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As we learned in last week’s episode, body image is something that most of us will struggle with at some point, and it can often result in having an unhealthy relationship with food. This week, we learn some of the root causes of body image issues and how to avoid falling into mal-adaptive behaviors.
Summer Forlenza joins us on Therapy Talks to delve into the spectrum of eating disorders and disordered eating, the link between trauma and EDs, and how you can support a loved one who may be struggling.
Summer Forlenza is a Licensed Marriage and Family Therapist who specializes in treating complex trauma and eating disorders. Summer is also a mental health educator who helps folks to better understand trauma, the mind body connection, and how to build better relationships with their body, brain, and fellow humans.
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Disclaimer: Therapy Talks does NOT provide medical services or professional counseling, and it is NOT a substitute for professional medical care.
[00:00:00] Hi everyone. It's Barb Egan from therapy talks and on today's show, we have summer Forlenza from Southern California, a licensed marriage and family therapist who specializes in trauma, EMDR therapy and eating disorders. So on today's show, we talk about the correlation between trauma or especially childhood trauma and eating disorders.
[00:00:20] The theme of control. We talk about tips for parents and support systems for people struggling with eating and giving you some tips on how to help your loved ones. And so I hope you join us.
[00:00:39] It's a beautiful may day. I'm feeling summer vibes. So I'm pumped you're here. And where are you located?
[00:00:47] I am in the inland empire, in Southern California. So Montclair, California, to be exact.
[00:00:53] Tell us about your work. What areas of counseling do you really love to work in? Sure. I am a trauma and eating disorder specialist.
[00:01:02] So the vast majority of my clients are coming to me with complex PTSD, meaning that they've had. Repeated traumatic experiences or experiences of neglect throughout their childhood and adolescence. Oftentimes that leads to eating disorders. There's a huge overlap between disordered eating and trauma, especially childhood trauma.
[00:01:21] So that is really my sweet spot and where I like to work. How did you get into. Great question. So it's so funny. When I went to graduate school, I knew that I wanted to focus on trauma. I knew that was my focus and I got trained in EMDR therapy, which is the trauma therapy while I was in grad school, because I just knew that's what I wanted to do.
[00:01:41] And then while I was in grad school, I heard from a number of my professors and some of my supervisors. That eating disorders were the thing that they always referred out there, if you refer out, those are really tricky, you need to specialize. And so that intrigued me. I was like, okay, what's going on there?
[00:01:57] So I did a good chunk about a third of my. Hours to get licensed working in an eating disorder treatment center. So I worked at PHP IOP and residential levels of care with folks who had disordered eating and eating disorders. And that work was so cool. Absolutely loved just seeing the transformation that can happen for folks and really connecting some of the ways that we were able to do work and therapy on our relationship with our body and with other people and with food to some of the bigger values and social justice things that matter to me it was just really powerful and I got hooked.
[00:02:38] Wow. So can you tell. Because you're right. You hear this all the time, whether it's in graduate school or I supervise at a university and with graduate students, and that's the thing with eating disorders often, it's you refer those out or you go to what was your time at the eating disorder clinic? Can you tell us what that's like to help our listeners paint a picture of that? Because most of us have no clue what goes on there. What type of therapy what's the schedule? What is it like?
[00:03:06] sure so most of the time, it's interesting. Cause when clients would come to us, they felt that way. They were like, I don't know what's going to happen. I'm really nervous. What are my days gonna look like? So there was a lot of overwhelm basically working in a treatment center and being a client in a treatment center. Your day is very structured. So one of the cool things about doing eating disorder work, especially that level of care is that we do meal support.
[00:03:28] So that means that you're having breakfast, lunch, dinner, and snacks with your clients. And that is you're playing a supportive and therapeutic role during an experience that can be really heightened anxiety experience for a lot of clients. So you're there with them during meals and snacks, and then we do group therapy.
[00:03:43] So we might do process groups where people are talking about their symptoms and their history, and what's going on. My favorite groups are run where our art groups, I love doing, creative arts therapy. We did a lot of painting. We did some work with music and those grips were my absolute favorites to run.
[00:04:00] And then we also had individual therapies. So each client would have an individual therapist and they would meet with at least twice a week, if not more. And those sessions would deviate between more talk therapy and processing and setting goals. And more focused trauma reprocessing work. So that's where I would use.
[00:04:19] Because again, there's such a huge overlap between folks who are coming in with trauma and who are dealing with higher severity eating disorders.
[00:04:26] Wow. Can you give us some more examples of that? Like you had said adverse childhood experience when you're walking with people and let's just take eating disorders. For example, since we're there, how does somebody know? Oh, this is what I have, cause we've been, we've had on the show before and we've talked about disordered eating body image. So what's the eating disorder. How does somebody know if you, or a loved one, maybe struggling with.
[00:04:53] It's definitely a spectrum and you'll hear me using eating disorder and disordered eating somewhat interchangeably because it's pretty subjective at the end of the day. What meets criteria for disorder and who gets to decide that? In general, when we're looking at meeting criteria for a disorder, we're looking at your ability to do stuff in your life.
[00:05:11] Are you able to go to school? Are you able to work? Are your relations. Totally falling apart. Are you only ever thinking about food and your body and exercise all the time? We do live in a world that really encourages disordered eating. So I would say. Many, if not, most people have experiences of disordered eating at least sometimes in their life.
[00:05:29] And that's when we're thinking about food more, maybe we're over exercising to the point of pain or exhaustion. We're helping ourselves a really rigid schedules about what we can eat and when we can eat. And all of that is really not very good for our bodies or our brains or our relationships, but it might not rise to that level of needing to go to evening sort of treatments, the folks who were at the treatment center and who are at those higher levels of care.
[00:05:51] Are really in a place where school is not happening, their friendships are falling apart. They're not able to set goals and meet them for the future because everything is about food and the body.
[00:06:05] Yeah. Wow. And so if you're working with someone. And they come in. Do they typically say, you know what, I'm struggling with an eating disorder or how do you unpack that? Like how does that, how do those layers come off to that? Almost never happens. No, because again, there's such a, of normalization in the world we live in. For disordered eating, we're coming calories, exercise, like the restrictiveness of it or the over of it. It can be glorified to if the diet culture, the fads and all of the.
[00:06:39] A hundred percent. And it's interesting cause you and I are speaking just after the met gala. And there's been a lot of news about Kim Kardashian and how she lost X amount of pounds and a certain amount of time by following a certain, very rigid diet. And my size of the internet, the circles I'm in are very critical of this, but I am very aware that there is.
[00:06:58] Many sides of the internet that see that as a model of what is, what should be possible. And I think it actually might be helpful to just take a minute to describe the different kind of categories of symptoms that people can experience with that. That'd be great. So you just mentioned some of them, it made me think about it.
[00:07:13] So the first category is restricting food and there's two ways that we can do that. The first is we can physically restrict that's when we're counting calories. It's when we say I'm not allowed to eat after a certain time or before a certain time. I'm not allowed to eat certain groups of foods, stuff like that.
[00:07:29] The second kind of restriction we can have is psychological restriction. And that's when we have in our brain and idea that there's good foods and bad foods. And every time I eat a bad food, I feel guilty. I feel shame. I might have to do it in secrets. I might spin out about what this is going to mean or feel that it needs to compensate for that with other behaviors, exercise or stuff like that.
[00:07:49] And both of them. Are really detrimental to our relationship with food and can really interrupt our ability to connect to our own hunger and fullness cues. So then we're at a place where we can't tell them we're hungry. We can't tell them we're fall. We start to distrust our body more and more, and that can lead to just making things more intense than more.
[00:08:10] So that's restriction. That's one set. Another category we have is what therapists call compensatory behaviors. It's basically the category of symptoms where you're trying to do things to make up for not restricting or eating to the point of being uncomfortable. So that looked like over exercising, right exercise.
[00:08:28] And this is really tricky, I think for me and as a therapist to talk about, because we know that exercise is really good for our mental and it's really good for physical. It's a good thing. But it can be abused to the point where, if you are feeling really guilty, cause you missed a workout session, you missed a run.
[00:08:45] If you feel like, oh, because I ate that yesterday, that means I need to do this today to burn it off. I have to. Yeah. When it feels compulsive, when you feel like, oh, if I don't do this, I'm going to shame spiral, and that's when. Putting exercise over relationships over school, over sleep.
[00:09:02] That's when it can really become danger or when they're injuring themselves. And when restriction and overexercising and go together, that can be really dangerous for our body, for our hearts, for our ability to focus and think clearly stuff. We also see, there's also a category.
[00:09:19] The other thing that can happen in compensatory behaviors in that group is when we talk about purging, when we talk about laxative abuse and they have oh, I need to get this out of my body. And those are both really dangerous. And whenever that's going on for any clients that I'm working with, I always loop in their primary care physician as someone on our.
[00:09:39] So that we can make sure we're keeping tabs on their physical health and getting the medication. They might need stuff like that. The other kind of eating disorder behavior we can see is binge eating. And that's when we eat to the point of being really uncomfortable or even feeling sick on a regular basis, like it's pretty normal to overeat on at certain events and like correct time.
[00:10:00] That's a pretty normal human experience. And we learned from it right when we. R, if we're connected to our body, our brain is whoa, I do not feel good right now. Okay, probably next time. I'm probably going to be like, oh, I'm actually done now. But bingeing has this dissociative quality to it.
[00:10:14] It has this quality of, I am not even really here. I am not totally even tasting or feeling what's happening to me. I am like lost in this. And it's this. Awful paradox that folks can find themselves in, because one of the major causes of bingeing is restriction because our body is oh, apparently we're in a famine and we don't have enough food.
[00:10:36] So if I have access to this right now, oh my God, I need to eat as much of it as I can. Cause I don't want to eat that. Yeah.
[00:10:42] Numb out and just keep going. It's instead of mindful, like we talk about mindfulness a lot, but this is. Eating really. It's like where you're just going back into the popcorn or the chips or whatever, and yeah.
[00:10:55] Yeah. And I think that is it's so interesting because in some of the parts of the world, in parts of our society, that glorify disordered eating habits, I think bingeing is also really glorified in the form of like cheat days and in the form of volume meeting. And you'll see stuff like that. In some of these disorders, W circles where the idea is oh, I just want to be as full as I possibly can be because, oh, I was restricting all week on Sundays.
[00:11:21] I get to email I'm sick, right? Yes. I've heard of that. Yeah. And it just gets us really painful cycle. It has really negative consequences on our physical health and it can totally destroy our ability to relate to our food in a healthy way.
[00:11:38] Wow. There's a few things. I think it's so helpful to break those into categories like you did. Thank you. That's a really good way to think about it. And as you do, it's wow, no wonder. Most people don't come into a therapy office saying I think I might have an eating disorder, a tough relationship with eating or food or body image. Those are pretty common, behaviors in our culture of restricting or diet, exercise, eat these foods, not these foods, vegan gluten-free Quito, and they're common words in our language today.
[00:12:09] So what do you do? Like how do you know when a tough relationship with eating or food or body image crosses that line that it's interfering with somebody's life?
[00:12:21] When somebody comes to me and they are, a lot of times, folks will come to me because they know, oh, you work with childhood trauma, you are a trauma therapist. And it's this is what I want to work on. So they'll know. Yeah, this really bad thing happened to me or number of bad things happened to me all in a row. So people have an awareness of that. And one of the things that. So important for therapists to do is to like, ask a couple questions about your relationship with food and exercise in your body.
[00:12:46] Because again, like you said, it's so normalized now to have really messed up relationship with the body . It's actually, it's so encouraged, so I always encourage therapists, ask those questions, but even if you're not in therapy, you can just get curious about what's going on with you, right?
[00:13:02] Are there foods that scare me? Are there foods? And I'm like, oh my God, I can't even keep that in. I can't have that. If you're feeling and thinking that kind of way, that's definitely a sign of disordered eating. Cause it says, it tells me that you're feeling out of control or you're feeling, an emotion that doesn't need to be attached to the foods that we eat.
[00:13:20] And then. A lot of times, if you have a difficult or a disordered relationship with food, people in your life are going to notice you might be hard to go out to eat with, you might be making lots of comments about food in your body. So you can also see what the people in your life that you trust have to say, what they noticing.
[00:13:38] Yeah, cause we all have blind spots and we all need those front row. People like Bernie brown talks about, are those safe people that you really trust their input and kind of give them permission to speak into your life? Yeah, absolutely. Find people, a therapist is a great person to do that, but also we can have our family, we can have a community of a religious community or a spiritual community.
[00:13:58] We can have, a like group sports activity, all kinds of ways to connect with other people who can see. And reflect back to us. Hey, I'm a little worried about you. I'm hearing this a lot or people that you might trust to ask and be like, I've been a little bit worried about this. Have you noticed that in me, like those are good ways to start paying attention.
[00:14:15] And then, if you are at a point in your life, you're like, okay, it's time for me to change the way I feel about food and change the way I feel about my body. There's a couple of things we can do. The, if therapy's accessible to you, finding a good trained, competent eating disorder therapist is one of the best investments you can make.
[00:14:35] Because one of the roles that we take, if we're anything disorder therapist, is we also lead your treatment team. So that means that I am going to be working with your primary care physician. I'm going to work with your dietician. I'm going to maybe talk to your psychiatrist if that person's on your team and eating disorder, coaches, if you want to have them be there.
[00:14:52] And we'll coordinate, we'll meet, we'll talk about what's going on. We'll make sure that everything's being covered. Those are really complex. They are more complex. One of the most complicated and. Disorders that we've got on the DSM because you have such, there's such an interaction between our psychological and our physical it's special it's orders.
[00:15:13] So if you can find a good eating sort of therapist to work with, that's a great start. You can also just start to engage with social media. That's that is anti-diarrheal. That is about intuitive eating, which is the end goal for a lot of folks who haven't afforded a relationship with food.
[00:15:32] It's not always where we start in recovery, but it is a lot of times where we're hoping to get and just starting to read and learn more about. Ideas that can help you to deconstruct what you've been taught about your and food and exercise. What can you describe intuitive eating for us? Sure. Intuitive eating is a set of 10 principles that can guide your relationship with food to a healthy way.
[00:15:59] Kind of the. Foundation of intuitive eating is mindfulness and self-care are the ways I would think about it. So it is paying attention to how you feel, paying attention to how your body is responding to different cues in your environment to foods, to movement, things like that. And it's also about taking care of your full self, right?
[00:16:22] So that means that we're going to be. Eating foods that make our body feel good, but we're also going to give ourselves unconditional permission to eat. If you're hungry, if you're thinking about food eats, because a lot of times we work really hard to not eat when we're hungry. And we come up with all kinds of creative ways to like suppress hunger and intuitive eating invites us to embrace hunger and.
[00:16:44] A guide, and also to be able to differentiate like what's hunger and what is that nine numbing urge to just distract. Cause sometimes food can do that for us. And a big piece of the mindset of intuitive eating is that, food's not bad. And even for comfort eating because you want to numb out.
[00:17:04] That's pretty normal part of being a human and from time to time, from time to time. Yeah. Yeah. That's a good way to put it too, to take the pressure off of yourself. We all do that from time to time. Yeah. And it's if we can be present in the experience as much as possible and think, Hey, did that work?
[00:17:20] Did I feel better? Do I feel good now? Would I be cool doing that again? Don't want to try something else. Those are. Really foundational parts don't do debating and is inviting us to be present in our body and thoughtful about our relationship with food kind to ourselves and to others.
[00:17:39] And ask us to take weight off the table as even a question or something that we're thinking about in regards to our relationship with food and say my body can sort out weight all by itself. I don't need to do that. That's not my job. My job is to find foods that I enjoy find foods that satisfy me find foods that are accessible to me and find ways of moving that are all those things to.
[00:18:00] Awesome. As you're talking, I keep seeing a big correlation between countries. Trauma or adverse childhood experience or experiences like complex PTSD. Can you speak to that of the theme of control and eating disorders and how it correlates with trauma as well?
[00:18:19] Totally. I sometimes say like the antidote to trauma is choice because trauma happens to us when we have no choice when we are helpless, powerless and trapped.
[00:18:34] And if you grew up in an environment where that those are the conditions that you're living in almost all the time and that's, shockingly common, it becomes you have a few. There's some good reasons why your body and brain might learn, Hey, if I can exert some control over this area of my life, especially in an area of life where you might be getting validation for what you're doing, people are like, oh my God, when they have no idea what's going on behind closed doors, right? Oh, you're exercising so much good for you or, yeah, you've lost so much weight. What could you do what you got to tell me what you did. I hear that all the time from clients that they get those comments and they're like, you don't want to do this.
[00:19:16] So you get rewarded for it too. So it's like you learn, okay. Control, especially in this area might make me. 'cause a lot of times our childhood adverse childhood experiences are interpersonal in nature. They happen between us and other people. And we do live in a world where Finn privilege is real and where we are rewarded if we live in a certain kind of body.
[00:19:36] And so it makes sense that people want to achieve. A body that they think is going to make them loved, accepted, safe, cared for. And there's a belief that I can control my self enough. I can make that happen, that's not actually true. Diets don't work, eating disorders don't work. They destroy your life.
[00:19:58] They don't make them feel better. And our bodies. Wait is really not up to us. It's up our genetics. It's up to the world, the part of the world that we live in. It's not something that we get to actually decide. So then people can find themselves in this trap where maybe they lost some weight for the while and they, their body's fighting back.
[00:20:17] It's working in the same way anymore. I also think. When it comes to the connection between adverse childhood experiences and trauma and eating disorders association is a really strong component because when you're a kid and you are in an environment that's not safe all the time, it is necessary for your survival, that you are not present.
[00:20:38] And I often will say I'm so grateful that kids have access to that when they need it. Because there are things they shouldn't have to be there for. And it's the strength that gets kids through things they shouldn't have to experience that then can become this. Very difficult to get out of pattern, that when things feel scary or intense, your brain says, oh, I know how we deal with this. We checked out, right? And that level of dissociation enables people to engage in these, eating disorder, habits, behaviors, really painful and really uncomfortable because they just think they associate, they don't, they're not there for that.
[00:21:16] It also makes it really difficult to come back into your body because trauma makes being in our body feel really unsafe.
[00:21:22] Wow. And so here you have, what you're saying is what served a purpose at one time Hey that was probably smart for your survival at that time as a child numbing out dissociating kind of that out of body experience in the sense that protected.
[00:21:41] But now as a teen or an adult, when that's happening, that's not serving you well anymore. That's a maladaptive behavior. How do you work with people to change that? Because I can imagine it's not as easy as just saying, Hey, that worked for you as a kid, but it doesn't work for you as an adult. Let's cut that out of your life.
[00:22:00] Now we're going to stop.
[00:22:01] I wish life worked like that.
[00:22:05] Yeah. I think that part of what. Is required to be a good trauma therapist and a good eating disorder therapist is a really strong understanding of how the association works and how we can address it. And, a lot of times it's slowly because the biggest thing that we don't want to do in trauma work is overwhelm or flood the person who is trying to heal.
[00:22:32] Because that's, when association is going to show up, it's oh, I know what to do, but. It's too much. Yeah. So we work slowly. We find things that are pleasant or neutral that we can bring our attention to. That help us to stay in the presence we learn, what it feels like to be grounded, which is to be present, which is to feel what's going on in our body.
[00:22:54] We do things like a body scans, which help us slowly check in with all different parts of our body. Okay. How does this part of my body feel? How does this part of my body feel? What does it feel like here we learn? What are the signs that I'm dissociating? What are early signs? Maybe I huggy, maybe I get fidgety.
[00:23:09] Maybe I get really still, maybe my face goes blank. What are the signs that, that starting to happen? And then everybody's got different things that helps them to stay present. What I will do whenever I do like any trauma reprocessing session, I always ask them like, bring some ice water with you.
[00:23:24] Do you have something to drink? We're not gonna get started till you got something to drink. Because I find that temperature is so oftentimes what I say is we need an anchor, something to put our attention on. That's not the bad thing. That's not the upsetting thing. Something that we can turn to.
[00:23:39] That's not numbed out. And so temperature can be a really good way to do that. Making physical contact with your body can be a good way to do that. Moving can be a good way to do that, but it's super unique to each person. And a lot of times it's a slow process. When we take our time,
[00:23:55] I love that. And I love the ice water. I've been doing some research and finding with polyvagal theory and different, the mind, body connection, basically your vagus nerve connects all your big vital organs helps connect the mind body base. That's the big premise of it. And there's been findings that show for people with insomnia or anxiety related again, trauma, how it manifests. Cold is really soothing. There's something grounding. As you're describing all these things, have a body scan or just feeling where you feel it in your body and grounding your feet to the floor, all those things, the coldness of it again, the vagus nerve goes right through. Middle half the core of who you are connecting your mind and body. And it's something very grounding because of the coldness of it. So that's fascinating. I love that you do that.
[00:24:44] Yes. That's one of my favorite tools is cold. So we like ice water. I've had people be like, I do a lot of virtual. I do only virtual therapy now. So I'll be like go to your freezer and grab an ice pack.
[00:24:55] And then we put the ice pack on the neck. We put it on the legs, put it on the wrists we use. I have had people go get ice cream out of their freezer and I'll go get ice cream out of my freezer. And we eat ice cream together because this is two anchors. It gives us taste and it gives us temperature.
[00:25:09] Yeah. So when you're working virtually, do you find that there's any difference in doing trauma work, especially complex trauma work or EMDR eating disorders then.
[00:25:23] Totally. I think you can do really good work virtually, but there's a few caveats to that. The first thing is that when you're doing virtual therapy, the therapist is not the person who's responsible for your privacy and your safety during session. You are. So I always screen people before they start therapy with me to make sure they have a couple of things. Do you have a private space inside? Not in your car? Cause I've tried that one doesn't work too well, too. Distracted inside a home. Where you can lock the door and know that you're not going to be interrupted or overheard.
[00:25:54] That's super important. The other things I think about are, if you have wifi, that's not that good, like doing trauma work or complex trauma work virtually is not the right choice. Because if I lose connection with you at the wrong time, or things are fuzzy, or our audio isn't working that can lead to the biggest thing that I'm trying to avoid. Ever happening in therapy is somebody getting dysregulated or dissociated or overwhelmed by what we're doing. And then being left alone by themselves when that happens. Harms that doesn't help. And sometimes people don't have the right home environment to facilitate virtual therapy. And other times they do.
[00:26:34] So I think you can do really good work, but it is very dependent on the client's ability to have privacy, good wifi safety at home. If you're living with people who are harming with you, doing therapy from home is also top of right choice.
[00:26:48] Yeah. Wow. That's those are great points. Thank you.
[00:26:53] I think that's true. Regardless of trauma, but especially in trauma, like absolution. Absolutely. Okay. So when you see eating disorders come up, do you often see that. What age or does it vary?
[00:27:09] Actually, it's most common for eating disorders to begin in middle school. Wow. That is when a lot of times symptoms start especially, eating disorders occurring all genders, but especially for young women there is a lot of pressures that start during puberty, right?
[00:27:25] Where your body is usually gaining weight, your body's changing. And we do live in a world that has this. Really. Uncomfortable for me association of female attractiveness with kind of like prepubescent features, right? Franklin,
[00:27:45] I'm going to second that I have a daughter
[00:27:50] it's really uncomfortable to see, but it's true. Like with people who are elevated to the level of, the most attractive and who are seen that way, a lot of times have qualities that emulate prepubescence. And so when your body does start to change, a lot of times for young people, there's a belief of oh, what's that putting his bad? And this is going to make me unattractive, which is going to mean that I'm on unlikeable or unlovable, and then I'm going to be alone and then I'm not, and then I'm going to be unsafe.
[00:28:18] Yeah. So it's usually starts in middle school. And the research does indicate that the earlier that you get intervention, the better because eating disorders can stick around. We, even, if you don't, once you start to learn more about eating disorders, you see it all over the place and you'll start to see it.
[00:28:33] Even in, our elders and in our senior community, there are a lot of people who have lived. Eating for a long time. And if you think about in the past, people use cigarettes, they use Baya pills, they use all kinds of stuff to suppress hunger.
[00:28:48] curb your appetite, that's like a common phrase.
[00:28:51] So common, right? Oh, if your body's telling you, you're hungry, it's wrong. Don't listen to that. You shouldn't eat. And your job as a person, especially as women, a lot of the times is to do whatever you can to not feel that, to get rid of it, to ignore it, to cover it up, do whatever you gotta do.
[00:29:08] Yeah, but it starts really young and, even as young as elementary school for some kids.
[00:29:14] Yeah. Cause I have small kids. And so just as you're, talking about. The shame around food and guilt, we're really intentional and not perfect. So I welcome any tips there too. But how do use, this is really good for my body.
[00:29:31] It's powerful. It's fuel. It's gonna make me. Really smart and I'm going to make me run really fast. What are some tips for parents? Especially of littles, but throughout teens to maybe especially around it can occur in any gender, but especially say the stereotypical girl middle high school wants to only eat a saddle salad.
[00:29:53] What are good words, parents or people, friends, support, people can use to encourage against that shame culture with.
[00:30:02] Love this question. I'm smiling because I'm so excited to answer it. Because I do think that, like I said, early intervention is what really can prevent this from ever getting into the level of an eating disorder. And that is a huge gift to your children. If you can, give them some of the resilience factors that help us to have healthy, related relationships with food. So the very first thing is that it doesn't. You can say all the right things, but if you yourself are dieting or talking negatively about your body or other people's bodies, that immediately is going to send a message to your child.
[00:30:32] The way that you eat and what your body looks like is a condition for love. Yeah. And when that becomes, when that starts to be integrated at a young age, it feels so true. And that is when things can feel really sticky and oh yeah, sure. I don't want to be doing these eating disorder behaviors, but if I don't, I'm not lovable and that's not possible.
[00:30:52] I can't live with that, so that's the first thing is just like check in with yourself. How am I talking about food? How am I talking about my body? How am I talking about other people's bodies? How do I talk about myself? When I try on clothes? How do I talk about the different kinds of foods that I enjoy?
[00:31:05] Am I putting things into categories of good foods and bad foods? All of those are things that the very first thing is just modeling a healthy relationship with food yourself. And sometimes getting some therapy with somebody who knows what they're doing is a great start. Also not like.
[00:31:20] I also recommend a lot of times that folks work with an eating disorder dieticians or a registered dietician who has worked with eating disorders because they are just the best. I see so many changes in my clients when we get one of an RD on their team. I work with them all the time and I love it.
[00:31:37] And I have one in particular who I just pray for and work so closely with. They're such a gift. Yes. They are such a gift. I love the way you put that. I think that's the first thing you do is check in with yourself, get to go with yourself. But let's say that has happened. What else can you do? One of the things I like to think about, and one of the things that's part of intuitive eating is like taking away the thought of this is a good food or healthy food, or this what gives me energy or anything like that.
[00:32:04] And instead of being curious about how satisfied we are with our food, because that. That encourages us to connect to how we feel about the food and how our body is reacting to the food. So I actually had a friend of mine reached out to me a couple months ago because their daughter who I think is seven, was starting to make comments about her body and about food and wanting to eat less.
[00:32:23] And so one of the things that we talked about and that she started doing it with her family that worked really well was talking about the textures of food. So not just the taste of food, be like, oh, I love how crunchy. Potato chip is, or I love how crunchy the salad is. Oh, I love how smooth this ice cream is or this yogurt.
[00:32:41] Oh, I, just thinking about textures of food because that encourages us to pay attention to how we feel when we eat. And texture is also something that gives us a lot of satisfaction with our food. And what we're thinking about with intuitive eating and with developing a healthy relationship with food is like, how do I choose foods that actually I'm going to want?
[00:32:58] And then when I'm done eating, I'm going to feel good. I'm going to feel sad. And I think part of what can be a challenge for parents but is really helpful to learn and to know. You can trust your child's body to choose foods that will nourish and sustain them. If you give them choice and you help them develop a healthy relationship with food, I often times will hear people afraid.
[00:33:23] If I give myself unconditional permission to eat, all I'm going to eat is candy. All the many, eat his chips, I'm going to eat his ice cream AMI, eat his cake. And that is really not the reality when you're shit, because it's one of those. Such joy. One of the most joyful things about this work, I think is the way it helps us to like really enjoy all kinds of foods.
[00:33:44] Like I, I'm a big candy person. I love candy. I'm also a huge salad person. I love salad. I love cucumbers. I love oranges. There's and when you get to see oh, Are good for us, all foods, give us nourishment or enjoyment or pleasure or connection with other people and foods are neutral. \ You're like, you don't have to think about it so much. Your body just craves what you want.
[00:34:08] It's so true. You're talking to a pregnant lady, so talk about cravings. So a seafood Oreo milkshake. I, my family, we were out, what were we? I think we were out to dinner like last week and I went home on the way and picked up two Oreo milshakes and I could beat myself up.
[00:34:28] I'm a former, elite athlete and work in that realm. So talk about restriction and over-exercise so that's how I was conditioned. So it's so weird. But as a pregnancy, I'm like my body. Changing. And I can't track me. It's my fourth time around. So I've had some weird cravings throughout, but I've just, I just think it's such a gift and I have such a deeper appreciation for my body of, wow, you can grow life, you can sustain it.
[00:34:55] I can have an Oreo milkshake. It's not, I'm not having five a day every day, so it's that power of shifting a perspective that is not easy. And I've had to do a lot of work in that, but that is a lot of. That's just a tangible example from going from restriction and disordered eating in my, university and high school years to now in my mid thirties of being able to hold it a little bit more loosely and not bring the shame in. And it's so freeing.
[00:35:22] Yes. And it's, so I love the way you just talked about and connected a lot of times, elite athletes and people who are athletes in middle school and high school, and college will develop a really disordered relationship always, but it does happen
[00:35:35] so prevalent. Yeah.
[00:35:39] It's encouraged.
[00:35:40] It's normalized. Like we would never say that, like we had RDS on our team. We had dieticians and nutritionists and team doctors and everything, but it was like, it was. Even around those terminology, it was like, that's just what you do to perform well. And it was glorified and normalized and it wasn't till I had some time and space away from that.
[00:35:59] And in my retired life, I'm seeing, wow. I have some weird habits. I want some freedom here.
[00:36:09] Yeah. And I think, it makes me think about one of the ways that we treat binge-eating disorder and it sounds so paradoxical. It freaks people out is okay, what is the food that you binge on?
[00:36:18] Let's say that it is like Oreos, for example. We're like, okay, your job is to make sure your house always has Oreos in it. You need to have Oreos available at any moment that you would want one. And if you want an Oreo, you need to ignore you. And that's super scary for people. Yeah. And a lot of times when I described this, people are like what are you talking about?
[00:36:37] Like that I'm not doing something right. But what we find is that like having unconditional permission to eat and unconditional access to all different kinds of foods takes away two things. One, it helps you to not just associate every time you're. Cause a lot of times binge eating, like I said, requires you to check out.
[00:36:55] And so you're like, okay, I want an L'Oreal right now. I'm going to eat one. And then we'll a lot of times in therapy session, we'll practice mindful eating. Hey, what does it taste like? What, sure. What are the different flavors? How full are you? How hungry are you? So you get better at that. And then you also address that element of a psychological restriction that says, oh, I can't eat this.
[00:37:14] It's too dangerous. I'll have too many. And when your brain and body starts really is oh, I guess I can have an Oreo, like whenever I want one. A lot of times the bingeing stops. You have to practice self control. I can trust myself. Yeah. If you're actually giving yourself permission to eat.
[00:37:30] You're not going to want to eat Oreos all day, every day for years. Like you're not, that's not going to happen. What will happen is that will become a neutral food for you. You'll eat it when you want it you'll stop when you don't. And you'll have other foods that you enjoy.
[00:37:43] Yeah. And I see that in kids, like just being a parent and in my own too, where we try to limit sugar in a healthy way. But when we, especially with our first and you're like, oh no, he can't have any sugar. And so meticulous on that. And then it would be like at birthday parties and it's oh, okay. And we're like, okay, we need to develop a little bit healthier relationship that we can have it in moderation and not over do it and I think that's really important too. So these are real practical things. And the things that we've talked about today as our listeners can probably identify is just because you experienced one or a few of the, signs or symptoms that we talk about doesn't mean that you have to be stuck there, or that you have to be labeled with the eating disorder, but that there's some tangible tools to get out of it, to bring some mindfulness that intuitive eating.
[00:38:33] I love that. Are there any. Other take home strategies that you think, Hey, to have a healthy relationship with food, whether you've had an eating disorder, you're in the midst of some disordered eating currently, or you just want to protect against it for you or your family or loved ones. What are some healthy parameters? What are some healthy.
[00:38:54] I love that. So one of the things I think about, and this is maybe with kids, I recommend this, but we can do this as adults too is to, start to notice when we're labeling foods as, oh, this is a treat or this is a dessert, or this is a fun food or something like that.
[00:39:08] And instead be like, Food. So a lot of times what we'll encourage people to do with their kids is to serve what we would call dessert, like with the meal, not like you can have all you're gonna eat tonight is cake. Cause again, that kid's probably not gonna actually want that either. But oh yeah, we have a chicken for dinner and we've got this spinach and we've got these oranges and we also have this cake and they're all on the table at the same time.
[00:39:29] And that means that you don't have to like. Eat enough of a healthy food to earn the dessert or anything, and just neutralizes food in a big way. And that's when we can start to eat intuitively cause we know, Hey, I can have taken if I want it or I can have Spanish if I want it. And there's definitely times when I would prefer to have cake and definitely times where I prefer to have spinach.
[00:39:47] It just totally depends. So that's one thing. If you're labeling foods, cause that's part of that psychological restriction and we can start to change that. Another thing I think about is, and that we do when you come to eating sort of treatment is eating on a regular basis, even if you're not hungry at the beginning.
[00:40:05] Because when you live in such a diet saturated world, We can really learn, oh, I shouldn't eat breakfast or I don't eat until noon or, oh, I'm not hungry. I'm not going to eat. And biggest thing we start to do is be like, okay, my body can expect that I will eat breakfast. I will eat lunch and I won't eat dinner every single day.
[00:40:24] And when we do that, we're actually giving our body as much nourishment as it needs. And it needs a lot more than people realize, like you need a lot more food than people think. And when you're starting to feed yourself on a regular basis, eating breakfast, lunch, and dinner every day, that also starts to shift the way your body feels about, how much trusts you and body trust is such a huge piece of it.
[00:40:47] And then I would also think about can you start to find relationships in your life with people who have modeled a healthy relationship with food in their body? Because if you're surrounded by people who are just soaked in diet culture soaked in the idea of. Your job as a human is to make your body as small as possible through any means necessary.
[00:41:08] That makes it really difficult. Then you're worthy of love where you're worthy of love right now, just as you are, your body doesn't need to look any kind of way for you to be lovable for you to be. Fun for you to be happy. I think that's a, such a huge thing is like a lot of times eating disorders promises that if we achieve something a certain size or a certain shape, that we will be happy and we'll have fun and we'll be loved.
[00:41:38] And I love to invite people like where can you find fun and pleasure and joy in your life? Like right now in the body you're in right now.
[00:41:47] Oh yeah. I love that. Yeah. Oh summer, you are such a delight. You are incredible. You do such incredible work, such powerful, important work. Especially in our culture today.
[00:42:00] That's very needed. Where can our listeners find you?
[00:42:04] Sure. I'm mostly on Instagram these days. My handle is summer the therapist put a period between the words going to search my name and I should pop up. So I'm on there pretty much every day. I also have a website summer. Forlenza where you can just read about my approach and what I do and kinds of therapy.
[00:42:21] But Instagram's the biggest place right now. So come find me there.
[00:42:25] Awesome. So trauma work, EMDR, PTSD, complex PTSD eating disorders. We would love to, I know we're almost at a time today and we focus a lot on the quarterly. Yes, childhood trauma or trauma and eating disorders and really unpacking eating disorders.
[00:42:42] We'd love to invite you on again and talk more on trauma or anything else too. You are so personable. And I just think when somebody is going through any of those, like those are big, complex, hard stuff. You're so warm and inviting. And so it was lovely to learn from you and thank you for your time and coming on.
[00:43:02] This was such a pleasure. I, if you can't tell, I love talking about this stuff. And I think, one of the things that I know kept me from seeking support at times in my life, when I needed it, is that I felt like the people who, a lot of therapists really presented as very clinical, very removed kind of cold, not necessarily cold, but clinical.
[00:43:21] I hear that word. All right. And you, when you hear how I talk, like I don't do that. And I think it does make things feel more accessible. Accessibility is the name of the game for me. So
[00:43:32] I love that. I know, and I supervise grad students and that's the very thing that I try to encourage them on is we are clinical counselors. That's our title here in British Columbia, but it's about being relational we're humans. And if we can be present with people, it's a game changer. I know that was the reality for me is my therapy. He was a cognitive behavioral therapy specialist. I could not tell you one strategy that we use, even though I work out of a CBT approach and I know them, I just know that he was present with me and he was so relational and I knew that he cared and I knew that he saw me and that made all the difference in the world.
[00:44:10] When we talk next, we'll have to talk about the science of why that works because
[00:44:13] yes. Okay. I'm going to email you right away. Hey, summer part two's coming on. Oh, thank you. Yes. Have a great day.
[00:44:24] Thank you summer
[00:44:31] Thank you so much.