Does Harm Reduction Have a Place in Eating Disorder Recovery?

Black-and-white recovery rules can sound “safe” on paper, but they often create the exact thing we’re trying to prevent: secrecy. We sit down with returning guest Johanna Scoglio, educator, writer, peer supporter, and author of *When the Water Still Holds Me*, to talk about harm reduction in eating disorder recovery and why it can be the missing bridge between clinical goals and real life.

We unpack what harm reduction actually looks like in practice, including a concrete example around movement. Instead of “never move again,” we explore nuanced questions that protect safety while honoring autonomy: What’s driving the urge? What feels compulsive versus joyful? What boundaries and accountability help you stay grounded? We also talk about collaboration that truly includes the client, how to pace goals so they’re sustainable, and how providers can hold both compassion and clear limits without slipping into shame or power struggles.

Treatment can also leave scars. Johanna shares what helps rebuild trust after harmful or traumatic care: validation, consistency, and a willingness to repair. We close with embodiment tools that don’t require constant body love, from yoga and breath work to sensory awareness and the surprising peace of being in the water.

Sponsored by Hilltop Behavioral Health. If you found something helpful here, subscribe, share this with someone who needs it, and leave a review so more people can find the support they deserve.

To get connected with Johanna, check out: https://www.adragonflysdream.com/

To learn about Johanna's memoir, check out: https://www.amazon.com/When-Water-Still-Holds-Long-Term/dp/B0GM8MWXT4 

Show notes:

Trigger warning: this show is not medical, nutrition, or mental health treatment and is not a replacement for meeting with a Registered Dietitian, Licensed Mental Health Provider, or any other medical provider. You can find resources for how to find a provider, as well as crisis resources, in the show notes. Listener discretion is advised.

Resource links:

Alliance for Eating Disorders: https://www.allianceforeatingdisorders.com/ 

ANAD: https://anad.org/

NEDA: https://www.nationaleatingdisorders.org/

NAMI: https://nami.org/home

Action Alliance: https://theactionalliance.org/

NIH: https://www.nimh.nih.gov/

How to find a provider: 

https://map.nationaleatingdisorders.org/

https://www.psychologytoday.com/us

https://www.healthprofs.com/us/nutritionists-dietitians?tr=Hdr_Brand

Suicide & crisis awareness hotline: call 988 (available 24/7)

Eating Disorder hotline: call or text 800-931-2237 (Phone line is available Monday-Thursday 11 am-9 pm ET and Friday 11 am-5 pm ET; text line is available Monday-Thursday 3-6 pm ET and Friday 1-5 pm ET)

If you are experiencing a psychiatric or medical emergency, please call 911 or go to your nearest emergency room.

Transcript

Opening Sponsor And Safety Notes

SPEAKER_01 0:00

Join us as we redefine, reclaim, and restore the true meaning of health.

SPEAKER_00 0:04

Let's dive into the tough conversations about mental health, nutrition, eating disorders, diet culture, and body image. This is Nourish and Empower. This episode is brought to you by Hilltop Behavioral Health, specializing in eating disorder treatment. Hilltop offers integrated therapy and nutrition care in one compassionate setting. Hello, everyone, and welcome to the Nourish and Empower Podcast. Today we have a very exciting repeat. Today we have Johanna Scoglio, who is an educator, writer, peer supporter, and mental health advocate. She is the author of When the Water Still Holds Me: Letters Through the Tides of a Long-Term Eating Disorder, a memoir rooted in harm reduction and a compassionate mind-body-spirit approach to healing. Drawing from her own long-term journey, her work invites a more values-aligned human approach to healing, one that makes space for complexity, imperfection, and hope. She is also the founder of A Dragonflies Dream, a nonprofit dedicated to community-based, peer-led and compassionate support for long-term healing. Johanna serves as board secretary for her local NAMI affiliate, is a certified yoga teacher, an intentional peer support certified provider, conference speaker, and volunteers with national eating disorder nonprofits. Trigger warning for today's episode. We are identifying the following triggers that will be discussed but are not limited to eating disorders, body image, and mental

Johanna’s Memoir And Nonprofit Update

SPEAKER_00 1:55

health treatment. Listener discretion is advised. This show is not medical nutrition or mental health treatment and is not a replacement for meeting with a registered dietitian, a licensed mental health provider, or any other medical provider. You can find resources for how to find a provider as well as crisis resources in the show notes.

SPEAKER_02 2:13

Hey girl. Hi, thank you so much for having me back on. Oh my God. Thank you for saying yes. Oh, I'm so excited to be here today.

SPEAKER_01 2:24

I was thinking you might be our like most guest who wins most episodes. I was as just with reading the trigger warning, I was like, Johanna could probably say this at this point because you heard it so many times.

SPEAKER_02 2:37

And I listen to y'all podcasts. So yes, heard it many times.

SPEAKER_01 2:40

Yeah, but we just uh we just adore you and love having you on, and we're so excited for another conversation on some really, really great topics. But before we jump into that, I feel like you've been up to a lot since we last spoke to you and your memoir came out. So can you just fill us in with some of the great stuff you've been doing?

SPEAKER_02 3:02

Yeah, thank you so much. So the memoir came out in February, and it's a little surreal, you know, for the longest time. It was just lived in the living room, and I was the only person who read it and a couple of like loved ones. And so for it to be out in the world is is really exciting. I've gotten some really nice, like thoughtful feedback, you know, whether it was like somebody from high school who I haven't talked to, you know, since high school, and then just others in the community and it really, really touching them and how important this, you know, story was to bring to light. So that part has been really cool. It's also in our local library here, which was really exciting. I love going to the library. So to see my book at the library here has been really neat. Um, and then the nonprofit has also launched, so a dragonfly's dream. We've had one in-person support group at this point. We have our next one coming up this weekend. And it was, I couldn't have asked for a better, you know, first group. Everyone who showed up was authentic and genuine and vulnerable. And we planted seeds and decorated pots and just talked about, you know, what growth we all are hoping for kind of in this season, kind of playing off it being spring. So yeah, it's been really some exciting things happening.

SPEAKER_00 4:18

That's awesome. It's also so fun because I know the last time we talked, it was like, oh, I would love for this to happen and I would love for that to happen. So to hear and to like, you know, go through the progression with you essentially, like to hear of like your hopes, and then like the next time that we chatted, so many of it is actually coming to fruition and like in play is also just so exciting as an outsider to

Why Harm Reduction Matters In Recovery

SPEAKER_00 4:40

watch you do. Well, thank you. I appreciate that. Yeah.

SPEAKER_01 4:46

So today we have a whole mix of topics that we're going to be picking your brain on. So harm reduction, embodiment, relationships with doctors, treatment centers, and providers. And even though it could all be separate episode topics, which we might find as we go through this, we may, we may also need a part two. But there's obviously a lot of connection, you know, that can come in with some of these topics too. And so just curious to hear of, you know, when when these topics come to mind for you, you know, what kind of drew you to wanting to talk more about these?

SPEAKER_02 5:23

Yeah, thank you. So kind of going backwards, and then I'll give, you know, more to that question, but going backwards, a handful of years ago now, I was in grad school for clinical mental health counseling, and I was in a course for addictions counseling, is what it was called. And we were learning about substance use disorder one week with harm reduction and peer support. And it really just sparked that question in my mind of why are these conversations not more interwoven in eating disorder care? I feel like harm reduction, like embodiment, mind, body, spirit connection, you know, what it means to live in a body, especially when you're in recovery and recovering from an eating disorder. I feel like those conversations sometimes end up on the outskirts, even though, like from my own lived experience, I feel like they should be a lot more central in the conversation. You know, for me personally, harm reduction really shifted how I viewed recovery, how I viewed healing. Um, it really moved away from kind of the traditional definition of what it means to recover, which can be, you know, very black and white, all or nothing thinking, very binary to really honor, you know, the individuals. It, you know, sometimes I say harm reduction really just means person-centered, compassionate care. Um, and I think sometimes that piece of it is lost. And so, you know, in my memoir, I have, you know, multiple like chapters on these topics, and it's a core piece of my nonprofit as well. But I've just seen personally the shift in my own like transformation when I started to lean into harm reduction principles in my healing, when I started to lean into what does it mean, you know, to have embodied awareness, to, you know, tune in more to what's going on in my body when for so long it was about controlling my body or ignoring it or numbing or not listening to the emotions that were coming up. And so, you know, part of like my healing journey has been wanting to bring these conversations to the surface for others to hear that there's other ways and other frameworks beyond their traditional frameworks to support individuals.

SPEAKER_01 7:36

Yeah. And I know you shared that harm reduction, that harm reduction approach has really shifted, you know, your own healing journey. And I'm just curious, and whatever you feel comfortable with. But if you almost have an example of what a harm reduction approach looks like, because I wonder if some people listening maybe have heard that terminology before, but are struggling to really understand

Movement Without All Or Nothing

SPEAKER_01 8:00

what that means in practice.

SPEAKER_02 8:01

Yeah, definitely. And I think that is a piece of it. And I think sometimes that's why it's not integrated or spoken about because there is a misunderstanding or there's this belief that, you know, it's kind of enabling or giving up on, you know, what it means to recover rather than, again, shifting kind of the mindset on what it means. And at its core, harm reduction is really moving away from like full elimination of behaviors, thoughts. It doesn't mean that, you know, there's not hope for that to be, you know, in the in the future, but it doesn't focus on that solely and strictly. It really honors the person where they are in that moment. It's like the small steps, it's honoring like their autonomy, honoring safety, dignity, like humanism, pragmatism. Those are like the core, core uh pillars, I guess you would say. But for like a really concrete example, you know, from my own recovery journey, I always use movement as like the example because that was something that I had, you know, uh just a lot of like shame around some trauma. Like when I was in higher levels of care, I remember the first time I was in a higher level of care, I was in an athletes and recovery session because I had, you know, I was an athlete, grew up as an athlete, and then it became movement became very interwoven with my eating disorder. And it was hard to kind of separate what was like joyful and what really was like that identity of being an athlete versus what was like compulsive and like guilt-ridden if I wasn't doing it. And I sat in that session and was told if I ever wanted to recover, like movement could not be part of like my story and my recovery. And I remember like leaving that group and feeling so defeated. And it forced me to lie for many years to providers. I wouldn't be honest and transparent with them if I had moved like in between sessions. I held such guilt when I was, you know, moving my body. And rather than it being approached with kind of that like curiosity and intentionality, and so shifting, you know, towards what a harm reduction approach would be is again not that all or nothing. Like you can never move your body to recover versus, you know, what are some of the reasons behind it? Let's like talk about this, let's look at it like in a much more of like a nuanced, complex, personalized perspective. And, you know, I had the privilege of working with some incredible providers who really, you know, were able to work with me on that piece and to really explore like what joyful movement could look like. And it wasn't always perfect, you know. Sometimes I kind of like pushed up against what, you know, as I become more, as I became more aware of what was compulsive. But if I didn't have that opportunity to feel safe and to feel like I could trust a provider and be honest with them, you know, I don't know if I ever would have found, you know, where I am now where movement is very joyful. And so that's always kind of the example I use, like for my own story of a way that harm reduction, again, just was able to kind of shift what it meant to heal movement.

SPEAKER_00 11:17

Thank you for sharing your personal story. And I think it's also one that a lot of people connect with, right? Like even as you're speaking, I honestly was reflecting on like my own clinical judgment and like what I do in sessions. And I'm sitting here and I'm like, wow, that does sound really defeating for a therapist for like a provider to be like, you can't move and you want to recover. And I'm like, wow, I've definitely said that to clients before. And it's like when you're a clinician, right? You're like, what's going to be the safest thing for you? Right. And like you want to protect that person. And so this is, I always love these moments where it's like, you know, as a therapist, you're like, wow, that was a really good moment. And as a client, you're like, that was trash, right? And like you sometimes you don't recognize the vast difference of what the perception is. And hearing from your perspective, and I know I have clients that are that will like point blank tell me this is unrealistic, stop telling me this. And then I'm like, okay, great. Like, thank you for advocating. Let's actually have that harm reduction conversation then. But it is just so helpful to hear from someone who's been through the journey, like how important having that harm reduction process can be. Because as a provider, you do think, like, okay, if this is so compulsive. And like for some people, that black and white nature of all or nothing might have to be the case, depending on like what the client is going through. But it is so important to have that in your toolbox as a provider to say, like, okay, not everything needs to be black and white. We do need to provide clients with what uh is going to be best for them because recovery is so individualized and like how and having that is going to provide the opportunity to give them something that can actually work for them. So as a provider, thank you for being so vulnerable and being open about it because it is something that I even think like in school and even in like uh supervision and stuff, being told take it away is more of the nature and the message than it is of like, how do we break this down? So, even more so, like I think it's just like such a good reminder that like not everything has to look a certain way and like you can do the harm reduction piece. So thanks.

SPEAKER_02 13:27

Well, and thank you for that transparency. You know, I've always respected probably the most providers who are human and can identify like, hey, in that last session, I said something, you know, that I reflected on and probably wasn't helpful or may have been harmful. Those are the best kind of providers out there, and it is collaborative, like at the core, you know, care, especially from a harm reduction lens, should be collaborative. And, you know, rather than it feeling like, you know, a hierarchy in the therapeutic relationship, it really is, you know, what the therapist or the you know dietitian is observing, kind of what their goals are, but also to the client, like what are your goals? Like what are you hoping for? And you know, sometimes they match and sometimes they don't. And it's like, how can we find something that again it goes back to? And like you said, I think sometimes with harm reduction, the concern with eating disorders valid is the safety piece. And so it is ensuring that there is still progress being made. I think sometimes it just really honors that sometimes you need to slow down or the goal needs to be, you know, a lot smaller maybe than you had hoped it to be. You know, I think about, you know, early on for me, like food challenges and weight restoration, it happened so fast and it just piled and piled and piled. And it didn't give my body, my nervous system, my mind time to adapt to process. Whereas, you know, later on working with dietitians and therapists who really honored that, you know, collaborative, person-centered, like what can we do this week, even though it doesn't seem like it's that like significant jump to the shore. That is where I found success. And then, you know, rather than oh, the next week, we're ready for the next goal, like keep moving. It was like, we're gonna do this for months. And you're gonna get

Collaboration Boundaries And Clinical Judgment

SPEAKER_02 15:20

bored with this goal. And, you know, it's gonna seem like, why are we not moving to the next thing? But like, I want you to have time to process the changes, to, you know, maybe get sick of this like fear food challenge to the point where it's like, oh, we're just, you know, we're having it again. And that again is where where the progress really came. It's making that those small gains sustainable over the long term rather than like the big gains that just I felt like I was on this wheel constantly and never making progress and always feeling like I was failing. And so it is, it's a shift in mindset.

SPEAKER_00 15:54

I love that you use the word collaborative when talking about provider client, because I think so many people, when they hear the word collaborative, they think provider to provider. And I think it's so important for people to remember that the client is provided, provided the client is also a part of the care. And so, in order to really ensure that like the client is getting what they need, you have to collaborate with them to make sure of like, hey, let's check in. What are your goals and things of that nature? And I I just I love that you use that word, whether knowingly or not, because I think it is such like such an important reminder that like everybody is a part of this team. And like, yes, we are the experts of recovery and like care on like an ethical standpoint, right? And clinically, but like the client is also the expert in their needs and their life. And so having that collaborative conversation with them is just as equally as important as having them with other providers and things like that.

SPEAKER_02 17:00

Yeah. It's that collaborative conversation, but still having boundaries and still having accountability. You know, it's a lot. It's a lot as a, you know, I think about like the providers in their shoes, it's a lot to balance to be able to really show that compassion, you know, that respect and that humanness to whoever may be sitting in front of them, while also being able to know when you can push a little bit more, when you might need to like, maybe this isn't the week to do it. It's a lot to balance, but to yeah, have have that collaborative boundary still, accountability still, and not be afraid to say, say the hard things to the client and know that if you have that like rapport and relationship with them and they really know that you have their best interest at heart because you've shown that over time, that's where like the trust is. That's where you know they they may be, you know, able to do whatever y'all are talking about because you've shown to them over time that you really want what's best for them.

SPEAKER_01 18:02

Yeah.

unknown 18:04

Yeah.

SPEAKER_01 18:04

And Jessica and I do a lot of our work in sessions together, right? We do a lot of joint sessions and we see a lot of benefits to that clinically. But I also think on these topics and like the shoes of a provider, we see a lot of benefits to that and just like our own growth here, because there will be times where one of us will stop the other person and be like, hey, wait, I actually don't agree with that, you know, and kind of like call that person out. Or, or there'll be times where we're explaining something and be like, I actually don't understand what you mean by that. Can you explain that more? And it, I feel like it just emphasizes that collaborative piece too of you know, having for a client, having both of like your primary treatment providers in the same space with you, working together and even seeing the collaboration amongst providers in the moment and just like how impactful that can be.

SPEAKER_02 18:55

So I can only imagine it's like a gift to your to your clients to be able to have that. That's so rare, yet it should be more of like the gold standard in eating disorder care. And you know, I know that clinicians do a lot of like talking kind of behind the scenes, like of a team, but how valuable to come together kind of in partnership is is a fantastic model.

SPEAKER_00 19:16

Well, it's also nice too because and I know it's also nice, I feel, because a client can see that like your treatment team can disagree or like your treatment team can like call each other out. Like if I know Maggie and I have had situations where like you know, let's just say I'm talking to the client and like are we butting heads? Are we not having this conversation? And then you're also teaching the client in that moment to like advocate for yourself, or you're teaching that client how to like learn to be confrontational, or it's almost like the client is seeing that it's not uh two against one, because if the two providers are trying to collaborate and come together with the client, you're seeing that it really isn't like just one same brain against another, and how like it really is everyone trying to come together, and what you're teaching the client so many different skills in that moment.

SPEAKER_02 20:13

So many, yeah. Listening and and that we're all humans and we all make mistakes, and it kind of even moves away from that perfectionist thinking, like again, whatever the conversation may be, but to show that there can be many different thoughts.

SPEAKER_00 20:30

Yeah. So if you were to speak to providers, like what advice would you say that you would give them in regards to like harm reduction or like balancing the safety and you know the clinical responsibilities with autonomy, harm reduction, and like a client's lived experience? What advice would you give them?

SPEAKER_02 20:50

Yeah. I think first and foremost, probably the answer to a lot of these kind of questions is you have to know the client in front of you. I think it really goes back to again, who who are you working with? That person-centered care is at the heart of it. And, you know, harm reduction, you know, sometimes I say, you know, maybe it's better for those that have been like on the long journey just because, you know, they need, they need a different approach than that, that all or nothing thinking that may work better with like a youth or an adolescent. Not to say that there isn't a place for for harm reduction. I think again, some all of the core pillars should be integral in care when we think about, you know, really respecting somebody and their autonomy and their dignity. But I think first and foremost is really at the root of it, again, is the safety piece. So, you know, ensuring that the person who you're supporting isn't a is in a place from a safety standpoint to be able to kind of lean into a harm reduction approach. So I think that that's kind of again this the Central piece because safety is a very legitimate concern. And then from there, it's you know working together on what does healing mean to you? What does recovery mean to you? Really honing in on values. Again, I'm a big proponent of values work, but asking, you know, the client, like, what does it mean to recover? And, you know, again, stepping away from that, pretend at this time like the thoughts may still be there, like there may still be urges for behaviors, but like how can we focus on other pieces of your life that are important? Like relationships. What does it mean to, you know, challenge yourself in that way, to have like social opportunities, movement, if that's something that's important to them? And that's not that's not everybody, but if it is, again, how can we work together to come up with a plan that's going to keep you safe, but is also going to allow you to start to explore what it means to move

Rebuilding Trust After Harmful Treatment

SPEAKER_02 23:05

your body in more of a joyful way and stepping away from that obsessiveness. You know, when it comes to like the food piece, again, it's working with the client in front of you of what goals can we have that again are going to keep moving you closer to to what you want. I know I talked in the last example, but like eating pizza, you know, to be able to go on the family trip to Italy years ago when I had gotten married, like those small steps to being able to do that. If it's somebody who struggles with, you know, binging or purging, it's, you know, okay, maybe we're not in a place where these behaviors we can stop like cold turkey, but how can we nourish ourselves throughout the day so it doesn't come to the end of the day and we haven't, you know, met like, you know, the needs that our body needs throughout the day? You know, if again, if somebody is, you know, engaging in that behavior to say, okay, can we try to like reduce the number of times that we're purging? Can we talk about, you know, getting in electrolytes? What does like dental care look like? Those are a lot of like the core pieces of harm reduction of meeting somebody where they are, ensuring that you know they have that that safety piece as you work with them towards progress. So again, it's not throwing in the towel like a lot of people sometimes think. It's just it's oftentimes a lot slower, but it doesn't mean that it's not it's you know worth going down that route.

SPEAKER_01 24:41

Yeah. I love too how we're talking so much about like the humanness in all of this and the the imperfections in all of this. And I know you shared an example of like a treatment interaction that maybe didn't feel as supportive. And I'm curious because unfortunately, a lot of people experience treatment interactions that maybe felt harmful or you know, felt shaming, felt disconnected from their values. So, what advice would you give to somebody of like how they can rebuild trust in the process after going through a difficult experience like that?

SPEAKER_02 25:16

That was going to be my first word, rebuild trust. So you said it in the question. Um, you know, unfortunately, there's a lot of truth to harm or to trauma that individuals have experienced in treatment, whether it's in higher levels of care or with different outpatient providers. You know, for me, I speak a lot in my memoir about what a gift, an imperfect gift, a higher level of care was for me, because in many ways it saved me in that season of life. And there was also a lot of harm within it and some things that I came away with, really having to like process and work through. So as a clinician, working with somebody who has experienced harm, trauma, holds shame to rebuild trust. I think first and foremost, it's validating their experience, validating the emotions that come up, validating how hard that experience was for them. You know, again, it's not like you're taking the ownership of it, but you know, I'm so sorry that that happened to you. And then it's slow, you know. I think rebuilding trust is a slow process. Even if you weren't the one that, you know, created that harm and that trauma, you know, it lives in their mind, it lives in their body. Sometimes there's that association of it happened here or with this provider. It's kind of like that blanket while waiting for like another provider to do something similar. And so I think it just takes time, it takes showing up consistently, not perfectly, but consistently for that person pouring into them with that compassion, that empathy, holding space for them to process maybe what they experience, and also recognizing that it may take time for them to want to explore some of those different pieces. Again, knowing kind of who the person is in front of you. But I think at the core, the validation piece is a big part of it before then you know doing all the wonderful things that you do as a clinician to really support that individual on their journey.

SPEAKER_01 27:25

I know you're focusing on doing peer support groups right now, but if you ever did a clinician support group, I'm there. I'm here for it because I feel like every time we speak to you, and so I I love our conversations. I'm just like, I feel like I'm learning so much as a clinician, too. So thank you for all of that. And if you ever, you know, go down that route and like I will be the first one there.

SPEAKER_02 27:46

Oh, well, thank you, Maggie. That's so kind of you. And I had never thought of that new dragonfly dream idea. We'll add it to the list. I feel like y'all in your podcasting, I have the dream of adding a podcast to mine because you know, as a guest coming on your podcast, it's you know, so enjoyable. And I love our conversations and the discussion. So you guys have all prompted that little spark in my own mind. Oh, fun. Love it. You'll be my first guest.

SPEAKER_00 28:14

Oh, yeah, yeah. Sign us up.

SPEAKER_02 28:15

We'll be there.

SPEAKER_00 28:16

But I think that, you know, I think that brings up like a really good question of like, is that something that's missing in the field? Is more clinician-led peer clinician groups just to have like more, like I guess that's really group supervision, if you really think about it.

SPEAKER_01 28:35

Well, I was even thinking more of like Johanna's sharing her lived experience, you know, to provide, right? Like it's a group of providers, but it's somebody who has, you know, gone through the process and is able to have a very, you know, transparent but also like sensitive conversation around, hey, these were the things that really helped me. These were the things that actually didn't feel as supportive for me. And like as a clinician, to be open to to hearing that and then like reflecting on some of like your own work and your own cases with it.

SPEAKER_00 29:09

I do love that idea. I do too.

SPEAKER_02 29:13

And I think sometimes the best clinicians I've worked with over the years have asked me in like initial sessions of what was helpful in the past and what was harmful in the past. And for them to be able to ask that and then you know, do their own reflection in between sessions of, you know, exploring this was harmful or not helpful, or this approach, you know, didn't work for them. But, you know, on the contrary, like they really benefited from, you know, or they really, you know, appreciated having like journaling prompts in between sessions. I think that that can be really helpful as well. And it shows, you know, the client at the beginning that you you want it to be a partnership, you want it to be collaborative. You, it's not just you directing what the conversation is going to be each week, but really pouring into like the wisdom that everybody holds. And I think sometimes, you know, I did for a long time I doubted like my own wisdom and like trust in myself and what I needed, or I had a hard time voicing what I needed. It took, you know, much later in life for me to to recognize like I hold a lot of wisdom from being on this journey, and I know what I need and what I don't need, and it's okay to speak up about that.

SPEAKER_00 30:29

Was it always let me let me rephrase that in my brain?

From Shame To Self Advocacy

SPEAKER_00 30:40

What allowed you to change it from I'm lying to providers because I feel shame to I'm gonna advocate for myself and because this is my recovery? Because I feel like a lot of clients do struggle with that, like especially with like doctors and treatment centers and things like that. Like, I feel like there's there is a struggle for people to feel seen and safe. So for you, what was it that you experienced that allowed you to go from I don't feel safe to, you know what, this is about me?

SPEAKER_02 31:15

Yeah, that's a great question. Uh I think uh a piece of it is age at the time. You know, my eating disorder started when I was 15. And for the first probably decade, uh, you know, care felt very forced, you know, forced in my like mind, you know, my parents were were getting me the support that I needed, a lot of denial. Like I I did not believe that I had a you know an eating disorder. I didn't see it as a problem. And so I was stubborn and angry and you know, very shut down. And so again, I think that was just a very unique situation because it's you know, when it starts really young and you aren't ready to to see that it really is kind of creating havoc in all areas of your life. But then, you know, kind of shifting and it took time, you know, there were some seasons where, you know, not that I in all seasons didn't want recovery and didn't have hope for that, but there were some seasons where where I was burnt out, where I was exhausted, where, you know, I felt like I was just treading water to stay afloat. And I almost didn't have like the energy to to really advocate for myself, to, you know, voice what I needed. I felt like this is just where I'm gonna be. I'm stuck in this other seasons where you know that hope was still there, but I I was more like motivated, more confident in my recovery. I feel like those were the times I was able to speak up more. And then it really was probably honestly in like the last decade. And I think part of it is the the shifting that like the whole field has had kind of from like 20, 25 years ago towards, you know, the last handful of years of more of that, you know, again, person-centered care models and kind of stretching what how we define recovery and healing and how we do how we approach people. But it really was a couple particular providers who the times where I was honest with them about, you know, in my mind, quote unquote, failing, struggling, not a whole, you know, week going by and doing the complete opposite of every goal we had set. And rather than being, you know, met with I mean, it was never like anger is a strong word, but like disappointment I would feel from previous providers. It was the new providers who I didn't feel that sense of like disappointment from them. And so I realized like, huh, I can be transparent, I can be honest. And that really shifted in me again, how how I started to view what what healing could look like when I felt like I could trust the providers in front of me to not kind of have that judgment.

SPEAKER_01 34:06

Can I ask you a little more about that? So, because as you were mentioning earlier, just about being younger in treatment, and you know, you use the word force, and I I think Jess, I'm sure, can relate to this too. But as a provider, I've had a lot of experiences working with younger clients who maybe aren't as invested in in their treatment at that time or do feel even get the sense as providers, like maybe are there because their parents or guardians or somebody is saying this is what we're doing, even if they themselves don't really want to be there. And I'm wondering for you, like looking back on your whole journey now, even though in some of those moments you probably thought it was a waste of time, or what am I doing here? I'd rather be doing all these other things. Do you feel like you needed to have some of those treatment experiences to

Working With Teens Who Shut Down

SPEAKER_01 34:55

really lead to like the growth and transformation that you've seen throughout your treatment?

SPEAKER_02 35:00

Yeah, that's another great question. Yes, definitely. And also think about you know, where I would have ended up if I did not have any treatment or I did not have, you know, my mom intervening and saying, like, you really need a higher level of care, like that it's really not a choice anymore. I did, I did need those appointments, those, you know, others around me recognizing what I wasn't able to recognize in myself at that time. And so I can see that. I mean, I smile now because you know, in my early years of going to a therapist, I wouldn't talk the whole session. They would keep asking questions, trying different avenues, and I would like stare past them, I would like move my eyes around the room. Like I would not talk. And I now I feel so sorry for that therapist because uh he tried. But it is, it is, and in many ways, like even though I wasn't talking to him, it was an hour like where I was doing a lot in my mind. I wasn't able at that point to express myself like I was able to, you know, later in life, but it was an hour of like pause for me to work through the emotions in my own mind to like slow down when the rest of my life was so fast moving at that point. And so maybe that is what I needed at that moment. But yeah, I think that you know, keep showing up, you know, if you're a loved one supporting, you know, somebody, you know, keep encouraging them, keep showing up for them. As clinicians, I imagine it can feel not sure if frustrating is the right word, but when you you you're trying, you're trying, and it just feels like there's kind of that wall there. But also know that certain things you're saying are getting through. It may not be something that they're willing to acknowledge or talk about at that time. But even just, you know, being in a room with somebody and showing them that there is somebody that that cares for their well-being, who they are as a person, means more than you may realize, sometimes beyond like the goals or what we're trying to work towards. It's like being in the same space as someone can go a really long way.

SPEAKER_01 37:16

Yeah, thank you for that. Because I I think for a lot of people, it can be really helpful to hear that of like you reflecting back and recognizing how, yeah, maybe in those moments I, you know, wasn't super thrilled that I was there, but like how it was all part of the process and part of the journey. And as providers, it it also can feel really tough. And I feel like Jessica's so much better at this than me, of being able to like sit in the silence and and sit in some of those moments. And I definitely struggle with it as a provider. So it's also, you know, it's helpful to hear that, yeah, maybe, you know, maybe there were certain things that were sticking, or even just right to have an hour of like sitting with your thoughts and reflecting and like the value that brings, or just even knowing, hey, if there's ever a session where I choose to share, like this person is here, they're consistently showing up for me. And a lot of people don't have somebody who's consistently showing up for them in their life. So the fact that like that provider is there at, you know, at the time they're supposed to be, and they're sitting with you that whole time, like I also see value in that. So thank you for sharing that because I think it's really helpful.

SPEAKER_02 38:22

And I think about that, like having been an elementary school teacher for 15 plus years is a lot of it is it's that consistency, it's that outpouring of love that you show somebody and show like youth. And like you said, Maggie, like for some, like that that's the consistency that they don't get elsewhere. And so they're gonna remember that. And as they continue on their journey, you know, the hope is that some of those walls start to come down, but it's you know, sometimes it's it's on their time and that that can be hard. It can be hard for providers, it can be hard for loved ones. But I'm a firm believer, like every kind of piece of the puzzle has its time, has its value, has its like place and purpose in that person's healing journey. And sometimes I think, you know, with with youth and adolescence, sometimes it's even like turning the focus on external things. So, you know, what do we need to do so that you can, you know, participate in the sport that you're really passionate about? Or what can we do so you can, you know, go to the mall with your friends on the weekends, or you know, play video games with your neighbors. So all of those things. Sometimes it's setting goals sometimes with that like external focus of what's really important to them at that age can be helpful as well.

SPEAKER_00 39:41

Yeah. Yeah, I feel like so much can be provided to clients in situations like that where like a clinician is asking question after question after question. And like, you know, I definitely experience where clients are like, Can you just shut up already and stop asking me one more question? And like in that moment, I get it, right? Like, if you just hear someone asking question after question, you probably just want to like rip your hair out because why? But I've also had clients like later on, just like you're saying, who are like, you actually showed up though, like you kept asking questions even if I didn't want to answer them. And like they're like, Yes, it's your job, but it felt different. Or I've had clients that are like, okay, like I came in and I shut down and you were still there. Or I was able to show my anger and you didn't come back at me with anger and I finally found a place where I could just sit there. Or like if I needed to be put in my place, you did it in a way that didn't feel belittling or whatever have you to show that boundaries are important. Because right, sometimes clients, when they're going through recovery, their eating disorder runs a household. Their eating disorder dictates their relationship, right? Like I always say to clients, like, uh two's company, three's a crowd. And like when that household is being run by the eating disorder, it is crowded. But parents are doing what they feel is best by like just like placating to it and be like, okay, honey, whatever you need because they just want their kid to be okay. But clients need to learn that's not how this works. And so it's like it is just so interesting to see like all of the different ways you support a client that like sometimes as a clinician, you might be sitting there and being like, wow, like I might have been really hard on them, or like, wow, we did literally nothing. We sat in silence for the whole time. But like then hearing back again, that's exactly what I needed, or like I needed to be put in my place, or thank you for giving me a safe space to be angry. Like I remember having an adult client years ago, and she seemed very angry. And you know, as a clinician, you're like, oh my God, what did I do? Right. Like for a moment there, you have that thought process of like, oh, oh shoot. But then she came back and then the next week and she was like, I've never felt safe enough to show my feelings of anger before. And she, and so then all of a sudden, as a clinician, you're like, oh, so we did something this day. And it just like, it's just such a revelation sometimes of like as providers, we think I'll say this about myself. As me, because I'm such an emotional being, I'm like, you show your emotions, you show your emotions, but you don't recognize person to person the internal boundaries that people set for themselves of what they cannot do, and it's as simple as showing anger.

SPEAKER_02 42:27

So it is just like I honestly forget where I was going with all this, but yes, it is and I was gonna say for me, it was the emotion of like sadness or being able to cry. I can clench my jaw, and I'd have providers say, like, I can see you clenching your jaw, like just let it out. And for years I would not allow myself to cry, whether I was, you know, in a session, not in a session. And again, it took kind of that safe space, that rapport to finally start to cry in a session. And again, it was the opportunity sometimes I had through the whole week to to let it out. And then it would get bottled right back up for the rest of the week. But it's what what allowed me again, as I progressed, to then be able, you know, to cry on my husband's shoulder now. So it is you're creating an environment for them to explore maybe some emotions that they they haven't had the opportunity or the safe space to explore.

SPEAKER_00 43:27

I love when a client cries in my session. I'm like, we're doing it, honey. I get so excited. And I know that sounds so backward. Well, maybe I don't know, but I always get so excited. Like I literally have a client who will start crying, and she's like, Don't start. And I'm like, You're doing it, girl. You're doing it. I'm so proud. Like, you're like, I just I love it. I love it, I love it, I love it. Doing the hard things. Exactly. Because it it is like, and again, right, being such an emotional person, and

Embodiment Through Yoga And Water

SPEAKER_00 43:55

let me tell you a personal story, like it is not always welcomed, right? Family and friends, it's like, oh my god, here we go again, just because this, just cause that. And like that's been something I've been very proud of of just being like it is who I am, like I am who I am. I'm emotional, take it or leave it. But like hasn't isn't always welcomed. So like when I see like the space is there for clients to bring that out of them, I'm like, yes, we're doing it. I get so excited.

SPEAKER_01 44:24

A lot of that's like the embodiment piece, right? Which I know is another thing we were talking about today, too. And Joanna, I'm curious for you as well. Just like what doesn't you maybe maybe that was an example of embodiment when you said, you know, like clenching the jaw and like feeling those feelings, but any other kind of examples of embodiment that you feel like you've experienced throughout your process?

SPEAKER_02 44:47

Yeah, definitely. You know, that embodiment, like the connection of mind, body, and spirit, and like again, really being able to like live within your body was really hard. I was very disconnected from my body, the body itself and my emotions, because that's a part of it also for a long time. It was controlling not only my body, but controlling my emotions, like what I showed to the outside. And so, you know, embodiment is one of those, like sometimes I wonder like when the shift happened, like how did it happen? Not sure I have like the answer for that. I think it's been kind of through like the ebb and flow in the last probably five years, I'd say. But a big piece for me was yoga. Initially, you know, when I was, I never really done yoga until I was in a higher level of care. And oftentimes that one group was the group that I felt like I got the most out of because it allowed me to slow down, to like be aware of like my breath, to be aware of like the sensations in my body. And so, you know, kind of when I had left higher level of care, rolled up like a yoga mat, really didn't touch it. I mean, it wasn't really until the pandemic that I kind of got back into yoga and breath work, just because, you know, we had the the time and space for it as I was doing teaching from home. And over the last handful of years, it's shown up in different ways. I think sometimes, you know, when it comes to embodiment, again, kind of that black and white thinking of some people are like, well, you know, I can never, never be aware like of my body, or I'm always like uncomfortable in my body, or like judging it or critical of it, or you know, movement isn't something that I even desire. And I think sometimes kind of shifting how we think about embodiment, sometimes it's even just like awareness, like honing into your five senses. Like, what does it mean to, you know, go on a like a walk and like barefoot and your feet in the grass? And what does that feel like? What does it feel like to, you know, listen to to a certain song or to use your hands, whether it's like artwork or pottery? And so I think sometimes, you know, we can think about it in a lot of different ways. For me, the thing that really um showed what like embodiment can do and how it impacted my own healing was aqua therapy. So swimming. And it just came about. Actually, I had a an injury, and my therapist at the time, you know, mentioned swimming. And in that moment, I was like, I've never had like an eating disorder therapist mention like a form of movement to do. But again, I think she knew from kind of her own like swimming how like therapeutic it can be to be in the water. And it truly is like the time I feel most embodied just because of whether the water is like warm or cold, like you feel that like from a sensory standpoint, like the buoyancy, just how it like literally is like pressure gentle on every like part of your body, and like what the breath work has to be. You kind of get into like this meditative flow, and it's the time I'm like most aware of my body. And oftentimes that carries through like the rest of the day. If I have like gone for a swim that morning, of just being a lot more mindful and aware. It's kind of my own like meditation. I feel like it's a great area to be explored in the eating disorder community. But yeah, so embodiment again can mean a lot of different things when we think about it in not like a perfectionist way, and recognizing it's another one of those to like approach with curiosity, to approach with time. You know, I think some people think it means like body love all the time, and I'm gonna feel comfortable in my body all the time. And like, that's that's not the reality. That's not the reality for anybody. There's days where where I don't feel great, where clothes feel funny or I don't even like the feeling of them on my skin, you know, where you just feel off for whatever reason. And I think those were the times in the past where then I would try to control it, like, oh, you know, it must be because I ate that certain thing or because I did move or didn't move, versus like continuing to show up for for yourself, for your body to honor what it needs despite how it feels, and kind of shifting from that like body love, which is great, but more towards like how can I show it kindness? How can I show it like gratitude for for what it does for me every day? That was a very long-winded answer. We love those.

SPEAKER_00 49:26

That brings like so many other questions and so many other things that I want to like uh dissect with you, but I know we don't have the time to, so sorry, you're gonna have to come for round three because I find it so interesting that that in the water, which like brings so many body image things to my brain, you felt the most connected. And it sounds like at peace could be my interpretation and not what you were saying, but it just sounds like the most willing you were the most the space where you were most willing to be present in your body was the water.

SPEAKER_02 49:57

Yeah.

SPEAKER_00 49:58

And I I have questions about it. Yeah, I love that for you.

SPEAKER_02 50:02

And I often say if like for eating disorder, like you know people with bathing suits and things like that, like you can show up in like your shorts and your t-shirt, like, you know, it doesn't it doesn't have to be a bathing suit, like to be able to get like the experience. You can, you know, you can float, you can swim. Like, you know, when I first started, I would like stand in the middle and just kind of like twist and like move my arms. Some days if I'm like not feeling a swim, that's kind of what I do. The pool community, at least here in this area, is beautiful. It's like all ages, all like body sizes, all like you know, athletic abilities. I've met a lovely, like older woman who we have many conversations when we run into each other, but that part is nice too, because when I used to go to the gym, it was like headphones on, zone out, disconnect from my body, disconnect from like all of my surroundings. Whereas here it's at the pool, it's so different for some reason.

SPEAKER_00 50:58

I feel like it's because you have to be present, right? Like you can't.

SPEAKER_02 51:00

Well that too, because then you would yeah, you'd crash into like the pool wall.

SPEAKER_00 51:03

Yeah, exactly. Right. And you can't like you can't put headphones on, you can't do those things. So it really does force that socialization if other people are there.

SPEAKER_01 51:18

So many thoughts, so many thoughts. Well, thank you again. This is, I mean, that hour just flew by. And I just want to highlight, too, before we uh have people get connected with you again, but I love in your background, you have your dragonfly and you have the lighthouse, which is such a big theme from your book. So I love little Easter eggs back there.

SPEAKER_02 51:39

I do, yes, I know the the dragonfly was a gift from my husband, and then that is actually my book cover, the original artwork. And then my graphic designer had like added a lot of saturation for it to be more of like a bright book cover, but that's the actual like yeah, book cover. So I love it.

SPEAKER_01 51:56

That's amazing. Yeah, I noticed them like midway through, and I was like, I gotta highlight that because I like that you have that hanging up behind you. Thank you. I know I keep I kept staring at them the whole thing.

SPEAKER_02 52:04

I was and then you have the plant that sometimes like is coming out of your head depending on how you're sitting.

How To Connect With Johanna

SPEAKER_01 52:11

Yeah. Well, if you could just remind people listening where they can find the book and how to get connected with the dragonfly's dream.

SPEAKER_02 52:19

Yeah, wonderful. So a dragonflies dream, our website is www.adragonfliesdream.com and it's with an S, no apostrophe, also on like social media, again, Dragonfly's Dream. And the website will give you all sorts of information about the nonprofit. And then the book, When the Water Still Holds Me, is on Amazon. And if you're local to the Raleigh Durham area, it is in the um local libraries as well.

SPEAKER_01 52:47

Amazing. Awesome. Well, thank you so much again. We really appreciate having you here, and we appreciate everybody listening in as well.

SPEAKER_02 52:58

Well, thank you so much. It's always a delight to sit down with you too. So I am very grateful.

SPEAKER_00 53:04

No, we appreciate this so much. And thank you everybody for listening, and we will catch you on the next one. Bye guys. Thank you so much for listening to this episode of the Nourish and Empower Podcast.

SPEAKER_01 53:18

We hope this episode helped you redefine, reclaim, and restore what health means to you.

SPEAKER_00 53:24

If this episode resonated with you, please subscribe, leave a rating, and comment and share with anyone else who may feel will benefit.