EDeology: The People Behind Today's Eating Disorder Treatment Landscape

“My Favorite Psychotherapist Went to Jail” with Kayla Perry

Moralistic judgment is the root of so much division in our field and in our society. The perception of ideologically opposing groups as uninformed, evil, or inherently harmful is the surest way to eliminate any possibility of dialogue. Moralistic judgment can be a way of naming oppressive systems that have been enabled or whitewashed; but when directed at individual people, it becomes a painful and dehumanizing form of exclusion. There's a particular brand of moral outrage that is reserved for fellow mental health practitioners. It's designed to protect the integrity of our profession and is expressed in statements such as “how can you_________, and still be a therapist”, or “this person should never have been treating eating disorders to begin with”. In clear cases of abuse and exploitation, this is true. However, when applied more broadly, we run the risk of flattening the humanity of the practitioner and the experience of those who benefited from their work  I recently came across an Instagram post by Kayla Perry, our guest today, where she spoke about a psychotherapist who had benefited her tremendously, who she later discovered served a jail sentence for unlicensed practice and insurance fraud. In this episode, we dive deeper into Kayla’s experience with this therapist before her sentencing and her perceptions of her afterward. I hope that you, the listener, will understand that this conversation is not condoning deception, but inviting you into the contradictions that live inside each of us, and exploring the question: are we defined by our worst behaviors? Kayla Perry is a Licensed Behavior Analyst with master’s degrees in Clinical Psychology and Applied Behavior Analysis. Known for her bluntness, curiosity, and love of debate, she takes a practical, direct approach that emphasizes common sense, critical thinking, and honest conversation over rigid clinical jargon. You can find Kayla on her Instagram and substack accounts linked in the show notes. Connect with Kayla Subtack: honestlyunorthodox.substack.com [http://honestlyunorthodox.substack.com/].  Instagram: @kaylas.common.sense  Connect with Elka Website: https://cubacubcounseling.com/ [https://cubacubcounseling.com/] Email: elka@cubacubcounseling.com

Helping our Children Develop a Healthy Relationship with Food with Katie Gilder, RD

Many of the hot topics in eating disorder recovery—health at every size, food neutrality, whether some foods are manufactured with addictive qualities—extend beyond eating disorders and to the messages we hold and teach our children about food and bodies. In this episode I am joined by Katie Gilder and we talk about how we address these issues with young kids. We discuss whether there's “healthy” vs. “unhealthy” foods in our homes, if we communicate distinctions between food types (such as meal time vs dessert) to our kids, how we respond to the children's comments about different body types. Katie is a registered dietitian with 15 years experience supporting clients across the lifespan. She specializes in treating adolescents and young adults with eating disorders, and has extensive training FBT(TAY). Katie works through a Health at Every Size lens and helps clients access intuitive eating. Katie is also a Board Certified Specialist in Sports Dietetics, and has a special interest in working with athletes. Connect with Katie: https://www.cultivatecounselingmn.com/katiegilder Connect with Elka:https://cubacubcounseling.com/

Can we treat trauma while an eating disorder is active?

Is an eating disorder the result of past trauma? When we see someone stuck in self-destructive and potentially life-threatening behaviors, it’s natural to ask what terrible event created this? Clinicians often debate the importance of addressing past trauma in eating disorder treatment, versus targeting present symptoms. Psychodynamic and embodied approaches typically emphasize past history and complex roots of a disorder, whereas behavioral approaches, such as family based treatment and cognitive behavior therapy, generally focus on reducing eating disorder behaviors and the associated distorted perceptions. In defense of both positions, people like to cite research studies identifying the percentage of individuals with eating disorders who have a trauma history versus those who don't.  As a clinician, while percentages and probabilities can help me understand general trends, they cannot tell me what is true for the individual or family that is right in front of me. In this episode EMDR certified psychotherapist, Angela Harris, discusses how she assesses whether someone is using eating disorder behaviors to mask or cope with trauma, how recovery might differ between someone whose disorder is trauma-driven versus someone whose symptoms are driven by other factors, and what happens when a client with a trauma history is treated using a primarily behavioral approach. We also discuss the timing of trauma treatment relative to eating disorder recovery. Many clinicians delay addressing trauma until a client achieves symptom reduction, because trauma work can surface painful memories and be temporarily destabilizing. This creates a kind of double bind: the person is expected to reduce symptoms before trauma can be addressed, yet cannot reduce symptoms without addressing the trauma driving them. In some cases, this leads to cycling from treatment center to treatment center, repeatedly relapsing. In our conversation, Angela explains how she balances safety while treating trauma and eating disorders simultaneously. Angela is a Licensed Clinical Social Worker, Certified Eating Disorder Specialist Consultant, and an EMDR Consultant in Training. Angela specializes in treatment of eating disorders, trauma, and dissociative disorders. Angela owns a private practice, Angela Harris Counseling, in Dallas, TX and is dually licensed in Oklahoma.

“I Learned from Some Very Smart Women You Don’t Do a Lot for Free”: On Money and Mental Health Care with Robyn Kievit NP, RD

Periodically, I hear someone describe a past therapist, a particular therapy modality, or a treatment center as “just in it for the money.” On the flip side, I’ve had many conversations with therapists and other mental health providers about how hard it is to hold fees, guilt for raising fees, strain strain related to enforcing cancellation policies, weak boundaries, and frustration with insurance policies that can make financial survival in this field difficult. Money is an unavoidable part of mental health care. My work brings me into regular contact with the depths of human suffering and the profound complexity of each person’s internal world. At times, I'm trusted with stories that haven't been told to another living soul. It is humbling. It's a gift.  The fact that mental healthcare is both a deeply human relationship and a paid service is an uncomfortable reality. Which makes it a topic worthy of conversation. In this episode, Robyn Keivit shares her story as a female entrepreneur, business owner, registered dietitian, and nurse practitioner. We explore the tension between providing affordable care and supporting ourselves and our families, the relationship between money and self worth, and the personal narratives that shape how we engage with the business side of mental health care. Robyn Kievit is a nurse practitioner and registered dietitian with more than 25 years of clinical experience. She specializes in supporting women through perimenopause and menopause using hormone therapy, medical science, and psychopharmacology, with particular expertise in eating disorders, disordered eating, and body image concerns. Robyn is a sought-out speaker at professional conferences and events and has been featured in numerous national media outlets.  More on Robyn: https://robynkievit.com/ Robyn’s course, Integrating Hormone Therapy and Psychopharmacology in Eating Disorder Treatment During Perimenopause and Menopause: https://robynkievit.com/resources/course-for-dietitians-beyond-nutrition/ [https://robynkievit.com/resources/course-for-dietitians-beyond-nutrition/]  Roby's podcast, NPRD: https://open.spotify.com/show/05VKEcGOKE8ZefoaLIe4ol?si=jbhI9chKRhOlAPJdsMMe9g [https://open.spotify.com/show/05VKEcGOKE8ZefoaLIe4ol?si=jbhI9chKRhOlAPJdsMMe9g]  More on Elka: https://cubacubcounseling.com/

This is your trigger warning!

In this episode, I discuss why this podcast has no content rules and how I address information that might be triggering to the listener. I also do a deep dive into the question, can words cause harm? More on Elka: https://cubacubcounseling.com/ [https://cubacubcounseling.com/]  Elka’s book, Binge Eating Demystified https://www.amazon.com/dp/B0FD493WZ3 [https://www.amazon.com/dp/B0FD493WZ3]