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Family-Owned, Patient-Focused: The Renfrew Center Difference

Podcast Transcript

Episode 18: And the Fire Burns: A Passionate Interview with Monika Ostroff, Executive Director of MEDA

[Bouncy theme music plays.]

Sam: Hey, I’m Sam!

Ashley: Hi, I’m Ashley and you’re listening to All Bodies. All Foods. presented by The Renfrew Center for Eating Disorders. We want to create a space for all bodies to come together authentically and purposefully to discuss various areas that impact us on a cultural and relational level.

Sam: We believe that all bodies and all foods are welcome, we would love for you to join us on this journey. Let’s learn together.

Ashley: All right, hello everyone! Ashley and Sam here. Thank you all again for joining us for another episode of All Bodies. All Foods., hosted by the Renfrew Center. We have an incredible guest with us today, and I wanna start off by sharing a little bit about her with you all. So, Monika Ostroff, MSW, MICSW, CEDS-S. Monika is currently the executive director of MEDA, the Multi-Service Eating Disorders Association, nationally recognized for her 25-plus years of experience and contributions to the field of eating disorders. She has directed several successful residential, partial hospital, and intensive outpatient eating disorder programs, in addition to having owned a thriving private practice. Monika is the co-author of Anorexia Nervosa: A Guide to Recovery and a contributing author to Self-Harm Behavior and Eating Disorders. She has presented at many national conferences, taught at the university level, and appeared on several radio and television broadcasts. Monika’s passion for treating eating disorders and mentoring other professionals was born out of her own struggle and full recovery from what today is known as Severe and Enduring Anorexia Nervosa. She strongly believes in providing compassionate care that combines alternative healing with evidence-based modalities. In addition to using meditation, yoga, and essential oils, she is certified in several alternative healing modalities. So, Monika, thank you so much for being with us today!

Monika: Thank you so much for having me! I realize the older I get, the longer my bio is.

Ashley: I’m reading it and I, you know, I think I told you this before we connected on here, I was reading about you online earlier. There are— you have done so much, and we’re so excited to have you on. I’m here to kind of talk about everything, and I would love to just kick it off, like, I can tell, you know, with the work that you’ve done, you’re passionate about this field, and we’re so appreciative to have you in it. And I’m just curious if you could talk to us, talk to our listeners, let us know how you got into this field and this work?

Monika: Oh, by accident in some ways. I, like a lot of people I think that are in the field, right, I clearly have my own personal history with an eating disorder that maybe took a little longer than the usual to get through. When I hit a place of kind of figuring it out and doing better, I actually didn’t want anything to do with talking about food or bodies ever for the rest of my life. I was done. And that didn’t last very long. At all.

Ashley: Yeah!

Monika: I, you know, when I looked back and was kind of reflecting on my struggle, I had— it was complicated, right? Like, I’m somebody like many people in the field, I have a very long and complex history of trauma, and that— my eating disorder makes a lot of sense in that context, and probably has genetic basis as well. My experience in treatment was back in the nineties, things were very different then than they are now.

Ashley: Yeah.

Monika: And I had a lot of difficulty in treatment with just how the care was delivered. It felt very pathologizing, very shaming, very disempowering. It’s very different today than it was then. So, when I was kind of reflecting of my five years in and out of the hospital, which were a combination of my eating disorder and, you know, sort of the symptomatology that’s associated with trauma, really. I looked back and I got really angry when I looked at how I was treated and what happened, things that were said to me, things that were done to me. And I thought, you know, “I can do one of two things. I can marinate in my anger and become a bitter resentful person, and probably be pretty negative. Or, anger is a pretty energetic emotion, I can take that energy and I can wrap it into something and maybe do some good.” And I felt really compelled and passionate about lending my voice, at the time, to other voices I think that were kind of emerging, to begin to challenge people to treat folks who have eating disorders differently. To move away from this kind of medicalized pathological model that is inherently, I think, shame based and patient blaming, to one that maybe recognizes the inherent strengths and wisdom in the person who’s struggling. And I started out literally speaking and writing, learned a lot from different people that I was talking with. And interestingly enough, in the early nineties I was still sick with my eating disorder but was volunteering for an organization called ABC Incorporated, which is no longer in existence. That’s where I met Rebecca Manley, who is MEDA’s founder!

Ashley: OK!

Monika: Yeah. So, Rebecca actually, “Becky” that many of us know her by, founded that in 1994. So, I did have some really early on experiences with MEDA where I was doing some presentations, going into schools for MEDA, doing some prevention work, I was leading one of their peer-led groups at the time. And then the nineties got really complicated for me with various hospitalizations. So, I was looking at what Becky was doing before I went to graduate school, and honestly was pretty interested in either partnering with her or doing something in my home state, which is New Hampshire. And quickly figured out that I should really go to graduate school, because my personal experience wasn’t quite enough to have the kind of impact I think I was hoping to have in the field. So, social work was a really great match for me because I love policy, and advocacy, and clinical work.

Ashley: Yeah.

Monika: And it allowed me to create a package where I could do all of those things. What I wasn’t anticipating was this kind of, like, right hand turn that I took when I got out of graduate school, which was, “I’m going to build programs, open treatment centers and run them, and have a private practice for a number of years.”

Sam/Ashley: Yeah.

Monika:  And that was helpful up on a personal level, but I think also, I worked really hard to try to have a presence and a voice in the eating disorder field to really help move treatment into one that was really much more strength based, that really challenged people to recognize everybody that comes in front of us, as having— they’re the experts on themselves, right? Like, we cannot trust an expert on anybody except ourselves. And yes, it’s true, right, there are different mechanisms that are protective, or sometimes dissociative depending on what’s happening in our lives, that might get in the way of us knowing everything we need to know about ourselves, and professionals can be really helpful in that regard. But professionals are not ever an expert on another human, only that person can be that expert. So, it was really a lot of fun to be going to national conferences and presenting some of the work that I was doing, weaving together different modalities and also having a direct impact. It was really soothing to my soul sometimes to be leading treatment centers where I knew that every individual coming to that center was not having an experience like the one that I had had years before, right?

Sam/Ashley: Yeah.

Monika: But then in, you know, 2019, Becky who’s our founder and then our board chair Leslie Bernstein, had met with me and we kind of like, “So, how do you like your current job?” And the really long story short is, Leslie extended the invitation to lead MEDA, which honestly feels like being home. So, MEDA has been this organization, I’ve always known it to be this kind of— I’m gonna quote Carolyn who’s sitting next to me.

Ashley: Yeah!

Monika: Perfect— “A place where we recognize that we don’t do everything right, at all.” We are very human, very loving, very kind. And it’s the place where you can literally come as you are, put up your feet, and know that you are loved, accepted, and we will help you figure it out. We want you to thrive in your life, and we all feel really passionate about that. So, I feel like I’m home. MEDA was the first national conference that I had ever really presented at as a licensed professional, which is really fun.

Ashley: Oh, wow!

Monika: And so today, I literally feel like my career just went full circle. And there’s so many fun things happening here that I just feel really lucky to be— let me put it this way: I get up in the morning and I think, “I get to go to work today!”

Ashley: Yeah.

Sam: Wow.

Monika: Which is really different than like, “I have to go to work today.”

Ashley: Right, right.

Monika: It’s an amazing team, a phenomenal community. And I mean, you guys are part of our community. It’s like, it’s really fun.

Ashley: And I have noticed working within this industry, working within this field, like we, there are, we are so connected. And I love that, I love going to the conferences, I love meeting the people that, you know, that I share a passion with. And I just wanted to say to that too, Monika, as Sam and I created this podcast and just really, we really wanted to provide a space for everyone to come and learn, right? And we also very much are aware that we don’t know everything and we probably never will. And so, you know, one of our taglines is “Let’s learn together,” you know. And so we love having people like you on here so that you can share your experience, share your story with us, and even share, you know, I would love to even hear more about MEDA, I guess, and their mission, and their passion, and what they’re doing in the community, if you could share a little bit about that too.

Monika: Oh, I would love to! It’s one of my favorite topics of conversation, actually.

Ashley: Awesome!

Monika: I know it’s probably shocking, right? So I’m literally in love with this organization, mostly because of it’s got such an incredibly strong heartbeat, and so much love and passion to help people who are struggling, and their families, move into a life that feels like one that is satisfying, and one they can thrive in. So, we are very focused on access to equitable care, and we’re working really hard on that. Do we have it down? No. But we are working very hard on it. We’ve done a lot to remove barriers to access to care for people, and we’re constantly learning about how we can make care more equitable, more diverse, and more meaningfully inclusive. So, we do a couple of different things. We have, if you think about us as kind of having different arms almost, we have a clinical arm where we literally do individual group and family therapy, treating folks who are currently struggling with eating disorders from a HAES-aligned, empowered lens.

Ashley: OK.

Monika: And that’s really important to us. We also have an online community called the MEDA Recovery Community. It’s at recoverwithMEDA.org, and that has two sections to it. One is a lot of different tools, webinars. Actually, there’s a really great webinar that you folks donated to us, Control the Scroll.

Sam: Yeah, that was one I did about social media.

Ashley: I was gonna ask, Sam, was that yours?

Monika: It’s so good!

Sam: Oh good, I’m glad you liked it.

Monika:  It’s in the webinar section, and that also comes with a number of forums that are live and they’re moderated by peer recovery, people that are in recovery or various stages of recovery, really. Just making sure that it is a really safe place where people can come and talk about what they’re going through, can share resources, can share motivation, or can get motivation when they need it. And it’s something that is free. There are some other levels where, you know, if you wanted the group coaching, that is a minimal sum, but we have a lot of scholarships. So, it’s literally accessible to everybody. And you can reach that 24/7, which was the goal, right?

Ashley: Yeah.

Monika: You can be in the middle of the woods, as long as you have a cell signal you can get some help there and connect with people. And we also have a really big effort to train professionals. So, we have a pretty popular national conference every year that we have been working really hard to ensure that the voices of people who are living in marginalized communities are really centered. So, our keynotes and many of our workshops are given by members of the BIPOC, LGBTQ, or folks who are living in larger bodies, to make sure that their voices are really heard and that we can all learn from them. I think we recognize that, you know, the voices of, like, the white, middle class, straight bodied person has been exhausted in many ways, and it’s really time to learn so that we can provide better care, so we can ensure that there is true equity and access.

Sam/Ashley: Yeah.

Monika: And we do a lot of training of clinicians and other— sometimes other treatment centers, but very often, like, community mental health centers, group practices, to help them. Universities, for example, to help their clinical staff be able to treat eating disorders with some authority and some, like a sense of confidence.

Ashley: Yeah. That is wonderful. And we can tag the organization’s website in our, you know, post when we put this up. But, you all are located in the northeast, correct?

Monika: Yes, we are just outside of Boston and Newton.

Ashley: OK. And who all has access to you, is it nationwide? Who all can utilize these resources that you have?

Monika: We actually have people from all over the world. We have people from different countries that also come in, especially for our— we do a number of Instagram lives that are supportive for people who are struggling in recovery, in addition to our online community, and some of our groups as well. And we have people from all over the country that access our services. I would say that we are heavily New England, if we were to kind of do up the demographics. We are still really wanting to make sure the New England states have what they need. Coming from New Hampshire, we didn’t have any treatment centers there until I opened one.

Ashley: Yeah, yeah!

Sam: Wow.

Monika: You know, Vermont is still struggling to get their treatment, a treatment center. But, you know, the New England States have a high need. But absolutely, when we do our free drop-in groups on Tuesday evenings and Thursdays, when people say where they’re from, we hear people from Florida, California, Oklahoma, Brazil, England.

Ashley: Oh, wow!

Monika: Like, all over. It’s really, really fun.

Sam: That’s amazing.

Ashley: That’s awesome.

Sam: Yes, we’ll have to include the Instagram handle too. These are great resources for the audience to have.

Ashley: Yes, yes.

Monika: Thank you!

Sam: One thing, well, two things actually stood out to me. You know, one of the things I just wanted to point out in the story you told at the beginning of this episode about your anger, and what a beautiful example of allowing your anger to fuel you in this direction. And I think that’s so important, you know, we teach with the UT about the function of emotions, and what a beautiful example of that! It’s like, “What are my choices here? Can I, will I sit in my anger or actually use it to do something?” So, that just really touched me, really such a wonderful example. And in your bio, I think earlier, Ashley and I were talking about all of your amazing accomplishments—

Ashley: Yes!

Sam: One of which, you wrote a book on self-harm.

Monika: I was one of the contributing authors.

Sam: Okay.

Monika: It was actually an anthology. So, there was a number of us that came together to create that, sort of almost like a textbook.

Sam: Yes. Oh, wonderful. And we, I was talking to Ashley about, we haven’t really even scratched the surface with self-harm on this podcast yet. And it’s so misunderstood, especially the relationship between self-harm and eating disorders. And I think oftentimes, especially with parents, when they find out their kid is self-harming, they sort of panic, understandably so. I was curious, what could you share about self-harm specifically?

Monika: I think it’s helpful to not panic and— but, you know, like everything, right, there’s a spectrum of self-harm, right? There’s, there are times when panic is necessary and people need to get emergent medical care, so I don’t wanna say don’t panic in that situation.

Sam: Of course.

Monika: It’s important that people get what they need. But when it comes to what it is and what it does, you know what I find is, even today, there are people in places that do I think a really great job with it, and there are people in places that really struggle to understand it. And when you think about self-injurious behavior as having a function, very similar to how we think about eating disorder behaviors as having a function— what function is it serving for that individual? Right? There are a number of things that it might be, and for one person it may be several things working in conflict with each other. It may be that person’s voice. They might not be able to express what they need, what they think. And so, they’re getting a need met through the language of their self-injurious behavior. It’s hard to understand, similar to the eating disorder language, right?

Sam: They’re communicating something.

Monika: 100%! And it, it may also be a way of self-regulating that doesn’t make sense to some people. However, if you are in such emotional pain, you can translate that emotional pain into a time-limited physical manifestation of that emotional pain and it becomes manageable. It can also become a very protective mechanism for somebody, especially who has complex trauma. If there is an eating disorder, right, and there is self-injury going on, what I see is a lot of treatment teams running around in circles trying to get those behaviors under control, which is important. I’m not saying it’s not important. But what tends to happen is, we are not addressing the fact that there is a very scared part of that person who’s trying to be very protective of their trauma that needs healing. Right?

Ashley: Yes, yes.

Monika: And that person really needs to know that healing is possible, and that hopefully right here right now, everything is ok, and they’re safe, and nothing bad is happening. If that’s not true, we need to get them safe in their environment. But that that tends to get neglected by these kind of worrisome behaviors.

Ashley: Yeah.

Monika: So, when people can take, I think, a step back and sit with a person and help them reflect to identify, “What is this doing for you?” And sometimes they don’t know, right? It’s hard for them to put into words that, “This is translating a really intense emotional pain that I can’t even put words on yet.” Or, you know, “I am trying to be seen in this world. My needs are never met. I’m trampled all the time. This is a way of me taking up some space and having people see me, or at least part of me.”

Sam: Right.

Ashley: I’m sitting here listening to you and I’m just thinking how lovely these words sound coming from you. How compassionate they sound, you know, helping us understand that we can really view self-harm as— and it feels mind blowing— but as a protector. As the thing that is protecting that innermost hurt, right? And so, when we can, even as providers, even as family members, view it as that, I think it might shift some of our language with our loved one.

Monika: I think there’s something that, you know, happened in the field a number of years ago, like 20 or so, but is still sometimes slow to catch on. And that is really moving away from this kind of patient-blaming, disempowering, the person’s just trying to.. it’s like attention seeking. I literally had this conversation with somebody earlier today. It drives me crazy when people say that a client is attention seeking. I’m like, “Attention seeking is wearing a flashy sweater.” It’s not harming yourself and you know, almost dying from an eating disorder.

Ashley: Yeah!

Monika: There’s other ways to get attention, that’s not it. But when we can really recognize that everybody— I’m gonna rephrase it. Because I say this a lot in terms of eating disorders, and I think it’s true of self-injury as well. People are doing the best they can with what they have. It is a strength that somebody found a way of surviving their life. Our job is to be an ally to them and work with them to find another way in which they can completely thrive and not be harming other parts of themself. Those protective parts that self-injure or engage in eating disorder behaviors are really doing the best they can to protect the person. They don’t know that what they’re doing is harmful. If you think about, like, Dick Schwartz IFS work, right, like no bad parts? There really are no bad parts.

Ashley: Yeah.

Sam: Well, I think also it just, it takes away so much of the shame that folks might be carrying around with them, that it’s like, “Something’s wrong with me that I keep doing this.” And it’s like, “Actually nothing’s wrong with you! This has been a survival strategy, and let’s just figure out different ways you can survive.”

Monika: Yeah! And good for you for surviving! Look at the alternative.

Sam: Yeah! Right, right. Exactly.

Monika: Sometimes I think we forget that, or people can forget it if the struggle goes on for a period of time. You know, I think that’s where a lot of the shame starts coming up, is if somebody is not getting better fast enough. I’m not sure who’s determining the speed of recovery and, like, what’s ok and what’s not, but I’m sure the two of you hear it all the time, too, that there are people that come in and they have so much shame because they’re not better yet.

Ashley: Yeah.

Sam: Mhm, absolutely.

Monika: And that’s when I think, you know, we as providers and even as a community, we need to take a step back and think about with those folks, what haven’t we done yet? What are we missing? A lot of times, I’m sure you’ve seen it too, there can be people that get, I think frustrated, or maybe they’re questioning their own skill set as a provider. And so, it’s easy to say, “That person doesn’t want to get better.”

Ashley: Yeah.

Monika: But that’s not the truth, right? Like, there isn’t anybody that doesn’t want to get better. It’s a struggle sometimes to get better, and sometimes people don’t have the right information, or support, or skill set. There’s a number of things that can be missing. Or there’s an area of their life that needs healing that we haven’t walked into yet, and we have to figure out what that is.

Ashley: And maybe they don’t know what it is.

Monika: Right.

Ashley: At that point. I was giving a presentation yesterday, Monika, and just kind of talking about really the intersection of trauma and eating disorders, and just how much it shows up. And I had done an expressive arts activity with someone, and she truly, like, I don’t think had put the two together, but she had drawn something and it was one of the first places where she had experienced “yuck.” And when that happened, I mean, it just, you know, she had gone through treatment, her insurance, she was kind of on her way out, you know, and when that got brought up, she actually ended up staying with us at Renfrew for a lot longer, because we were able to finally kind of work on that piece that she truly did—she did not have words for it prior to that. She had not made that connection prior to that. She didn’t know why the eating disorder was protecting her, right? So, just to speak to what you were saying.

Monika: That is such an important point too, because I think sometimes, like, we get, we’ll get adults in and we expect them to be able to explain and describe everything, and a lot of their wounds happened before they were able to actually put words on them. And so doing some of the— using the modalities that you just described is such an amazing way of giving them access to that part of themselves that really needs healing.

Ashley: Yeah, yeah. I’m thinking about— so, you mentioned that you experienced what is now known as Severe and Enduring Anorexia Nervosa. I’m curious how you have seen us shift, and how you have seen us change in regards to working with that modality? And even as you’ve opened up treatment centers, you know, what is important to you when working with someone that might be experiencing that? What do we need to know as providers?

Monika: Oh, that’s— there’s a little piece of that like fire that gets ignited, right? As providers, I think it’s really important to never set a bar for any individual out there. So, what I have seen time and time again, are providers who will say, “Well, so-and-so has been struggling for X number of years, and therefore the most we can hope for is: fill in the blank.” That’s garbage! We don’t have any ability to determine what another human being is capable of doing, or where they’re capable of going. It’s our job to remove barriers. It’s our job to step back and try to figure things out. And I do think, with some of the severe and enduring eating disorders, there are things that we haven’t… we don’t know yet, right? We’re still doing brain research. Like, I know my brain is different than other people, and I accommodate that. Right? Like, I found we have to accommodate that to be healthy. And there are people still trying to figure out how to do that. We’re still learning. The most important thing is being able, I think, to listen to the people that are struggling, what they’re saying that they need while we’re trying to obviously also protect them, you know, and keep them alive, and healthy, and as well as possible while they are moving towards their own recovery. Letting people define what their own recovery looks like. Rather than imposing what we think their recovery should look like. It’s really hard to get a treatment alliance when you do that. The thing— and I’ve shared this other places— that the thing that really made me the most angry when I hit a place of being functional again, was I reconnected with a provider that had treated me in programs. Who I liked, not gonna say I didn’t. She was interested in having me speak to a program that she was running, so she was kind of like, “Oh, you know, come down and let’s talk about what that would look like,” kind of thing. And she was interested in some of the writing that I had done. But when I walked through the door, after she said “Hi,” before I could say “Hi” back, it was like, “Oh, hi Monika, we all thought you’d be dead by now!”

Sam/Ashley: OH!

Monika: What the— like, what even is that?

Ashley: What?!

Sam: Wow…

Monika: What I got angry about, right, was not, like, I don’t see that as a comment around, like, severity. So, anybody that might be listening to this, I really hope you’re not triggered by that because it’s not about severity. What this is about is treatment professionals who gave up. And so you can hear I’m sounding angry, right?

Sam: Yeah!

Monika: Like, it’s treatment professionals who gave up. And if you are somebody thinking that about one of your clients, then there is no way on this planet that you are giving that client’s treatment your all. You’re not working anymore. And that is not fair to the person struggling.

Sam/Ashley: Mhm.

Monika: If you’ve gotten to a place where you’re frustrated with, whether it’s your own skill set, you don’t know what to do next, consultation is not working for you— like, whatever it is.

Ashley: Yeah.

Monika: You have an ethical and moral obligation to find care that does work for that individual. Like, you don’t give up on any human being.

Ashley: Yeah.

Monika: So, that’s the thing that happens with this particular subgroup of folks struggling, I think, is that people do give up, and they become complacent, and they’re doing, like, good enough care keeping somebody, you know, kind of just getting by. I don’t think that’s good enough! I’m sorry, I still sound angry.

Sam: You don’t have to apologize.

Ashley: No, you sound passionate! Yes!

Sam: That makes perfect sense that you’re angry about it.

Ashley: Yeah.

Monika: I just, I don’t know how we can come into this field, right, and say we’re here to help people, and then we give up on a section of people.

Ashley: Yeah.

Sam: Mhm.

Ashley: And this is someone that is really kind of experiencing this over, and over, and over. And it might, I mean, it might feel extremely painful to the person experiencing this for years. Years, and years, and years. Yeah.

Monika: It’s really difficult to put words on how horrible the experience is to feel like there is something so inherently wrong with you that you can’t do recovery right. Whether it’s from self-injury and eating disorder, or both. And the provider’s frustration is something that you can— it’s palpable. You can feel it when you’re in the room, you really feel like they don’t like you, and it’s really hard to get better working with people who don’t seem to like you.

Sam/Ashley: Mhm. Right.

Monika: And you already don’t like yourself very much, right? But you’re hurting. I struggle a lot with that. Like, even today, trying to figure out how do we, how do we put in safeguards for people? Because I’m still seeing these people hurt over and over again, you know, by… I think ultimately probably well-meaning providers, right? Like I don’t wanna say anybody is, like, not well meaning. But it’s a really vulnerable group of folks that deserve to know that they can heal. I don’t know what every person’s healing looks like, right? But I know everybody can heal. I think everybody is gonna look different, but nobody should be sitting on the receiving end of hopelessness coming from a team or a provider.

Ashley: Yeah. And I’m curious if that speaks to just even how we’ve evolved as, you know, the eating disorder industry and the field, you were mentioning MEDA offers all sorts of opportunities to connect, right? And we really, really see that as something that someone that is in so much pain, that is really trying to heal but struggling to do so, getting connected with support people, staying connected. Like, I’m even curious if you had those services, you know, back in the day when you were experiencing this, what might have been different? If you had that support, if you could log into that app.

Monika: I think about that a lot to tell you the truth. I look at folks, when I am on the forums— Ruth Elliott, who’s our clinical director, who’s also an amazing clinician and a dear friend of mine— we’re on there posting as well, trying to offer support along with the moderators. And the love and compassion that people are held with, you can really— and people do, like, people will show up there and they just, you can tell they just hate themselves so vehemently. And there is so much kindness and compassion coming at them, so much understanding, you know, where people can just hold that space a little bit and understand like, “Yeah, that’s where you are right now,” and offer them hope, and motivation, and compassion, and experience. With people saying, “I remember when I felt that way, here are a few things that were helpful to me.” Or, “Don’t forget that—” you know, there’s just a lot of, there’s a lot of connection, and I think it could have been really helpful in those moments that felt really dark, that felt really messy, where I was maybe the most disempowered that I have ever been, to have somebody kind of be like, “Actually, things— you can heal.”

Ashley: Mhm. And mean it when they’re saying that.

Monika: Absolutely.

Ashley: Yeah.

Monika: And a lot of times, I think it is… it can be people, right, who have been there or who currently are there, where you work together.

Ashley: Yeah.

Sam: We can’t heal in an environment that confirms our worst fears about ourselves.

Monika: Yes.

Sam: And it’s really about finding a safe space where you are fully accepted for just being authentically you. It reminds me of just, you know, you showing up at work every day. It’s like, finding those spaces where you feel accepted no matter what, you feel loved, you feel held. And it’s so crucial to healing.

Monika: I agree with you. I just think coming to a place where you can literally be you, whatever that looks like, on any given day, and know that you are loved and accepted with compassion no matter what, is so important.

Ashley: Yeah.

Monika: You don’t have to wear a mask. You don’t have to be pretending that you’re somebody else. You can just be whoever and however you are, in all of your messy, unique, wonderful glory.

Ashley: Mhm

Sam: Mhm! How freeing! Yes.

Ashley: Monika, I was having lunch with a provider the other day in Kentucky. Her name is Hillary Bacon, and I’m saying her name because I’m gonna share her idea. So, she’s getting her graduate degree— I’m sorry, her doctoral degree. And the information that she’s working on is kind of studying the system of AA and NA, and how much community that provides, and the mentorship that it provides, and how it does provide exactly what you are saying, the “Come as you are, be who you are, this is what’s going on.” And talking about, how can we create something like that within the eating disorder community? Where we have sponsors, where we have mentors, where we have weekly meetings literally meeting in, you know, every city. How can we create something like that? Simply for that support and simply for our people to show up as they are, you know?

Monika: Yeah, it can be so healing. I think sometimes people are reluctant to try that because the fear is, like, “Everybody’s gonna trigger everybody else, and then they’re all gonna relapse!”

Ashley: Yeah.

Monika: AA and NA are not perfect, right? There are people that get triggered there, there are people that sometimes have lapses, but the idea is the more recovery you have, and the more healing mentors have done, the more stable that becomes. And it seems like we’ve never really gone far enough with that in the field.

Ashley: Yeah. I think, I think there’s something there. I think we can!

Sam: I’m curious, Monika, when you were going through your healing process, do you remember what was helpful to you, when you were able maybe to shift your thinking, or when you had an “Aha” moment? Just for all those folks out there who are thinking to themselves, “I’ll never get better.” I’m just curious, what helped you?

Monika: A million things to be honest, because I think that like anything, it’s this evolution. One thing that was important for sure was developing some semblance of self-compassion. It’s really hard to hurt something you care about, right? Learning to develop something like an inner-parent, an inner-best friend, is really helpful as well. But also recognizing that recovery is not a destination. That healing isn’t finite. I didn’t wanna know this, to be really honest. I did not want to know this. I actually wanted recovery to be a destination. I wanted healing to be finite. And realizing that we are constantly evolving, right? We’re constantly healing, and we’re constantly learning to become the next version of ourselves. And when I also thought about this, this might sound really weird, but this was also helpful to me. You know we’re always saying like, “Be in the present, it’s really important that you’re in the present.” I think that’s really true. But a way of conceptualizing it was, my— who I am right this second is my future self to my past self.

Ashley: Yes.

Monika: Who I am right now is the past self to my future self. What do I wanna do with that? Like, it’s a moment of power. It was a different way somehow for me to kind of conceptualize “the power of now,” to quote Eckhart Tolle. But, you know, thinking about the choices that I’m making today certainly impact my future self. But the choices that I make today are also going to be a memory of a past self for my future self. And there’s a lot I can do with that, right? I can choose to be— I can choose to lean into and embrace a lot of pain and discomfort in service of healing and becoming a better version of me. Not specifically for other people, but for me and other people. And what I can contribute to the world. And those contributions I think also circle back to heal me.

Ashley: Mhm

Sam: Wow! So, it’s about conceptualizing the present as, “What can I do today for future me?” That’s really powerful.

Monika: When you start connecting, you know, the past, present, and future self together, I think it’s just really helpful. It makes you really realize that you really do have a lot more power in this present moment. I can choose to do something that’s really, really, really uncomfortable right this second, but it’s temporary. And if it’s in service of something better… you know, I’ll tell people all the time, like, “It is actually possible to eat lunch and cry at the same time. Who wants to do it?” I used to not do it either. But it’s possible to do that, and it is in service of something else when you realize that you might have to do that for a period of time.

Ashley: Mhm

Monika: But it actually lends itself to healing you, and when you look back on it, like I can look back on it and be like, “Yeah, that period of time wasn’t fun. But it allowed me to get to a place where I have a lot more freedom.” And being willing, this is the other thing that’s really important. Being willing to be reflective and really honest with yourself. I never wanted to be different from other people, and some of that was a survival mechanism, right? And I wanted to be able to say like, “Yeah, I think my brain is completely healed and I’m, like, as recovered as you can ever be!” And then I got to this place where I was like, “You know what? My brain is different.” My brain loves numbers, and symmetry, and patterns. And I can pretend that’s not the case and probably fall down the rabbit hole 800 times, or I can say, “You know what, Monika? Your brain is different. How about you figure out a way to accommodate it and live a healthy life with it?” So, for me, what that looks like is, like, shifting, for example, shifting my relationship with movement. That was something that was a big part of my eating disorder. So, if my brain likes symmetry and patterns, and my body, for reasons of common, like, chronic pain, really needs physical activity so I can keep my pain levels down, how do I navigate that? I navigate that by, I don’t have a routine. I will never do the same thing more than two or three days in a row tops. Why? Because on day number four or five, I’m gonna wake up feeling like I have to do that thing.

Ashley: Mhm.

Monika: So I know that about myself, so I don’t do it. Strength training is really helpful for my neck and my back. I’m not gonna ever be the person that you see on any type of machine that has numbers involved. If I am, my sweatshirt is over it. Is that necessary? Probably not at this stage in my life. But, you know, I’m used to accommodating myself that way to stay healthy.

Sam/Ashley: Mhm.

Monika: And I think, you know, there would be— if you had asked me that 10 years ago, I wouldn’t have shared that information. But I also think that I’m doing people a disservice by not sometimes sharing that information, because does that mean I’m not recovered? Because I vary my routine and I, you know, spontaneity is my routine to make sure that my brain stays healthy? There are some people that say, “Yeah, that means I’m not recovered.” Ok. That’s their opinion. I live a very healthy, mostly balanced life in other areas. But there’s a, you know, some rumor going around that I work a lot. But other than that—

Sam: I think that’s just beautiful! The self-compassion and self-acceptance.

Ashley: Yeah.

Sam: That radical acceptance, like, “This is how my brain works, this is who I am.” And we’re experts on ourselves, and being able to take care of ourselves that way is important.

Monika: Maybe someday as we’re doing more brain research and we’re looking at the structure, maybe someday they’re gonna figure out how to change that type of pathway in the brain. What I know right now is we don’t know the answer to that, and I’ve got that brain! And I prefer to live life the way that I live it now versus how I was gonna live if I kept going.

Sam: Right, right.

Monika: So, there’s a lot of freedom right now that I’m grateful for every single day.

Ashley: Monika, thank you so much. We have— I have one more question for you. How can our listeners connect with you, connect with MEDA? How can we do that?

Monika: Oh, well, join us on our recovery community! We’d love to have you there. Which is recoverwithMEDA.org.

Ashley: Ok.

Monika: And that has all the links to everything else that people would need, including our Instagram account. And if people are interested in our group services, MEDAinc.org is our main website.

Ashley: Ok. MEDAinc.org.

Monika: And our email addresses and links are all there.

Ashley: Awesome. Thank you so much!

Monika: Thank you so much for having me!

Sam: Thank you so much, Monika, and thank you to our listeners for joining. I hope you enjoyed this conversation today. If you loved this episode, you can support us by subscribing, rating, leaving a review, or sharing with others. And if you want more, you can follow us on Facebook, Instagram, Twitter, and TikTok at @RenfrewCenter. For free education, events, trainings, webinars, resources, and blogs, head over to our website www.renfrewcenter.com. And any comments or questions you’d like us to answer in a future episode, be sure to email them to [email protected]. I hope you join us next time on All Bodies. All Foods.

Ashley: Thank you for listening with us today on All Bodies. All Foods. presented by The Renfrew Center for Eating Disorders.

Sam: We’re looking forward to you joining us next time as we continue these conversations.

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