Your Relationship with Food - Amy Pershing

https://www.thebodywiseprogram.com/

Binge Eating Disorder: The Journey to Recovery & Beyond

Amy Pershing LMSW, ACSW, CCTP-II is the Founder of Bodywise, the first binge eating disorder treatment program in the United States, founded in 1995. She is the Director of Pershing Consulting, which offers training to clinicians treating BED around the world. Amy is also the creator of “Hungerwise™,” a 9-week program for ending chronic dieting and weight cycling, offered online.  Amy also serves as Vice President of the Board of the Center for Eating Disorders in Ann Arbor, Michigan.

Based on over 35 years of clinical experience,  Amy has pioneered a treatment approach for BED that is strengths-based, incorporating Internal Family Systems, somatic trauma techniques, Attuned Eating and Movement (AEM), and a “health at every size” philosophy. She lectures and keynotes internationally and writes extensively on the treatment of BED and
her own recovery journey for both professional and lay communities. Amy has been featured on numerous radio, podcast, and television programs speaking about BED treatment and recovery, relapse prevention, weight stigma, and attuned eating and movement. She is a founding member and Past Chair of the Binge Eating Disorder Association (BEDA), and is the winner of BEDA’s Pioneer in Clinical Advocacy award. She is the author of the book Binge Eating Disorder: The Journey to Recovery and Beyond (Routledge/Taylor and Francis, 2018) and many articles and chapters about BED treatment and advocacy. Amy maintains her clinical practice treating BED in Ann Arbor, MI.

Transcript

Your Relationship with Food 

Todd Zemek speaks with Amy Pershing

Todd Zemek (00:05):

This podcast is about relationships, and today's episode is no different. It's about our relationship with our bodies, relationship with nourishment and safe connections with others, our relationships with how we protect ourselves from all sorts of things. Perhaps as especially shame. There'll be elements of your relationship with others and yourself that will be touched by our conversation today. And all of this will come from our discussion about your relationship with food. I've been so looking forward to talking with our guest today, Amy Pershing. She's the founder of Body-Wise, the first binge eating disorder treatment program, the United States. She's also the creator of Hunger Wise, a nine week program for ending the chronic dieting and weight cycling that you can access online. And she's also the vice president of the Board of the Center for Eating Disorders in Ann Arbor, Michigan. So thanks for joining us, Amy.

Amy Pershing (00:56):

Thank you so much. I'm delighted to be here.

Todd Zemek (00:58):

I was so keen to speak with you after seeing your training program on PESI.com, and it's just so obvious when someone's walking their walk, you were just so open and warm and candid about what you've been through with your relationship with food. And I was really in touch with that because I've had a similar experience myself, been open about your experience of therapy and being a therapist and then weaving in some of your ideas about internal family systems and even a feminist approach. So just on a, on a personal note, I was just really excited to exchange notes with someone like you and have the opportunity to chat.

Amy Pershing (01:36):

Absolutely. Me too. I find that it's true for many of us who do this work, that we were brought to it by our own journey, and I think that that really adds kind of street cred, <laugh> to know kind of a connection that might otherwise not be.

Todd Zemek (01:54):

There. I think that people can feel the truth. I agree. And that that's the difference between someone who's been, you know, taught an empirically validated treatment as opposed to someone who's there for healing. And you can feel that someone has been supported in leading their own life rather than just going through the motions. So, so yeah, great to, great to meet, and I'm sure that people are gonna be fascinated by this and benefit from some of the info and some of the just, just turning the lights on for people about their relationships with food and so many of the things that's attached to, but perhaps particularly in relationship binge eating disorder. And one of the things I was really struck by was that you were saying that three times, it's three times more common than anorexia and bulimia combined. So why don't we know about this? Why aren't we talking about this?

Amy Pershing (02:46):

Absolutely, Todd, wonderful question. Thank you for asking <laugh>. Well, I think there are a number of reasons, actually. One of them historically, I mean when, when I started doing this work, binge eating disorder, actually a diagnosis, so it was emotional eating or you know, emotional overeating, something like that. But it wasn't considered a clinical eating disorder. Maybe it was a subclinical or a subset of another disorder. The larger issue that that really precluded clinical attention research, attention insurance coverage is relevant here, was that people with binge eating disorder were really considered people who were struggling with a willpower issue, not an eating disorder. So the notion is you might go to the doctor, they might, you might talk about their eating issue if you brought it up at all, but you might, if you did the treatment that you were going to get for, that was going to be another diet program.

(03:41):

It was going to be a, well, you just have to want it badly enough, you gotta stick to it, you gotta have enough willpower. So it's really defined not as an eating disorder, not being understood, the behavior not being understood through the lens of an eating disorder, which is how is this behavior adaptive? How does it make sense? How does the person use it for psychological pain or whatever else might be going on. But instead it was considered a behavioral issue. So that's one thing. The other thing I think too is that, so diets, and we can talk more about this if you like, but, but diets have about, depending on the study, an 80 to 95% failure rate after six months. So essentially what was happening is people with binge eating disorder, were going into whomever their healthcare provider might be, even if it was a well-meaning therapist who might say, let's work on your underlying issues and then hopefully you'll be able to stick to your diet. Essentially what they were doing was prescribing something that a diet that in other eating disorders would be considered a symptom.

Todd Zemek (04:41):

So they'd be encouraged for something that was destined to fail.

Amy Pershing (04:43):

That's exactly right. And of course then the client would blame themselves for not having adequate willpower. And we start the cycle all over again. So it really wasn't been maybe 10 years since b e D really has a diagnostic code of its own that's distinct and we're really, you know, talking about it. We've had maybe over the last six or eight years, I think people calling and saying, I have been eating disorder and I need help. So we, it wasn't for, you know, the last several years that people were really calling it what it is, which is needing disorder.

Todd Zemek (05:16):

So thanks for, you know, sort of starting to speak about some of the myths there. And again, in popular culture, it's the sort of thing that comedians pick on. I'm sort of wondering in terms of the frame of an addiction, what would be the parallels there? How would it be similar or different?

Amy Pershing (05:31):

I talk about this in my book too. There is a, a group that suggests that binge eating disorder is a food addiction. Some consider it like a sugar addiction or, you know, from a specific food. And the theory behind that typically suggests that it is an addiction, like a, like a dopamine addiction. So you know that there's, we're getting a dopamine hit by going to the food, and so therefore that makes it an addiction. But what's true is dopamine seeking behavior is we're dopamine seeking creatures. So getting a kiss, petting a puppy, their dopamine hits <laugh>, right? I mean, that's really what we do. First of all, secondly, I don't think you can be addicted to food because it's a substance that we need. So even if we think about it practically speaking, if we use an addiction model, the narrative is one of abstinence.

(06:17):

Well, that's not actually possible. So, you know, I, I remember somebody describing once in my own recovery, I was in OA for many years and I remember someone saying that an alcoholic puts the lion in the cage, but someone dealing with a food addiction has to take the lion out of the cage multiple times a day. Which I thought was a good way to say that. It's, it's sort of doomed to failure to try to use an abstinence model. I think in fact what we need is a model, not that suggests that we're powerless over food, but in fact that we take our power back in terms of our relationship to food. Most of my clients have been told pretty much their whole lives that they cannot trust their body around food. I think it's actually dieting that makes that seem true. And I think an abstinence model reinforces that narrative. It doesn't heal that narrative.

Todd Zemek (07:08):

So you were mentioning Overeaters anonymous, just really curious, what was your experience of that group? Like?

Amy Pershing (07:15):

I was in it for a number of years and I've been dieting since I was a little girl and it didn't ever work. That is, I didn't lose weight and stay thin. That's what it would work meant. And so I thought, well I, apparently I'm one of those people who can't do it, so I need to go and, you know, go take part in this program that's going to, you know, I'm gonna admit that I'm powerless and I'm going to, you know, go through all these steps and that's gonna help. So I was on what at that time was called Gray Sheet, which was a very restrictive food plan through oa. There's some that are less restrictive now. And I was in it for many years and basically what it did was maintain my eating disorder. So I would go through cycles of abstinence and I would stick to the plan and, and if you didn't stick to it to the letter, you had to call your sponsor. First of all, you had to call your sponsor and commit your meals for the day.

Todd Zemek (08:10):

And confess

Amy Pershing (08:12):

And confess. That's right. So I was off by anything. I had to call and confess

Todd Zemek (08:18):

Detective work. Yeah.

Amy Pershing (08:21):

It maintained that shame narrative and I never got out of it until I got out of a way. Mm-Hmm.

Todd Zemek (08:26):

<Affirmative>. Mm-Hmm. <affirmative>, what was your progression, if, if you're comfortable speaking about it in terms of your own therapy and your journey with this, what's worked, what's not worked, what would've been some of the milestones along the way for you?

Amy Pershing (08:39):

I think probably the biggest thing, and this just sounds like an odd way to say this, I think, but probably the biggest thing for me was I had to stop trying to fix my body. So I really had to start thinking of my body as my home and not as a billboard. And that's a, a very difficult thing to do. I talk about, you know, using a feminist lens and really where things started to shift for me was I was in graduate school and I started learning more about feminist approaches to doing psychotherapy and that they're about empowerment. That they're about taking their voices back, that they're about challenging things that tell us were defective at their core. And I started to think about that vis-a-vis my relationship with my body and with food. And I was working as an eating disorders therapist at that time, still really struggling with how to best help my clients.

(09:30):

And I realized that if I was going to continue to try to fix this body, I was going to be stuck in that always. That was also part of my history. I came out of a, of a family that didn't allow for emotional expression, that didn't allow for trusting your own instincts, your own gut, your own wisdom. And so it was really a reclamation of my voice in general, but with regard to my body in particular. So I think I had to take the risk to see if it was really true that if I trusted my body would indeed it be a disaster. Because that's what I'd been taught. And in fact, I learned that the opposite was true when I was doing that. There were also some early writers, Janine Roth was one of them at that time, who was, she wrote a book called Breaking Free from Compulsive Eating. I think it was one of the very first books that talked about these issues. And she's actually changed some of the way she works at this point. But early on she was really advocating, listening, learning to understand cubes, you know, our bodies will never ask us to binge and they will never ask us to restrict. So we really do have what we need to have a healthy, loving relationship with our bodies. I had to risk it. I had to to give up. Trying

Todd Zemek (10:46):

Sounds like that switch from billboard to a home means that we can reduce the shame and come home and hopefully home would be a place where you're safe enough to relax. I guess for a lot of people, that sense of home is a fortress. I can certainly relate to that as well. And it's one of the reasons I was drawn to you in your work was that I am, you know, very ectomorphic, very thin person, but I've struggled with that binge eating disorder also and continue to get support and treatment with that. Part of it has been internal family systems. So it's got a special place in my heart. And similarly that transition from, I've certainly, you know, dedicated perhaps a decade of my life to my body being a billboard, much as wouldn't tell now at the age of 50. But that had defined me for a certain period in terms of coming home. I guess I had to work through that fortress first and develop some compassion to who was in that home cuz I, I had no idea who they were. And so I guess I'm, I'm interested that perhaps for both of us, and I suggest for most people listening that complex trauma has been part of that picture. Just really curious to sort of talk about that, to invite anyone listening, I guess in a way into our homes so that they can discover their

Amy Pershing (12:12):

Own. Absolutely. And I think so much too complex trauma, there is trauma of relationship and you know, I think for at least when I was growing up, you know, so much of how your worth and value your lovability, right? The messaging was you needed to have a certain shape and size in order to be accepted. That was a, you know, fundamental truth. And I don't have that kind of body, I never had that kind of body. It's just not my body. And so I think that that along with all of the other messaging that I had about having to be perfect and having to, you know, get everything right and make sure everybody was happy with me all the time, blah, blah, blah. You know, all this stuff that goes with, for many of us being a survivor of complex trauma, we learned that kind of who we are as is is not okay. We have to adapt, we have to fix, we have to figure out how to present who we are. We have to mask and hide and you know, otherwise only show certain things. And so I think that was a big piece of it for me. And my healing with all trauma is, you know, I can't, you know, I'm 55 so I I can relate to that

Todd Zemek (13:23):

<Laugh>

Amy Pershing (13:23):

For sure. I think that's one of the graces of getting older <laugh> was you kind of care less <laugh> how other, how other

Todd Zemek (13:30):

People, I guess the flip side is caring more in terms of who's in that home. Yeah, yeah. And for me, certainly one of the ironies is being a therapist that, and I've done a considerable amount of therapy, but it was only a couple of years ago when I, I started doing some schema therapy that it was just like, oh my God, this is who I'm caring for. I had no idea. I was so lost <laugh> in that regard. So yeah, it's, it's lovely that there are are more methods and that more therapists have some tools to be able to take us to that place of introduction.

Amy Pershing (14:04):

Yes. The vast majority of my clients are trauma survivors. There's a, with eating disorders in general, people with b e d have the highest rates of trauma.

Todd Zemek (14:14):

Mm-Hmm.

Amy Pershing (14:15):

So, you know, if we, we think about often that relationship with food is a saving grace. Mm-Hmm. And what I find for, for myself and for my clients is I actually feel a lot of gratitude now on the other side of my eating disorder for many, many years. I feel a lot of gratitude for having had it, it's how I survived those parts. Being from the A parts lens, you know, the part of me, the firefighter is the, the languages, you know, that learned to go to food when things got overwhelming or frightening or whatever, I just couldn't deal with them. Got me through. I find that it's that kind of gratitude and compassion and my clients can find that for their eating disorder. They find that for their bodies as well. So I think our job isn't to always be happy about how we look or whatever. I don't think that's really our body's job. Our body's job is to be our home first almost. And I think it's much easier for people to get to that space when they realize just this is how you made it.

Todd Zemek (15:16):

Certainly my patients would be familiar with parts work and internal family systems firsthand. But for people who aren't familiar with internal family systems, could you just give us a quick, very quick overview of what that is, how it works?

Amy Pershing (15:29):

Sure. The basic tenant behind it is the idea of multiplicity of mind, which basically is that we are all internally made up of multiple parts. That that is normal. And a, a really clear way to think about that is, let's say you're planning on going out with a friend and a part of you may be thinking, oh I'm really looking forward to it, it's going to be great. And another part, maybe a part that feels socially anxious is wishing that the event would be canceled. Both of those parts are important. They both have things to say, right? So the idea behind internal family systems is that we have those myriad parts within us. We also have a core what's called our self. And that self-energy is our birthright. Each of us have one, it is undamaged by trauma. It is often defined by what we call the eight Cs. Compassion, clarity, calm, I'm not going to be able to get them all.

Todd Zemek (16:31):

Very was about to feel very impressed by your memory. Yeah. Creativity. But I guess the, the vibe of those eight Cs is being at home being at a, a sense of genuine home.

Amy Pershing (16:40):

Yeah. A sense of genuine home. That's right. It's often feeling part of something bigger. It's an energy where we're able to put our struggles kind of into perspective in the broader truth of the world. People often connect to that energy in nature or through doing art or meditation or other spiritual practices. But it's where we feel kind of the chaos of our internal world ease back a bit and we can just be so that self. So the idea behind I F s is that we want to be as self-led as we can. Nobody is self-led all the time, but we want to be there as best we can and we want to know A and B, we want to know when we're not in it, when we've been taken over by a part or sometimes it's called blended with or hijacked by a part. And that is when a younger energy takes over. Really good clear example of that is here we have a virtuous road rage. People can get really angry very quickly on the road here. It's actually a big cause of accidents in the US and that's when a part takes over and suddenly behind the wheel is an enraged teenager who is going to be vindicated no matter what. Maybe you felt that way in some situation. That's just a, you know, kind of clear example for

Todd Zemek (18:00):

Me. It's a great example. It's a great example. Yeah. And there's an intensity behind it, isn't there as, as opposed to that, that experience of self where the protective parts can relax and sit with you. Yeah. Often I'll, I'll sort of introduce my patients to that once we've worked with some protective parts so that they can contrast because previously they can't see the forest for the trees and some of that intensity can be a great marker for whether we're at home or not. Whether it be being led by that adolescent protector or that sense of wise self, that healthy adult to sort of come home.

Amy Pershing (18:35):

Yeah, that's right. And we have, usually our parts are where there's trauma parts end up taking on these extreme jobs that they otherwise would not have to take on. So for example, if we have a part that goes to food that binges, you know, that is a protective part. It's trying to probably stomp down sadness or fear or whatever might be going on that we're feeling shame. And so that becomes that part's job within the system and that's the result of not being able to freely have feelings, for example. So the work of, if s where there's trauma is going to be to help that part, one of its jobs is to help that firefighter part not have to do that job anymore. So that we're more from self to deal with whatever those feelings are that maybe that firefighter has had to push down over time. So it's a really loving, kind, gentle intervention I find it helps us to have the parenting that we desperately needed. It's empowering because really the core healing happens within, which doesn't mean we don't need community, but I think what it does is it helps us be in community safely

Todd Zemek (19:56):

And we can get to know whether we call them exiles or, or vulnerable parts or you know, children, once we feel safe at home, it's the most beautiful thing when they come out from behind the couch and want to be seen. There's something really beautiful about that. You had mentioned something really interesting about the fear of letting go of that strategy. Can you tell us about that and patients experience of that?

Amy Pershing (20:23):

The fear of let no and trusting,

Todd Zemek (20:26):

Yeah, the fear of if they were to make progress that this means that some of those protectors, some of those firefighters would, would need to let go of some of that. And I think you gave an example of someone saying that it was like, now those parts could kind of either relax or, or really do their thing. They didn't have to, themselves didn't have to sort of fight anymore because they were protected and they could sit back and, and let those firefighters really get to work.

Amy Pershing (20:54):

I think that the process of doing that is and that's one of the things I really like about IFS is it's a gentle process. So protectors don't ease back. They need to trust self before they'll ease back. So self has to earn their trust. We're really gonna step in from self and protect the system. And so yeah, I think we can learn from, clients can directly communicate with, let's say the part that goes to food can directly communicate with that part. What is it afraid would happen if it didn't do that job? What does it think would happen with the system? And usually it's that it would be overwhelmed by those feelings, by the experiences. So our job really is to help those protector parts know that we've got them, we can take care of them, we can protect them, we can give them what they need so that they can feel safe and ease back a bit.

(21:45):

Protectors are protecting, they got that name because they're protecting, as you referenced earlier, exiles and exiles are the parts that hold the deepest pain of trauma. They hold the narratives of being unworthy or unlovable or broken or damaged beyond repair. And that's really where those stories, those very young parts hold those beliefs about themselves and the protectors protect those parts as best they're able. But of course what's true is exiles are never very far from the surface, right? They're always afraid and activated. So I really love that we go into the most scared places from this compassionate loving space and bring them home, right? And bring them to here

Todd Zemek (23:02):

It's interesting as for motivation, sometimes people won't do things for themselves, but they would for their children. And so if, if we're using that, that metaphor of our internal system of a family, that can be a, a tremendous motivator when we get to meet those childlike parts of ourselves. And, and then it's like, how would I call this child defective anymore? How would I be so cruel, so brutal. And then, you know, effectively learning to laugh <laugh> often for the first time. So, so it's such a gift, such a beautiful opportunity.

Amy Pershing (23:35):

It really is. I find it now, you know, I've worked psychodynamically, I've worked in a number of different models. I find if f s heals shame much more quickly because we can first of all have a little distance from the shame because it's a part that's holding it. And when we're in self, we can, there's a spontaneous access to compassion just as you're saying, for those young scared parts. So I find it works much more quickly and organically

Todd Zemek (24:09):

Once it's established, that sense of trust and that proof that that self is reliable and respectful. There seems to be some momentum, which is really lovely because there's a new frame to grow, there's relationships to grow into, which is just, is really lovely to see that paying off. In terms of strategies, it's interesting, like I've had a a, a few patients, I'm, I'm not an expert with eating disorders by any means, but I've had a few patients where once we've done some of that work and there's been a healthier relationship with themselves, they've started to go out and explore more specific assistance while we've continued to work. And that would never have happened without that compassion being built as a result of what we'd done there. But once people are at that stage, what sort of strategies, when you're talking about dieting, kind of being a well-intentioned fool’s errand earlier, but what kind of strategies can people start to, to use that could be sustainable and helpful?

Amy Pershing (25:12):

I think a really, really good place to begin is with listening. So many of us learned to stop listening to our bodies, to distrust them. And so I think a big part of it is really reestablishing your relationship with your body. So that's the first thing. Then we're looking at understand and really listening to, and this sounds basic, but it, it is revolutionary for many people knowing when they're hungry right? Or when they're full. How do different foods affect you? Suppose there was no such thing as a good food or a bad food because that's what's really true. All foods provide something. So sometimes they provide just a quick burst of energy. Sometimes they're more sustaining, sometimes they provide a lot of macro and micronutrients. Sometimes all they provide is what I call vitamin J, which is just joy

Todd Zemek (26:08):

<Laugh>.

Amy Pershing (26:09):

They're just wonderful, right? And they're part of living a full life. Suppose that we say there's no such thing as bad food and we start listening. And that already is frightening because mostly people think if I'm left to my own devices, all I will eat is cake <laugh>, right? And so what I'm saying here is your body that

Todd Zemek (26:30):

Well too, <laugh>,

Amy Pershing (26:32):

<Laugh>. And you might initially,

(26:35):

Right? I mean at first you might say, oh, blessed bee, I can have cake now <laugh>, right? So there might be a stretch of that, but our body will never ask us to eat only cake. It will never ask you to eat only broccoli either. So we need to start listening. How do different foods affect you? What combinations of foods taste best or give you the strength or the energy that you would like to have? And there's not a right or wrong answer, right? For example, I love pancakes. I always have, but they make me sleepy <laugh>. So I know that. So I have them on Sundays. I don't have them on Mondays because I will fall asleep on my clients, which is a bad idea. So I know that about my body, I know other people that's not true. They enjoy them at other times. So get to know your body. The idea that we know a nutrition profile for any individual human is not accurate. We do not really know nutritionally what humans need to be at their best. We really don't know. The data is really kind of big data. So it's, it's not indicative for any individual person of what they might need. The best indicator of what you need to eat is your body.

Todd Zemek (27:53):

So it's the beginning of a more nuanced relationship where you're able to sense for the first time to listen, to be with, respond to where someone hasn't been responded to previously. So a lot of lifetime firsts would be unfolding.

Amy Pershing (28:10):

Yeah, I encourage my clients too, while they're exploring hunger and fullness, I also just ask them to be curious about their body in general. When does it need rest? When does it need movement? I, I don't use the word exercise with clients. I really talk about movement so that we're really reclaiming the joy and the delight of moving. Most of my clients move in order to lose weight, not for joy. Bodies like to move typically, right? So what happens if we honor that desire and we listen for it? When is your body hot or cold? You know, when do you need touch? When do you not need touch? Right? What are all of the different ways that your body talks to you? And of course, as I mentioned, you know, a lot of my clients are survivors of trauma. Many are survivors of physical kinds of trauma, physical abuse, sexual abuse. So this is a very scary process sometimes, and it has to go slowly. We have to be very gentle. It has to be self-led. We have to help the parts that are afraid of this process to feel safe. But given that context and that safety, I find that this is essential to developing that long-term recovery where it no longer feels good to not take care of

Todd Zemek (29:32):

Yourself. It no longer feels good to not move, to be constricted and locked up. And yeah. And, and I guess, you know, being curious about movement, very different to being curious about how many times I've got to go to gym per week so I don't feel defective anymore or I feel good about or Yeah. In terms of stigma and trauma, I mean these are the sort of things that in terms of pop culture, it's kind of obvious on the one hand, but can you speak to that a little bit in terms of body shape? And it's lovely to hear you talk about it actually. You're so compassionate and so flexible and accepting of whatever might be for someone's body and for their relationship with it. So yeah, I was just keen to hear you talk a little bit about the stigma, some of the cultural things, and I guess this feeds into what you were talking about in terms of that feminist frame and, and patriarchy and that sort of things as well.

Amy Pershing (30:26):

Yeah, I think weight stigma is predicated on a number of things, right? One is that a thin body is a standard body that is that if everyone did what they were supposed to do in terms of their eating and movement, quote unquote supposed to do, they would be in a thin body. That's the narrative, right? So thin is healthy for everyone and possible for everyone. It's not, bodies come in a huge array of shapes and sizes. First of all, they're also affected by, obviously by genetics, but also by epigenetics and environment and access to healthy food and trauma and all of the things that affect our body as we move through our lives. So we have to really reconsider how we define a healthy body and what that really means. Health isn't, even as we think about health, it's not even possible for everybody. We tend to moralize health, you're a better person if you're eating well or exercising a certain number of days per week.

(31:25):

We tend to call that a better person. And so we moralize health, which I think is also really unfortunate for one thing. Not everybody has access to that life. So that's problem first, but it's also just not a possibility for everybody. So all of those things kind of come together to make for this idea of stigmatizing or judging people based on their shape and size. And that permeates our culture in myriad ways. And for one thing, this is especially true in the US that, and I think it's globally true, that if somebody feels good in their body, regardless of its size, if they feel that they deserve that, that body deserves the best care, they're not gonna spend as much money to fix it. So weight stigma is a multi, multi-billion dollar engine, right? It drives a lot of

Todd Zemek (32:19):

Money. That's how marketing works, isn't it? That you, I I've heard people say this, that you wanna light a fire and then charge people to get out.

Amy Pershing (32:28):

Yes.

Todd Zemek (32:29):

It's a, a psychology of fear around being defective. So, so many motivational programs will start with, you know, anything's possible and then try to weave that into metaphysical things. But again, it's a, a cycle of coming back to that defective stance.

Amy Pershing (32:48):

Yeah. And you know, and most of what is being pedaled to fix the alleged problem does not work <laugh> anyway.

Todd Zemek (32:57):

Right. So toxic Yeah. Yeah. Being delivered by the person who's got to nirvana, you know, has, has, has reached perfection because they've been, you know, they've got a body type where they're Instagram's thin or they've been working out, you know, in a way that's been compensating for, for other things. Yeah,

Amy Pershing (33:16):

Absolutely. Or we have. But to watch Oprah, you know, who bought Weight Watchers and now they're trying to package it as WW because they, you know, and they're changing the, the names of programs now to sound less diety because they know that, you know, the narrative is changing, that people are catching on that dieting doesn't work and it's solving a problem that doesn't exist. Right. By which I mean that people need to lose weight to necessarily always be thin. That's a big piece of this work, I think is in really helping ourselves as therapists, but also our clients to begin to question the messaging. You know, to ask who benefits from your shame feel bad about your body? Who benefits? What would change in your life if you didn't? If your body was the accepted body right now in the culture, what about your life would change? And what holds you back from that? It's shame stories.

Todd Zemek (34:18):

That's interesting actually, because in our, in our culture, we, we don't really value being content.

Amy Pershing (34:24):

No, we certainly don't.

Todd Zemek (34:26):

<Laugh>. That's exactly, which is exactly what you're, exactly what you're speaking about. If we we develop a different, more compassionate relationship with ourselves, then there is a chance that we could come home and we could actually be content. We don't really have a frame for that.

Amy Pershing (34:40):

No, we really don't. I'm actually working on a new book and one of the things that I'm talking about in the book is exactly this issue that, you know, contentment does not, it doesn't drive the engine of capitalism for one thing. Right. And we're, everything we're looking at here is woven deeply into our cultural narrative. I noticed in my Facebook feed in the last six or eight years, as I said, I'm 55, I've noticed in the last six or eight years the number of ads I get for anti-aging products. Unreal. You know, and thousands of dollars so that I look like I haven't lived my life <laugh> basically mm-hmm. <Affirmative>. Right. So, you know, imagine if it was okay to age,

Todd Zemek (35:23):

Imagine that. Yeah.

Amy Pershing (35:25):

Imagine if we are moving around through the world and we were treated with esteem because we showed that we've been around a long time <laugh>, right. It would change things considerably. Right. But that's not what we're shown.

Todd Zemek (35:38):

No. And we could value wisdom, which was around being content and having arrived and we'd be valuing the relational side of life rather than quite a masculine I idea of having to conquer or, or strive or be strong enough, smart enough to dominate.

Amy Pershing (35:57):

That's right. Actually talking about the use of war metaphors in the way we talk about our bodies. And it is just, you know, we're conquering them and we're, you know, controlling them and we're fighting back against aging and all this stuff is very kind of war narratives that we are in a battle somehow to look as though we have not lived a life

Todd Zemek (36:18):

Coming back to that fortress, that beautiful fortress <laugh>. Yeah. Speaking about being content and, and that part of that is the nourishment of relationships where we're seen and responded to might be a silly question, but can anyone do this alone?

Amy Pershing (36:33):

I don't think so. We are interconnected. I think just fundamentally we need each other. We need our planet. We are part of one organism. I think about us a little bit like an aspen, you know that, right? Where you see all the trees above ground, but it's really one entity. So, you know, if we think about our job in healing is to be in a relationship with ourselves that allows us to keep ourselves safe and allows us to connect. So I think we do need connection. Absolutely.

Todd Zemek (37:06):

If someone's out there listening and they're going, okay, well my body's been a fortress. I've been, you know, struggling perhaps with some of this complex trauma. I haven't learnt to respond to myself. I've been feeling defective. And I'm sure most people are nodding to some of those things. <Laugh>, what would be your tips in terms of, I don't know how to, how to assemble a team, how to, if, if you're not going to be able to do this by yourself, if you met someone like that and you had five or 10 minutes with them to give them a few pointers, where would you start?

Amy Pershing (37:43):

I would start by saying that, assuming that they identify as a trauma survivor, first of all, cuz not everyone who's a trauma survivor identifies as a trauma survivor. But let's assume that they know that. I would start by saying that the behaviors that you do that disturb you the most are there to protect you. They're there for good reasons, you're not broken, but you have found your way to this point. That is a win. But many of those behaviors that had to be in place then are damaging now. And so the job of recovery is gratitude and compassion for what you've had to do and space and courage and strength to shift those narratives to what's actually true now. So I would say make sure that your team is strengths based, right? Make sure that they're approaching these struggles from that place of strength and valid from understanding that we do what we do to survive.

(38:49):

So that's one thing that's not as common as it would sound. So <laugh>, that's one thing. And then also I think just again, do they, for this, for binge eating disorder in particular, you know, your treatment team, whoever you see needs to know about weight stigma, they need to know about body as home versus billboard. They need to help you to challenge the cultural narratives that are everywhere. They need to help you find a community of people who are also challenging, who are also questioning. So we can't do this alone. We do need to be with a community of people who get it right. Whatever we're struggling with. I think that's true, right? We need our peeps, we need people who've been through it and get it. And I would also say that recovery is possible. We're, you know, a lot of, I think our work is hope merchanting. It is absolutely possible to get better, to feel better in the world, to be able to move around more as yourself, which after all, that's what recovery is, right?

Todd Zemek (39:48):

Yeah. It's so lovely when the impossible becomes possible mm-hmm.

Amy Pershing (39:52):

<Affirmative>

Todd Zemek (39:53):

Not through pushing, but through having been related. So you're saying that a lot of people may not be able to identify their own trauma because they're still in the fight. And I'm, I'm thinking a lot of people out there might go, okay, let's, that's all very well, they might have compassion for the ideas that we're, we're speaking about, but it may well be right under their nose without them, them knowing e either within themselves and that they'd go back to this defective frame of pushing or self-blame. But similarly for the people in their worlds, I'm imagining that it's entirely possible that a lot of these struggles would not be known by people that were very, very close. You know, partners might not be aware. I'm imagining that just our conversation might Yeah. Turn the lights on for people to, to start noticing some of those subtleties.

Amy Pershing (40:50):

One way I think about it is if you are wondering, you know, is there relational trauma in my history that might be related to my relationship with food? One way as we think about it is, you know, just kind of a key way to determine it from my vantage point anyway, is how safe is it to go in? What does it sound like internally? What you use with yourself should be the gentles kindest voice you have.

Todd Zemek (41:16):

Hmm.

Amy Pershing (41:17):

It's not something's wrong.

Todd Zemek (41:19):

Can you say that again? That's, that's really important.

Amy Pershing (41:23):

We should be able to go in safely. To go inside safely, right? The voice you use with yourself should be the gentlest, kindest voice that you have. And if it's not, something's wrong, you think about how much my clients talked than I did too. You know, use a shaming voice or a judgmental voice. A perfectionistic voice, right? Assessing, constantly going over, did I say the right thing? Did I do the right thing? Was this okay? Was that okay? Just a constant attack. And again, from an I f S lens, that's a protector part. It's trying to make sure that we are acceptable because in relational trauma we learned we were not love was scarce or fragile, right? Or conditional. So we have to make sure that our, our own love is not

Todd Zemek (42:14):

A lot of that wounding was also as a result of what didn't happen. So, you know, emotional neglect in terms of responsiveness to that inner truth is something that so often slips through the cracks because nothing happened. There's nothing to see here that hollowness or, or thoughts about self-harm or that sense of being alone or, or inexplicable thoughts about worthlessness. Or you'd be better off not being here as if that's the soundtrack to what's inside. It's a really great message that you're giving is that that's a sign, that's something some responsiveness is required and often there are personal sort of romantic notions around just not being destined for this world or not fitting in or something like that. But that, that is a sign that it could be a candidate to really benefit from engaging with this type of work.

Amy Pershing (43:12):

Yes, I agree.

Todd Zemek (43:13):

Jumping around a little bit, but in terms of relapse, any comments about making a start? And I guess I'm asking because this is part of my journey at the moment as well as I, I start to find my feet to, you know, develop a more, you know, safer, more caring relationship with myself. But any thoughts on relapse?

Amy Pershing (43:31):

Yes. I don't believe in relapse.

Todd Zemek (43:33):

Okay. <laugh>,

Amy Pershing (43:35):

I don't think there is such a thing as relapse.

Todd Zemek (43:36):

Mm-Hmm.

Amy Pershing (43:37):

<Affirmative>, I think recovery is messy and bumpy and people will have long stretches, let's say with bingeing disorder for, I think it's true of any kind of recovery, but let's say with bingeing disorder in particular, that, you know, they may have stretches of time where they're binging isn't really happening. Could be a long stretch of time and then they, something may come up and here it is back again. So again, I always come at it from that strengths perspective. If that firefighter, as I mentioned before, is going back to the food. We've missed some cues probably, right? Somehow we missed that part or parts. There may be an exile in there that's gotten somehow stirred up and we need to turn back toward and find out what's going on. Cuz we've probably missed something in there. Maybe another part that tried to distract us from looking at whatever might be going on there. Always think the symptom as a way of listening. Something's going on. Get curious.

Todd Zemek (44:37):

Okay. Okay. And so an opportunity to continue to deepen those relationships so that they can be heard and responded to. And if you're coming from a base of nothing where that just simply did not exist, I guess that's going to take a few different experiences to kind of deepen that further under just the natural pressures of life. Yeah,

Amy Pershing (44:59):

That's right. And you know, could be that maybe you will always have bumps. I mean, I think that we, we have this definition in some way, I think of like recovered period. End of sentence. We're done.

Todd Zemek (45:11):

Complete arrival. Yeah,

Amy Pershing (45:12):

That's right. Check the box. Yeah,

Todd Zemek (45:14):

Yeah,

Amy Pershing (45:15):

Yeah. I don't think it works that way, <laugh>. I, I don't think I've ever actually seen that happen. Right. So suppose we change our definition of what, of what it means to be in a good space around our eating disorder. Maybe that means most of the time our eating is intuitive and in connection with body cues. And if at some point we hit a bump in the road and it's not, we get really curious, I missed something. Let me figure out what's going on here. Right. But that we're not treating it as a relapse. The word I think sort of pathologizes it. It's as though you've fallen back.

Todd Zemek (45:52):

It does. Yes. Thank you. Yeah, I, I appreciate that. As I said in the beginning, I, I, I loved your book binge Eating Disorder, the Journey to Recovery and Beyond. I'd really recommend that it's one of those lovely books that's equally beneficial for therapists as it is for patients. So I really recommend that. In terms of, if people have been touched by what you've been saying and wanted to benefit from more of what you offer, how would they do that

Amy Pershing (46:18):

For professionals? I have some trainings, so if you go to my website, it's the BodyWise program.com or you can go to PESI.com, which is an international training site. And I have a training on binge cheating disorder and, which is

Todd Zemek (46:31):

Excellent. Which is just absolutely excellent. Yeah. I really love that.

Amy Pershing (46:35):

Yeah, thank you. And we also have on, I see some body image classes and courses and just a number of different things. So that's a good place to get professional training. So

Todd Zemek (46:46):

Thank you Amy, thank you for your work and for being you. Thank you for chatting. I've, I've really, really enjoyed it.

Amy Pershing (46:51):

Thank you. It's been a delight to be with you Todd.