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

Podcast Transcript

Episode 2: Supporting Your Loved Ones: Signs, Challenges & Helpful Tips

[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: Hey Sam, how are you?

SAM: Hi Ashley, I’m great. How are you?

ASHLEY: Oh, I’m so good. It’s so good to talk to you again and do the podcast again.

SAM: Yes, we’re back!

ASHLEY: We’re back! So, I was thinking that maybe today we could talk a little bit about how we or maybe even teach some of our viewers how to support somebody with an eating disorder or even with some disordered eating. I know that we’re seeing a lot of that, just kind of culturally coming at us. And so just wanted to see your thoughts about talking about that today.

SAM: Yes, it’s one of the most common questions I get on social media, I get direct messages about it, and we’ve written blogs about it, we’ve done posts about it. Let’s make an episode on it, so, that people know what to do. People want to help. And I think one of the fears is they’re afraid they’re going to make it worse.

ASHLEY: I think you’re right with that.

SAM: So, let’s talk about how to support someone with an eating disorder or disordered eating, which is very common, unfortunately, and I want to normalize the fear of saying the wrong thing and that it’s okay to mess up. We can talk about that too.

ASHLEY: I absolutely love this topic because I think when people first even learn about an eating disorder, whether it’s a loved one that has it, whether it’s themselves that have it, they can kind of get a little nervous or scared that they’re going to say the wrong thing, that they’re going to maybe imply something that they don’t mean to imply or step on toes. And sometimes it feels like they’re walking on eggshells and you, and I have both worked with clients and their families in this or their support persons, whoever. Just from the get-go, I think it’s important to just bring in the word grace in this opportunity of educating oneself. That’s another kind of great area just to start with some education, but to also start with grace for oneself because often we really will say the wrong thing at some point, you know, because we are in this culture, we’re in this society where diet talk is so normalized, body dysmorphia talk is so normalized. So, learning or relearning how to retrain our brains is going to take some time. So, I just want everybody to walk in with that at the beginning, just being able to give themselves grace as they start this process.

SAM: Absolutely! I always say mistakes are inevitable, they’re going to happen. What’s important is that you figure out whether it’s with your partner or your family, how are you going to handle the mess ups? And, when there’s a rupture, repairing the rupture can make the relationship stronger. So, I want to remind everyone of that as well that mess ups are okay because we can always go back and repair whether it happened yesterday or even like 10 years ago, you can always go back and repair, it’s never too late.

ASHLEY: Yeah, you can repair, you can. So, in talking about how to support somebody, I’ve got a couple of things listed and I just thought maybe we could go through those. So, I’ll just kind of share what I have listed and then let’s talk about it. So, one of the first things that we can do is educate ourselves and we can give more tips on how to do that and places to go online to get some information. Another thing we can do is not be afraid to apologize if we have said something wrong, kind of what you were just talking about. It’s okay, that’s going to be part of the process, we’re going to have to make repairs and that doesn’t mean it’s going to be easy; it’s going to be a little bit challenging but making those apologies or repairing is okay. Finally, and this is my favorite topic and I think it’s great because it’s also the title of our podcast, Sam, it’s that all bodies and all foods fit!

SAM: Yes, exactly! And easier said than done. I talked about this with families a lot where I explain, we need to make some shifts in the house. All foods are okay and some families, right away agree, “yes”! And then when we, when it’s go-time to execute it, there’s some slips, there’s some mess ups because diet culture is everywhere. It’s sort of ingrained in us, unfortunately. And we are not going to, like you said, we’re not going to unlearn it overnight, it’s going to take time.

ASHLEY: Diet culture was my next topic we need to be aware of. Our culture encourages us constantly to be on a diet, it encourages us constantly to look a certain way, to be a certain way and so you know, knowing how to see that, knowing how to gain perspective and as far as what’s happening with your current situation and how that has shaped or influenced by culture of today. And the very last point and then we can jump in and dive in all of these is to seek professional support. We don’t expect people to know how to automatically support somebody. I mean we don’t, it makes sense that you might have to reach out even for your own self, if you have somebody in treatment, maybe you go to a support group, you know, there’s tons of different places that you can find this stuff, so seeking professional support, is so important.

SAM: I am so glad you brought that up because it was in the back of my mind the whole time you were talking. I mean it takes like an interdisciplinary team to treat an eating disorder obviously, to put that sort of pressure on yourself, whether you’re a parent or a partner to try to take that on that, I’m going to help my loved one get better, it’s just unrealistic. And, so yes, great reminder that eating disorders, they require professional support. Not only, you know, yes, there’s a therapist, there’s a dietician, there might be a psychiatrist, not only that, but they need to understand eating disorders and be specialized in them. So, it can’t even be just any therapist, it can’t really be just any dietician, so specialized professional support if you’re fortunate enough to have access to it, is ideal. It’s not, I know it’s not always possible for everyone. unfortunately. And that’s a whole other episode, just the disparities in healthcare. But yeah, that ideally, we do want an interdisciplinary team, that’s treating the eating disorder and then, you know, levels of care on top of it all. There are all different levels of care and it’s important to figure out what level of care best matches your needs, depending on the severity.

ASHLEY: Yes, and we do not expect somebody to know that. And that’s why the professional that’s specifically trained in eating disorders is so beneficial because they will help explain what they might be seeing in their professional opinion, what the client might need. And often they can connect people to, like I was mentioning earlier, those support groups, treatment opportunities or anything like that.

SAM: Right. One of the first questions I ask mothers, fathers, partners, caretakers, what support do you have in place? Do you have a therapist, friends, family, who do you lean on? Because an eating disorder affects not only the person who has it, but everyone around them, it’s scary. It’s anxiety provoking and it is important that loved ones have their own support in place because you can’t pour from an empty cup.

ASHLEY: I think loved ones or support people might not recognize if they haven’t had a support system in place or if their loved one needs additional help. We’ve seen people walk in our door before who may have anxiety or trauma and come to find out just through extensive work that we’ve done with them there might also be an associated eating disorder with this, and they might have had absolutely zero idea and so thankfully you and I if we see an eating disorder, we can work with that, but if there’s another therapist that happens to see that and they don’t treat that, jumping on board with somebody that does, could be so helpful and beneficial. It might be intimidating initially if somebody didn’t realize that they did have an eating disorder, or if they knew that they had some patterns that weren’t helpful for their system, but they didn’t realize that it was an eating disorder, that can be extremely intimidating not only for the person, but for the support person too.

SAM: Yeah, very disorienting. You know, many folks feel like they’re making healthy choices. It’s like, what do you mean, this is disordered or what do you mean, this is an eating disorder, I thought I was living my best life, I thought I was, you know, making all these lifestyle changes. It turns out that these choices were causing mental and psychological harm. That’s another episode, all the psychological issues that come from malnourishment that people don’t realize. It’s like, why am I anxious, why do I have sleep issues, why are all these happening. Well, you’re under eating. That could be part of the reason. But yeah, it can be very disorienting when someone realizes, oh, this is this is an eating disorder and it’s scary because eating disorders are among the deadliest mental health diagnoses second only to the opioid overdoses.

ASHLEY: Which I seriously is something that people don’t necessarily recognize initially, and I can understand that, but they may not recognize the severity of it because maybe it’s simply been a pattern for so many years, or maybe it’s a new pattern. But it’s been really cool to see people kind of come out of those patterns and start to recognize themselves and then the rest of their world kind of shift and maybe parts of their health start getting better, you know, or their immune system, they can fight off colds better, you know, things like that.

SAM: They have more energy.

ASHLEY: Yes, they have more energy because they’re being nourished. So, that is a cool thing to see. But it can, I like the word you used, it can be disorienting not only for the person that’s being diagnosed, but also for the support people.

SAM: Yes, absolutely. So, going back to how can you support your loved one and you mentioned educating yourself on eating disorders, which I always suggest to families, again when I say families, I really mean friends, caretakers, really any loved one. The NEDA website, the National Eating Disorders Association, they have great information on there about eating disorders, there’s current research. I think it’s so important for folks to educate themselves about eating disorders so they can develop some compassion and empathy for what this person is experiencing. This isn’t a choice. This isn’t a diet gone wrong, although diets can trigger the onset of an eating disorder. This is a serious mental health diagnosis, and it deserves the attention, the medical and psychological attention that it deserves. And that’s why I think it’s so important for everyone to learn about eating disorders so that they do understand that this is a psychiatric mental health diagnosis.

ASHLEY: Yes, and I will say, also that what comes along with educating ourselves, I think that culture tells us sometimes that certain things are normal, or that the only eating disorder is anorexia or that a person diagnosed with an eating disorder must look a certain way. And so, we kind of have these blinders in place or just kind of have these ideas of what this looks like. The more we can get educated, the more we start to understand that really an eating disorder can impact and affect absolutely any person, regardless of race, size, gender. It does not matter. An eating disorder, this serious psychological mental disorder can affect anybody. And so, educating ourselves also helps strip away those biases that we’ve maybe held onto that, that maybe we didn’t even know we were holding on to, you know, just things that we were taught through culture through just living our lives. Yes, NEDA is a phenomenal resource. I would also mention that our Renfrew Library is beneficial. Support people or those recently diagnosed can get all sorts of information, definitions, blog articles, ways to talk to your teens, etc.

SAM: All sorts of stuff is on there, much more than we can put in a 30-minute episode. So yes, if you want more, that’s where to go. I’ve written quite a few blogs, and I think you have too, Ashley.

ASHLEY: Yeah! So, you’ll see our names.

SAM: Yeah, See our names! Yes, education is so important as a first step.

ASHLEY: And I like to, I was going to say, I like to say this when I’m in session with clients and their families; now I’m saying this to you and our great world of podcast listeners. So, you know, you’re welcome, anybody out there to take this idea if you want. But, I’ve always told my clients that I’m going to write a book and it’s going to be the best seller book, Sam. It’s going to be called Life the Manual. And it’s going to be a big 500-page book and it’s going to have everything explained in it. And you open that book up and guess what?

SAM: What?

ASHLEY: It’s blank!

SAM: It’s blank, I love it!

ASHLEY: It’s blank, there’s nothing explained. We have got to walk into this this process knowing that there are going to be a lot of things that we do have to learn. There are going to be a lot of blanks that we will have to fill in. A lot of things that we’re going to have to relearn and a lot of times that we’re not going to say the right thing, which kind of brings us to our next point, don’t be afraid to apologize if we say the wrong thing because that’s going to happen.

SAM: It absolutely will, and I’ll tell you that in family therapy, when we have a moment where someone wants to apologize for something, I just want to point out the tremendous amount of healing and bonding that can happen in that moment. I’ve also seen it go the other way, where, I think of apologies as an art, there really, there’s a way to do them that can be very healing and so when they are done in that way, wow, I mean you really see a relationship strengthen in that moment, it’s remarkable. So, yes, I know there’s a lot of caregivers out there, maybe partners as well, friends who feel guilty because they feel like the eating disorder in some way was their fault and I just want to put it out there to those folks who are listening, no one can cause an eating disorder, so let’s get rid of that guilt and that worry because it’s not possible. However, there are ways that you can make recovery harder for someone who is in the process of recovering and so this episode is about learning the things that make recovery harder, the things that are triggering, the things that are activating. I want to say that because I know, especially parents are afraid that they’ve caused it and there are so many factors that go into the ideology of an eating disorder, genetics, culture, psychological, you know, biology, all of it and the brain. So, it’s not your fault parents, I know you’re listening, I’m telling you it’s not your fault and there are partners out there, it’s not your fault. And there are things that you can choose to change and do differently to make the home environment a place where recovery thrives rather than a place where an eating disorder thrives because of course we can create environments where eating disorders thrive, you know, like the beauty industry, if you’re in that sort of industry or there are certain sports that are really focused on weight. Those are environments where eating disorders thrive, unfortunately. So, let’s make the home environment a place where it’s hard for eating disorder to grow.

ASHLEY: Yes, let’s make the home environment encouraging, let’s notice when we have the urge to say something. I’m going to bring up an example somebody might have in their home. So, let’s say mom and daughter are watching TV and they see a celebrity who has maybe lost weight and then mom says, oh look at her, she looks so great, doesn’t she look great, wow.

SAM: Or wow, she got healthy.

ASHLEY: Right, oh wow, she got healthy.

SAM: The assumption that weight loss means healthy when we know we cannot tell anything about by somebody’s weight.

ASHLEY: Even noticing when we start sentences like that, when we start having conversations like that, it’s very normal in our culture to get together or if we haven’t seen anybody in a long time, “oh ,you look great, what have you been doing, did you lose weight?”, even noticing and practicing pausing when we have the urge to express something similar or something on those lines, pausing and not expressing that.

SAM: Yes, and that takes practice.

ASHLEY: And sometimes we will forget. And so, when we’re talking about those apologies, like we’re talking about really bringing some awareness into the dynamic, into the relationship and noticing if you have said that to say “I’m so sorry, I think what I may have said may have been could have been triggering, it could have been hurtful, it could have been uneducated, please accept my apology for this.”

SAM: Imagine in that moment what it might have been like for them to hear that, that must have been really confusing for you, or that must have been hurtful. That can really add to an apology when you can really put yourself in their shoes and try to imagine what it was like for them. So, to break it down here, when we’re talking about comments of the bodies of celebrities that’s a no-no, but also really any kind of comments about weight are not okay and that includes negative comments about your own body. And so, it’s one thing to say, “oh, I never comment on anyone else’s body”, but if you are making all kinds of negative comments about your own, your loved ones listening to that as well, and you’re sending the message that bodies are important, bodies can and should be judged and those are the messages that can get internalized and the eating disorder latches onto those.

ASHLEY: Oh yes, those internal negative talk self-talk messages, or if you hear your loved one speaking negatively about themselves, like, “Oh well if they don’t like themselves the way they are, how am I supposed to like myself?” Absolutely, those get internalized, and I’ll just add one more thing on to that is that if you are supporting your loved one and the two of you go to another place, maybe it’s a grandparent’s house, maybe it’s another family member’s house and they start to bring something up, feel free to speak up on behalf of your loved one. If they are having a hard time with that, feel free to say, you know, that is we would label that as diet talk, we would label that as unhelpful and we don’t need to talk about that because again, just what you were saying, that might be hurtful for her or him to hear that, it might be hurtful. So, let’s not do that.

SAM: It’s about being able to create and maintain boundaries and it’s okay to have that boundary, that I don’t talk about my weight or anyone else’s weight, I just don’t do it. So not only with bodies, but I also want to give some concrete guidance here to our audience. So, I always say there’s no judgments about body size, weight shape and also no judgment about food.

ASHLEY: No judgment about food. And when you say that what comes to mind, because that to me is mind blowing.

SAM: Well, it’s interesting because when I bring this up in family therapy, it seems like a no-brainer to many folks. And then in the very next sentence, they’ll say, well we eat healthy in our house anyway, and I say aha you see healthy is a judgment because by saying there is healthy foods, you must also say indirectly that there are unhealthy foods. And so, the second we put a judgment on something, what families really need to understand is that the eating disorder, one sentence can play repeatedly on a loop. I mean it is like torture. One comment can just send someone spiraling for the rest of the day and to say comments like, “Are you really going to eat all that?” or “Haven’t you just eaten?” or “Are you sure you want to eat that?” All those comments stick. Families must take that pause and realize that they’re doing, and I think a lot of times they don’t even realize it’s happening, but it can be so hard.

ASHLEY: And just to add on to that, I like to explain it as good food versus bad food. Or maybe we don’t label bad food. Maybe we do, but we always label the good foods, right? Or you mentioned the healthy foods, right? A lot of times we have that good food label and just backing up a little bit if we know that an eating disorder is a serious psychiatric mental illness, there is something going on within our brain, we are not connecting dots. Maybe it started with some anxiety, maybe it started with some trauma, maybe it started with some depression and then we come to our food. What is happening is, if salads and apples are labeled as the good food, I must eat salads and apples. But let’s say, I’m traveling and staying at a hotel, and they have a continental style breakfast. So, they only have muffins and cereal. So, I elect to eat the banana nut muffin instead of grabbing the apple from the continental breakfast. Internally, what happens, what plays out in that message, especially if I am having a challenging time with anxiety, depression, PTSD, or anything else. The message that I then received or sent to myself is that I am bad, I have just eaten that bad food and therefore I am bad and then we get stuck in this cycle of shame and yuck and can’t find a way out. And so that’s why the good versus the bad, we need to take that off the table, no pun intended, but take that off, that’s not how we need to view food.

SAM: Right, I hear families a lot use the term healthy. They also use the term junk food. I hear this a lot, “we don’t keep a lot of junk food in the house”. And I really encourage families to get rid of that word as well. What we teach at Renfrew is that you can have any food that you want. There’s no moral value to the food. And this applies to all eating disorders by the way because some people think, oh well I have binge eating disorder, this doesn’t apply to me. And the reality is, yes, it absolutely does. But even the state of psychological scarcity to feel like you can’t have something, you shouldn’t have something is the very thing that makes you want it.


SAM: And the minute you start labeling food as forbidden or bad or unhealthy or a binge food, that creates a psychological mindset that will probably make it more likely that you will binge on that food, or you will crave that food. You will have intrusive thoughts about that food. So, this applies to all eating disorders that are restrictive eating disorders, but also binge eating disorder and every eating disorder in between.

ASHLEY: So, again the mindset of all bodies, all foods, all bodies fit, all bodies are welcome, all bodies are beautiful and so are all foods. There is no moral value to a size of body, nor is there a moral value to a type of food.

SAM: Exactly. All foods. All bodies. Another concept I really love is we don’t have to make it our goal to love our bodies. Our bodies are going to change, we age. Our bodies are never going to meet society standards because society standards always change because they’re always selling something. It’s about can we respect our bodies and accept our bodies enough to nourish them and to listen to them and give our bodies what they need.

ASHLEY: And I just want to point out, support people, those of you that are listening, somebody that might be dealing with an eating disorder, it’s okay if this takes time. Are we willing to accept ourselves and nourish ourselves with what we need? Body image is part of what we work with eating disorders. And even if we don’t come out and we’re saying like, “I have the best body in the world, you know, I’m great.” It is okay to still practice accepting where we are. That absolutely takes time.

SAM: It’s a journey. It’s a process and it we’re not going to unlearn all this stuff overnight. It took me years to get to a place with food and with my body where I arrived at a place of acceptance. So self-compassion is key.

ASHLEY: Self-compassion is huge here and this kind of leads us into our next thought, which is culture. Culture is a huge factor in kind of getting us to where we are, and I just quickly touch on, social media. We see that a lot, our ages, you mentioned this earlier, we’re growing, and our body is ever evolving and that might be challenging, especially in our teen years or maybe you’ve just had a baby, our body has changed in that respect. And so, I’m noticing the influences of culture of social media, and it can be helpful as we focus on where to go from here.

SAM: Yes, absolutely. Well, thank you Ashley. This was a really good conversation.

ASHLEY: This was so good. I’m so glad we could talk about this, and I just want to continue to encourage everyone, that self-compassion piece is huge and it’s so necessary. It’s okay if you don’t necessarily know everything right off the bat. This is the dance that we get to do with our loved ones. We get to learn their needs and we get to unlearn and relearn some things that we need to know.

SAM: Yeah, absolutely. Thanks so much.

ASHLEY: All right, Sam, thanks!

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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