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Where do you start to heal? The framework I use to help clients with Christa Biegler RD

Picture of Christa Biegler with title Where do you start to heal? The framework I use to help clients with Christa Biegler RD

This week on The Less Stressed Life Podcast, I am answering the question, where do you start if you are trying to heal? In this episode, I go over the framework I use to help clients and how it has evolved over time.


  • 4 steps of the Integrative process coined by Jefferey Bland
  • Where people commonly get stuck in their healing process
  • Timelines for healing


  • Removing barriers to healing & replacing nutrients
  • Using symptoms & testing to create awareness to help & heal your clients
  • Using the AWE method to empower your clients and sit them in the driver's seat of their own health

Learn more about my signature program for helping clients heal from Food Sensitivities and fatigue here:



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Transcript :

Christa (00:09):
Hey there, welcome to the Less Stressed Life where I help women and families overcome fatigue, food, sensitivities, and inflammation. And the goal here is really to help you heal yourself. So if you find this show or episode helpful, please repay the favor and share it with a friend or leave me review on the purple podcast app. If that's where you listen, I'm your host, Christa. Biegler, integrative dietician, nutritionist, and lover of all kinds of foods and my chickens. So not very long ago, I did a Q and a session for practitioners and the most commonly asked a version of the question that was, that I received the most was some version of how do you really get started or how do you start helping people? Or how do you develop a care plan when there's a lot of different things going on, or essentially anyone could ask this question, where do you start if you're trying to heal?

Christa (00:58):
And so I thought I would take this episode and kind of go through the framework that I use and how that has evolved over time. And I hope you find it really helpful. So first of all, there is a well known framework for healing, and I'm gonna get into that. And then there are adaptations to that framework that I've made on my own. So I'm gonna get into that. So we're gonna talk about the four R process, and then we're gonna talk about the awe process. And then we're gonna talk about how that results in changes in gut health and food sensitivities and energy and whatnot. But first I want to kind of tell you where some of this came from. So once upon a time, a very, very long time ago, maybe 2010, which doesn't feel very long ago. And then you realize it was 12 years ago.

Christa (01:47):
I had a mentor and a spiritual mentor, and I remember him saying that there's really only two emotions, fear and happiness. And if you've been listening to this podcast for a while, you've heard me say that I feel like it's a broken record statement. I have there's fear and happiness, but sometime pre COVID, maybe it was 2018 or so maybe it was 2019. I remember going to Dutch Fest that dried urinary tests for comprehensive hormones. They put on a conference one time thing. Never did it again. It was probably, I don't know it was, it was probably 2018 because they were gonna skip a year and then the world fell apart. Anyway. So I went with a few friends. I remember Robin Johnson was there and Dr. Lee Wagner and we were walking along the boardwalk and I don't know what we were talking about, but I do remember having this conversation about fear versus happiness and I this in my brain.

Christa (02:37):
Do you ever have those thoughts where this is how I remember it? So I'm gonna give Dr. Lee Wagner, who is an old friend of mine credit for this. She said, yeah, but I think there's another emotion main key one and that's awe. And that really struck me. I was very taken by that thought process. I'll come back to that later. So when I started my practice in about 2015 ish ish, I'd been working in conventional medicine and different contract jobs since about 2010. That was really when my career pretty much started. So I worked in school nutrition. I worked in dialysis, which is really intensive lab based medicine. And you have a, you know, it doesn't sound that fun, but you do get to have like an ongoing relationship with clients, really get to read labs very well. And in 2015 ish, I had someone I had bought I'd, you know, discontent is kind of how we change <laugh>.

Christa (03:28):
And so when you're working in, in conventional care and you have limited ability and people don't get better, it's, you know, you get kind of sick of that. So I remember there was essentially the short version is that there was basically a knock on the door. Someone had emailed me, I'd bought this training, whatever. And she said that this person in my state was looking for a dietician to do blah, blah, blah, like this food sensitivity testing for his, I think it was for his RA. And I, I think that's, that's what it was. Anyway. The rest is really history. I jumped in and worked with the training that I did have at that time when I was a food based person. So I was looking at food as medicine and essentially long story short for the next few years, I was drinking from a fire hose, getting information from mentors pain mentors to help me get to the next level, but really, really listening to how my clients improved based on the framework I had gotten from initial trainings and until, and it worked beautifully for a while until the food wasn't enough anymore.

Christa (04:30):
But before that, regardless, I wanna share, if you haven't heard of the integr process, you probably have some other words it's known by are the four or five R process. So I'm gonna give Dr. Jeffrey bland, who is really not, he's actually not, not a very old man. So I, I believe he's the FA the kind of father of the integrative process of the four or five R protocol. He's certainly credited for it. And I'm gonna give him credit for that today. I'm actually gonna see Dr. Bland. He's doing a he's he and microbiome labs are doing a co conference in Denver next month in September. So if you're going to that, please let me know. I just registered for it today. So anyways, I'll see Dr. Jeffrey bland at that time, but he coined this four or five R integrative process.

Christa (05:16):
And the steps to that process are remove, replace repair repopulate. So that can be the four steps. And then sometimes there's some other step that people add rest, rebalance, reassess, I mean, insert whatever our word you want. So it just kind of depends on the person. The thing is we can all use a same, the same word and implement that a little bit differently. So for me, when I'm helping to implement this integrative process, let me elaborate on that just a little bit. So the remove phase, I think should take two, three, maybe four months, and that's removing barriers to healing. Now, let me get clear. There are all kinds of symptoms, diagnoses, et cetera, that you can put through this lens, food sensitivities, rashes, eczema, acne, fatigue, bloating, gas, Buring ingeneration reflux, constipation, sleep issues, brain fog, joint, and muscle pain, sinus congestion, mouth ulcers, hormone issues, right?

Christa (06:24):
It's such a huge topic, but any diagnosis, any autoimmune diagnosis, et cetera. So remove the barrier to healing. That's like really getting you stuck. So that might look like gut I balances. It might look like toxic burden. So detoxification issues like just, you have a lot of burden that you're carrying around. So clearing that, removing that removing gut imbalances, cuz if you have gut imbalances, it impacts your enzyme production. And if enzyme production is affected, then digestion is affected. If digestion is effective, then food tolerance is affected. And now you have food sensitivities stress, which is such a huge topic because if stress is not managed, I saw a really interesting pose from Dr. Dadis Cari and recently, and I'm gonna ask him to come on the show and talk about this. And he talks about gluten sensitivity. I think 60% of it starting the bar brain, which that's another story for another day, but your brain drives the majority of everything.

Christa (07:30):
Like it was the starting point of where things started to become inflamed. So stress is a thing, stress chronic stress, depletes, nutrients that affect fatigue. It suppresses those nutrients affect digestion, detoxification, energy hormone. I mean, it just touches everything. So I don't mean that like super lightly. And I there's certainly things we can do about it working on how we digest the stress, like cuz you can't necessarily, you can change the outside stressors, but we also change how you're processing it on the inside. So remove stress for me gut balances to me, toxic burden to me and then food issues. So that kind of just varies depending on the person, how we approach that. And then I'll come back to the evolution of this later. So that's the remove phase for me. Now, one thing that I think is really important is that the remove phase, some version of it, usually food based is published.

Christa (08:29):
Some version again is para published everywhere. So sometimes people start to do the remove phase and in step one you can feel good and it can be a good thing. And so, because we're a society of like instant gratification, we're like, whoa, I feel really good in two weeks, that's exciting. But sometimes people just get stuck and remove and don't reintroduce and some people restrict and restrict and restrict or remove and remove and remove of some sort and never really get past that point. And that's a huge, huge, huge problem. So remove, I think should last three to four months if you're doing it right. Maybe two at the minimum, that's kind of where I, I start with the minimum and then go to the maximum. If I need to, the next step is replace. And to me replace means replacing enzymes, replacing nutrient deficiencies.

Christa (09:24):
So that can mean a lot of things I don't necessarily use enzymes in practice. Cause I think there's better ways to do that, but ultimately you heard me say a minute ago, if you've got gut imbalances, which should be removed, that will influence down the line, how enzymes work and if digestion and that affects food sensitivities overall. So making sure, and also when you've got gut, like just basic 1 0 1, if your gut's not quite working correctly, then you're not gonna digest, absorb nutrients. And so you're gonna be putting a lot of money in and not getting a lot out. You're not gonna be getting an ROI or a return on investment from your healthy diet, from the things you're eating, et cetera. And so when you've got gut stuff going on or just some burden, that's really, you know, it, it's usually gonna start in the gut.

Christa (10:07):
That's where all of your nutrients are absorbed, right? So if you're not digesting, you cannot absorb them beautifully. So really replacing the holes that were created. So I would say like if you're imagining a road, these are potholes, I call that kind of filling in those potholes. The next step is repair and then repopulate. So I kind of grouped this into one as well. I think that this phase, and let me go back a step replaced to me and I kind of came up with the timelines for this based on how long, like compiling experience over an amount of time where, you know, working on nutrient replace tends to take three to six months, you know, so that's where I came up with replacing this and, and restarting or, or kind of restimulating your own enzyme production can take 3, 6, 9, 12 months. And it's something you work on for a while, depending on what your stress is like and what the barriers are that are in the way.

Christa (11:07):
And I had already mentioned that the remove phase, I think two months is a good amount of time. I don't mean that people have to make a crazy restrictive diet for two full months. I actually think three weeks on a dietary experiment is a good starting point personally. Autoimmune, you know, autoimmune situations can kinda have some nuance to that for sure. But I think three weeks is a good, good starting point. And then having an exit strategy or a reintroduction plan is important. So that's remove that's replace repair and to populate. So to me through the experience and what I've seen with clients and what I know about like the duration of tissue healing and all these things repairing or populate lasts two to four months after the remove process. And so that can look like that can look like filling in the G the grass, if you're pulling weeds, you know, with, with different things in the gut, like if you're removing weeds in the first step, then you need to fill that back in.

Christa (12:02):
Otherwise the weeds grow back. So it was a huge problem. Simple, easy to understand analogy would be that, you know, often with antibiotics, we're killing all grass and weeds. This is not the best analogy, but a little bit and often, you know, weeds go back when there's empty space. And so we just wanna think about that can happen with, with other natural things as well. And so we wanna make sure we're filling in those gaps. So that's a little bit about re repopulate that maybe probiotics that maybe pre products and maybe something else and the repair has to do with that tissue lining. So I think one fallacy is to believe that leaky gut is a root cause fully in itself. And, and yeah, I mean, it's kind of in an intermediary, it's kind of between a root cause and a secondary thing, cuz usually leaky gut is caused or intestinal permeability is caused by stress, gut imbalances, et cetera, or different, you know, there can be some food implications, et cetera.

Christa (12:58):
So to me, those are the root causes and then the gut becomes permeable, but regardless it needs to be fixed. The problem is, is that sometimes people just use things for repairing gut gut lining and they, they aren't successful either. So there's multiple pieces of moving parts there. So replace or I'm sorry, a repair just means potentially repairing gut lining, soothing nutrients, et cetera. And you know, there's some wiggle room here, right? Like if someone's got a really burning esophagus, I'm gonna add stuff like that right up front, but repair and repopulate that is like, if you break down muscle and rebuild it, like you're you're healing after that, right? Like healing takes some time after symptoms are gone technically. So I think that repair and re populate that should last for at least two to four months after the remove phase and can be repeated really at, at any time potentially.

Christa (13:49):
So that's the basic integrative process. So let me loop back. I think that that's really work that's that's the work. So to me, I wanna loop back to that conversation. I was having on the boardwalk in 20 18, 20 19 at Dutch Fest where we were talking about awe. And I think that we should be in awe of our bodies and how far they can take us, despite how, whether we intend to abuse them or not with how much how much distress they can handle because they really can handle a lot. And it is amazing and I am in awe of it and they can carry you far and they can, your body can rebuild and heal in these cells can heal. So I think it's kind of amazing. So I really like to think about, about awe, but so I think the integrative process is the work.

Christa (14:43):
So the w and a and later on in practice, after I started implementing the integrative process, I found that if people didn't really have awareness first, they couldn't really fix things. So how I was automatically cultivating awareness and practice was I was using this then called a multiple symptom questionnaire or a symptom survey. You can Google that up if you want. And it's a lot of symptoms that are not diagnoses and people don't even think about 'em like itchy ears or stuffy nose or whatever. So things people don't even always think about cuz it feels kind of normal if they've had this nagging and annoying symptom for a while. And this is, I like to stereotype men frequently to their face all the time that they are, I think stereotypically a little less aware than women. And so that becomes a challenge because if you don't have awareness, you can't appreciate fix something or notice the subtleties of healing until like kind of the massive symptom is gone.

Christa (15:42):
I also think it's why we drive. You know, I think we keep healthcare in business. It's like we don't, I just, I think our self-awareness is not as awesome as it could be. Now that says, I think there's a fine line because sometimes you can get kind of those orthorexic behaviors when you wanna be like so healthy to where it's like that in itself is a stressor sometimes. But I digress. I don't think the podcast is for that today. <Laugh> awareness in general being aware that something is an issue is important. And so I think also awareness has to do with maybe test results. So it's symptoms plus test results. To me, I think symptoms are equally as important if not more important than test results, because test results vary how practitioners implement test results, vary dramatically. I'm seeing an unfortunate thing. Maybe it's another podcast, but I'm seeing an unfortunate situation right now where it feels that I see a lot of, so it used to be that people came to a functional or integrated medicine practice when they felt like they weren't getting answers in a conventional practice or wanted to do a more root cause approach.

Christa (16:50):
And now I see more and more people that have seen other functional or integrative providers, quote unquote, I don't know anything about their background, et cetera. I have suspicions and, and thoughts, but I see a lot of people kind of failing out of that or plateauing out of that or maybe getting worse and then they kind of arrive at my door stop and I will just say, that's fine. I don't, I like pulling things apart and detecting it and connecting the dots. But it does take a little more work. I think that writing down, having a lot of self-awareness writing down the timeline and what you did and what did or didn't work helps me sleuth that so much faster. So if that's you talking to you <laugh> so awareness is both in testing and in symptoms. So for me, I've kind of adjusted my big overarching process to awe a w E E.

Christa (17:49):
I think if you don't have awareness first that comes from symptoms and testing, then you are not always gonna be as successful when doing the work, which is the w I think the work is the integrator process. It's that for our process remove replace repair repopulate. And then lastly, what's the last one for me. For me, I didn't really want people to rely on me forever. I've got friends that have had clients the same clients for years and years and years, and that is fine. And I have relationship with clients that I've had at the beginning of time. And later on, I, I, sometimes people reach out to me and they say, I was your client from blah, blah, blah, and blah, blah. I'm like, yes, I remember <laugh>. I, I remember everybody. I think I remember everyone anyway. I have an unusual, <laugh> unusual filing system in my brain.

Christa (18:37):
I think I remember everyone pretty well. I didn't want people to rely on me forever. I'm happy to share and educate and connect the dots and do deep dive detective work. And I'm good at that as a practitioner, but ultimately I want women to feel empowered, to sit in the driver's seat of their own health. I don't want 'em to rely on me forever. I want them to be able to use a reproducible framework and kind of use it for another symptom, help their family help themselves. Because as someone asked recently, she said, well, are we like what was getting to the end of, of a, my program that we were working on together? And she said, well, are we just like good? Or can this happen again? I'm like, what got you here can get you here again. You know, our life has stuff and road bumps that happen.

Christa (19:26):
So not that I'm not available. I just want my clients to be able to answer their own questions by using a framework that makes sense and is reproducible. And yes, it has tons of nuance for different conditions. When someone books a call and they've got X, Y, Z symptom, I'm probably gonna have little different input than if they've got X, Y, Z diagnosis, right? It's just, there are nuances, but I love common denominators and there are so many common denominators in trying to help and heal. All right. So one other thought on this framework overall, and maybe this is another topic for another day, but I do think that I do wanna mention that, like, the things that you remove at the beginning of the RS are majorly impact inflammation overall. So gut imbalances and stress chemistry, those provoke inflammation in the body and create immune system dysfunction with th one and th two immune messengers, which can look a little different.

Christa (20:24):
It can look like a person who never gets sick, or it looks like someone who's got like a lot of, lot of allergic type conditions. The other thing I would just wanna mention this too, that I think is really kind of interesting is that you can get brain inflammation from regular inflammation and you can get autoimmunity from this whole systemic inflammation situation. But if you have a concussion history, you can also, that can also like drive so much because it's starting in the brain. So that concussion history be a good topic for a podcast is, is nutrition for concussion support. But I am so fascinated by people who have had concussions in high school, maybe they're in their early twenties and the cool stuff we can do, the stuff that they're reacting to and sensitive to, and the cool stuff that we can do when affecting their immune system and, and calming it down.

Christa (21:10):
So when you've got that systemic inflammation, it causes those symptoms like bloating and inflamma or bloating and fatigue and brain fog and cravings and sleep issues, et cetera. And ultimately the outcomes look like being sensitive to food or having symptoms and nutrient deficiencies. I think so many symptoms are nutrient deficiencies as well. So I hope that helps answer the question. You know, how do you get started? Where do you go? This is kind of how I have laid it out. The awe process awareness through testing and symptoms, lots of tests, lots of cuz you can kind of categorize symptoms as well for like what's going on with the liver, what's going on with the gut, et cetera, and then doing the work through the integrative process, using the results of those symptom questionnaires and testing to implement. And then at the end, the goal is really empowerment, which doesn't happen overnight.

Christa (21:59):
<Laugh> I am a generally fairly impatient person. So I, my protocols and plans used usually are like fairly efficient and expedient <laugh> and I would say aggressive but not everyone can handle that. And so sometimes you have to slow things down and meet people where they are. So I think if you're doing things in the right way, you can have great success and as little as one month, and you have even better success in a few months and a handful of months, but the things that got you started on healing, you should expect to like continue those positive habits, 6, 9, 12 months, and kind of be reassessing throughout that year. Well, that's it for me today. Right now, enrollment is open for my program, food sensitivity solutions and the fatigue fix. This is a four month program. That includes the framework that I just shared with you right now.

Christa (22:50):
It includes one on one optional, weekly access to me, testing both a stool test and mineral test trainings for that empowerment piece, because I want you to learn the 1 0 1 before we get to one on ones, the 1 0 1, the basics, like here's basically what's going on in a stool test. And then that way, when you get to that one on one, you just understand it better. You can ask higher level questions and then ultimately you can get more out of it by having then a couple of touchpoint, even before you get to your one on one. So I have kind of changed how I work with clients just from a stress and client management perspective and, and wanting to do more things in life, but also feeling really called to this work. And so we kind of open and close enrollment. And so in August right now we're enrolling to start in mid-September.

Christa (23:40):
And so, you know, back to school rush shall be over, I think by then, but the point is, is that to get started in September 15th, you have to enroll by August 31st just because we need to ship out tests, get those going. So that way you can kind of hit the ground running and not be waiting around for test results. The next time that'll be open, that'll be open for enrollment for this one-on-one program is in October to get started on November 1st. So if that's something that's interesting to you jump over to Krista, or if you just go to Krista, you'll find it have a great day. And I will see you next week. Next week, I am talking to Jillian griefs and we are talking about adrenal P C O S or a hypoth like Amor. How to DIY P C O S food recommendations of testing for P C O S.

Christa (24:29):
So if that sounds good to you, come on back for that and share with a friend access to functional or specialized medicine testing and standard blood work is a big piece of personalizing care plans to help our clients succeed, but getting accounts with multiple labs and ordering and tracking results from many different web portals slows efficiency by bogging us down in admin work. This is why I'm completely obsessed with our podcast sponsor at Rupa health. It's a single portal that allows you to order from over 20 specialty labs in one incredibly simple dashboard, I'm talking less than 30 seconds to set up your free account in about 30 seconds to order the labs you need. All the results are in one place, and I can securely send clients their results with a click of a button. A big advantage for our clients is that standard blood work can be ordered for almost two thirds, less than other direct to consumer lab sites. Rupa is a lab concierge. So they send the lab invoices on your behalf of a client pays for their own labs. They help them get set up with a lab, draw, navigate testing questions, and they provide the requisition forms. It's literally a dream go sign up for free to help streamline your practice and simplify ordering labs for your [email protected], that'sRRUPA and let them know I sent you when you sign up.



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