Podcast Transcript

Renfrew Conference Mini-Series Episode 2: The Pleasure is Mine: Sexual Satisfaction & Eating Disorder Recovery with Kate Dorrough, LAPC, CRC, NCC

[Bouncy theme music plays.]

INTRO

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.

INTRODUCTION TO THE EPISODE

Sam: There seems to be one thing we’re not talking about enough in eating disorder treatment and body image work… sex. Despite the need for a broad approach to support ongoing eating disorder recovery, many mental health professionals feel really uncomfortable talking about the relationship between eating disorders, healthy relationships, body image and sex. Kate Dorrough is our guest today. At the Renfrew Conference this year she gave a fascinating presentation on this topic. She helped attendees understand the relationship between sexual satisfaction and eating disorder recovery and even included strategies to help clients explore their current relationship with their body. Let’s talk more about this today.

EPISODE

Sam: Welcome back to All Bodies. All Foods. I am thrilled to be here today with Kate Dorrough LAPC, CRC, NCC. Kate is a clinical case manager and counselor at Kennesaw State University’s Counseling and Psychological Services. Kate is KSU Healthy Eating and Living Team Facilitator, a multidisciplinary team that specializes in working with students with eating disorders, disordered eating, and body image concerns. Welcome to the show.

Kate: Oh, it’s so great to be here. Thanks for inviting me.

Sam: So, you were a speaker at the conference and we were thrilled about your topic.

Kate: Yes.

Sam: So the title of your workshop, Cultivating Sexual Satisfaction While in Recovery From Eating Disorders.

Kate: Yes, myself and my co presenter, Ariana White, that was something that we wanted to propose. She’s a sex therapist and so, and I specialize in working with eating disorders. So, we came together, and we proposed this workshop and here we are.

Sam: Dare I say we do not talk about sex enough in the eating disorder world.

Kate: Yes.

Sam: Do you agree?

Kate: Yes. And that was why we proposed it. And that’s actually something that we wanted to broach because I think it’s, you know, it could be taboo for some folks and especially when we’re talking about, you know, body image and body shame and you know, what does that look like when we’re wanting to satisfy ourselves or being with other people? So, we just wanted to bring that and highlight it, bring it to the forefront.

Sam: Why do you think it’s so important that we are talking about this, having trainings about it, why is sexual satisfaction an important component of eating disorder recovery?

Kate: Well, and, and I’ve definitely listened to many of your episodes, and you know, one of the things is with eating disorders is that it’s a disconnection from one spot, right. So, you know, bringing in the work of reconnecting with your own body and what does that look like? And sometimes the literature is about how well does your body perform? And you find that too when it comes to sex, like how well are you performing? And so, really the focus, we want to bring the focus on more of like what brings you satisfaction, not at a performance level, but really getting to explore what that meaning is for you. And I think when you’re in eating disorder recovery, you’re finding those reconnections with your body. So, I think this is an element that’s just integral to who we are as human beings and needs to be discussed in a way that’s open and compassionate and fun.

Ashley: Sam and I were just kind of discussing this prior to you coming in and we were talking about the idea of pleasure and satisfaction and thinking about someone that has an eating disorder or is in recovery from that and the disconnect, right. What has your has been your experience when you’ve worked with a client that you are helping them to rediscover their sense of pleasure and satisfaction but that might also feel really scary.

Kate: Yeah. Well, you know, it’s interesting being at a college counseling center because our model is brief therapy, which doesn’t really quite sometimes go hand in hand when someone is in recovery from eating disorders. But we also have, we, we get, you know, the pleasure of sometimes working with clients long term. So, you know, to answer your question about, well, how do you develop that tolerance at first to then explore this idea of what is satisfaction mean to me. And you know, it can look a lot of different ways, you know, when it comes to even food of like what’s satisfying or when it comes to even like doing some values exploration. I work with clients about what are the ED values and what are your values. And that can center around okay this is something that is a little scary but it’s worth going in that direction because it’s aligned with my values. And so, and some of it also looks like some body work too, you know, like riding that wave of maybe some discomfort but then maybe on the other side of that, there’s actually like, oh, well, that wasn’t as scary as I thought it was going to be. So, walking them through that so then there can be a place of finding that satisfaction and doing some experiments and you know brainstorming what could be some ideas to try.

Ashley: And I’m just thinking about like, so for example, I, we had a client one time who she was sitting on the couch in our group room and was kind of, you know, curled up, had her knees up and had a pillow on her. And, you know, we were processing, asked her what she was experiencing, what was coming up for her in the moment, asked her if she could talk about that and put her feet on the floor and take the pillow off of her because she deserves to be seen essentially and to not hide. And I’m thinking about that with someone saying to them like you deserve to feel pleasure, you deserve to feel satisfied, you deserve to taste food and enjoy it, right? And I’m just thinking like what a shift that I can’t imagine the freedom that someone is going to feel when they can finally have that shift. Now, I also imagine that that takes a lot of work.

Kate:  Yeah. Well, and I think something that you speak to Ashley is permission and sometimes that permission, we want it to come from within. We want it to come from our clients, but sometimes it is witnessing someone and seeing them, noticing, noticing, I notice the pillow, I notice, I wonder what it would be like to put the pillow down to put the feet on the floor. And that’s a place where you can find sexual satisfaction. Like, I wonder what it would be like to try this toy, or I wonder what it would be like to be in front of the mirror or I wonder. Right So there’s a lot of wondering and yeah, and like being with the client in these moments of, you know, having like um activating some emotional experience, right? And the safety of, of the counselor, client relationship and using that as a template, right to go out. And so when I say, you know, having some emotional activation, it’s like, okay, so right now we might be having a snack together, for example, and this is bringing up a lot of thoughts and feelings and images and then, oh wait, I can eat the snack and you know, there was some fear, there was some racing thoughts and I was able to do it. So, it’s kind of using that idea and saying, okay, let’s use that and what could it look like for you and exploring those sexual satisfactions.

Sam: There are so many parallels when you think about it. I’m curious, folks and eating disorder recovery, folks with eating disorders, what are they, what are the themes? What are they struggling with when it comes to sexuality?

Kate: Well, you know, I think for some it’s feeling stuck, you know, because their bodies have responded to restriction in a way, so, they might feel stuck in maybe even though they’re 19, 20 22 or 24 they feel 16. And so, they’re in that place of, well, what does it even mean to, for me to know myself in a way of like, what would be satisfying to me sexually? And I think, you know, and depending on the presentation for some, it’s, it’s been, sex has been a means for self-worth, but it’s in performance for others. And that is a high correlate with eating disorders. Like, how do I appear? How is this rigidity or lack of control? How is it being perceived because I don’t want anybody to know, right? The eating disorder breathes silence and so I think there’s a lot of parallels as far as, you know, with folks with eating disorders that disconnection from body and you know, bringing that back and what does it look like when we’re stepping away from performing for others and performing even for this ideal and getting to the core of what it means to be me. So, there’s a lot of, looking at, you know, what are the parts of me. The authenticity. What are, you know, and even dare I say, which, you know, in some fields and eating disorders, there’s a sense that you don’t say that eating disorder served you and I actually come from that place of okay, it served you up until this point and now you’re noticing that it doesn’t serve you anymore, you know in this place of recovery. So, how do we recover? What is ours and not the eating disorders? And so that’s kind of some of the work that I do.

Ashley: Yeah, I love that.

Sam: I’m curious, I imagine there are times you bring partners in? Other folks in?

Kate: Sometimes, now, see, it’s, it’s based on our university setting. If it was like couples or anything, they would have to be a KSU student. So, they’d have to be like the, the, the partner would have to be, like if we wanted to do ongoing or something now, as far as consultations now, yes, like if there was a one time like this person is exploring, you know, like what’s okay to share, what’s not okay to share. How do you create a place of some comfort because there will be discomfort. So how can you, like, I remember doing that with one client who was in recovery and, you know, sex was kind of painful and it was like, I don’t, I don’t really know what is pleasing to me. So, walking through some things of like these are things you can do to help her feel safe. And you know, and able to communicate that in the counseling space. So then, you know, it’s not necessarily about okay, what are, what are some of the fun things that you can do to find that satisfaction again. But it’s really about that intimacy and creating safety so you do feel like you can risk a little bit.

Sam: How do you create safety? I mean, what are if, what’s some of the guidance you give to partners to create that emotional safety?

Kate: Yeah. So, you know my to them about choices. So, you know, especially like not that everyone who has an eating disorder or is in recovery from an eating disorder necessarily has a trauma history, but in the course of eating disorders, a trauma happens. So, and there can be a sense of a loss of choice and so creating some choices around, you know, would this be okay or would this be okay? Right. How does that feel? What are some of the sensations that are coming up for you right now? Like, or if you know, doing something like taking the finger and just stroking it across the arm, like what feelings are coming up for you. So, it’s like starting in those places where it’s like the these pieces that are really important for connection. But like it’s like, okay, okay, this feels a little uncomfortable but I’m feeling some warmth here. So, giving them some language about like warmth and tingling and so like some of those physical sensations. So, those are some of the things and then, you know, and then a choice too is a big one.

Ashley: I’m just thinking like we talk about safety and choice and language really like somebody with an eating disorder learning how to take back their voice and being the one to say the thing that they need, right? And not saying the thing that somebody else needs so that they can please that other person, not saying the thing that they think that they should say, not saying the thing that, you know, the world thinks that they should say or the eating disorder, but like what they need and the work that you’re describing feels so it feels so empowering to me, like I’m over here and I’m like, I’m so glad that you exist and that you’re creating this space because sex is so vulnerable. It’s such, I mean, it is, oh my goodness. It’s such like an intense space for people to experience. And if I’ve been disconnected from my self and my body and my, my wants and my needs for so long, like I can’t, I just feel like that’s got to be such a confusing message for me to hear that like I can have ownership, I can have choice, I can have my voice and say this. And I’m very thankful that this space exists for someone to be able to work through some of that stuff in a safe manner and begin to empower themselves and start owning their voice again. I think that sounds incredible.

Sam: Also, how it can generalize to other areas of their life because needs are needs, whether it’s physical needs or emotional needs and teaching partners how to talk to each other and create choice and checking in with how does this feel. I mean, that, that applies in so many situations.

Ashley: And it’s so nice isn’t it when you can do that with your partner and when they can hear you and you can check in with each other and yeah, it’s just so nice. We need that.

Sam: It’s how you deepen intimacy in relationships.

Kate: And I think too, you know, sometimes we don’t have this language because it’s about, well, this feels good or bad, it’s very black and white. Where it’s like, okay, let’s look at giving you more language to practice. You know, it’s like, oh, this feels warm, or this feels tingly, or I feel uncertain about this and I’m willing. Because the eating disorders gives us very few options if any at all, right, it takes your voice. So, this is about okay, so this is some language to help you reclaim and then you can start to make it your own, right? It’s sort of this invitation and then answering to that invitation.

Sam: It reminds me of emotions wheel out. The it’s sort of like, you know, how are you feeling? Bad. Here’s an emotion wheel. What is bad? But it’s like, is there a Sensations Wheel?

Kate: Yes!

Sam: I love it.

Kate: It’s an Emotion Sensations Wheel. I’m trying to, I need to remember. It’s a counselor out of, I believe Seattle, Washington. Braman… Lindsay Braman and she did this like Emotion Sensation Wheel and she also made a pillow. So, like I, so the clients will sometimes… (inaudible)

Sam: I’ve seen that. I’ve seen that. Yes, yes, yes!

Ashley: Well, and I’m just thinking about the idea of shame with eating disorders and how that it is such a theme that we play out, we see play out with someone with an eating disorder and how when you’re talking about sensation words and the words like warm or tingly, like in my mind, I’m like, is there also a shame component maybe associated with certain words. But then being given permission to explore what those words mean and then being encouraged to test it out with yourself, like check in with yourself. How do you actually in a safe space respond to that word? Is that word an okay word. So, I just love the language of that, of the sensations.

Kate: Yeah, definitely.

Sam: Well, this has been a stimulating conversation. Thank you for being here. (laughter)

Kate: Thanks for having me.

Sam: This workshop is going to be so helpful to so many clinicians and I just want to thank you for your work.

Ashley: Kate, will you come back? Can we do a full episode?

Kate: That would be cool.

Ashley: Let’s do that.

Sam: That would be great.

Kate: Yeah, that’d be really fun.

Ashley: Awesome. Thank you So much.

Kate: Thanks for having me.

OUTRO

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.]