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Honoring 100,000 Patients Treated Since 1985

Podcast Transcript

Episode 8: Social Media & Mental Health: A candid conversation with TikTok psychologist Dr. Paula Freedman

[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: Alright. Hello everybody and thank you for joining us today. We have a really exciting podcast. We’re gonna be speaking with Dr. Paula Freedman about her ventures on social media and how she connects with us that way. So, thank you Paula for being here and Sam, I’m gonna let you take it away for the moment.

Sam: Yes, I’m thrilled to introduce Dr. Paula, who I’m connected to on TikTok. And it’s so exciting to have Dr. Paula here in person. Dr. Paula Freedman, she/her, is a licensed clinical psychologist, certified intuitive eating counselor, and writer in Chicago, Illinois. In her private practice, Humankind Psychological Services, she provides treatment for individuals who struggle with anxiety, perfectionism and eating disorders. She is the author of the Addiction Recovery Workbook and regularly writes about all things anti-diet culture for Psychology Today in her series “Fat” is Not a Feeling. She also trains and mentors psychology graduate students, teaching them to treat mental health disorders from a weight-inclusive lens. Dr. Paula loves a good metaphor, a witty comeback, and being in nature. Thank you so much, Dr. Paula.

Ashley: Yes!

Dr. Paula: Thanks for having me! I’m so excited to be here and talk to both of you, and Sam, I know we’ve connected on TikTok so it’s always kind of funny to like, actually interact with someone after seeing their face and hearing their voice, it feels like you know them, but you don’t know them…

Sam: I know, I instinctively want to tap the screen and like what you’re saying, but I can’t do that, I can’t do that today.

EVERYONE LAUGHS

Sam: So, for our audience members who might not know, you’re a psychologist, you’re on TikTok and you’re on Instagram, and you’re basically, I mean, daily, it seems like multiple times a day, you’re creating and sharing mental health content, education, all about eating disorders. Not just eating disorders, but anxiety, fatphobia, diet culture. I mean, there’s a lot going on on your page, and so informative. You have over 50,000 followers on TikTok, you have over 22,000 followers on Instagram. So, I’m just curious and I’m sure our audience is curious, what made you want to start this journey on social media creating content online? Many folks don’t realize we do this for free.

EVERYONE LAUGHS

Sam: Yes, we do this because most of the time, I think, because we just love it, and we want to educate the public. But what inspired you to start creating online and what has the experience been like for you?

Dr. Paula: That’s a big question, it depends on the day in terms of what the experience has been like. But I actually started, I started with Instagram, really on a whim, maybe like five years ago? And I feel like this is kind of an annoying answer, where it’s like, “I never had these grand plans and it kind of just happened,” but it kind of did just happen. I got on Instagram mostly out of curiosity, I was like, “Oh, wouldn’t it be interesting to be a therapist on social media and just see what that world is like?” And of course, I was not the first or the last to do that, but at the time I was like, “Oh, this would be a really, like, different perspective to bring.” Turns out there was already a whole community of mental health people on there, and I was like, “Oh, that’s cool too!” So, I ended up really just discovering all of these wonderful people doing great work and getting their message out and providing free education and resources, ended up making some friends who I now have, that we’re friends in real life, which has been really cool and kind of an unexpected bonus.

Ashley: That’s awesome!

Dr. Paula: And I also, I’ve always loved writing and been a writer and I found that on Instagram, being able to write those longer captions was just an opportunity for some creative expression and a chance to share some of these things that I’m thinking about and talking about with my clients all day long, but to a different audience and really reach a lot more people too, than you could ever reach with, you know, just your caseload of clients in a given week. I’m like, how amazing that this tool or this coping strategy or this piece of information that I know I’ve found really valuable, and my clients find really valuable, I can now get it out there to, you know, thousands of people.

Sam: Millions!

Dr. Paula: Yeah, yeah! Who I never would have reached before. It’s amazing.

Sam: Paula, you’ve had posts that have gone viral.

Dr. Paula: It’s a little bit scary. It’s a little bit like, I understand how people, like, blow up and then it really takes a toll on their mental health, or they end up kind of chasing the fame and the numbers. Because it’s like, I hate to admit this, but it does, if you get that dopamine hit, like, it feels good when the post goes viral, it feels really good and it’s like, “Oh my gosh, they like me,” you know? It’s a little bit, you definitely have to, like, be careful and stay grounded and not, you know… Like, it’s great to, like, be excited about that and be like, “Oh my gosh, wow, this resonated with so many people.” But also remember that, like, if I find myself chasing that, then it’s time to take a step back because that’s not really why I’m on there, you know what I mean? So…

Sam: Right, that’s not ultimately what’s fulfilling in the end.

Dr. Paula: In the end, and I don’t know that I mean, I don’t want to be a famous person. Like, that doesn’t sound like an enjoyable life to me. So, it’s sort of finding this balance between like, “This is great that I’m reaching so many people and that this message is getting out there,” but also, I don’t ever want to be trapped in it, you know? And I think it can become that way, especially like you’re saying, you’re going on multiple times a day, you kind of have to like feed this algorithm, right? Or else nobody’s going to see your stuff.

Ashley: Right.

Dr. Paula: So, it’s figuring out like—and this isn’t, like you said, it’s, we’re doing it for free. So, I have a full-time job and a full time practice.

Sam: Right.

Dr. Paula: So, like there are definitely times where I have to check myself, where I’m like, “I’m doing all this, you know, free content. And for the most part it’s a lot of fun and it’s really rewarding. But if there’s ever a time where I’m more stressed about that than about like the stuff that pays my bills and the stuff that actually enhances my life, then it’s like maybe I need to chill for a moment and kind of reassess where is my energy going,” if that makes sense?

Sam: No, that makes a lot of sense.

Dr. Paula: So yeah, and then I joined TikTok like a year ago. I guess about a year ago, during the pandemic. Partially because my husband is very into it and was like, “You should go on TikTok!” and kept telling me about all this, you know, he’s very, because of me, well versed in all the anti-diet stuff. He was never interested in any of that, but just living with me, he has no choice but to understand it all and hear about it all day long. And so, he was like, “There’s a lot of diet culture on there. You should go combat it.” And so, then that was what really got me on. And it’s like, let’s try to chip away at some of that toxic stuff that’s out there, so.

Sam: Right. It’s a major challenge. There’s no shortage of things to combat on TikTok.

Dr. Paula: Oh my gosh, I’m sure you’ve seen that too like, just having the Renfrew account.

Sam: Oh, for sure.

Dr. Paula: It’s like a little scary. And they sneak their way in because they use all this language of intuitive eating and, you know.

Sam: Oh, absolutely. And also, the really harmful stuff, you know, people learn ways to, they learn the loopholes of the algorithm. You know, misspelling things on purpose, creating hashtags that don’t really make any sense, but the community knows. And yeah, it’s really, it’s really harmful, but it is nice to know that maybe we’re playing some small part in—

Dr. Paula: Kind of counteracting.

Sam: Yeah, exactly. Just creating more helpful content.

Dr. Paula: Exactly. And there’s so much misinformation too. That’s another reason I feel really motivated to keep making content is just, like, who knows where people are getting their information about mental health and wellbeing. And there’s all of this stuff out there that is just like not helpful and not accurate, and so to be able to say, “Here’s what the science says,” you know—

Sam: Well, right. And you have these content creators presenting things with such conviction that it really sounds like they know what they’re talking about. So, it can be really confusing.

Dr. Paula: Sometimes I find myself doubting myself! Where I’m like, “Wait, I thought I knew what I was talking about!” But then this person comes in and they sound so confident—

Sam: Right, right. And if they have a ton of followers and it seems like a lot of people are liking it, you start to think, “Well maybe this is true, I don’t know.” Yeah. So, it can get really confusing I think for the public.

Dr. Paula: It can be—

Sam: Yeah. I mean, I think, yeah, even when I create some posts on TikTok, it’s like, I try to put little sources, I’m like, “See, there’s research behind it!”

Dr. Paula: Me too. I find that I have to do that, even for things that I didn’t think I would have to cite sources for. Like, I would think, “Oh, maybe this is common knowledge.” People always come in, “Where’s the source? Where is the source?” And it’s interesting, and maybe that’s just me getting defensive, but it’s interesting because I noticed that there are people with no credentials and no training, and no background and they can say whatever they want and no one’s challenging them.

Sam: Or they’re deleting their comments and you can’t see who’s challenging them, right? Who really knows. But you know, I was curious Paula, we were talking about your posts going viral, do you remember the first one that went viral for you and why do you think it went viral? Like, what do you think was interesting about the post?

Dr. Paula: Yeah, I’m trying to think which one was maybe the first. Actually, the very, very first was like, probably within the first month that I got on the app.

Ashley: Wow!

Dr. Paula: And it was about atypical anorexia, and how someone can have anorexia and be in a larger body and it’s just as serious and just as deadly. And, you know, unfortunately the stuff that goes viral a lot of times is controversial stuff and the stuff that people want to, like, argue and kind of crap all over, you know?

Sam/Ashley: Yeah.

Dr. Paula: So that was one of those where immediately people started being like, “What are you talking about?” and saying really just trolly, toxic things about people in larger bodies, and it was just like very full of fatphobia. But that was also really eye-opening cause I was like, “Oh wow then if this is, like, if I’m just taking the pulse of this app and that’s what’s here, then we need to really be talking about this more and giving more education and throwing more information at people.” So, I think that was the first one. And then the ones more recently that I did not expect—it’s funny because I feel like you’ll put all of this work into, you know, a very well researched or what you think is a very creative and kind of, you know, different piece of content and it’ll fall flat, but then it’ll be like the dumbest thing that took you no time or effort that, like, everyone goes crazy over it. So now I have this series where I’m basically arguing with myself, where I, you know, kind of role play, like, comments that people commonly hear as like judgment or criticism and then making comebacks, whether it’s like an assertive communication comeback or just like a sassy response. And I did not expect that to be the thing that I was known for.

EVERYONE LAUGHS

Sam: And here we are!

Dr. Paula: And here we are!

Sam: Could we try a little bit of that role playing later? I would love to try that out.

Dr. Paula: Absolutely, yeah!

Sam: Okay, let’s do it. Let’s do it.

Dr. Paula: It’s a lot of fun. It’s funny cause I’m like, “Gosh, like, you know, I guess you really don’t have to work so hard.” Sometimes you just have to be a little bit, if you’re just like a little playful, like, people gravitate towards that.

Sam: Right, right. Well, I think it’s so helpful because you’re giving a script for folks who sort of maybe don’t know what to say in the moment, they sort of freeze up, they’re in like Fight/Flight/Freeze/Fall because they’re so activated by these comments that are so hurtful and inappropriate, and you’re giving them the words, the tools, to handle when that happens, which is really cool. I can see why that would go viral. It’s sort of like, “Yes, the words, I needed these!”

Ashley: Yeah.

Dr. Paula: In hindsight, and I think honestly, some of these things are kind of therapeutic and cathartic for me to make too because some of them, like comments like “You’re so selfish” or “You’re so sensitive,” those are things that have been lobbed against me before. And I, you know, spent a lot of—been in my own therapy and gone through my own processes around it and around just sort of like developing a greater sense of security. And this is who I am and I am sensitive, and you might say that intended as an insult, but it doesn’t have to insult me. Like it can just be a fact. “Yep, it’s a part of my personality,” and you know, being able to really reframe that. So not every comment that I make a video about is something that I have any personal connection to, but for the ones that do have a personal connection, I also come out of it being like that felt really good.

Sam: Yeah, it’s like therapeutic.

Dr. Paula: Exactly. Like, I can understand how like psychodrama works or you know, like art therapy, right? Like, that expressiveness in like a really healing way.

Sam: I bet your therapist is proud, if they watch any of your TikToks.

Dr. Paula: She’s not on—

EVERYONE LAUGHS

Dr. Paula: But I will say she has helped me a lot with the boundaries around it and figuring out, because, you know, you get trolls and you get… who just are hiding behind the screen and trying to provoke you or trying to make you feel like crap. And, you know, I’ve definitely had my day ruined by a troll before, so she’s always very helpful and being like, “These are strangers on the internet, go interact with the people in your actual life who actually know you and let them remind you who you are, and this is a literal stranger who is on there like basically to stir stuff up,” and you know, so she helps in that regard. And she’s a lot older than me too, so I think that also helps, like, you’re not, you’re removed from this world.

Ashley: You’re disconnected.

Dr. Paula: Yeah.

Ashley: Yeah, Paula, I was going to ask, like that I’m so fascinated with this. Social media intimidates me so much just because I want to put out content as well, and I think about that a lot, like, “How am I gonna be perceived,” you know? Is this gonna be helpful? Are people going to like this? Are people gonna say really mean things? So, like how do you deal with that?

Dr. Paula: I was gonna say, yeah, probably all of the above.

Ashley: All of the above. How do you deal with the challenges of that, you know?

Dr. Paula: Definitely there are a lot of challenges and like I said, I kind of just stumbled into this.

Ashley: Yeah, true.

Dr. Paula: I just like sure, this seems fun, and I think knowing what I know now it probably would have helped to be more intentional about like, “What’s my message? And what’s my goal here? And why do I want to do this?” as opposed to just, like, going with it and seeing what happens. But definitely having boundaries, like in real life, you know?

Ashley: Yeah.

Dr. Paula: I think it’s hard because I’m the same way, Ashley, where like, I just, I want everyone to like me, I want to help everyone, I want everyone to also not just feel helped and cared about, but also understand me and understand my intentions and not misconstrue things, and that just isn’t gonna happen, especially when you’re putting something out into the void and you don’t know who is receiving it. It’s like, I thought of this comparison the other day, where usually when you’re interacting with other human beings, it’s in a very specific context, right? Like, you’re at a party, or you’re in a group, or you’re in a club, or like you’re like, you know, some type of community where everyone is there to interact in a certain type of way.

Ashley: That’s so true.

Dr. Paula: And social media, it’s like the entire world is in your living room. And it would never be this way, you know. Like, people who have nothing in common with you, people who are super similar to you, people who, like, hate you just from looking at you for one second. So, it’s just like when you’re opening up the app, that’s what you’re gonna get is like everything, you know.

Ashley: Gotcha. Yeah, yeah.

Dr. Paula: It takes some getting used to and it definitely takes some sort of coming to terms with the fact that people are going to misperceive what you say. And it’s also, like, it’s the internet. So, you could literally, you say the sky is blue and people will yell at you and be like, “You’re wrong, how could you say that? Like, what about the people who perceive the sky this way?” Like it’s just, there’s just—you could say the most innocuous thing and it is going to get twisted into like, “You’re actually a terrible person and you should never speak again.” So, you have to be able to be like, “Okay, you’re a stranger on the internet, I’m not gonna say that seriously,” you know.

Ashley: Right.

Dr. Paula: And, I mean, I think the things that get to me the most are the things that probably hit on, you know, my own stuff of “I want everyone to like me, I want everyone to understand me, I want everyone to find me, you know, find that I’m validating them and making them feel cared for.” And so I think what gets to me the most are the people who either say explicitly or imply that I don’t really care, or that I’m not a good therapist, or you know, like I say, I said, I posted something about people pleasing, and how people pleasing is designed to serve a purpose for the person doing it. You know, that it’s, it’s about trying to control what you feel inside, which I do believe to an extent. And all these people like latched onto that and they were like, “I can’t believe this person is a mental health professional. I would never trust her. Like listen how she’s talking about somebody.”

Ashley: Oh, wow.

Dr. Paula: “And do talk to your clients who are domestic violence victims that way.” And I was like, “What?” It does, it stings. I’m like, “Wow, you think I’m a bad professional?” But then you have to remember, this person saw 10 seconds of a thought that comes into my head, like they don’t know me. And if they think that I approach every client, and if I approach everyone everywhere with this one idea and that’s the only thing, I ever say to them, that’s not how it works.

Ashley: Right, right.

Dr. Paula: You know, there’s really no nuance on social media. And it’s like, I go through the analytics sometimes, of like which videos or which content does better than others—people watch like an average of I think, like, six or eight seconds of everything.

Ashley: Wow.

Dr. Paula: So, it’s like you have to be able to pack it in in six seconds. You’re not gonna get a nuanced, complex topic fully covered in that amount of time. It’s just, it’s not possible. But I feel like I’m talking about all the negatives, and obviously I wouldn’t be doing it if it wasn’t valuable.

Ashley: Right, yeah, what are some of those like really cool experiences that you’ve had since doing this? Because it, I mean, TikTok is one thing, but then blowing up also on—I’m sorry, Instagram was one thing, then blowing up on TikTok, like that’s incredible and people really are listening and responding to you. And I mean, even I’m like, I’ll go through your TikTok and I’m like, “Oh, that’s—oh, that’s good! Oh, that’s good!”

Dr. Paula: Thank you!

Ashley: “I want to bring that into session, I want to talk about that with my clients!” Like yeah, so what are some of those good, exciting points of it?

Dr. Paula: I do the same thing. I follow a lot of fellow therapists and clinicians, and I’ll have the same experience where I’m like, “What a cool way of approaching things or like, wow, I feel really seen there because like I go through that too as a therapist,” you know? So, I think that is a major pro, is just feeling like there’s this pretty big community out there of people who can really relate to your everyday experiences. Also, I think that just, like, the practical side of having this space where you can share so much information and so many resources and a lot of people don’t have access to therapy or access to treatment.

Ashley: Yeah.

Dr. Paula: It’s not obviously a replacement, and it’s not going to be nearly as individualized or anything like that, but it’s good information and if that’s what someone has access to, it’s better than nothing, you know? So, I think there’s that. Um, and yeah, I’ve got some cool opportunities. I wouldn’t have connected with the two of you wasn’t on there.

Ashley: Yeah!

Sam: True.

Dr. Paula: And um, yeah, just meeting some great people who are doing really important advocacy work and being exposed to people with different lived experience for me. I mean, I think it really is a cool thing. I mean, there definitely depends on the moment, I feel like there are times where I’m like, “This is amazing!” and times where I want to throw my phone out the window and never look at it again. So, it’s very intense. Um, but yeah, overall it’s a lot of fun and I feel like I’m more of a, I’ve always been a writer, I’ve always expressed myself better sort of in private, in that way. And being on TikTok has really pushed me out of my comfort zone. It forces you like you have to show your face, you have to speak. Also, you don’t have to be buttoned up and polished and perfect too, like people want you to just kind of show up and be yourself and have it be really authentic. So, that has really been a lesson for me in just not needing to be perfect and being able to just kind of, like, “I’m just gonna try this out because it feels kind of fun to me today,” and see what happens and you have to get out of the mindset of like, “I want this to do well, and I want a lot of people to see this,” because, like, obviously that’s great when that happens, but you can’t be chasing that or else it’s gonna also be, it defeats the purpose. Because then you’re not authentic. So being able to really let that go and be like, “I’m on here because it’s fun and because sometimes I think I have something cool to say that some people might find interesting and that’s it.”

Ashley: Have any of your clients ever seen a post and brought it into session and they’re like “Dr. Paula, we have got to talk about this today.”

Dr. Paula: Yes, and that’s been a very interesting thing to navigate is like having, you know, clients see you and follow you and knowing that they’re going to find you. And if someone out there is considering starting an account and they’re a mental health professional, like expect that your clients will find you. Like, that’s just, they’re going to, so don’t think that you can—unless you make it private, I guess. Um So yes, I have had that happen and I have, I’ve kind of evolved in like my feelings about all of that, about like, “Is it okay for them to follow me and do I need—how much do I need to hold back because I know that they’re gonna see whatever I put out there?” Because I do think that there’s like, the therapeutic relationship is really sacred and I want to like protect that and I feel like that’s one of the reasons that we’re not supposed to disclose too much, you know, because it’s like, that’s one of the things that makes this a unique space and different from just talking to a friend who you do know everything about and you do know what, you know, the fight they had with their partner last night and all of that. So yeah, I do have clients who will sometimes reference things. I think that that also probably makes me maybe not a good fit for everybody.

Ashley: Sure.

Dr. Paula: Like, I think that there are some clients who, it would just not be in their best interest to have a therapist that they were seeing, “seeing” outside of—I’m doing air quotes—but people seeing outside of session in that way, or getting, like, any peek into their life. But then there are others who, I mean, I have clients who have found me through social media and we’re really great fit to be together. Like, I find that those clients tend to be a really good match because they’ve already gotten a peek into my style and the things that I’m passionate about and my personality and if they’re gravitating toward me then we’re probably gonna click, you know? So, in that regard it’s been really, it’s been really valuable, but I do have boundaries which I think everyone should have, in terms of like, they’re allowed to follow me but I don’t communicate on social media with any clients. Like, no DMs. No—they have another, they can get in touch with me through the appropriate channel, right, of my professional email and all of that. But sometimes people try or they don’t realize, you know, they don’t they aren’t thinking about it. And I think especially these days because so much does happen over social media, it’s like, “I just want to share you share this post with you,” or, you know, they’ll comment. I don’t respond to any comments that are clients because I want to respect their confidentiality and all of that. So just having those policies in place.

Ashley: Sure.

Dr. Paula: And then yeah, being really mindful, because it’s like whatever you post, they may see. And so, that really makes me think every single time I put something out there, that that is something that I consider, “Is this something I’m okay with them knowing about me, is this something I’m okay with them finding out, or is this going to potentially harmer our therapeutic relationship?” And obviously you can’t always know, I mean, we’re just making our best guesses.

Ashley: Right.

Dr. Paula: But so far it’s gone okay. And I think I’ve taken more risks, like especially recently, especially as my following has grown and I’ve started to feel like, “Wow, this is an opportunity to get messages that are important to me out to so many more people,” it kind of puts you in this weird position where it’s like, “Well I don’t want to disclose, I don’t want to over disclose and put my clients at risk, or put our relationship at risk, but I also don’t want to squander this opportunity to advocate for something that I really care about to all of these people who I otherwise would have would never have the chance to be speaking to and to have them here what I care about.” So, I don’t think there’s one answer, I think we all have to kind figure that out for ourselves.

Sam: It’s a balancing act and it requires a lot of thoughtfulness.

Ashley: Yeah.

Dr. Paula: Definitely. And I think some people do it better than others. I’m not trying to bad mouth anyone, but there are definitely people on there where I’m like, “I can’t, what do your clients think of you for saying that,” you know?  I’m not saying I’m perfect, but I think just, you know, I think it’s easy, probably, the bigger you get, the easier it is to forget or to not really be considering the fact, like when you think about I have maybe 20 or 30 or 15 clients, and then I have these other however many hundreds of thousands of people, you know, you have to prioritize. I think you have to prioritize your clients or else why are you working with clients, right?

Sam: Yeah, I agree. I agree. It’s so interesting that, you know, you found clients through social media and they’ve sort of like discovered you through there.

Dr. Paula: Yeah.

Sam: And so, you have clients who are obviously very active on social media, I imagine. I’m just curious, you know, in your work with clients, what have you seen as far as the impact of social media on mental health? Especially, I mean, you treat eating disorders. And what have you noticed? Like, what do you think are the impacts both, whether they’re harmful or beneficial, either way? How do you think it plays into the work?

Dr. Paula: Um, definitely pros and cons, right, that there’s definitely harms. And then there’s definitely, I think, things that when I think back to my own childhood and adolescence, I’m like, “Wow, how amazing would it have been if I had this resource in some of these accounts,” you know?

Ashley: Yeah.

Dr. Paula: I think it’s, I mean it’s kind of a recipe for objectification and self-objectification. How it’s literally, you’re documenting not only what you’re doing, but how you look while you’re doing it. And there’s the filters and all that. So, I think even just like the emphasis, it’s impossible to not have any emphasis on appearance. So that’s challenging, you know?

Sam: Well, it’s an image-based platform.

Dr. Paula: Yeah, exactly. And I mean, I’ve even, I’ve had those moments where I see my face on a TikTok and I kind of cringe and I’m like, “Oh, that’s my face,” you know? And then I have to do all the stuff that I teach my clients about accepting and, you know, like, “Yeah, that’s what my face looks like that day. Okay, cool.” Like, you know. And I mean, like so much is curated, right? So, there’s so much that seems like it’s just someone living their easy breezy life and looking so beautiful but obviously they’ve designed it to be that way and maybe spent hours trying to craft it so that it comes off like it’s easy, breezy, nothing. So, there’s that and there’s a lot of comparisons, and I feel like it’s hard to say how much of this also is exacerbated by the pandemic, and everything going virtual, and everybody sort of living their lives on Zoom and on camera. But I don’t know that we are, I don’t think we are really built to be confronted with, like, an image of ourselves to the extent that we are these days where it’s like, I mean, even as we’re having this conversation, my face is right there in the corner. It’s like having a mirror that just follows you around everywhere, you know. So that can definitely be difficult and cause a lot of harm, especially when you’re trying to, like, detach importance from your image.

Ashley: From image, yeah.

Dr. Paula: So, there’s that. But also, I think it can be like a form of exposure therapy in a way, too. Kind of like I was saying how I see my face on all these TikTok’s and I have a reaction to it, but by now I’m not really as affected as I was when I started making them because it’s like, “Yep, all right, that’s my face,” you know. Sort of like how you can become exposed to seeing the number on the scale and not having it mean anything, it just is whatever it is that day. So, I think that that can be valuable too, but obviously depends on where people are in their recovery process. And then there’s a lot of great communities out there that people might otherwise not have a way of connecting with that really support recovery, that support body diversity, or even just like kind of curating your feed, which, I mean, I do that with clients a lot where it’s like, “Hey, who are you following on social media?” And I can recommend some accounts who are gonna feed them the type of messaging that we’re trying to really internalize, you know, so that’s great too.

Ashley: I think, I think that’s one of the coolest things about social media in general, is that we, you know, we’re so spread out. I mean, we’ve got our big cities, but there are definitely people that don’t live near a city or don’t live near places of support, and they can go online. I say this while also understanding that social media can also, you know, provoke a little bit of the comparison and the insecurities and things like that. And also, it can just give us such community and like, I mean, to have 50,000 followers on TikTok, like, what a community that has to feel like for them to connect with you and each other there. I just think that’s so great.

Dr. Paula: It really is, it’s really cool. It’s like, wow, you are capable of creating these connections and then bringing other people together on some shared value or some shared interest. And really, it really is pretty incredible that this exists. And, it’s also, I feel like the flip side, it’s not real life and people a lot of times will think that they know you because they know this part of you, and they don’t. And so, there’s a lot of assumptions I think too, so use at your own risk, I guess.

Ashley: How do you kind of navigate that, Paula? So, like if somebody—so, often, if someone can’t afford therapy, right, or for whatever reason they might reach out to social media to these communities to seek support. How do you navigate that when maybe somebody DMs you or comments and they’re specifically asking for support, what’s that like?

Dr. Paula: It definitely happens quite a bit and it’s hard because like I said, I want to help as many people as possible, but I have to have a boundary there. So, I have I have a policy, like just a personal policy, I guess, where I don’t give any advice, individual advice, on social media. Whether in the comments, in the DMs, anywhere. It’s just, I have to stick to that or else it can get really slippery.

Ashley: Sure, yeah.

Dr. Paula: And also from an ethical perspective, a legal perspective, I don’t want to get myself in a situation where someone who isn’t my client is now, you know, receiving—

Ashley: Thinking that they are your client.

Dr. Paula: Yeah, exactly. So, I have to be really clear, no interaction on here ever constitutes, you know, a provider patient relationship and I don’t give individual advice. So, I have sort of these, you know, I don’t like copy paste them or anything like that, but sort of go-to statements to let people know, you know, like can validate, “Hey, it sounds like what you’re going through is tough. I don’t give advice on here,” encourage them to get in touch with a local provider if they can and if they can’t then, you know, like talking through things with a friend or talking through things with someone that they trust, someone in their real life, like kind of getting them off the internet to find their help in real life.

Ashley: Yeah.

Dr. Paula: Occasionally, you know, I’ll say “Here’s a good book or workbook,” or you know, share a resource or “Here’s a website where you can find a therapist,” or something like that. You know, I’m happy to, like, help you figure it out, but I’m not gonna be the one to give it to you. And also, it can get really draining, and I am a person and have my own life and I don’t always have the capacity to be there for everybody else, especially strangers on the internet. You know, like if it’s taking me away from my actual life or my actual clients, like then that’s kind of a red flag that it’s time to spend less time on social media, spend less time engaging in the DMs and all of that.

Ashley: Yeah, yeah.

Dr. Paula: People don’t always understand it. I definitely have had the experience of saying, you know, basically telling someone, “I’m sorry, I can’t address this with you” and it’s like, “I thought you were a therapist, like you’re supposed to care, you’re supposed to help me.”

Ashley: Yeah, yeah.

Dr. Paula: And I’m “Uhhhhhhhh, like I get it, I understand how that is hard to hear and I’m not your therapist, like I’m just not. So, sorry.”

Sam: It’s for their safety. It’s for their safety ultimately. And I think that’s hard to understand, especially when, you know, they might not have access to mental healthcare, and they don’t really know where to go, and ultimately, it’s a safety issue.

Dr. Paula: Yeah, that’s the bottom line, is I don’t want to sign on for anything that I know I’m not really equipped to address and to put someone else in a situation where you’re not actually getting the right support, like…

Ashley: Right.

Sam: Exactly .Exactly. You know, you talk a lot, Paula, about how important boundaries are on social media

Dr. Paula: Oh yeah.

Sam: And I’m just, for the audience out there who maybe struggle with—they can’t get off their phone, they feel like they’re addicted to TikTok—you know, do you have any, like, concrete advice that you might give as far as like, what, I’m just curious, what boundaries maybe you put in place. Do you set a time limit? Do you go into the settings and mess around with that? I’m just, I’m just curious because I think sometimes people want to know. “Yeah, but how? How do I set boundaries?  Help me.”

Dr. Paula: Right. I think it’s definitely, it’s different for everyone. I haven’t done that yet, the going in and messing with the, I know you can set like a curfew—

Sam: The settings?

Dr. Paula: Yeah, I haven’t done that.

Sam: I haven’t done that either. It’s an option, though. It’ll like cut you off after a certain time. I haven’t done that. Maybe I should.

Dr. Paula: I think the same way where I’m like, “Maybe I should,” and I definitely, I think I, I go through phases and it kind of depends too on, like, what’s going on in my life and on the app. And if I’m getting a lot of comments, it’s like, “Oh, this is exciting. I want to keep up, I want to check out, I want to like check the updates and see what people are saying .” Or if there’s a troll sometimes it kind of hooks you in. But one of my boundaries that I can say I’m not always perfect at, but I don’t take my phone in the bedroom with me. Because there was, it was sort of like the first thing I would check in the morning and that just was not healthy. And I recommend that for anyone who is having a hard time, like cutting themselves off is like—don’t, don’t open it up in the morning until you’re actually in a space where that’s what you are choosing to do, and that’s what you have the time and the energy for, rather than just because it’s there. And it’s just like, I don’t think, I don’t want it to be part of my morning routine, you know, I want my morning routine to be like my actual life, you know.

Sam: Do you like lock it in a drawer, or? I feel like I have to put it in the trunk of my car.

Dr. Paula: If that works, I say do it! It doesn’t, I don’t—I’m not at that point, at least right now. But I do put it like on the other side of my apartment so that I can’t even, I can’t—I know people who, I mean I have clients who are having a hard time and they have it next to their bed, and it’s like they just roll over and grab it. It’s like, “Well let’s make it, let’s make the barrier to entry a little greater.”

Ashley: A little longer.

Sam: A little more effort.

EVERYONE LAUGHS

Dr. Paula: Yeah, that’s a little, that would be hard to resist. I totally get it, right? It’s like, yeah, if you’re trying to get sober, you wouldn’t keep the alcohol right next to you, you would probably not have any in the house. Keeping it on airplane mode until you’re ready to start your day, or at the end of the day you can do that. Because I know a lot of people with smartphones too, like, you have come to rely on it for so many other things, so it’s hard to just turn it off completely if it’s your alarm and it’s your way of, you know, connecting with people. So just figuring out like, “Is this enhancing my life right now or is this taking away from it?” So that’s usually a good question. And then there are times, like, I can feel the burn out creeping in. I can feel it in my body where I’m like, “Wow, I am, this is like zapping me.” And so then I try to take a whole day or a couple of days off completely and just not even go on at all. Or I’ve gotten to the point where sometimes I go on, I post my piece of content and then I leave and I don’t go back on the app for the rest of the day, you know. Where it’s like I dropped my little thing and then I go back to my actual life. But if you’re not creating content, if you’re just consuming it, like, you don’t even have to get on it at all, you can just not do it for—which again, easier said than done. But I know now they do have those settings you can put in and say, you know, “Don’t. I’m not allowed to go on this app more than 20 minutes a day,” and then it kicks you off, so that’s an option too. Or deleting it from your phone and then redownloading it when you want to use it.

Ashley: Yeah, I often do that. I’ll delete something Monday through Friday and then I’ll download it for Saturday and Sunday.

Dr. Paula: I think that’s brilliant. Does that help you, do you find it works?

Ashley: It does, it does! I do that with Instagram quite a bit just because otherwise, just like you’re saying, you just mindlessly sometimes can pick it up, you know. And it’s not necessarily meeting a need, it’s helping past time sometimes, you know.

Dr. Paula: Yeah! Have you heard of the book Digital Minimalism?

Ashley: I’ve heard of it, I haven’t read the book.

Dr. Paula: Okay.

Sam: I haven’t heard of that. That sounds like a good one, though.

Dr. Paula: Cal Newport is his name; I think he might be a psychologist. Anyway, it’s basically about all of this. About like how, it’s kind of, these apps are really designed to keep you using them for as much as possible and as long as possible, and to keep you kind of in this, like, addictive cycle. And I mean, he advocates for kind of an extreme that I personally haven’t done, where you’re, he says, “Take 30 days and do a complete detox where you don’t use any technology at all unless it’s like necessary for your job.” I haven’t done that. But I did take away some valuable information from it, of like ,”Here’s some ways you can kind of limit it, and these things that we think are necessities are actually just like conveniences.” So, you know, it’s like we think, “Oh, I have to have my phone on all the time because I use it for my alarm,” and it’s like, there’s another solution, you can get an alarm clock, you know. There are ways around it.

Ashley: So true.

Dr. Paula: You don’t actually need it, you just think you need it, and by kind of breaking out of that. Like I noticed there was a time where I was like, “I don’t have any hobbies. I used to have hobbies, you know, I used to like draw and read and do things, and now I scroll on my phone,” and I think that’s true for a lot of people.

Ashley: Wow.

Dr. Paula: So, it’s like, yeah, when was the last time you did something after work or after school that wasn’t just looking at your phone, you know?

Ashley: Right, right.

Dr. Paula: So, that was a wakeup call for me to really like put some limits in place and be like, leave my phone across the room or don’t take it with me every day or, you know, sometimes my husband and I will go to dinner and don’t take our phones and it’s just—take it away so that you don’t even have the itch to—

Ashely: To check.

Dr. Paula: Yeah, exactly.

Sam: So smart. Such great—I love, I love those ideas. Especially airplane mode. I’m gonna try that one.

Dr. Paula: Yeah, that’s just like a quick—it’s so easy and—

Sam: You just take a break from all the internet stuff, but you still have your calculator on there and everything.

Dr. Paula: Yeah, exactly.

Sam: Not that I’m using that!

Dr. Paula: Or your notes app or whatever.

Sam: Exactly, exactly.

Dr. Paula: You don’t have to always be plugged in. And I think, I mean, I can give this advice, I don’t always take it, but I do think that it’s kind of destroying our critical thinking skills. And I mean, of course, here I am on here contributing to the problem, you know.

Ashley: But I also think there’s such a balance though, Paula. You know, I mean, I think what you’re providing is so helpful and like we said earlier, so many people are soaking it up, you know, it’s so rich for the population that is watching your material. And there can be a balance too.

Dr. Paula: Oh, for sure.

Ashley: We can also put it down.

Dr. Paula: Put it down!

Sam: Yeah. Remember there’s other things.

Dr. Paula: Yeah. There’s other things. The world existed before all of this, people had meaningful lives before all this. And, like, you’re a whole person and I think that’s something, like, that’s sort of every so often I have to really check in with myself and be like, “How attached to this am I?” And I don’t know if that’s just like kind of my, you know, act, mindfulness, stoicism, kind of like way of approaching life? Where it’s like, if I’m really attached to this and I’m really so wrapped up in it that it feels like I will lose something really big If this goes away, then I need to take a step back and invest energy in other parts of my life. Because I don’t ever want it to come to a point where, if this all went away tomorrow, which it can because people on the internet can turn on you in a second. You could have one post that gets misconstrued or say one wrong thing and you’re canceled and you, you know, you go from 50k to zero. So, knowing that, like, you really can’t get too attached to that either, and knowing like, I’m still me. If this all went away tomorrow, my life would still be pretty much the same. I mean I would probably have more time.

EVERYONE LAUGHS

Dr. Paula: And I would be sad. I mean, I find it meaningful. But I think if you ever get to the point where it’s like, “Without this who am I?” then that’s kind of scary.

Sam: Time to reflect.

Dr. Paula: Exactly. Time to recognize like, “What am I doing here? And where else do I derive a sense of self-worth and validation?” And that’s just my perspective, I know there are other people—and I know that people make their living doing this, so I think that has a whole other layer.

Sam: It does. That’s such a good point, that’s such a good point. I know we are almost out of time, I was really hoping we could try this role play because these are some of your most popular posts.

Dr. Paula: Oh my gosh.

Sam: Where you, basically you’re giving your audience tools to respond to really triggering comments, really inappropriate comments, and it’s just so valuable. So, I thought—so I can be the person giving the triggering comment—

Dr. Paula: Okay, you’ll be the rude judgy person.

Sam: I’ll be the rude podcast host here, and maybe I’ll say a triggering comment and then you have like multiple ways to respond, right? So, I was thinking maybe could you give us two or three ways to respond?

Dr. Paula: Sure, I can try! I can tell you, I mean, before we get into it, just because I feel like this caveat is necessary: a lot of these are just kind of for fun.

Sam: Right.

Dr. Paula: Like, I wouldn’t—I try to give a response that’s like clear, and assertive, and sort of that like healthy communication like boundary setting thing. But sometimes some of the responses are also just, like, a little sassy, a little maybe, like, passive aggressive, but they’re things that you can say to yourself, like to your own brain if your brain is giving you stuff that is rude.

Sam: Right.

Dr. Paula: I just want to say I don’t condone all of the sass.

Sam: Or maybe even if you, you know, those with eating disorders, they have an eating disorder thought like this, they can challenge it with a recovery voice.

Dr. Paula: Exactly, yes! And I think it’s fun to like be a jerk to that voice that’s been like, bullying you.

Ashley: Yes, absolutely.

Sam: Yeah, totally!

Dr. Paula: I don’t recommend being a jerk to people in your life, but the bully in your brain, that’s a different story. Okay, anyway—

Sam: Okay, ready? Okay, here we go:

  • Paula, are you really going to eat that? Maybe! Only one way to find out.

EVERYONE LAUGHS

  • Paula, are you really gonna eat that? Yeah, why do you think I have it on my plate?

EVERYONE LAUGHS

Sam: Nice, nice! Ashley? You want to try one? I don’t want to be the bad guy the whole time.

Dr. Paula: Okay! You’re actually really nice in real life.

EVERYONE LAUGHS

  • Paula, you ate that so fast. Yeah, I was really hungry.
  • Paula, you ate that so fast. Yeah, so I can get away from your judgments!

EVERYONE LAUGHS

Sam: I love it!

  • The fast I finish the faster I can get out of here!

Sam: Okay, let’s try one more. One more:

  • Paula, you are really overreacting. I’m actually just reacting.

Sam: Wow, I like it, I like it!

EVERYONE LAUGHS

Sam: Thank you so much, Paula.  This has been so wonderful to have you on.

Dr. Paula: Oh my gosh, so much fun.

Sam: Yes, so much fun and thank you for all you do for mental health online and in person. We just adore you.

Dr. Paula: Oh my gosh! It’s mutual.

Ashley: I just want to say thank you too. Like, I feel like, you know, you do this, all three of us are clinicians on here, and we do this because we care, and I just love that, I love your heart, but I also love your sassy wit that you share.

Dr. Paula: Thank you!

Ashley: It’s so fun, so thank you.

Dr. Paula: Thank you, I appreciate that. It has been a lot of fun, like, it has surprised me how much I really find it rewarding, you know? And it’s fun to also interact with all these people who are like, “Oh, what about—” Like, people come up with their own ideas and say, “Oh, I could say this,” and I’m like, “That’s brilliant, I love that,” you know. So, it’s been a lot of, it’s been a fun bonding experience. And I agree, I think being a clinician we care so much and we want so much to help people, but it’s nice to also just kind of, like, bring some humor in sometimes and just have fun and be like, yeah, we want to, we want to help, but like it doesn’t have to always be serious.

Sam: I love that.

Ashley: Awesome.

Dr. Paula: Yeah, thank you for having me, this was so much—it like flew by, I’m like, “Oh my gosh!”

Ashley: I know!

Sam: It did.

Ashley: It went by so fast.

Sam: Alright, See everyone next time.

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.

[Bouncy theme music plays.]

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