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Understanding Eating Disorders: A Conversation with Dr. Tiffany Loggins
30 Plays5 months ago
In this episode, we delve into the world of eating disorders with clinical psychologist Dr. Tiffany Loggins. We explore the signs, symptoms, and risk factors, while debunking common myths. Our guest will also discuss treatment approaches, the importance of self-compassion during recovery, and how to develop a healthy body image.
What You'll Learn:
- Common types of eating disorders and their signs & symptoms
- Risk factors that can contribute to eating disorders
- Dispelling myths and misconceptions surrounding eating disorders
- How a clinical psychologist works with individuals struggling with eating disorders
- Different treatment approaches for eating disorders
- The importance of a personalized treatment plan
- Challenges and setbacks during the recovery process from an eating disorder
- Tips for maintaining motivation and self-compassion throughout recovery
- Building a strong support system for people with eating disorders
- The complex relationship between eating disorders and body image issues
- Strategies for developing a healthier body image and promoting self-acceptance
This episode is for you if:
- You're concerned about yourself or a loved one who might be struggling with an eating disorder.
- You want to learn more about the signs and symptoms of eating disorders.
- You're curious about treatment approaches and the recovery process.
- You'd like to understand the importance of body image and self-esteem in eating disorder recovery.
Dr. Tiffany Loggins, Psy.D. is a culturally sensitive, licensed clinical psychologist, author, and mental health and wellness speaker in San Francisco. She specializes in working with diverse communities of color and holistic approaches to helping individuals live in alignment with their authentic selves. She also has specialized training working with individuals struggling with severe mental health conditions and eating disorders. Given her clinical background serving individuals with a wide variety of settings including universities, hospitals, and community-based mental health settings, she also simultaneously utilizes both a multicultural framework and evidenced-based approaches to help individuals illuminate new insights that accompany feelings of direction, purpose, and passion.
She currently has a private practice in San Francisco, CA called Discover the Authentic Self, where she provides virtual individual, group, and couples therapy to help others in their process of transformation and resilience. She believes therapy is not a one-size fits all, rather she focuses on mutual collaboration to create a unique approach catered to everyone, as one should be the author of their own journey to healing and growth. She also has published a self-help workbook, Essential Tools for Cognitive Behavioral Therapy that is available for purchase on Amazon. It is a user-friendly resource that can help guide individuals on their self-healing journey or is also beneficial for therapists, as it provides evidence-based techniques and coping skills to manage an array of common clinical issues including depression, anxiety, anger management, sleep, self-esteem, OCD, PTSD, and eating disorder.
Resources: Essential Tools for Cognitive Behavioral Therapy
You can also book a free 15–30-minute phone consultation or learn more information about scheduling a talk or a workshop at https://www.tiffanyloggins.com/
For more information on Dr. Tiffany visit https://linktr.ee/drtiffanynicole
Want to be a guest on the pod? Email us at podcast@solwell.co
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Transcript
Introduction to the Soul Well Podcast
00:00:05
Speaker
Welcome to the Soul Well Podcast, where moms of color find strength and community in the mental health space. Each week we ignite inspiration as we set our intentions with affirmations and dive deep into honest conversations with fellow moms and mental health experts.
Mission: Shattering Stigmas and Empowering Moms of Color
00:00:20
Speaker
We're here to hold space for you, to shatter stigmas and elevate the voices of moms of color. We'll fight for policy change, empower you with mindful resources, and most importantly,
00:00:31
Speaker
remind you that you're never alone on this journey. It takes a village to raise a mother. Now let's meet at the well.
Episode Focus: Eating Disorders with Dr. Tiffany Nicole Loggins
00:00:40
Speaker
Hey mamas and welcome back to the Sew Well podcast. I'm your host, Autumn Colon. In today's episode, we are diving into the world of eating disorders. What are they? Understanding them, noticing the symptoms and getting help.
00:00:56
Speaker
We are going to be speaking with my guest, Dr. Tiffany Nicole Loggins. Dr. Tiffany is a licensed clinical psychologist, author, and wellness speaker based in San Francisco. She specializes in working with diverse communities of color.
00:01:13
Speaker
using holistic and culturally sensitive approaches to help individuals align with their authentic selves. With extensive experience across universities, hospitals, and community mental health settings, she combines multicultural and evidence-based methods to guide her clients towards clarity, purpose, and passion.
00:01:34
Speaker
She currently practices through her private clinic, Discover the Authentic Self, where she offers virtual therapy. And she is the author of self-help workbook, Essential Tools for Cognitive Behavioral Therapy. That is going to be linked in our show notes.
Media Influence and Cultural Perceptions on Eating Disorders
00:01:50
Speaker
And if you are not familiar with eating disorders, what they are, understanding them, this is going to be the conversation for you. I learned a lot about understanding how our behaviors can lead to something like an eating disorder and what they even are. I mean, a lot of us get our idea of what eating disorders are, I'm sure, from the media and television, but it goes beyond that. And I wanted to talk to Dr. Tiffany about how it specifically impacts Black and brown families because we don't hear a lot about eating disorders in our community. And so,
00:02:27
Speaker
This conversation was definitely informative to me and I hope you learned something from our conversation as well.
Journal Prompts for Unlearning Self-Sabotage
00:02:34
Speaker
To get us started on this episode, instead of doing an affirmation like we normally do, we are switching it up with a journal prompt. This season of my life and what I've been sharing with this whole world community is unlearning, unlearning self-sabotage and unlearning some bad behaviors.
00:02:53
Speaker
um And so these three journal prompts are three prompts to help you unlearn bad behaviors and getting to the root cause. And so take out your pens, take out your notebooks, pull out your notefo your notepad on your phone, and write down these three journal prompts. Take these journal prompts with you as you begin to unpack and unlearn bad behaviors. Number one, identify the root cause.
00:03:23
Speaker
What emotions or situations trigger my negative behavior? What underlying needs am I trying to meet with this behavior? Number two, reframe your thoughts. How can I reframe my thoughts about this situation? What positive affirmation can I use to replace negative self-talk? Number three, visualize positive outcomes.
00:03:51
Speaker
Imagine yourself successfully overcoming this behavior. How does it feel? What does that look like? What positive changes occur in your life as a result? I want you to take these three prompts and journal them, whether that is writing it down, speaking it out, or talking to your therapist. We all need to unlearn some bad behaviors, especially if they're rooted in self-sabotage. I hope you take these with you and learn something about yourself.
00:04:21
Speaker
And with that, let's jump into today's episode.
00:04:26
Speaker
Hi, hi, and welcome back to the Sew Well Podcast. I'm your host, Autumn Colon, and today I am joined by Dr. Tiffany Loggins. How are you? I'm good. Thanks for having me. I'm excited to be here. Yeah. Yeah. Yeah, me too. I'm excited to have you and to just dive into our topic and talk about all the things. so Today's episode, we are talking about um eating disorders and understanding like just the psychology behind that and you know your experience in
Understanding Eating Disorders in Diverse Communities
00:05:01
Speaker
that. So can you give our audience a little background on who you are and what you do and all that?
00:05:10
Speaker
So I'm a clinical psychologist and I have a specialty working with eating disorders and a little bit about some of my training and experiences. I got my specialty training in Oakland and they have an enhanced eating disorder program that I spent a year at.
00:05:30
Speaker
underneath with Kaiser, and it was such a great experience. um One of the reasons why I decided to get into the field, specifically eating disorders, was one, it's very relevant and personal. um Two, I realized that there weren't a lot of black and brown therapists. And when I did my pre-doc in University of San Francisco, we had so many college students, young college students,
00:05:58
Speaker
um Of all different backgrounds who were struggling with eating concerns and none of the supervisors Could work with them and I ended up seeing a lot of them and I realized wow I need to get more information and more training. So I ended up going to Oakland had an amazing experience um Got hired on as my first staff position at Kaiser San Francisco where I was seeing both eating disorder patients in general patients for about ah five years and And then I transferred to San Leandro, Kaiser, and now I work exclusively with eating disorder patients. So anyone who's coming in from um the East Bay, so Fremont, San Leandro, they see me and I help get them either triage, sometimes they stay with me, and we we'll probably talk about this a little bit more in depth during the podcast, but
00:06:48
Speaker
um we get them into higher levels of care and just get them whatever services they need. So I see a lot of it and I find it very rewarding and it's very relevant. A lot of people struggle with eating disorders. Some people might not even realize that they're struggling with it too. um So yeah, I'm excited to kind of dive in and explore that a little bit more.
00:07:10
Speaker
Oh, I don't know why I can't hear you. Oh, sorry. I can't hear you. I was on mute. um All right, great. So we're just gonna dive right into it. So you you um I like for our audience to kind of really take this as like, they don't know anything about anything, right? So I would love for you to define like what is an eating disorder or you know maybe even talk through like what some common eating disorders actually are. Yeah, so it is a pattern of
00:07:46
Speaker
eating because there's a huge cluster and most people are very are familiar with anorexia and bulimia most people are very familiar and they think of a stereotype which could be a young white woman who's very thin right so we can definitely talk about those eating disorders right so In essence, an eating disorder is some kind of pattern or dysfunctional eating and it can be related to, of course, our eating patterns, but it can also be our thought patterns. So when we look at anorexia, which a lot of people are very familiar with, which is the person is engaging in some type of restrictive eating. This could be skipping meals, calorie tracking, avoiding certain types of food. So someone might be like, oh, I don't want to eat processed foods or
00:08:33
Speaker
sugary or carb, carby foods. Um, and, uh, along with that, they also have to have this fear of weight gain, right? So if a person doesn't have that fear of weight gain, it would fall under probably feeding or eating NOS, which means there's some type of pattern or eating that's going on, but they're not having a fear of either weight gain or some significant impact on their, on their body image.
Exploring Various Eating Disorders and Misconceptions
00:08:59
Speaker
Right. And that's where it's kind of like body dysmorphia.
00:09:01
Speaker
things can come in too. And typically we always thought of anorexia as just someone who was just heavily restricting, but now the DSM-5 has made a little bit of a change with that because we see people who can also engage in purging behaviors or compensatory behaviors. So there'll be excessively exercising, laxative use, um purging, those types of behaviors.
00:09:27
Speaker
So now we have a subtype that we can use if a person is doing that in in the context of heavily restricting, right? And it can be very hard sometimes to diagnose people um using just the dm DSM diagnosis. So a lot of times you'll see that people fall into feeding or eating NOS, which just means they're engaging in either restriction. It could also be binging, which we'll talk a bit about that when we look at bulimia.
00:09:57
Speaker
So that's kind of anorexia. um Bulimia is a bit different, right? So they're engaging what we call these binging behaviors and they are purging. And the purging does not have to just be you think of someone like sticking their finger down their throat and making them voluntarily purging.
00:10:17
Speaker
we could be through excessive exercising and or it can be through laxative use too. Those are all all kind of compensatory behaviors. So most people are very familiar with anorexia and bulimia. But the craziest thing is those types of eating disorders, I actually see those less common. And the reason that it's only about 2% of people who struggle with an eating disorder will fall into those kind of discrete categories.
00:10:47
Speaker
So another one that I actually see that is way more common is either feeding or eating NOS, which just means the person is engaging in some dysfunctional eating behavior. So it could be restricting, calorie tracking, it could be excessive exercising. And then sometimes you'll see people one year, they're heavily restricting, and then I could see them and they'll come in.
00:11:14
Speaker
And they are more on this other side of binging, where they're kind of vacillating between restriction and then feeling kind of out of control with the eating, right? And you see that a lot after someone has been, sometimes I see that people do like a fitness competition or if they um do some kind of um weight loss challenge and it'll show ah trigger our brains. And we'll probably have this question come up about Well, how do eating disorders kind of develop? And there's no reason factors and we'll talk about that. But then the ones that I typically see are people who have a very unhealthy relationship with food in their body. Meaning they're kind of vacillating between they're like Monday through Friday, they're following a really
00:12:06
Speaker
this diet plan that they have is kind of restrictive. Then on the weekend, they might feel very out of control and they're just kind of vacillating between this and it starts to impact their health. It starts to impact their emotions because now they're feeling a lot of shame and guilt because they're like, oh, I'm not able to do this and why can't I stick to this? And it can be very distressing, but they don't fit neatly into anorexia or buli or bulimia. So I see a lot of brain feeding or NOS. Another big category that has ah been coming up too is um binge eating disorder. And this can happen where um someone is eating ah excessively. When I say excessively, I'm not saying
00:12:50
Speaker
you know, you had some pizza and you just likes a cake, right? to To someone they might go like, oh, that's, that's binging. But that's really not binging is binging would be the person is eating pretty normally throughout the day. And then um they'll have these episodes. It could happen once a week. It can happen two to three times a week. And there's different categories or some types in the DSM that allows us to understand the severity, right? um And so the person will eat, we'll say an excess of 4,000 calories in one sitting. People compulsive, they feel out of control. um They eat to the point of feeling uncomfortable. And it's followed by shame and guilt. And they're often engaged in this behavior alone.
00:13:42
Speaker
Now, sometimes you will see these episodes in the context of restriction. And that's why it's very important when I meet with someone, because think about it. Even if you say, oh, I binge watch this television show, or I binge, your definition of binge could be very different than my definition of binge. Maybe binge, you know, a whole season to me really isn't binge. And for you, you know, I don't watch that much TV. So like you know I put all three episodes in like, that was a lot. That was a binge. Yeah.
00:14:12
Speaker
So this is how I help clients and help me understand what's really going on. right There's basically four different types of binge behaviors that help me kind of understand what's going on. You have your clinical binge, and this is where I'll ask the person, tell me exactly what you're eating. And like if they're eating ah se excessively over, you know, maybe like three to 4000, 5000 calories in one sitting, and They feel very out of control. They're eating until they're uncomfortable. They have been eating normally throughout the day. That is a clinical binge. To be quite frank, I don't see those as often as people might think. And that's because of your subtypes. So the next one is called a compensatory binge. The next two that I'll describe is but probably the most common. A compensatory binge is when the person is engaging in some kind of restrictive behavior. So they are... maybe they're doing like a low carb diet or they're trying to stay below X amount of calories or whatever it is. Or there's a lot of people will skip lunch, have a very light, um skip breakfast, have a very light lunch. And then when they get home, they have not been eating. And so then they will engage in binge behavior. But the thing is, that's not a binge behavior. That's actually your body being completely hungry. It's like a ball.
00:15:35
Speaker
to do that, humans before did not have access to Uber Eats in the grocery store. So it was evolutionarily advantageous for us to eat a lot and then we would have food we wouldn't have food for a long time. So our body, we put ourselves in this, we create an artificial scarcity mindset then our body is going to do exactly like that. It's going to binge when it gets around food because it doesn't like to go without food for a very long time. So right when I start to tell clients, like you're not eating properly, you're not fueling, you're not having enough protein in your day. That's a big one. Um, so you're, you're actually not binging. So those feelings yeah and shame that you have really aren't necessarily justifiable. It's just this poor relationship you have with food. And then sometimes when people come in and they say they binge,
00:16:26
Speaker
If I notice it's compensatory,
Emotional Eating: Triggers and Impacts
00:16:28
Speaker
um I help shift their relationship with food. We make sure that they're eating a really good breakfast that's robust with high protein, um whole unprocessed carbs, and just like eating until they feel satiated for breakfast, lunch, and beer. They don't feel starving and they don't engage in that compensatory binge. So sometimes it's just be easy as that. Now a lot of people do that compensatory bingeing and they don't even realize that's kind of what's going on.
00:16:56
Speaker
The next one is called a subjective binge. And it's exactly how it says, which means subjectively to the client, it feels like a binge. And this could be, sometimes people will have two donuts and to them, it feels, they'll say like, oh, I felt, I binged. And then I'll say, what did you eat? And they're like, oh, I had two bagels. And I like honor the client and say subjectively to you, that is a binge. But if we're out of that context of just looking at your worldview,
00:17:26
Speaker
It really isn't a binge, right? It's maybe an unhealthy relationship. Maybe you view food in terms of like good food, bad food. Right, right. And so then sometimes it's just shifting that dynamic and helping the client to start to stop demonizing food and to hunger cues a lot of times.
00:17:49
Speaker
um yeah The next one is kind of, I like to call emotional eating. We all, right? This is where we are not listening to our hunger cues. The way that I like to describe this is with emotional eating, a lot of times clients feel like, you know, I'm just like ruminating. I'm thinking about eating X, Y, and Z, and I can't get it out of my hand. And I, you know, I go in the kitchen and I just start going to town. And emotional eating is when the person is using food to cope with an emotional experience or to change into a different emotional state. So I'll often tell the client, it's not that you're addicted to food, even though there can be that going on. on It's that you're actually addicted to it.
00:18:41
Speaker
um a different emotional experience and you're using the food to cope. So let's say that I am working and I get an email and the email stresses me out. Maybe it's from my boss asked me to do something and I started to feel kind of like anxious and like, oh, I don't want to do this. And so humans do not like to feel uncomfortable emotion. We like to, who so the first thing I might think to do when I feel emotionally dysregulated is I go into the kitchen and I get a bag of chips.
00:19:12
Speaker
Now you might think, oh, well, you know you're just you're just kind of going in there just to get something to eat. But in reality, what could be going on is you're experiencing a uncomfortable emotion and your nervous system is dysregulated. And you have you are now craving a different emotional experience. It's not that you're craving a bag of chips. You're actually craving an emotional experience that you have associated food with. So it's like, Oh, now I get a dopamine hit. um I'm distracted. I'm numb. So sometimes we're just bored. And we're right. Stimulation, sometimes anxiety. And I'm seeking feeling numb, loneliness, it's a friend, it's comfort, right? um And so that emotional eating, I work with so many clients on that. So yeah, those are kind of the four different types of kind of
00:20:11
Speaker
when people say, I'm binge eating, you can also tour those four categories. Right, right, right. do So I have a ah series of questions, right? um So how do you, like, how does one, I guess, self-determine whether or not they may have something like this going on in order to then come and see someone like you? Like, are are they, like, how do they know they're exhibiting abnormal behavior?
00:20:41
Speaker
I think a lot of it will start with the rumination. When you're ruminating on, should I eat this? Should I not eat this? When you're calorie tracking, and I get it, there are some people who can engage in the behaviors that I'm discussing and they don't have issue. They do not have an issue. The way that you can tell it's causing an issue though, is you start to have a fear of eating to the point that you're engaging in, I would say maladaptive,
00:21:09
Speaker
Disorder pattern so like purging you're purging in any way which is like, oh, you know what? I went out last night. So now I need to run X amount of miles, right? There's a little bit of an unhealthy dynamic because then it's like why do you feel that you have to or this kind of compulsive behavior to engage in it? right great Another thing that can happen too is if it and the biggest thing I'm always looking at is is there what the behaviors are? Is there a fear?
00:21:39
Speaker
yeah I got this fear that my body's gonna change. That's also a tip off. Are you avoiding different types of foods? The compensatory behaviors when you're feeling like, well, I have a headache today and I really don't feel like walking or exercising, but like I have to. And it's like, well, right kind of asking yourself why. um The other thing too, I would say too, is if you start to notice that it's impacting your social functioning. If you're ever thinking,
00:22:10
Speaker
Oh, I don't want to go out to eat with my friends because I'm not going to be able to control what I eat. Right. Right. And it can even be the opposite way. Maybe there's sometimes clients who feel like, well, I noticed when I do go out to eat, I eat with my friends, but then I binge at nighttime. Right. Where you're feeling kind of out of control. So if it's impacting your social functioning in some way, the other way that it could be happening too is maybe you are engaging in binging or emotional behavior and we're hiding it. So we're hiding the wrappers, right? You're kind of having a secretive behavior. So you can see how you eat with someone being very restrictive or it can be the other way. The other thing is it's impacting your health. If you start to feel fatigued, tired, loss of menstruation, feeling cold, excessive hair growth. I mean, the list goes on and on.
00:23:09
Speaker
your t Say the thing about the teeth. The teeth. If your teeth are very sensitive and you've been purging, acid reflux, it will, from purging, the acid from the stomach will eat away at your teeth. It'll cause them to be very sensitive. um Acid reflux because it's causing you to have, I've had clients who felt like there's like a hole in their throat.
00:23:35
Speaker
Hmm. Yeah. Yeah. Yeah. I get that feeling. yeah that' Right. So that means the behavior that I'm engaging in is now starting to impact my health and it can be the opposite way. And sometimes I don't think people think about this too, but I've had clients who have weighed over 500 pounds and they are having severe health issues as you can imagine diabetes. right We've also been seeing, um,
00:24:03
Speaker
an increase in 18, 19, 20-year-olds having non-alcoholic fatty liver. And that comes from excessive eating of processed foods. Right, right. Which comes up, tells very nicely into the other eating disorders that people probably have never even heard about, but that do exist. So um people have heard of PICA, where someone's eating a non-nutritive substance. Sometimes we'll see this, um there's certain cultures from different parts of Africa that this can happen. um Pregnant women, they will have craving for like chalk, baking soda, things like that. And we don't really hear these as often, but usually this is a sign of some kind of nutrient deficiency that can happen. Another one is,
00:24:56
Speaker
are fed, avoidant, food restrictive, ah no, are avoidant, restrictive food intake disorder. Right? No one, people are like, what art? Never. what So you usually see this in younger children. This is okay where you might also see this with people who struggle with or who've been diagnosed with autism.
00:25:23
Speaker
it's not uncommon to have sensory issues. So what will happen is they will avoid food, but it's not, think of a kid who's like an extreme picky eater. The kids are usually picky eaters, they want to eat their chicken tin. My son's a picky eater, my son's a picky eater. So I know. But think of like to a significant and severity to where it impacts their growth. Right, okay. You can see this where They look at the growth chart and the child is not hitting that growth chart. And sometimes it could be picky eaters going on, or it could be that the child is having sensory issues. So they don't like the way the food looks, feels, feels taste. And it's one of those things where it's with kids, it it can make them very sick and they will not, they will refuse to eat. And it's not one of those things where it's like, okay, you don't want to eat that. Well, I'll wait till you get hungry. And then you eat.
00:26:20
Speaker
It's very extreme. And a lot of times I'm not seeing kids who have it because I don't work with children, but I work with adults who grow up and they have ARFID. And how it looks as an adult is they eat foods that are often very packaged. So think about it.
00:26:41
Speaker
An Oreo in America looks very similar to an Oreo in China, right? Right. Burger looks the same for McDonald's as it does. People who have ARFID do very well with a few select processed foods because there's no shift and change in the way the texture looks. So like the way I've baked chicken is very different than someone else's baked chicken. Right, right. A peach.
00:27:08
Speaker
ah raw like A completely raw peach can look very different. Some can be soft, some can be firm. For someone who has ARFID, they don't like that. They like they like things to be nor like very the same. same picture So a lot of the clients that I have, they will eat the same meal over and over and over again. So clients who like to eat just like peanut butter and jelly sandwiches, um a plain hamburger.
00:27:37
Speaker
um cheese pizza and they will not want to eat anything outside of that or they'll eat something for a really long time and then they'll be repulsed by it and it can cause them a lot of issues as you can imagine if you eat a lot of Processed foods you're gonna be at higher risk for diabetes non-alcoholic fatty liver high blood pressure so we work with them to start to, it's like, oh, okay, you like canned peaches. Let's see if we can try um peaches that are cooked on a stove. And then we try to do, maybe we could do a raw peach. And sometimes if you're trying to do that with them, it can work really well. Sometimes they'll get very repulsed and it caused them to be very distressed by it. Yeah, yeah, yeah. That is, wow kind of I give a very quick kind of lay person, but yeah. So most people have to do that.
00:28:31
Speaker
Yeah, I've never, I mean, I've never, I've especially never heard of the the last one, like in the way and severity in which you describe it, right? Like I, like my son, he has ADHD, ADHD, and so he has always been a picky eater. Like if he will eat a burger every single day, like if you let him eat a burger every single day, but like he only eats a chicken patty from like a specific chicken patty, like every, you try to give him something else, he's like,
00:28:59
Speaker
he just won't eat it. But it's not to the severity in which like that you describe it. And just thinking about my son just brings me to this question of like, how do things like this develop over like over time? Or where does it begin for a lot of the patients that you're seeing? Yeah, someone with ARFID, we do see it in a lot of people who are neurodivergent, people who can have like sensory issues or Um, and you're going to see that one in childhood. So to me, that probably has more of a genetic component to it versus what we might see in someone who has anorexia. And people can also have a genetic predisposition for all mental health issues, but it's kind of similar to, um, a loaded gun, a loaded weapon but by itself in a room with no one around.
Genetic and Neurotransmitter Aspects of Eating Disorders
00:29:50
Speaker
is not a dangerous thing. It's just there, nobody's there, it's a locked room, nobody can get in there, right? And that's kind of how genetics are. Just because you have a genetic predisposition for something doesn't necessarily mean you are going to have it. It just makes you a lot more vulnerable. It's acceptable. Yeah, yeah. You know, the minute we open the door, or we unlock it, it's like, okay, makes it a little bit more likely to go off. oh Yeah, right.
00:30:14
Speaker
That's how I like to think of it. So there are there is a genetic component to eating disorders, for instance, with someone who has bulimia, we will they will often have symptoms, they will often have comorbid, sometimes ADHD or depression, which we know can come from um lower levels of dopamine. Right? No one who has binge eating a lot of times when I'm working with them, they look very similar to someone who struggles with substance abuse, which we know also has a genetic component or it could come from if you've had a lot of trauma. Like trauma in our environment impacts our brain chemistry. And so one of the things that we see is like lower dopamine, lower levels of serotonin, anorexia. We can also see some differences in neurotransmitters. That's why some SSRIs and psychiatric medications do very well for clients who have eating disorders.
00:31:10
Speaker
um So right there's that genetic component that we have to acknowledge is there. And then parenting styles. Parenting styles can impact the development of an eating disorder. um There's like a lot of different theories. There's theories that um authoritative parents, parents that have a tendency to compare siblings, parents that are achievement focused,
00:31:40
Speaker
parents who have their own issues with food. up To me, when I'm meeting with a client, one of the questions that I always ask the client when I do an intake is I ask them, I say, tell me when you first noticed that you had a body. When was the first time you noticed that you had a body? It's interesting. You know, people think about it.
00:32:01
Speaker
It's interesting. I don't even know what I would say. I don't know. One of the things that I've heard from clients is it's interesting if you think about it. So I've heard things like um I was trying on like a costume or an outfit and someone made a comment.
00:32:24
Speaker
way to comment about someone else's body. It can even be positive comments. So sometimes people think, oh, you you have to be overweight and you're bullied, which we do see that, of course. But a lot of times I have clients who have always been the thin one and they got a lot of praise where that fitness became equated with their identity. So then it allowed this kind of fear of weight gain. It's like, oh my gosh, if I gain weight, then what?
00:32:49
Speaker
Or if you have a parent who is on TikTok, you probably see this on social media, an almond mom. We do an eating disorder. And an almond mom is just basically a mom who's like always worried about what she's eating. She only wants to have like a very small slice of the piece of cake, and she probably makes comments about her own body. That's the other thing. Even if a ah a parent isn't, and I'm saying parent, because it can be mom and dad. Dad has a lot of comments about people on TV.
00:33:19
Speaker
That can be very triggering for a child if you're watching TV and a parent says, oh my gosh, um she's fat. In a very negative way. A smile then learns like, oh shoot.
00:33:33
Speaker
being fat. I don't want to be, I don't, yeah. There's this, there's this like, there's this like the other day, like my daughter was hanging with her friend and they were singing this song and I was like listening and they were like, big back, big back. Which. Sure explorer, big back, big back. Yes. Yes. And I'm like, first of all, I was like, why are you singing this song? And then I heard her call the cat a big back because he steals all the food from, and from the And I'm like, whoa. So when you hear it, it's like, ha, ha, ha. But then also, that's where these message these these messages start to get into our children at a very young age to like, oh, well, you're going to be made fun of if you are shaped in this way. Or it's a negative thing to be you know whatever. So if it's detrimental. you know but and i But I also think
00:34:28
Speaker
some of it from the parenting perspective like the almond mom is like not necessarily like they don't even recognize that they're doing it I know I know that I just need in a vulnerable moment like a few years ago maybe a 2018 I was having a lot of issues with my like my gut health. And so I was seeing a gastroenterologist and I was diagnosed with IBS. I wasn't able to get out of bed sometimes based on like foods I was eating. So I did this whole food diary process where I was like writing about all this food and stuff that I was like consuming or whatever. And ultimately, I was like eliminating a lot of things and it was all
00:35:07
Speaker
like animal-based products and so I was like okay well I'm just gonna try being vegetarian and then I was like okay I'm gonna be vegetarian and then I was like well I like dairy doesn't do well with me so I'm gonna just become vegan. So I've been vegan for since 2018 however in the past year, what like what I have noticed like in my own house and just with myself is that it has created this like good, bad food environment. And my daughter, who is going into her pre-teen years, she's very adamant about, well, maybe I should be a vegetarian because like that's what she wants to do. And like she's like, I'm going to have a salad. What do you want for lunch? I'm going to have a salad. like right And I'm like,
00:35:53
Speaker
Salads are great. I love salads. like I'm glad you're choosing like the you know the the the healthy option. But I just notice how unintentionally me being so focused on, I have to obsess about my food because I have this condition. And like there are things that I cannot eat, right that they physically make me sick. It has made everybody in the household just like more aware of like what they're eating all the time. And it's like, I don't know.
00:36:18
Speaker
i know personally i have an unhealthy relationship with food And that's just my own thing. um So I'm, which is part of the reason why I'm like, I'm glad we're having this conversation. I want to bring this up because parents like, you know, like me myself just don't, aren't aware of like how those little subconscious little things that you're doing, you know, impact our little ones, you know? Yeah. I know. Yeah. you And you, you know, I always tell parents the patients I work with, your parents have, I always just believe this, sometimes they don't, but you know, but I always say your parents have good intentions. Like, yeah yeah, that's for you. However, they're also flawed people who've also been socialized to fat phobia, and colorism, and all sorts of different things. And they may not have done the work in the healing. And so, yeah,
00:37:09
Speaker
You know, we just have to recognize that. But yes, the way our parents' relationship is with food and culture has a very big part of that. um Yeah. Something else I do want to say about culture that we have seen in the research is, you know, um and of individuals who are in the LGBTQIA, they're at higher likelihood of having eating disorders. um And we can also see sometimes why this may be.
00:37:37
Speaker
We've noticed too, people who are coming from the BIPOC community also can be at a risk, higher risk too as well. um There's differences too in the manifestation of eating disorders. So sometimes we might, there's always this myth that Black women and Latinx individuals, they don't get eating disorders, especially Black women, they don't get eating disorders.
00:38:02
Speaker
Yeah, right. They're just masked, honestly. it Yeah, it's a lot different. It's a lot different. So they've seen that um black women, for instance, tend to have can still have eating disorders just like everyone else, but there are going to be at a higher likelihood of having a binge eating, right and believing. So another thing that is interesting that I have seen in the literature as well, have I've seen a anecdotally, just in my experience, is a lot of people who have an identity of being a minority. So whether that's sexual orientation, gender orientation, or racial or ethnic background, unconsciously, because of society and their experience of not feeling like fully human, right, of having to be oppressed and discriminated on, they
00:38:58
Speaker
feel like I can't really control my sexual orientation, my gender, my ethnicity, or race. But what's the one thing that I can control? I can control my body image and weight. So I have seen this a lot. It's like I can't be brown, gay, and fat. Right, right, right. So that's something else that we've seen the intersectionality of race and ethnicity and gender and all of these things can also make people I wouldn't say cause an eating disorder, but it's definitely a factor that can exasperate or predispose someone to especially someone who might be transgender. Sometimes I've seen clients who, um, they stop eating because they don't want their, their breasts to come in or yeah other different types of things too. When they're doing that transition and dealing with gender dysphoria, definitely see that a lot.
00:39:53
Speaker
Right. all Right. Yeah. Wow. Wow. Yeah. Thank you for sharing that. I'm like, yes, let's get all the the information and and out there. And you brought up an interesting um topic, which I wanted to bring, which I wanted to talk about, which was like myths and misconceptions, right? Like around just like these disorders and these, you know, conditions that people may have. Can you talk a little bit about like what the common, you know, symptoms or that, not symptoms,
00:40:22
Speaker
what the common like myths and misconceptions are? I think the first one is that people can control it, right? You see this a lot where someone's struggling with an eating disorder, and maybe they open up to family about it. And no fault of their own, whoever the support system is, they're trying to do the best. But sometimes they just don't understand that this is kind of can be outside of the person control. It's compulsive. It's kind of similar to someone who is struggling with substance abuse. And if you really think about it, when I'm working with people who have an eating disorder, it really mirrors someone with either OCD or substance abuse issues. So what is OCD?
00:41:07
Speaker
You aren't going to say you're just faking it, just stop doing it. Or someone is addicted to alcohol. you You know, it's like, how come we're able to acknowledge that this may be out of this person's control? It's the same thing with food. It's just manifesting differently. It's just making up in food or these compensatory behaviors. And so I think that's the biggest thing that I would want to say is this a lot of times is not under people's control if they have an eating disorder. They may be feeling like they are literally a prison in their brain of all the anxiety and the fear. And the other thing is, if you think about it, our society socializes us, predisposes us to have an eating disorder, dial it up, workouts, what I eat in a day. I mean, it's for a young woman whose name is when the ages of like nine and
00:42:04
Speaker
18 or 21 or 25 it's like You can pull up on your phone and go on tik-tok and you can have the steps on how to have an eating disorder Yeah, yeah, right and you're also seeing a lot of filtered images and All sorts of stuff I think the other yeah, this would be the the cultural component of it that anyone can suffer from this and any ah BMI, you don't have to have a super low BMI, you can have a very high BMI and have an eating disorder. Yeah, yeah. I think people just think.
00:42:39
Speaker
Oh, skinny white girl. Like that is like what they think of oh eating disorder. And then, or just like, you can't, you know, like people who may be overweight and they just see like, you're just irresponsible and uses a choice. And like, you know, like it's just, they throw on their, what their worldview is or their predispose what like opinions and they just assume, which, you know, doesn't get anybody anywhere. Right. Um, yeah. So.
00:43:07
Speaker
It's the sad part about it. It's true. and I sometimes see this when I work with MDs. They also don't really necessarily always understand it either because sometimes we'll get referrals and I'll have clients. I'm like, oh, what did your doctor say? and this This is coming from someone who is in a higher BMI, but they have an eating disorder.
00:43:30
Speaker
And they will get from their and their MD who might not, is it catching in or doesn't necessarily under really understand what's going on? Because an MD is just thinking your BMI, the blood pressure, they're just looking at certain metrics, which we know the BMI metric is not something that is a very great tool rooted in science. And so I have a client who's like engaging in disordered behavior, but they have a high BMI and the MD could be telling them, yes, restrict this, eat less of this. And it's also kind of engaging in that. And then when I meet with a client, it's like, oh, we have to deal with their reprogramming. So it's not too late, people. Sometimes there can be people in the empty field too that just aren't as aware. And the good news is they're very good about referring out. They're like, this client is doing this, you know, I want to see them.
00:44:22
Speaker
Um, yeah. Yeah. And I also, that was going to be good. Other misconception is about men. Okay. I think that is something that people feel like men don't really have eating disorders. Not true. Right. They can have it too. A lot of times you can see people who are you know, the chicken and rice all day, every day. Is that automatically making someone an eating disorder? No, but it is something that we should maybe want wanna to talk about or I'd be curious, like, do they go out? And, you know, there's no black or white, but it is just to say there can be men too who are also struggling with this as well. Right, right, right, right.
00:45:06
Speaker
and that And they never, and they don't necessarily know. And I was like, as you were talking, a question came into my mind, which which is like, how does someone get to someone like you? Right? Because if someone is exhibiting these behaviors and they go with their doctor and they're like, you know, you know, if you're exhibiting depression system or anxiety symptoms or whatever, like, okay, we know, we know what that looks like. We know we're going to do, we're going to refer out. But like, how do you, how does someone get,
00:45:32
Speaker
help from ah someone like you. So working in the hospital, I'm usually getting referrals from other therapists, psychiatrists, or medical doctors. And usually what's happening in different ways, it could be a therapist that's picking up on something, um MDs, it could be one or two things are going on, they're either very low weight, or something's going on with their weight, and it can or it could be very high. And or they could be having severe health issues, diabetes, I see a lot of clients like that. But a lot of times too, the only time you'll really see someone kind of coming in is they get tired, they have some kind of health issue that happens, a friend's family are urging them is another big one. Because unfortunately, if someone is engaging with an eating disorder, and a lot of times when they're losing weight, they get a lot of positive feedback from people.
00:46:31
Speaker
yeah It's not until people look, look and it's by the time someone's looking a certain way, it might be it's like, wow, you probably should have came in six months ago, right? Yeah, right, right. So a lot of times it is coming from an urging of family, a very low BMI. They've had some kind of health crisis.
00:46:51
Speaker
and in blue um flag something or they said something in a interview or something like that. And then once in a while you do get clients who are like, okay, I know I have this and I see these a lot. I know I have this, but I'm not ready to change. And that's why right and a lot of times they sit with me in therapy and I'm seeing them to help them understand what's going on. And the hope is to get them into a higher level of care.
00:47:18
Speaker
Just because you're working with a therapist isn't always the best treatment for an eating disorder. Everyone, right? for every single For every single person. I mean, because eating is such an everyday thing. It's not like something you need. like some Like you said, some people might need a higher level of care where they may need to go in someplace for treatment or like do an inpatient or whatever.
00:47:39
Speaker
um i had this one question that came to me and do you see patients typically with like uh addictions to food for example like addicted to sugar can't stop eating candy like all day long like or whatever like is that something that you're treating as well i'm glad you brought that up because that's kind of a not taboo but there is this idea i would say in the eating disorder field where you're gonna see people's have different theories on that. So I'm just gonna say what it's just a theory of mine and it's not black and white and everybody's very and unique. To me though, in the clients that I have seen who don't fall necessarily always into like anorexia sometimes that is that yes sugar is addictive.
00:48:32
Speaker
right And so sugar is also a toxin as well. um right So when I'm working with clients, I run a group on Tuesdays, it's called an emotional and binge eating group. A lot of the people I see in there, they are addicted to sugar. Like if I gave them a substance abuse questionnaire, but I just changed the substance from, you know, drug to food, they would hit it. They would literally lose the criteria. I've tried to quit. can't I can't monitor it. It's secretive.
00:49:02
Speaker
impacting my functioning, my health, my money. you should But when I'm working with a client, I work with them on four pillars that I have, that I view as interesting, which is there's brain changes. If someone has been eating habitually and consistently processed foods in particular, so think donuts, french fries, a lot of packaged foods and a lot of sugar,
00:49:30
Speaker
you have changed the chemistry in your brain just as much as someone who's been abusing alcohol or cocaine. Meaning, if you are eating a substance that creates highs of dopamine, what tends to happen is your body is going to downregulate. The same thing that happens with addiction. That's why you need more of it. So like, one muffin, I need two muffins, I need more. And you kind of see that with people who binge, they will eat more and more, right? Because they have been developing a dependency That's addiction. If I take that clear away, there are clients who they're like, I feel shaky. I feel down. I feel sad. I'm my blood sugar. It's like, Oh wow. You and I have withdrawal. It's very- Withdraw symptoms. Right? So that's addiction, right? Yeah. I'll have to work on four pillars. I have to realize that if this person has been doing this,
00:50:21
Speaker
their dopamine is pretty shot because your body will down regulate your dopamine receptors because you are abusing a substance and your body does not like too much of anything. So it's like, oh, okay, well, I'm gonna get rid of these dopamine receptors because you're using a substance that's allowing you to have a lot of dopamine. Now, if I take that away, it's gonna take 30, 60, 90, 120 days for your dopamine receptors to upregulate again. During that time, clients feel apathetic. They feel they can have withdrawal symptoms. So I have to address that.
00:50:51
Speaker
The second thing is blood sugar. You've been eating a lot of sugar. It's a toxin. Your pancreas requires you to release insulin you can and it has to shuttle it out of your blood so you don't go into a diabetic coma. So when a client is has been eating a lot of sugar, I've had clients who eat like average four liters of coke a day. Four liters of coke, that's a lot of sugar and that just goes a lot. right give italian So I also have to be cognizant of their blood sugar levels too as we're trying to change their relationship with food. So I also have to be working with their MD. Are they on insulin, metformin? um So there's also that component of it, right? So that also shows you that sugar is also addictive too because if you're pulling that away, clients can get very shaky if they're not immune.
00:51:42
Speaker
um The third thing is emotional. Sometimes people are engaging in using this substance because they have low dopamine. They're masking, depression, anxiety, loneliness, trauma. So they're emotionally regulating their system. That's the same thing that someone who drinks alcohol, who's addicted to cocaine, they are regulating their nervous system in a very maladaptive way. The last thing is behavior. It's a habit. They're like, I always eat.
00:52:11
Speaker
I always have four liters of Coke every day. So then I also have to address that. That's why diets don't work. And that's why people who are struggling with what I think can be food and sugar addiction, I have to take all of that into consideration at the same time, which is very powerful.
00:52:29
Speaker
for someone. Yeah. Yeah. Yeah. Yeah. Yeah. Absolutely. Yeah. and and And the reason that I wanted to ask with that is like, because everything is so individual, right? Like the treatment of of it is so, like the approach is going to be different. The the work is going to be different for each of your clients. So can you talk a little bit about like the treatment approaches to you know, to some of these, I mean, you don't have to go through the whole effort, but like, you know, the common ones. Yeah. So much, right? I think part of it is psychoeducation. I'm just like, giving people education on things they're eating, how it can impact them. Motivational interviewing is probably the number one thing that we do, because most people don't want to change their behavior. CBT,
00:53:19
Speaker
which is cognitive behavioral therapy, p dialectical behavioral therapy to improve people's emotional regulation, distress, tolerance. We might be even be bringing in support systems because support systems, sometimes you're making a change, but your support system is not. Higher level of cares, you know, your residential, partial hospitalization programs, and things about patient programs. If you are very severe, we just send you to the hospital and they just do weight restoration. And we have to be very careful because people can their salt levels can change and their electrolytes can change to a deadly level if you do not properly monitor someone. um Group therapy is huge, just like we see in substance am abuse. Group therapy is...
00:54:03
Speaker
probably a cornerstone to treatment. and You have meal groups, you have coping mechanisms, talking with other people who are also struggling, can can build it can be very therapeutic. Tons of, I mean. Yeah, yeah, yeah, tons of ways to get help. Working with a nutritionist. And eating a nutritionist, there's different ones. And we only work with nutritionists who only,
00:54:32
Speaker
who pretty much only work with eating disorders. So I wouldn and i wouldn't just give them a dietician, because sometimes that can not be very helpful. Intuitively helpful for some people, um body image. So I don't teach body positivity. I teach body neutrality. I don't... Okay. Okay. What's the difference between those two? Yeah. to So body positivity says, I have to love my body. I should always love my body.
00:55:00
Speaker
Whatever it is, I should love it. I have to love it. I don't believe that. And it doesn't and when I'm trying to decline, it does not work. Body neutrality does. Body neutrality says, I don't have to like my body. I don't have to love it at all. However.
00:55:18
Speaker
you Body positivity is only looking at body from outside. By who Charlie says, I have a spiritual body, I have a personality, I'm intellectual, I do have weight, right? The way it looks. I have a physiological body that my heart never stops beating. ah My lungs, I have immune system. I can walk, I can see, I can hear. I have this amazing body that does so much for me.
00:55:44
Speaker
and right right And so how I describe it to clients is, I want you to think that you have a friend who only calls you when they need something. When you hang out with them, they're very critical of you. um They're not nice to you. right Would you be that person's friend? And they're like, no. right But that's the same relationship that you have to your body. Your body does so much for you.
00:56:06
Speaker
And all you can say to it is, well, I don't like the way you look. So I'm day. I'm going to abuse you. I'm not going to take care of you. Even overeating and just eating a lot of processed food is also not appreciating and taking care of my body and the weight and all the things that it does. So Biodiversity in essence says, I don't have to love my body, but I can appreciate all the things that it does for me. And I can also appreciate that I am not just my weight and size. And because of that, and I want to be appreciative and I want to have a good relationship,
00:56:36
Speaker
I want to treat my body well. It allows more space for people to think about it. And that, honestly, it resonates so much more with clients than yeah my body. And it's like, that doesn't work.
00:56:52
Speaker
Yeah. I feel like, I feel like there's this like false, like, um, I can't think of, there's like a word for it where it's like you're, everything is like woo woo. Like, you know, like, yes, yes, yes. And it's like, we don't need like, some things it's okay to be like, it's just a shitty situation. Like sometimes it's okay to acknowledge that it's a, you know? Um, so it's like very similar to that and that aspect to me. And it either way that you describe it sounds,
00:57:21
Speaker
just like so much healthier for the individual kind of like having a relationship with self right like my whole self and not necessarily the the out the outward image that i'm trying to you know let i'm trying to look like or appear or whatever you know um and so that kind of gets into this like complexity of relationships between Eating disorder and body image issues which we talked a little bit if you talk a little bit about the one I actually the question before we start reporting about body dysmorphia Right because my question was like is that
00:57:57
Speaker
technically necessary, like, is that classified as an eating disorder? Because I, um like, I've heard it, you know, I've, I've, I've no people, i've I've heard about it, but I've, I've always been like, what is that? How do we, like, how, but I know it has to do with the body image, you know, situation. So can you explain what, what that is and the relationship between that and eating disorders? So a body dysmorphia has its own kind of entity. So like, when I go to my notes,
00:58:24
Speaker
I would diagnose someone with an eating disorder and then I would have had the body dysmorphia. So every person who has an eating disorder does not have body dysmorphia. Every person who has body dysmorphia may or may not have an eating disorder.
00:58:35
Speaker
It's like, think about it. If someone has a body dysmorphia, think of, I don't know if you've heard of like the cat woman, the woman who has had all those plastic surgeries, and I'm sure you've seen really a body dysmorphia. Like something is, right they might not be engaging in food in a a weird or disordered way. So they could right they could have body dysmorphia, but it's not manifesting through disort through eating. Maybe it's manifesting through, they get lots of plastic surgeries and fillers.
00:59:04
Speaker
right So no, I think a lot of times you may see someone who has body dysmorphia and you will see that manifesting through their eating, but not always. And yeah, I have definitely worked with eating to disorder of patients who have body dysmorphia. right And even if you think about people who say, oh my gosh, when I was X years old, 10 years ago, i would back then I thought I was and needed to lose all this weight. And then 10 years later they'll look at that photo and they're like, I can't believe I was thinking I needed to lose weight. I looked great. Right, right, right. So yeah, yeah. It can be it's like, well, what was going on during that time? And you know, you're thinking of your body in a different way. I also think if you are someone who's like in some kind of sports, like ballet, gymnastics, I've seen a lot of that, you've done fitness competition, that can also lead to people having body dysmorphia because
00:59:59
Speaker
just the nature of it. You're around people who who might have very small bodies and you're comparing yourself that can create a distortion in how you're really viewing your body. right Viewing your body. Yeah. Yeah. Wow. Yeah. So much like, you know, that we can go over and we can talk, we can talk through. I just want, I want to kind of delve into a little bit of like the journey to recovery, right? And like kind of talking through like,
01:00:24
Speaker
Um, you know, like what are some setbacks? What is the process for, you know, recovery from, um, some of these, you know, conditions? Sometimes for people it can be a lifelong journey that they're doing of managing and recovery. And, you know, someone might say, let's say lapses or relapses, right? Like if I have someone who has been, has a long history of purging daily,
01:00:53
Speaker
and I'm working with them. I never expect that client to all of a sudden stop. I mean, even if they're say, you know, I was purging this past week and there was one time where I was able to not do it.
01:01:08
Speaker
Like they're in recovery, even if someone comes into therapy and they have been still engaging in the same exact behaviors, but they are now noticing like, wow, this isn't really that good. They're in recovery. Like they are starting that process. So I think the biggest thing I like to say about it is it's not like it goes from.
01:01:28
Speaker
I was doing this behavior till I completely stopped. It's like, oh, now I'm kind of thinking about things a little bit differently. Or, wow, I was able to go a couple days without doing this to wow, I'm, I'm good. Like I'm having my three meals, I'm moving quite a long to wow, I had some stressors come up and like those behaviors pop back up, you're still in recovery. And you know, where I think that's the biggest thing I would, I would like to take away to be is that A lot of times people who struggle with eating disorder, struggle with what we call black and white thinking. And that's great. So they're like, I'm fine, I'm tired and I have one thing. And like, because I had that one thing, now I'm going to, I'm totally messed everything up. And I really like to teach clients to be what I like to call in the gray or, um, Lenahan would say is dialectical thinking, which is the ability to hold two things at a time, meaning
01:02:24
Speaker
I can be in my recovery. And there may have been a day where I restricted or I purged, you can, right right because if you don't think of it that way, you will struggle so much because you cannot put that type of expectation that you're going to be in recovery and you're never going to engage in those those behaviors that you're never going to think or you're never going to have a bad body image day. When you do that, you're just a little bit earlier in our recovery. And just that and so i I like working with clients and telling them, you always be honest with me. And sometimes I tell them, I'm like, this sounds kind of unhealthy, but I like when you have lapses.
01:03:03
Speaker
They're like, I like when you have lapses. And they're like, why would you want me to have a lapse? Because we're going to learn from it. Because maybe something happened that day, we can be able to be preemptive about it. But if you didn't have this lapse, I wouldn't be able to help you or you wouldn't be able to have the insight to know, you know, on days that I talked to my mom, I ended up restricting that night. Oh, wow. When you talk to your mom, stuff is coming up.
01:03:30
Speaker
How can we create a boundary now? So I love lapses. I love when you come in and have them because it gives me, these are something to do today. Yeah. Yeah. And, and something to like to work on because of, you know, like once they leave, you know, your care or they're not in your presence and this experience happens for them, they are not going to like, they may not know how to deal with it, but if they're working with you with the lapses,
01:03:52
Speaker
happen, then, you know, then like we can address what actually led to it. So that way, when it happens, when you're not in my presence, right, like you can actually be able to handle it and deal with it and know what's going on or whatever. So yeah, it's scary. Like sometimes people have lapses, they're like, Oh my God, I messed. And it's like, no, lapses are fun. They're cool. We can changing our relationship to it allows us to not be so scared. And by not being scared of it, it's just like, okay, it happened. And I'm moving on.
01:04:20
Speaker
right exactly exactly yeah and um i wanted to kind of pivot a little bit into like your story a little bit like what got you into this line of work of like this is what i'm going to like focus my own research on and my you know like what i'm gonna study um and do so i was an athlete always probably since like i'm into division one basketball and um i played it right and i think the I never really thought about body image, like that question of did I realize I had a body? So I think it was my sophomore or junior year I tore my ACL and it was during the time where you're like having all the scouts come and it was not the greatest thing that happened. And I went from like working out all the time, never really thought about what I was eating.
01:05:10
Speaker
And then when I had the injury, I remember, um I don't know, maybe it was like, I was getting ready to have my cast off and start like the kind of the rehab process. And I went in somewhere and it was like coaches, right? And one of them said something to the effect of like, have you been working out in the cafeteria or something like that? Because I had gained weight. Oh my gosh. Yeah. Yeah. Right. cause I could barely freaking walk for a while. And um I was like, Oh my God, I didn't even realize it. And so
01:05:44
Speaker
I had to get back into shape. I'd get back in shape, I had to rehab, um which was a really tough process. And I do remember just being like, man, I felt like I was starting from the ground up and I and i ended up getting a scholarship and things worked out, but I had to work really hard and I had to start thinking about my nutrition. I started to notice that I was, I could be a little bit restrictive and right and I ended up getting back in shape and things were good. And then I went off to grad school and I think that experience around food and having to like get back into shape right probably wasn't the healthiest thing that I did but you know I don't know that I'm just trying to get my scholarship and be back and yeah and then when I went to grad school I did research on um because it wasn't really talked about during that time that must have been around 22 to the
01:06:41
Speaker
September 11th happened and I tore my ACL like around that time or had surgery around that time. So that was 2011. I didn't really know that like black women could even have eating disorders. There was no one around me who was like talking about it. So then when I went to grad school, I became just like interested in it during grad school in psychology. So I did a research being on, I had black and white participants.
01:07:06
Speaker
And I had photoshopped images and then like normal images and I tested their body image, but body image and body dissatisfaction before and then after looking at the images to see if there was difference. And I think that was me starting to like kind of understand like, oh, there are some differences, but it can just manifest very differently. um right I also think I always struggled with like perfectionism. That's another thing that can lead to that um high achieving, right?
01:07:35
Speaker
And I think those factors in it too, and I started to notice it then, you know, continued on through grad school. And I think I became just so hyper focused on trying to get through grad school and testing. And then, um, when I got to my pre-doc internship at University of San Francisco, there were so many college students that were coming in with eating disorders. And I kept thinking, I saw like Bracken Brown students and I was like, wow, I want to do the same thing.
01:08:03
Speaker
during the same time. And just remembering, like, I didn't have anybody to kind of guide me or teach me. So that kind of made me feel like, wow, there's no black therapist in the eating disorder field. There are, but just where I was at, I did not see that. I think it was just like my personal story, um seeing that there was such a need in this one college place I was at, which you can only imagine everywhere. And then I had got the,
01:08:32
Speaker
the specialization in it. And I learned so much, but I did feel like a lot of the people that I was learning from were white. And sometimes I didn't necessarily always agree with their approach because I didn't feel like it really resonated with black and brown people. So I started a group that was for black and brown patients who had eating disorders.
01:08:53
Speaker
And a lot of them often felt alienated when they sought help yeah because there's just a difference culturally. And I felt like some of my white supervisors just didn't get it. When I'm like, y'all aren't, you're kind of missing something. And I always felt like, wow, I can bring in a different approach or a different way of thinking about things that isn't so kind of, I would say like kind of whitewashing away.
01:09:22
Speaker
Yeah, yeah which which talks ah which which goes to like the importance of having culturally relevant care and having and having black and brown doctors and people who look like you who understand and can get the colloquialism and know and speak the language. and It's like part of like why I like want to have this this platform for black and brown you know clinicians and doctors and and therapists because they are out there and they're specializing in things like this and there's help and there's resources and um it's terrible.
01:09:58
Speaker
in to know that like there's such a disconnect like in the in the in in the space right like there's not a lot of like you said it's not a lot that exists but like where are they and how do you find them and and and like like like is this covered by insurance so people who are at who are in disadvantaged you know communities like or don't necessarily have access right like How are we getting them the help that they need also? You know what I mean? If they just, it's just so much, you know? I mean, if you just think about the barriers of care for black and brown or minority groups just to get therapy, just, just to get therapy, let alone to get like specialized care and like a eating disorder, and you might want a therapist that looks like you. It's not impossible, but it's pretty hard. It could be very hard. Yeah. Yeah.
01:10:50
Speaker
Yeah. do um So with that, is this, you know, obviously I know that you have to be licensed in the state, right? And then you have to see patients in that you know particular state. Like are you licensed across the United States? Like how how are you seeing patients is just in the hospital setting? Yeah. So I have a private practice and I'm also in Kaiser.
01:11:12
Speaker
And Kaiser, I pretty much only see eating disorder patients, but then in my private practice, I see everything. So I see eating disorders, but like lower level people who aren't, because think about it. It's just me in private practice. So I would not see someone who has like a but severe eating disorder. A lot of times I'm working with clients who probably have had some kind of treatment and they're in maintenance, or I work with clients who maybe have binge eating or emotional eating. I can definitely handle of that, but in, you know, the entire level of care.
01:11:38
Speaker
um I'm licensed in the state of California, but I am looking to get licensed in New York and Illinois. Those would be the two. Okay. Are going to be probably where I'll try to get reciprocal. Okay. Yeah. Is that like where your family and your background is? Not necessarily. it More like places that I would probably end up moving to eventually. It was always nice to go ahead and get licensed and where you might see yourself landing if I don't stay in California.
01:12:07
Speaker
in California. Are you like from California? Is that like home town? my texas hometown so okay. Cool. Okay. Awesome. I'm sorry. That's just like off topic. I'm like, yeah, ask it all.
01:12:20
Speaker
Um, so I wanted to, um, you know, just talk, ask you, um, if there's anything else that you wanted to share, like about, you know, eating disorders or the recovery journey or just anything at all that you would love to just like share. Cause obviously like, I'm not going to know all the questions of all and all the things, but I just, you know, is there anything that, you know, that came to you and as a part of our conversation, um, that you would want to share with our audience? I think the biggest thing is.
01:12:49
Speaker
that not to have like shame or guilt around whatever it is you're experiencing because so many people struggle with it and right the other thing about eating too is so personal like sometimes I get worried about like posting stuff on social media or something because people are so like well no that's wrong or this is right and this is wrong and this is right and how this approach And the one thing that I like to kind of think about to tell people is what one person does and finds fine and it doesn't cause them dysfunction, another person, it might not be that way. And there's room for everybody. And, you know, if you are feeling like you're struggling with these concerns, you know, reach out to someone who is a professional. and we Right. Right.
01:13:41
Speaker
you know it's hard to say don't have shame and guilt, but like so many people struggle with it and it doesn't define you. And we live in such a society where it would be nearly impossible for you to not have some type of disorder eating, even if it was like health issues or you know just what you're seeing online or you know it can start to seep into our brains and impact how we are treating ourselves. Yeah.
01:14:08
Speaker
Yeah. Yeah. And, um, you, you started to get on this when you, in your, in your response of like, where do people go for help? Like, you know, like what are their resources or organizations or websites or anything at all that that people who, you know, you know, are listening maybe are like, I think this might be me. And what should I do next? What's my next step? I think the one place that people can start well if they can't get into therapy immediately is going to your primary care physician or your MD and telling them and a lot of times they are they're the ones that are sending you referrals. So they have usually organizations MDs, they have a certain protocol. I don't care if you have who costs my shield, Kaiser, an MD is getting like, oh, you're struggling with an eating disorder.
01:14:53
Speaker
they have a responsibility too, to make sure that they direct you. So if you're someone you're like, I don't know where to go, I would say go to me your your psychiatrist or wherever you're already connected. I think it's easier for people to get in with a PCP a lot of times. um The other thing is they have ERC, eating disorder recovery,
01:15:13
Speaker
even if you just go online, right? There's places where you can go that are gonna give you some psychoeducation on it. A lot of times if you just like click on a residential program, that's probably not the best way to go, to be honest.
01:15:29
Speaker
I would think it would be a lot easier if you went to your PCP. um Eating Disorder Recovery Center has a lot of places. If you go on Psychology Today, probably the easiest way where you can type in your insurance that you use, if you're paying on a pocket, and then you can Psychology Today, you can type in eating disorders, and you will find a therapist who is specialized with eating disorders.
01:15:55
Speaker
Yeah. Okay. Yeah. Thank you for sharing that. And for those of you who are listening, I'm going to make sure I put all of these resources in, you know, in the show notes and in the description for, for anyone who may be interested. But if anybody's interested in working with you, um, how, how would they be able to reach out and to, to work with you? Yeah. So you can go to tiffanylogins.com really easy. I'm also on social media, TikTok, Instagram, Dr. Tiffany Nicole.
01:16:24
Speaker
um You could probably find me on Psychology Today too, as well. Those would probably be the easiest way. Social media, either my website, which is really easy, tiffanylonger.com. I'm thinking you just... It's perfect. yeah at one point And there is how to get in contact.
01:16:41
Speaker
Okay, great. I will make sure to include that as well. um Lastly, is this is just like a bonus part that I love for my guests to share with our audience, you know, is what is your favorite affirmation, scripture or intention that you can close us out with today? I would say my favorite one that I always go back to that I think resonates with want everyone in any situation is pain happens.
01:17:11
Speaker
but suffering is created. And what that means is that we are always going to experience pain in our life. It's a part of living, but oftentimes we try to avoid pain. We try to distract from it, numb it, ignore it. And by us trying to do that, we oftentimes inevitably create more suffering for ourselves in the future. um yeah And so usually if you are noticing something uncomfortable or painful and you're like, ah you probably inevitably are creating your own suffering. I think I like that quote because it allows people to understand that what they're going through is like normal and it is painful and it hurts, but it also gives us a bit of accountability and agency that maybe there is something that we can do about that to be able to confront and face that pain. So we're not creating more suffering for ourselves in the future. And I think that works with everything, not just eating disorder, it's like anything in life.
01:18:06
Speaker
Right, right. Oh, wow. I love that. I've never heard that one. And so I think yeah, I've never heard that one. And I think You're so right and so spot on. um Accountability, it's a choice. you can get you know You can get help. Help us out there. It's all about what you actually do, right? Like how and what you do about it. And so thank you for sharing that, Dr. Tiffany. Like I appreciated this conversation. I'm like, I have a list of questions for like after this. I'm like, let me find out, you know? I'm like, I want to talk. But I appreciate you for coming and sharing with our guests today. Thank you. Thanks for having me.
01:18:41
Speaker
Yes, it was a great conversation and to our listeners, I hope you heal well and we'll see you next week.
01:18:51
Speaker
Welcome to the Soul Well Podcast, where moms of color find strength and community in the mental health space. Each week, we ignite inspiration as we set our intentions with affirmations and dive deep into honest conversations with fellow moms and mental health experts. We're here to hold space for you, to shatter stigmas and elevate the voices of moms of color. We'll fight for policy change, empower you with mindful resources, and most important remind you that you're never alone on this journey. It takes a village to raise a mother. Now let's meet at the well.
01:19:28
Speaker
It's the teaser episode, and I am so, so, so excited. I am your host, Autumn Colon, and I'm glad you're here. Welcome, welcome, welcome. This has been a vision, a purpose, a dream on my heart for so many years, probably since 2011, I wanna say. I have been dreaming of just bringing this to the masses, and I'm so excited.
01:19:56
Speaker
Um, but are you ready to prioritize your wellbeing while embracing motherhood? That is what the Soul Well Podcast is all about. This is going to be your one-stop shop for mental health, self-care, being a part of an empowered community, or to just listen in on some mom chat. We are going to be getting all into it this season.
01:20:15
Speaker
And I'm so excited to bring you guys along on the journey. Get ready to ignite your inner strength each week as we open with affirmations. We're going to have mental health tips and mindful exercises to just help each and every one of us on our healing journeys. We'll delve into real stories from moms like you.
01:20:36
Speaker
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01:20:58
Speaker
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01:21:10
Speaker
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01:21:28
Speaker
And I am excited to talk to you. I'm excited to get into this season. There's so much that I want to share, so many conversations and connections that I just want to bring to you. We're going to do this together. This is just the beginning. Hit the notification bell wherever you are listening to us today and join us next week as we delve into more mental health conversations.
01:21:50
Speaker
The Sew Well community offers a safe ground for the transformative healing and restoration of intergenerational trauma, ensuring moms of color have a space to rewrite their stories, recover, live well, be seen and heard. Join us online and on Instagram at Sew Well for daily inspiration, blogs, events, and more. See you next time.