and to be true to them selves. Koala Mom offers a “safe place to escape from the pressures of the world”. And KM wants to build their inner strength so they can cope with disappointments and difficulties when they arise.

Perhaps it’s a bit of a leap, but the parenting role we play as counselors and nutrition therapists cannot be ignored. On the Tiger side, denying you privileges, including engaging in physical activity, traveling, even driving a car, is often essential—for your own safety. And often, few others will step in to set these very necessary limits. And if they did, if might be difficult to hear from those that are closer to you. These limits are set out of care and concern. They are not punishments, merely safety measures, road-blocks to prevent you from detouring into an abyss. I may present what appears rigid, (as described in a phone conversation with one parent today). Yet this very parent, in the same call described how safe and trusting her daughter had become of my guidance.

Yet if I fail to be appropriately nurturing, to be part Koala Mom, to support you in making your own decisions, I am truly sorry. It’s not that I don’t trust you. It’s not that I don’t believe your stated intentions. It’s just that eating disorders are fickle. They don’t always behave rationally and sensibly. Motivated to recover, you’ll come to appreciate this. Like Dana who admits that my direct and seemingly harsh stand, while troubling to hear, was just what she needed. Yes, it shook her up, and got her back on her feet. At least for now.

And so at times, my Tiger Mom side may emerge—seemingly strict, tough, heartless. Tough love, maybe, but with only the best intentions for recovery. But I hope you’ll have absorbed my encouragement and belief in your ability to get through. Perhaps, as patients have reported, believing in you even when you have stopped believing in yourself.

And hopefully you’ll know that you have a voice that I am always willing to hear—even if I don’t always agree what you might be saying.

You won’t always like what I have to say. (Or, the recommendations of your own nutritionist, or therapist, or doctor, if it goes against your unhealthy intentions.) But please consider that this seemingly callous approach is anything but. It comes from truly caring about your success and recovery. And the need to balance the Koala with the Tiger.

I'd love to hear what you're thinking, so please comment!


  1. Yes, there is definitely a place for balance between the two. I know from my own treatment that if things are too ‘tiger’ I just don’t listen; too ‘koala’ and I end up feeling disempowered.

    In fact my own experience has been a bit too ‘koala’ – my fault though. I can see the difficult position they are in – I always have the option of discontinuing treatment if I don’t like what I hear – something I do regularly for months at a time.
    The result of all this loving ‘koala’ treatment though has been that I really didn’t know that I was in control of my recovery. All I heard was that this wasn’t my fault – which whilst it may be true, did nothing for my sense of power and purpose.

    Thankfully someone I trust recently told me outright (in a ‘gentle tiger’-like manner) that I do have control over my recovery. And although this frightened me at the time because I didn’t believe it, over time it has empowered me. In fact over the past week I have attended all three of my treatment team appointments (with support from my husband).

    So perhaps ‘gentle tiger’? Not too scary. But not too fluffy either :)

  2. It's so helpful hearing the perspective from the other side. Thank you! And yes, I like the gentle tiger!

  3. It sounds like you have developed an approach that is based on your philosophy and grounded in thoughtful reflection. I think that various approaches can be extremely helpful, but flexibility and balance is also key, which you describe. I think it also depends on the temperament and needs of the individual patient. Great post!

  4. Not only does it vary by patient, but with that patient's readiness to hear what I might have to offer. And that might change like the wind!
    Thanks for your input!

  5. I really think I'd be much better off if I had been tigered more when I was in early stages of the disorder, and in trying to scramble out of it. My real mother was totally hands off and passive about the ED and my recovery efforts. And I really needed aggressive incentives when it came to work with the nutritionist. It was great to have someone to talk to about my eating patterns, and was eye-opening at times, but if I wasn't pushed, there was no way I was going to budge, and so I didn't. My regular therapist when I was an undergrad pulled off the koala-tiger combo very well, and some of the sessions that have stuck with me the most have been the blunt, "look here damnit" moments. But she was also an incredible safe zone for me.

    Does seem like a fine line to walk at times, though, I'd imagine it greatly depends on the patient. Really interesting to hear it discussed from the treatment side of the equation.

  6. I love the use of the new verb "tigered"! And definitely validating to hear your perspective.
    Thanks for commenting!

  7. This blog could not have come at a better time. I have been very effected by the weather, much more than ever before that I can remember or consciously acknowledged. I have not been on my best behavior to say the least. But I find that you are just the way you should be with me, prodding when I need it and backing off when I need that. I don't find that you fit into either "Mom" category. I can only speak for myself but I believe in you strongly and the way you treat me. If Dana is really falling back into bad practices, then she needs the strong approach. No one likes to have it pointed out that he/she has slipped up but sometimes firmness is the only way to get back on track. I know myself that what I say doesn't always coincide with what I do concerning my eating habits but finally I have realized that I am only lying to myself and hurting myself if I don't face my behavior honestly. Sometimes it is easier to say what someone like you might want to hear so as not to confront the truth. I haven't done this very often with you but I used to do it a lot with other programs. This shows me that I am really taking this seriously.
    As far as what Jane said to you about your being distant and unfriendly, I choose to read that as the attitude she brought to the session, not the way you acted. As you say, your job is to counsel and that does require many of the same skills as being a parent. It is not always pretty but it is your responsibility to help the patient be successful. After all, again I will speak for myself, I was very childlike for a long time in denying what I was doing to myself and how much I needed to stop. One of my toughest issues is exercising, as you know, and you won't let me forget it but are letting me come around on my own power. That is not being the Tiger Mom or the Koala Mom.
    I don't know if this is exactly an answer to your email, but I totally support what you have done to help me and I look forward to our sessions because of the strength and encouragement I receive.

  8. I know that in my interactions with my partner, I don't respond to koala unless I know I am not being humored along. But really having the hard truth put in a cold and unvarnished way doesn't work for me, either.

    So, I think as Anon says above, it requires sensitivity from the issuer to be cognizant of the effect her words have on the recipient. I found this honest post to be very interesting indeed.

  9. Thanks so much for sharing your experience!
    And the honesty you describe is so critical to moving forward. Pleasing me or your providers ultimately doesn't serve you well.

  10. My recovery team has had a tough love approach with me pretty much from the beginning --- at least after they came to know the incredibly stubborn girl I can be :)
    And like you said, I think that there is definitely a place for the tiger and the koala. There was one moment I will never forget when my therapist just held me in her arms and let me cry (for the first time in years) for our entire appointment ... it was the safety and comfort I needed. And there are others where she flat out tells me like it is, and even told me she could not see me if I did not agree to enter into an IOP. Same goes for my RD and even my ED doc. There are times I have absolutely despised all of them, but those were the moments that really propelled me forward in recovery, and I know now that it was just my ED that was angry.
    Today, I am eternally grateful for them and all they have done and continue to do for me. I have a ways to go still, but I am confident I will get there with my "team" behind me.

    When I am stuck in recovery, I tend to respond best when I am "tigered" ... but knowing myself, the tiger approach would have never worked if I had not been absolutely sure that they truly cared about me. I had to learn and trust that first.

    Thanks for this post :)

  11. I think a healthy balance of both koala and tiger is what works (for me anyhow), and Lori has given me just that. She'll push me when I seem to need it most and/or when she sees I'm stagnant, yet she takes on more of a "koala" trait when I am getting on the right track. If she wasn't there to push me I wouldn't even think of taking the risks on my own. I, personally, need both to progress (depending on where I am at). Ultimately it is my decision which direction I want to take in recovery - I sometimes make the right decisions (Koala), and I sometimes make the wrong decisions (Tiger). I'm first to admit it's not easy when I am the recipient of "Tiger Mom", however, that is exactly what I need to shake me into reality. So thank you Lori for being a tiger AND koala, it's been that perfect mixture and balance that has gotten me to where I'm at today.

  12. Thanks for your feedback!
    Perhaps the greatest achievement resulting from this Tiger/Koala style has been moving people to become vocal and share their voice--their fears, their own ambivalence about recovery, and their need for support through this challenging work we do.
    Thanks for your comment!

  13. Hi,

    I think the tiger voice needs to be used very carefully. The first time I went to a therapist I was really terrified - I still remember sitting in the waiting room and thinking my heart would explode out of my chest because it was beating so hard. (There were a variety of cultural reasons why it was hard for me to walk into that office - going to therapy is not something the people I know do.)

    Fast-forward a couple months: at this point I think a lot of people would have calmed down, but I was still very nervous. Part of it, I know, was because of the cultural issue. But a big part of it was also the therapist. She was almost all tiger, without much koala mixed in. Also, I think she mistook my reticence for lack of motivation, and so she started pushing all the harder. Unfortunately, when I saw that she wasn't happy with me, I became even more reticent. Uh-oh, we have a vicious cycle!

    I'll grant that my situation was somewhat unique, but I have to imagine that others have also been scared off by tiger behavior. Feeling safe in a koala-like relationship is essential for me before I trust anyone enough to get anything out of therapy.

    Thanks for reading!

    P.S. I am totally recovered now -- I got a different therapist who was a better fit. :)