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Speaker 1: Hi guys, and welcome to a new episode of Couch

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Speaker 1: Talks on You Need Therapy Podcast. My name is Kat.

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Speaker 1: I am the host, and if you don't know what

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Speaker 1: couch Talks is, it is the special bonus episode of

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Speaker 1: You Need Therapy where I Kat answer questions that you

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Speaker 1: guys sent to me to Katherine at You Need Therapy

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Speaker 1: podcast dot com. Now quick reminder before we get into

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Speaker 1: the episode that although I'm a therapist, it's called You

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Speaker 1: Need Therapy. I'm answering your questions. This podcast does not

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Speaker 1: serve as a replacement or substitute for any actual mental

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Speaker 1: health services. However, we always hope that it can help

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Speaker 1: you wherever you are. And speaking of helping you wherever

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Speaker 1: you are, I was happily surprised by the response I

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Speaker 1: got from Monday's episode. I say happily in a kind

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Speaker 1: of both and kind of way. I'm grateful that content

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Speaker 1: spoke to some of you and it was really helpful,

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Speaker 1: and also, of course that means that people are struggling,

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Speaker 1: and so that at the same time doesn't feel really

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Speaker 1: great that people resonate with what I was talking about.

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Speaker 1: At the same time, it does feel great because it

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Speaker 1: offers you guys hope and understanding and allows you, guys

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Speaker 1: to ask for the help you need or even just

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Speaker 1: start having conversations with yourself, your friends, your mental health professionals,

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Speaker 1: all of the above. So that was really cool. If

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Speaker 1: you don't I'm talking about I put out an episode

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Speaker 1: on Monday about eating disorders, and it is always so

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Speaker 1: interesting the episodes that I get the most feedback on

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Speaker 1: because I kind of put that episode out out being like,

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Speaker 1: I feel like I've talked about this before, or this

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Speaker 1: isn't going to resonate with everybody, and I have to

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Speaker 1: wrestle with that, like, well, that's not the point. Not

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Speaker 1: everybody is going to get something out of every single

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Speaker 1: or directly get something out of every single episode, because

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Speaker 1: hopefully we aren't all struggling with everything, you know. But

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Speaker 1: oft when I do that and I put an episode

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Speaker 1: out that I'm like, oh, I don't know, those are

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Speaker 1: the ones that you guys resonate with the most. And

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Speaker 1: actually those are the episodes that usually are the easiest

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Speaker 1: for me to create. So that was helpful for me

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Speaker 1: and encouraging for me, and I enjoyed that part of

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Speaker 1: hearing your responses. So if you haven't listened to that episode.

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Speaker 1: Go listen to it. It's just me talking about one

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Speaker 1: of the things I'm most passionate about in the mental

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Speaker 1: health world, and that is eating disorders. Thank you so

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Speaker 1: much for everybody who sent an email, and my heart

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Speaker 1: goes out to anybody who again resonated with some of

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Speaker 1: that stuff. So full disclosure. Last week I recorded an

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Speaker 1: episode for Couch Talks. I don't know what was going on,

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Speaker 1: but the recording was super bad and that it was

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Speaker 1: cutting out a lot so we couldn't use it, and

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Speaker 1: I had to do some work on what was going

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Speaker 1: on to fix that so that wouldn't continue to happen.

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Speaker 1: And then I said, I told you guys that I

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Speaker 1: would put that episode out this week that I had

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Speaker 1: recorded last week, and that was a bunch of It

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Speaker 1: was a couple of rapid fire questions that you guys

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Speaker 1: I said sent in. I'll still answer those questions, but

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Speaker 1: I wanted to push that back a week because the

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Speaker 1: question that I'm going to answer today is about the

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Speaker 1: episode from Monday, and I thought it was timely and

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Speaker 1: I wanted to address this as it came up because

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Speaker 1: it was important and while it's on the top of

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Speaker 1: our minds. I think it can be helpful to stay

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Speaker 1: in that lane. So I'm going to read today's question.

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Speaker 1: Just a reminder for everybody. I always keep these anonymous.

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Speaker 1: I read what you guys send me. If you tell

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Speaker 1: me something in that email you don't want me to read,

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Speaker 1: I won't read that. But I don't share your names.

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Speaker 1: I don't share where you're from. So you can feel

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Speaker 1: safe sending in your questions because a lot of times

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Speaker 1: the questions that you're asking other people are also thinking,

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Speaker 1: and so you feeling safe enough to send in a

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Speaker 1: question is helping somebody else, and I want that to

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Speaker 1: continue to happen. So I'm going to read the question

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Speaker 1: and then we're just gonna chat about it. Here it is, Hey, kat,

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Speaker 1: I love listening to your podcast. I was listening to

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Speaker 1: the previous eating disorder episode and where you mentioned warning

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Speaker 1: signs struck me. I am currently in my thirties, and

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Speaker 1: ever since I was twelve or thirteen years old, thanks

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Speaker 1: to who I Am, but also physical education in my

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Speaker 1: Southeast public school, I have struggled with body dysmorphia. I

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Speaker 1: used to measure different parts of my body for changes

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Speaker 1: no one in my family knew, and it wasn't until

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Speaker 1: later in life when I admitted it, that I realized

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Speaker 1: it was not normal only based on their reactions. I

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Speaker 1: have disordered eating, with chewing and spitting when I'm stressed,

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Speaker 1: feelings of guilt when eating certain foods that I or

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Speaker 1: society deems as bad. I use exercise too in quotes

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Speaker 1: make up for overeating, and I have skipped meals when

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Speaker 1: I feel like I over eight or was feeling large.

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Speaker 1: I was able to check off many of the items

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Speaker 1: you listed off. It even brought up my chew spitting

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Speaker 1: to my therapist once and she said she didn't think

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Speaker 1: it was a big deal. I suspect she has an

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Speaker 1: eating disorder too, or simply doesn't counsel in this space.

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Speaker 1: Before listening to your episode, I thought that the habits

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Speaker 1: I do are normal and are just a way of life.

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Speaker 1: I am a high achieving perfectionist with anxiety, and the

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Speaker 1: anxiety has been the main mental health issue I deal

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Speaker 1: with in therapy. But when I listen to your episode,

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Speaker 1: even after hearing how I related, I still thought, but

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Speaker 1: I don't have an eating disorder. I manage my disordered

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Speaker 1: eating well so it won't get bad. Clearly, I have

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Speaker 1: control issues my friends who have struggled with eating disorders

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Speaker 1: and sought treatment had eating disorders, and I haven't been

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Speaker 1: that bad, so mine can't beat that. Basically, my question

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Speaker 1: is this, do I need to seek a therapist who

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Speaker 1: will engage in these conversations. From the bottom of my heart,

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Speaker 1: thank you for the work you do and for providing

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Speaker 1: thoughtful content this email I'm so grateful for. And again

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Speaker 1: it's that like double edged sword where it's like, Oh,

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Speaker 1: I hate that you're struggling with this, and I'm also

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Speaker 1: so grateful that you felt safe enough to reach out

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Speaker 1: to me and ask this question, especially because the answer

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Speaker 1: to this question also might be twofold, right, Like I

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Speaker 1: want it to be no, because I don't want to

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Speaker 1: have to deal with this and I want to be

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Speaker 1: able to keep these behaviors. And also like I want

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Speaker 1: it to be yes, because maybe you want relief from

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Speaker 1: this thing that you have convinced yourself as normal but

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Speaker 1: also makes you feel like you're in a jail cell.

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Speaker 1: And I get that feeling, And so thank you for

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Speaker 1: sending this email, thank you for sharing some of the

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Speaker 1: things that you are struggling with. And I also want

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Speaker 1: to start off with saying I'm sorry that you brought

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Speaker 1: some of this stuff up, and it feels like it

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Speaker 1: was just brushed off or ignored, because chewing and spitting,

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Speaker 1: even if you do not have an eating disorder, should

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Speaker 1: be a concern if you are bringing that up to

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Speaker 1: a therapist. And I don't know the ins and outs

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Speaker 1: of what that conversation looked like, but I just am

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Speaker 1: apologized on the behalf of the mental health field that

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Speaker 1: it sounds like in some ways it has failed you.

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Speaker 1: It takes a lot to share certain things in therapy

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Speaker 1: and to admit certain things in therapy when like part

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Speaker 1: of you, like I said, might not want to, but

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Speaker 1: then there's that other part that's like, oh, well, maybe

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Speaker 1: I just have to get this out and then I'll

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Speaker 1: be forced to deal with it. And I don't want

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Speaker 1: to deal with it, but at the same time, I

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Speaker 1: don't want it anymore. And so when you work up

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Speaker 1: the courage to share something like that and it's again

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Speaker 1: like brushed aside or minimized, that can be really harmful

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Speaker 1: in the sense that, oh, like this doesn't feel normal.

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Speaker 1: But okay, I guess you're saying, this is just the

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Speaker 1: jail cell I'm going to live in the same time,

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Speaker 1: it's like, Okay, that is concerning, and we should be

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Speaker 1: helping you when you're sharing things that you're doing that

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Speaker 1: are very dysfunctional, and that behavior is pretty dysfunctional. And

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Speaker 1: I don't say that to make you feel like you're dysfunctional,

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Speaker 1: but that behavior that you grabbed onto in order to

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Speaker 1: feel okay, move through things. Like I said in the episode,

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Speaker 1: like these behaviors we gravitate towards because we're wanting something

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Speaker 1: very normal. We want a very normal, very can't blame

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Speaker 1: you human thing that we all should be allowed to have,

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Speaker 1: peace of mind, relief, safety connection, Like that's why we

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Speaker 1: reach for these things, but they end up causing more

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Speaker 1: dysfunction and dysregulation in our life long term, then they

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Speaker 1: really actually help us meet those needs. So, in a nutshell,

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Speaker 1: if you wanted me to answer this very simply, yeah,

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Speaker 1: I think that it would be so helpful for you

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Speaker 1: to seek out a mental health professional who has the

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Speaker 1: ability to have conversations around disordered eating. Also anxiety and

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Speaker 1: disordered eating those go hand in hand, which I'll get

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Speaker 1: to in a second. But it doesn't mean you have

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Speaker 1: to switch therapists completely. I mean, I've had people refer

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Speaker 1: clients to me, and I see them for the disordered

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Speaker 1: eating parts, and they still see this therapist for other parts,

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Speaker 1: and we kind of like work together and I can

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Speaker 1: help educate that therapist as I'm helping the client too.

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Speaker 1: So if you have a good, really ship with a therapist,

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Speaker 1: you don't have to like totally throw her out. But

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Speaker 1: I also think that she might have shortcomings that are

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Speaker 1: now hurting you and the treatment that you're getting. And

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Speaker 1: you deserve to be able to get the treatment that

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Speaker 1: you deserve and that you need. So I would say, like, yeah,

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Speaker 1: depending on what your goals are, you really might want

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Speaker 1: to seek out some extra help, and you can even

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Speaker 1: have that conversation with your therapist. I think it could

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Speaker 1: be really helpful to even bring up like I brought

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Speaker 1: this up to you, and I got the sense that

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Speaker 1: it wasn't a big deal to you, but I'm learning

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Speaker 1: that it is a big deal. And there's also these

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Speaker 1: other things that I didn't share with you that I

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Speaker 1: do as well. I really need to work with somebody

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Speaker 1: who can understand these and can help me move through them,

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Speaker 1: because there's a part of me that doesn't want these anymore.

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Speaker 1: And I say also, depending on what your goals are

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Speaker 1: because you say, like, the anxiety has been a big

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Speaker 1: part of your therapy and it's been a big focus,

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Speaker 1: and eating disort of behaviors again are sometimes our way

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Speaker 1: to control anxiety, and then at the same time they

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Speaker 1: end up perpetuating it. So while you're working on these

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Speaker 1: other things out here, it's like that eating disorder is

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Speaker 1: kind of like putting the kabash. Which side note, my

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Speaker 1: husband says that kabash is pronounced kai bosh, and I

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Speaker 1: think that might be actually correct, but it still feels

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Speaker 1: weird to say kaibosh because it feels socially kobosh is

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Speaker 1: the right way to say that word. So do you

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Speaker 1: have any thoughts and feelings on that debate. I'd love

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Speaker 1: to hear them, but I couldn't not say that as

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Speaker 1: I was saying kobash, because now I'm thinking about, like, well,

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Speaker 1: who thinks it's kibosh and who thinks it's kibosh? Anyway,

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Speaker 1: moving on, I was saying, sometimes the work that you're

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Speaker 1: doing can be kind of like stunted by then those behaviors.

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Speaker 1: Then you're continuing to use like you're using them to

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Speaker 1: control the anxiety, but at the same time they are

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Speaker 1: perpetuating this anxiety. And so if it feels like you're

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Speaker 1: running around on a hamster wheel and you're not getting

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Speaker 1: the progress that you want, that really could be why.

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Speaker 1: And it's really hard to work through something when we're

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Speaker 1: still holding tight onto the thing that keeps us connected

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Speaker 1: to that thing. It's like, I want out of this

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Speaker 1: toxic relationship, but I still want to be best friends

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Speaker 1: with them, right, Like I don't want to date this person,

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Speaker 1: but I am still going to live with them, which

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Speaker 1: it makes me think about like fand of pump rules,

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Speaker 1: like we can't hold on to something and also let

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Speaker 1: go of it at the same time, and that kind

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Speaker 1: of might be what it feels like you're doing with

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Speaker 1: your anxiety because of what these behaviors do. And also

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Speaker 1: just there's so much in this that I could go

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Speaker 1: on forever and ever. And if you are experiencing body dysmorphia,

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Speaker 1: that is rooted in a lot of anxiety disordered behavior

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Speaker 1: as well. So all of these are tied together, and

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Speaker 1: I wish we could pick and choose the ones that

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Speaker 1: we want to work on, and then those get to

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Speaker 1: be helped, and then these we don't have to worry about,

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Speaker 1: but they have a weird web of connecting to each

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Speaker 1: other at the same time, and so I think if

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Speaker 1: you want to work on one, you're going to have

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Speaker 1: to work on all of them if you really really

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Speaker 1: want true relief. And besides all of that, some of

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Speaker 1: the thoughts and the feelings and the beliefs that you

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Speaker 1: might have yourself based on some of the beliefs you

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Speaker 1: have around your body image and bodies in general. I

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Speaker 1: hope that it can be addressed as well, because it's

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Speaker 1: hard to really learn to love myself and love my

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Speaker 1: body when I'm doing these harmful things, and I still

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Speaker 1: believe these negative beliefs about what bodies should be and

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Speaker 1: how I deserve to treat my body. So I definitely

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Speaker 1: think it would be helpful for you to reach out

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Speaker 1: to somebody at least do some more digging on your own.

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Speaker 1: Doesn't mean you have to give up your therapists, like

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Speaker 1: I said, but this is not normal behavior and you

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Speaker 1: don't have to live this way. And I hope that

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Speaker 1: sounds free to you, as much as it might sound scary.

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Speaker 1: I don't think you have to be an eating disorder therapist.

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Speaker 1: I don't think I have to be specialized in that area.

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Speaker 1: To read the email that you've read and admit and

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Speaker 1: know and hear that there are some things that you're

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Speaker 1: doing that are not probably helpful for you and you

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Speaker 1: deserve freedom from I feel a lot of sadness too,

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Speaker 1: because if the reaction you got by your therapist, a

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Speaker 1: couple things could happen from that, and depending on the

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Speaker 1: person you are, like you could have taken that a

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Speaker 1: couple of ways. A therapist ignoring something like that could

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Speaker 1: encourage me to continue it because it's like, oh, it's

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Speaker 1: not my eating disorder isn't bad enough. We'll watch this

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Speaker 1: and then kind of up the ante, right because you

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Speaker 1: want to be good at your eating disorder, or you

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Speaker 1: become even more discreet, Like there's a couple of ways

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Speaker 1: that could go. Or it could just also send you

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Speaker 1: that message which I think it kind of sent you

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Speaker 1: for a second that like these aren't that big of

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Speaker 1: a deal, Like other people do this when other people

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Speaker 1: might do it, but other people do not do that

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Speaker 1: in healthy functionality of treating and caring for their bodies.

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Speaker 1: Other people might do it out of their own dysfunction

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Speaker 1: or their their own stuff that they also need to

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Speaker 1: and want to work on. And then like what you said.

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Speaker 1: It sends this message that like, well, I don't have

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Speaker 1: an eating disorder. And that's the really tough part because

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Speaker 1: I didn't go into this in that episode. I didn't

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Speaker 1: go into all the different eating disorder diagnoses. But the

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Speaker 1: way that the DSM works now, and I'm grateful for this,

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Speaker 1: is that it used to be so directive and like

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Speaker 1: you had to meet all these very very specific criteria

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Speaker 1: that left a lot of people out of being categorized

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Speaker 1: in these disorders. And so they could say things like oh,

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Speaker 1: it's not that bad, or even health professionals or insurance

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Speaker 1: companies or something would be like, oh it's not that bad,

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Speaker 1: so they don't need help, and it's like, Eh, just

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Speaker 1: because this hasn't happened, it doesn't mean you don't need help. Also,

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Speaker 1: remember these disorders are progressive, so just because it hasn't

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Speaker 1: happened yet, it doesn't mean you're not going to get there.

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Speaker 1: And we shouldn't have to wait that long. We shouldn't

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Speaker 1: have to wait until you're in a hospital on a

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Speaker 1: feeding tube, or that you can't stomach certain foods, or

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Speaker 1: that you've lost all your friends or you've I mean,

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Speaker 1: we shouldn't have to wait to a rock bottom like that.

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Speaker 1: For you to deserve to get help, you should be

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Speaker 1: able to get help the second it starts to feel

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Speaker 1: not helpful for you to do these behaviors. I didn't

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Speaker 1: go through all the diagnoses, but now there's the way

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Speaker 1: that we diagnose, is there actually are diagnoses that are

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Speaker 1: specifically for eating disorders that do not fit these very

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Speaker 1: specific categories, because that so often isn't the case, and

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Speaker 1: these disorders also morph into each other. You might start

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Speaker 1: with these behaviors, then you move to these behaviors, and

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Speaker 1: you move to these behaviors, and so you've had a

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Speaker 1: little bit of everything, and you're like, but it's not

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Speaker 1: it's not a lot of this. It's a little bit

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Speaker 1: of everything. And so it confuses the client, It confuses

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Speaker 1: it can confuse the health professional. And now we get

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Speaker 1: to look at is this impacting somebody's quality of life?

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Speaker 1: Is this impacting their view of themselves, their view of

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Speaker 1: the world. Is this impacting their ability to live a

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Speaker 1: fulfilling life. Then like, it doesn't matter what you call it,

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Speaker 1: it matters, right, And so that last part when you're saying, like,

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Speaker 1: I have friends who have had eating disorders and they've

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Speaker 1: gone to treatment and like mine, isn't that That's a

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Speaker 1: conversation that happens all the time. And rather than compare

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Speaker 1: it to something else in order to meet a criteria,

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Speaker 1: if you ask yourself, is this how I want to live?

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Speaker 1: If you ask yourself, does this impact the quality of

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Speaker 1: my life? Is this keeping me from things that I

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Speaker 1: truly want in life? And whether that's relationships, whether that's

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Speaker 1: a relationship with yourself, whether that's jobs, or like social

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Speaker 1: experiences or joy. If this is keeping you from experiencing joy,

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Speaker 1: then it doesn't matter what we call it. It doesn't

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Speaker 1: matter if you have done things that your friends haven't done,

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Speaker 1: It doesn't matter. None of that matters. It matters that

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Speaker 1: it's impacting you. And I really want people to hear

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Speaker 1: that is. We could go through the diagnostic criteria all

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Speaker 1: day long. We could talk about war, stories of our

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Speaker 1: eating disorders, and none of that matters when it comes

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Speaker 1: to like you deserving or if you should get help

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Speaker 1: or ask for help or reach out. I think what

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Speaker 1: matters the most in that is if it feels like

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Speaker 1: to you, especially because I say this because especially it

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Speaker 1: takes some time to come out of that, to realize

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Speaker 1: that it's not helping anymore, and it sounds like you're

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Speaker 1: already there. And so if this is impacting you, then

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Speaker 1: like it matters, and we don't have to categorize it

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Speaker 1: as like a level five or a level four, like

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Speaker 1: that's not a thing. We don't have to do that,

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Speaker 1: We don't have to qualify it. The qualifier is if

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Speaker 1: it's impacting the life that you want to live, if

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Speaker 1: you were really honest with ourselves, that happens long before

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Speaker 1: we are in the place where we would meet a diagnosis.

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Speaker 1: That's often why people in the professional space put so

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Speaker 1: much emphasis on disordered eating, Like, yeah, your life is functional,

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Speaker 1: but this is the route to get to where it's

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Speaker 1: not functional. And so if it's already keeping you from

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Speaker 1: certain things and you're in a disordered eating phase, we

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Speaker 1: don't need to meet all these criteria. What we need

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Speaker 1: to do is notice that this is no longer becoming

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Speaker 1: helpful or no longer acting as a helpful strategy for

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Speaker 1: you anymore. And so I just want to offer you

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Speaker 1: that I could go on and on about the nuances

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Speaker 1: of that feeling of it's not bad enough. In comparison,

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Speaker 1: that can be a whole episode on its own. I

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Speaker 1: have a lot of empathy and compassion for that feeling.

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Speaker 1: I get it. But if it is if it matters

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Speaker 1: to it matters. So if you want to reach out

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Speaker 1: to somebody, I say do it, and your therapist, if

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Speaker 1: she's not the person that can help you do that,

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Speaker 1: she should be able to actually help you find that

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Speaker 1: person too. So thank you for this question, thank you

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Speaker 1: for listening. Also, thank you for your feedback. Thank you

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Speaker 1: Rols for your feedback as well. Like I said, it

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Speaker 1: felt good for me to hear that it was helpful

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Speaker 1: for you guys. So that's going to do it today.

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Speaker 1: If you guys have any feedback, questions, anything, you can

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Speaker 1: send to Katherine at You Need Therapy podcast dot com.

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Speaker 1: You can follow us at You Need Therapy Podcast, follow

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Speaker 1: me at cat dot Defada, follow my practice at Three

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Speaker 1: Courts Therapy, and until Monday, I hope you guys are

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Speaker 1: having the day that you need to have. PA