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35. How Much is Too Much? Understanding & Treating Over-Exercise in Eating Disorder Recovery · All Bodies. All Foods.

0:01
Hey,
0:01
I'm Sam.
0:02
Hi,
0:02
I'm Ashley.
0:04
And you're listening to All Bodies All Foods presented by the Renfrew Center for Eating Disorders.
0:09
We want to create a space for all bodies to come together authentically and purposefully to discuss various areas that impact us on a cultural and relational level.
0:19
We believe that all bodies and all foods are welcome.
0:23
We would love for you to join us on this journey.
0:26
Let's learn together.
0:29
Hello and welcome back to another episode of All Bodies.
0:32
All Foods.
0:33
I'm your host,
0:34
Sam and I'm here with Ashley and this episode is all about exercise and your relationship with it.
0:41
Many people in this culture struggle to have a positive relationship with exercise and this is especially true for those with eating disorders.
0:48
Exercise can actually be an eating disorder symptom.
0:52
For example,
0:52
it can be a form of purging when used to compensate or undo a binge eating episode.
0:58
And it can be used compulsively to escape uncomfortable,
1:01
physical or emotional experiences.
1:03
People with eating disorders can sometimes experience intrusive thoughts and intense relentless urges to exercise.
1:10
Even when it's clear that the exercise is causing significant physical and psychological harm.
1:16
Our guest.
1:17
Kristen Kristen Respon is someone who works at the residential center and has played a big role in helping patients with eating disorders,
1:25
explore their relationship with exercise and ultimately develop a healthier and more peaceful relationship with it as patients approach their discharge date,
1:34
she provides one on one consultations to help them maintain the progress they've made.
1:39
Kristen is an mot and the clinical program manager at the Renfrew Center of Philadelphia.
1:45
She's received her pa her bachelor's degree in health,
1:47
science and exercise,
1:48
science and wellness management from the University of the Sciences in Philadelphia and her master's degree in occupational therapy from the University of the Sciences in Philadelphia.
1:58
Her background experience covers a wide range of settings and populations including providing physical activity education and working with individuals on life skills.
2:09
Welcome to the show,
2:10
Kristen.
2:11
Hi.
2:12
Thank you so much for having me today.
2:13
I'm so excited to be here.
2:15
We're thrilled to have you.
2:16
I was hoping you can tell us a little bit about yourself and your role at Renfrew.
2:22
And what led you to the mental health field and eating disorders?
2:27
Absolutely.
2:29
So I feel like my journey here at the Renfrew Center has been quite interesting over the years I actually started here as an intern.
2:38
It was my level two field work for occupational therapy.
2:42
And when I was sent here,
2:44
I had no idea what to expect.
2:47
I knew I would be facilitating groups.
2:50
And when I started to do that.
2:52
I just really enjoyed it and I found a passion for working with,
2:57
you know,
2:57
individuals through group therapy to see the progress that they make through their experience here in residential.
3:05
And it was something that when my field work ended and it was time to graduate,
3:09
I was excited but also wanted to come back to rent for and work.
3:13
Um So luckily as soon as I graduated,
3:16
I was able to,
3:17
to come back here as a group therapist.
3:19
And from there,
3:20
I was also the exercise coordinator.
3:23
And when that position was there and available,
3:26
it was pretty perfect because I was able to use my education from my bachelor's degree,
3:32
which which you said was exercise,
3:34
science and wellness management.
3:36
And that was something I kind of always was doing was working with people in their relationship with movement and then being able to come here and do life skill groups and work with people around their relationship with movement was the best of both worlds.
3:49
So I've been here ever since I've um recently grown into the clinical program manager here.
3:56
So now I'm overseeing the programming at Spring Lane.
3:59
And as you said,
4:01
it's a residential facility.
4:02
So we do have that 24 7 care and it's really structured here.
4:07
So just making sure that the program is running smoothly and supervising some of our group therapists.
4:14
That's amazing.
4:15
And by the way for our listeners,
4:16
we have a whole episode on the residential level of care in season three.
4:21
So if you want to learn more about our programming and all of that,
4:24
you can go check out that episode.
4:27
Well,
4:27
thanks Kristen.
4:28
It's so nice to see you and have you on the show today and I have a quick question,
4:33
kind of quick.
4:34
I don't know.
4:35
Um I'm thinking about so exercise in general and like we know movement can be so beneficial.
4:45
Um I did a Instagram live this morning and was even talking about joyful movement and,
4:51
and how to,
4:51
you know,
4:52
engage in,
4:53
in that and how the benefits,
4:54
how it can be beneficial,
4:56
like mentally,
4:57
socially,
4:58
physically,
4:59
all of that.
5:00
And then some of our clients find out that this might be a symptom of their eating disorder and I can only imagine how confusing that um realization might be for them.
5:17
Um,
5:18
you know,
5:19
being used as a compensatory tool.
5:21
And I'm just curious if you could speak to that experience for some of the clients that um you work with and how like I,
5:30
I'm just imagining that that feels shocking,
5:33
right?
5:34
Like,
5:35
oh,
5:35
like this is something that I've been over using,
5:39
right?
5:40
And maybe even something that is not helpful for me.
5:43
So anyway,
5:44
just curious if you could speak to that a little bit.
5:46
Yes,
5:47
absolutely.
5:48
And like you said,
5:49
it's,
5:49
it's so complicated there is this,
5:52
you know,
5:52
with movement,
5:53
it is something that's so popular in the world that we live in today and,
5:57
and just part of our culture of go,
5:59
go go.
6:00
Right.
6:01
And you know,
6:02
having residents here and being in this level of care and then not being able to do what they were doing prior.
6:11
I think the,
6:12
the initial phase is really hard to,
6:14
you know,
6:15
notice like,
6:15
wow,
6:16
maybe this relationship with exercise and movement was more harm than good.
6:22
Maybe there was that slippery slope and that fine line that I went into this with inappropriate intention and then it shifted and maybe I don't have control over this relationship as much as I thought I did.
6:35
And it's really hard because it becomes part of someone's identity,
6:39
especially for athletes,
6:41
you know,
6:41
in high school and college and,
6:43
and even after,
6:45
for recreational sports,
6:47
it is part of your identity and it's not to say that that identity needs to be given up completely.
6:52
It's just re evaluating,
6:54
you know,
6:54
how can this look like a relationship that's gonna be helpful in recovering?
7:00
Yeah.
7:01
And so what would be like some of the signs that somebody might be struggling with compulsive exercising versus,
7:10
versus not,
7:11
I guess?
7:12
Yeah,
7:13
absolutely a question.
7:14
I always like to ask someone,
7:16
especially when they're trying to figure out the difference of,
7:19
you know,
7:19
is this more eating disorder driven or is this something that I truly enjoy a question I always ask is if your body never changed,
7:27
would you still do it.
7:29
And I find that that question can really help to identify.
7:33
Is this joy?
7:35
Am I flexible with this routine?
7:37
Is this something that I'm willing to take time off of or is this something that I'm doing because I want Xy and Z or I want to change Xy and Z?
7:47
Um,
7:49
and when I think about,
7:50
you know,
7:50
someone who is struggling with compulsive exercise,
7:53
some of those,
7:54
you know,
7:54
warning signs or signs and symptoms that we typically will see is,
7:59
you know,
7:59
if they're withdrawing from their family and friends,
8:01
you know,
8:02
kind of using it more as an isolation tool,
8:05
um rather than,
8:07
you know,
8:07
going to those social events if they're doing it at inappropriate times or inappropriate settings.
8:14
So,
8:15
within their schedule,
8:16
if they're waking up extra early to make sure it's fitting in or they have to stay up late to squeeze it into their schedule or also with inappropriate settings and times,
8:28
I'm thinking like in the middle of a heat wave or it's snowing and raining outside and feeling like you still need to do it.
8:35
Um,
8:35
holidays,
8:36
you know,
8:36
not taking time off to spend time with family and being flexible with that,
8:42
you know,
8:42
and another sign is,
8:44
you know,
8:44
to justify eating or to compensate for something that someone ate.
8:49
Um Also,
8:51
you know,
8:51
if you were doing it despite an injury or a medical complication,
8:55
so if your prescribers are recommending that you're not doing it right now and you're not willing to follow that.
9:02
Mm mhm Thank you.
9:03
That's actually really helpful and kind of I feel like deciphering um like the joyful but also like the want,
9:13
like you were,
9:14
you were just mentioning like for some of us like it is part of our identity,
9:18
right?
9:18
Especially if somebody grew up playing sports or dancing or so like it's so teasing out,
9:25
I feel like the identity piece,
9:28
the compulsive piece,
9:30
the the want for joyful movement,
9:32
but also like um the cultural expectation piece to look a certain way,
9:39
you know,
9:39
like using the air quotes,
9:41
I just feel like that has got to be,
9:43
yeah,
9:44
so complicated um for our patients and individuals coming in to work with us.
9:52
Absolutely.
9:53
And a lot of it is,
9:54
you know,
9:55
weight focused or body composition focused,
9:57
right?
9:58
Certain sports and things like that and that makes it even harder because it,
10:02
it then brings the focus on,
10:04
on these parts of our bodies and,
10:06
and wanting to change them and things like that.
10:08
So it does,
10:09
it starts to kind of take the joy around it.
10:14
Yeah.
10:14
So Kristen on the flip side for our listeners,
10:18
ha what are some of the signs that you have a healthy relationship with exercise?
10:24
That's a good question.
10:25
So when I think about,
10:26
you know,
10:28
do I have an appropriate relationship with exercise?
10:31
Being flexible,
10:32
you know,
10:32
are you willing to say I'm tired today and I'm willing to take the day off or,
10:37
you know,
10:37
I'm,
10:38
I'm sick,
10:38
I'm not feeling well and that's ok.
10:41
That's what next week's for and giving my body the rest it needs,
10:45
um,
10:45
noticing if I have an injury,
10:47
you know,
10:47
be willing to take that time off,
10:50
um,
10:52
maybe wanting to do it with other people or trying new things and having fun with it.
10:57
I feel like if there is,
10:59
I should be doing this versus I want to be doing this,
11:02
that mindset um can be really helpful too to just notice the one and the desire versus that I should.
11:09
And I have to,
11:10
hm I love that perspective too because it does require you to check in with all the other needs that you have your need for sleep or your need for connection and being able to say to yourself this need is more important or maybe just as important as maybe movement right now and I need to,
11:30
you know,
11:31
lean into the needs that are,
11:33
that are present in this moment for me.
11:37
Absolutely.
11:38
Yeah.
11:39
Um OK.
11:40
Well,
11:40
that's really good information.
11:43
Um So thank you so much.
11:45
I know that you,
11:47
you really played a big role in running these groups at the residential level of care.
11:53
And the idea is that,
11:55
you know,
11:55
for many patients coming into res we believe that our program can help you develop a healthier relationship with exercise and a lot of that is through group therapy.
12:06
So my question is how can some of these groups help people not only explore their relationship with exercise,
12:14
but actually have a better relationship with it?
12:18
I was hoping maybe you can walk us through some of the groups that you run and why are they helpful?
12:24
Absolutely.
12:25
Yeah.
12:26
So,
12:27
you know,
12:27
one of my favorite groups that I facilitate would be the gentle stretch group.
12:32
And what we're doing in that group is we're really going from head down to toe.
12:37
We are,
12:38
you know,
12:38
stretching all parts of our body and while doing that and,
12:43
and I'm guiding them,
12:44
the residents through it.
12:45
I'm asking them,
12:47
how does that part of your body feel?
12:49
So,
12:49
really allowing them to connect with the body and to notice while they're stretching what that muscle is doing for them,
12:56
you know,
12:56
really looking at the body as this neutral standpoint of what's the function in it?
13:02
How is this helping me,
13:04
how is this allowing me to,
13:05
to walk and get to the places I need to be and do the things I need to do?
13:11
Yeah.
13:11
And it also,
13:12
you know,
13:13
as we're doing that,
13:14
I'm always kind of guiding them through the deep breaths to really slow down their breath,
13:21
you know,
13:21
slow down the body and,
13:22
and in turn slow down the mind.
13:24
So that's been one of my favorite groups to facilitate.
13:27
And then after kind of talking about everyone's experience with it and,
13:32
you know,
13:33
being able to take that time out of our day to appreciate what our body can do.
13:38
Um,
13:39
another group that we have would be the mindful walking group.
13:43
That was also one of my,
13:45
my favorites because it really allows you to connect with your body.
13:49
But it's,
13:50
you're outside,
13:51
you're able to connect with nature.
13:53
You're allowed to,
13:54
you know,
13:55
notice what's going on with your feet as you're kind of taking each step,
13:59
noticing,
13:59
um the crinkle of the leaves as you're stepping on them,
14:03
noticing any of the thoughts that are coming up,
14:07
um and just allowing your thoughts to be and not judging them.
14:11
And,
14:11
you know,
14:12
really after doing that and going at a slower pace,
14:15
we're really just looking at,
14:17
you know,
14:17
what urges have come up when you're doing this or,
14:21
you know,
14:21
what experiences was someone noticing in those moments?
14:28
Um We also have a mindful labyrinth which is outside.
14:31
It's beautiful here at residential and it's very similar to the mindful walk where they are outside and they're setting an intention before going through the mindful labyrinth,
14:42
going through,
14:42
slowly noticing each step that they're taking.
14:46
Um once they get to the middle,
14:47
evaluating that intention and then working through it back out through the labyrinth.
14:53
Um We have a gentle yoga which is very similar to a gentle stretch.
14:58
Again,
14:59
it's connecting with your body,
15:01
you know,
15:02
noticing your breath a lot of it is,
15:04
is focused on the mindfulness,
15:07
the nonjudgmental present focused awareness.
15:10
So really just noticing,
15:12
you know,
15:13
what urges are coming up,
15:15
how can I challenge that?
15:16
How can I,
15:17
you know,
15:17
just sometimes let those thoughts be and then at the end,
15:22
kind of feeling what it was like in your body to connect.
15:28
I'm wondering Kristen in these groups,
15:30
what do patients struggle with,
15:33
you know,
15:34
what are they sort of battling in the moment?
15:36
What are the challenges that,
15:38
that you notice?
15:40
Absolutely.
15:41
The,
15:41
when I think of the gentle stretching group in particular,
15:45
you know,
15:46
when we talk about it,
15:47
after a lot of people will share that,
15:49
you know,
15:50
I was stretching that certain muscle and I just wanted to keep going,
15:53
I wanted to start doing some repetitions or I wanted to do,
15:57
you know,
15:58
the best form that I could possibly do in it or even just comparing to what physical activity or exercise was like prior to treatment.
16:08
So noticing that they did take some time off,
16:11
you know,
16:11
and part of it even just connecting with the body is difficult because a lot of times people will engage in exercise and they're so disconnected that they're not necessarily feeling what's happening in the body and when they start to feel it,
16:24
they're like,
16:24
I don't know,
16:25
like that felt a little different or maybe I didn't enjoy that as much or I enjoy this a lot more than I would have thought.
16:32
Mm.
16:33
And that makes me curious about um some of the clients.
16:37
So Sam and I have talked about this before on the show.
16:39
Like we both,
16:40
you know,
16:40
worked um at various centers for the Renfrew Center and um at the location I worked at,
16:47
in Nashville,
16:48
we had a registered yoga teacher and so she would do yoga once a week with the clients there and I'm remembering that.
16:58
So actually kind of on the flip side of the question,
17:01
Sam just asked you,
17:03
we had some clients that this was maybe the first time in a,
17:08
in a long time,
17:09
if ever that they were actually connecting with their body in any type of movement.
17:15
And so a lot of,
17:17
you know,
17:18
anxiety,
17:19
fear maybe would be present.
17:21
And I was just curious if you could speak to that too.
17:24
Yeah,
17:24
like those that are,
17:26
this is like the first time that they're paying attention to their body on purpose,
17:33
you know?
17:34
Absolutely.
17:35
Yeah.
17:35
And that's,
17:36
you know,
17:36
really hard I think,
17:38
especially if that's something that,
17:40
you know,
17:40
with exercise has been avoided,
17:42
it makes it really difficult to connect with the body noticing,
17:47
you know,
17:49
maybe what was coming up for them.
17:51
If there is a trauma response or if there is a fear of judgment,
17:55
especially in a group setting,
17:57
it's very hard.
17:58
Um Sometimes,
18:00
you know,
18:00
comparisons come into play,
18:02
you know,
18:02
they may not necessarily know someone's relationship with exercise,
18:07
but just noticing that maybe this person was able to do this position,
18:11
you know,
18:11
and hold it longer than I was or just feeling like people are looking at them in their body and judging and,
18:18
and it makes it really,
18:20
really difficult,
18:21
um,
18:22
especially here in res in the groups that we have,
18:26
you know,
18:27
we're allowing them to do what they're comfortable with and,
18:30
and willing to stop and,
18:32
you know,
18:32
willing to,
18:34
you know,
18:35
check in and talk about it where maybe necessarily going to like a yoga class after res you may not have that opportunity.
18:41
So this is a nice place to really start with that.
18:45
That's great.
18:46
Yeah.
18:46
Yeah,
18:47
it seems like mindfulness is in almost every group.
18:51
Why do you think building that skill is important when it comes to your relationship with movement?
18:59
You know,
18:59
when you think about mindfulness,
19:01
the nonjudgmental present focused awareness,
19:03
right?
19:04
When you're connecting with your body,
19:06
it is very difficult to be neutral and to be compassionate,
19:10
especially for someone with an eating disorder.
19:13
There are so many different thoughts coming up,
19:17
you know,
19:17
with body dysmorphia,
19:18
what they may be seeing may not actually be there.
19:21
It may be difficult um to even just have some of these ruminating thoughts and not being able to,
19:28
to share that.
19:29
And part of it is really just challenging the cognitive flexibility in it that I can have this thought.
19:37
And it's not this only thought Right.
19:39
And where's the room to work on that relationship and start from the beginning?
19:45
It's kind of like starting literally from the beginning with your relationship with movement and trying to find what you like,
19:52
you know,
19:52
find what's enjoyable versus,
19:54
you know,
19:55
things that I've just have always done or things that I've just no exercise to be or I've been told to do.
20:02
It's like,
20:03
well,
20:03
you know,
20:04
the person I follow on Instagram does this workout routine.
20:08
So this is what I should be doing and it's more about checking in with yourself about what actually meets your needs,
20:16
what actually feels good.
20:18
Um It's,
20:20
it's very similar actually to improving your relationship with food.
20:26
Absolutely.
20:27
It's very similar,
20:28
you know,
20:29
I know at Renfrew,
20:29
one of the things that we do is we really encourage and invite patients to think about,
20:36
you know,
20:37
when you are mindful with the food,
20:38
is this something I actually like or ha have I been told not to eat this not to enjoy this because of a diet or,
20:48
you know,
20:48
something like that?
20:50
But I see a lot of similarities in,
20:52
you know,
20:53
when you improve your relationship with movement compared to improving your relationship with food.
20:59
Absolutely.
21:00
And there are like you said,
21:01
there are so many different social media platforms that recommend and,
21:06
you know,
21:07
influence someone's relationship and then you start to think,
21:11
is this the only way or is this what it's supposed to be like,
21:14
and a lot of times people don't enjoy it.
21:16
So then it kind of feels like work.
21:18
It feels like something they have to do and it takes away from that joy.
21:23
So finding things that someone enjoys doing that they like to do.
21:28
I think we'll over,
21:29
like,
21:30
in time really help with that relationship.
21:32
Yeah.
21:33
Right.
21:33
It's like you have to wonder how beneficial is movement.
21:37
If it doesn't feel good to you,
21:39
it stresses you out,
21:40
it feels like an obligation.
21:42
It's really not a coping skill anymore,
21:46
right?
21:46
And it's,
21:46
I mean,
21:47
if it feels that way to you,
21:48
Sam,
21:49
it's messing with like,
21:50
like I think of health as like there are multiple pillars,
21:54
right?
21:54
Like there is the physical health,
21:56
but there's mental health,
21:57
there's spiritual health,
21:58
there's financial health,
21:59
all of that and like if it's,
22:01
if we're accessing just one of those pillars,
22:05
but like if that does not feel congruent with the rest of what is going on for us.
22:11
Um You know,
22:11
that's something to consider,
22:13
that's something to think about for us.
22:15
Um So Kristen,
22:17
I'm curious,
22:18
so like we know that when somebody like goes to residential,
22:23
um you know,
22:24
they're there for multiple weeks,
22:26
they're often in what kind of feels like a bubble.
22:29
Um And then they leave and they go,
22:32
you know,
22:33
back home,
22:34
hopefully they're doing the PHP or IOP step down,
22:37
but they're leaving res and they're going back home and prior to them leaving.
22:42
Um,
22:42
you provide a one on one quote exercise,
22:47
consult with them,
22:48
right?
22:49
Um,
22:50
so what can someone expect during these sessions with you and what might be included in their plan for going home essentially?
23:01
Yeah.
23:01
So we do have an exercise processing group that I facilitate weekly.
23:07
And the purpose of this group is for anyone for any type of relationship with exercise to kind of come in and have that safe place to talk about it.
23:17
And that's typically where the conversation first starts in a group setting to really just notice,
23:22
you know,
23:23
what it has been,
23:25
someone's experience,
23:26
what are some of the influences,
23:28
what are some of the fears of discharge?
23:30
And,
23:31
um,
23:32
also for them to,
23:33
you know,
23:33
as a group work together to re evaluate some of their thoughts and beliefs.
23:39
And from there,
23:40
we then do these exercise consultations.
23:43
They typically do them the week or two before they are leaving where they're in that mindset where they're starting to prepare for discharge.
23:51
However,
23:51
it's not too overwhelming at that point.
23:54
And in the consult,
23:56
we're really one looking back on their past relationship.
24:00
Um,
24:01
because it's individual,
24:02
they're allowed to share a lot more about their relationship and how it has specifically impacted them.
24:08
Um,
24:09
and then also really looking at what they want to do,
24:12
you know,
24:12
thinking about going home.
24:14
I typically have them,
24:15
we kind of work through a list of like what do I really enjoy doing?
24:19
What do I love to do versus what do I know that I do for eating disorder reasons.
24:24
And from there,
24:26
we're able to really identify,
24:27
you know,
24:28
going home,
24:28
those initial phases.
24:30
Like what can someone incorporate that would help with this relationship?
24:35
Um We look at it from a level system of really working through your physical endurance and your emotional endurance.
24:43
So a lot of the activities,
24:45
you know,
24:45
we're starting off slow.
24:47
I will have everyone who I meet with always says I'm so excited to go home.
24:52
I wanna get back to this routine or I'm excited to go back to my sports team and they're gonna want to go and do everything right away because they have the energy to.
25:02
However,
25:02
it's like,
25:03
really,
25:03
you know,
25:04
talking through that,
25:05
yes,
25:05
you may feel that you're ready,
25:07
the body may not necessarily be and how can we slow that down and kind of meet halfway and then also really just kind of gauging where,
25:16
where they're at right now.
25:18
A lot of times,
25:19
you know,
25:19
kind of seeing what they feel is appropriate and I kinda like to listen to see,
25:23
you know,
25:24
the progress that they've made over the weeks and really noticing where their relationship started to turn maladaptive and where they,
25:32
they would like it to go,
25:33
going home.
25:34
Yeah,
25:34
we also talk about,
25:36
you know,
25:37
what are some of their warning signs and red flags?
25:39
So it's really helpful from a relapse prevention standpoint um to think about that in relation to exercise.
25:46
And we also,
25:47
you know,
25:47
just really also talk about the food and how that's gonna tie in.
25:52
You know,
25:52
I use this analogy that our bodies are like a and in order to get from point A to point B,
25:58
we need gas in the car and our bodies are similar,
26:01
right?
26:02
So in order for me to be able to do,
26:04
you know,
26:04
that activity that I wanna do,
26:06
I need to make sure that my body's fueled and I have found that that analogy has really helped residents to kind of take a step back and really look at the whole picture.
26:16
Yeah,
26:17
that's awesome.
26:18
Um It makes me curious.
26:20
So have you had the experience of maybe having one of your um residents?
26:27
Let's see,
26:28
the maybe they were a part of a team,
26:31
a dance team,
26:32
a cheer team,
26:33
any sort of athletic team and they couldn't wait to go back,
26:38
right?
26:38
Like they were so excited and um what was also coming up for them when they were connecting with you is that they knew that there would be body talk there.
26:50
They knew that there would be um Yeah,
26:52
just ii I guess like body talk,
26:55
you know,
26:55
food talk,
26:56
things like that.
26:57
What are some helpful tools that you share with those residents and clients as they're like as they're stepping back into that group?
27:07
Knowing that that stuff might be there also,
27:10
knowing that this group means something to them and it's important for them to be engaged.
27:15
Um,
27:16
but how do you help them with that?
27:18
Yeah.
27:19
So,
27:19
you know,
27:20
when you're thinking about going home and you're going back to these sports and you're right,
27:24
I think residential is kind of like that bubble where we are respecting a lot of,
27:30
you know,
27:30
those conversations and we're not necessarily having them as often in the community.
27:35
So going home,
27:36
that is a,
27:36
a very big fear.
27:38
I'm going to go back onto this team or I'm gonna see my friends and you know,
27:42
diet culture will be out there,
27:44
there will be people talking about certain,
27:46
you know,
27:47
activities that they're doing or trends and things like that and part of it,
27:52
you know,
27:53
when we talk about that,
27:54
we're really looking at,
27:56
you know,
27:56
reappraisals,
27:58
you know,
27:58
reminding themselves,
27:59
you know,
27:59
your journey is very different than someone else's and there may be a lot of disordered movement out there and,
28:06
and disordered eating and,
28:08
you know,
28:08
knowing all this work that someone has done here in rez like,
28:12
what can that look like at home?
28:14
Are they able to vocalize?
28:16
Yeah,
28:16
this isn't helpful for me to hear in this moment.
28:19
Is it helpful for them to kind of educate a little bit more on what they've learned here?
28:24
Um And at the same time reminding themselves of,
28:28
of this plan and,
28:30
and why they've worked so hard,
28:31
you know,
28:32
all those things that they'd like to do in the future.
28:35
Yeah.
28:36
Mm.
28:37
But you know anyone who's listening in the eating disorder world,
28:41
they know that we really do encourage folks to change,
28:47
make a shift in the terminology instead of even saying exercise to shift it to movement.
28:54
And,
28:55
you know,
28:55
I started this episode saying exercise because I know a lot of listeners out there,
29:01
that's the word we hear all the time in the fitness world,
29:04
in our culture.
29:06
And,
29:07
but really a lot of the work is about shifting your perspective about what exercise actually is.
29:14
And the word movement seems to be sort of a word that helps you have sort of a more peaceful connection with exercise.
29:23
I'm just curious,
29:23
Kristen,
29:24
why do you think making that shift is important?
29:29
Absolutely.
29:30
I look at,
29:31
you know,
29:31
movement as this umbrella term and,
29:35
and we kind of share this here in groups all all the time that in this umbrella term as movement,
29:41
you can have exercise,
29:43
you know,
29:43
physical activity and you can have gentle and mindfulness in there.
29:47
And I feel that this umbrella term really is more neutral and peaceful where for some other folks,
29:54
you know,
29:55
when you hear that word exercise,
29:56
a lot of times the automatic thought is fitness centers,
29:59
gyms,
30:00
dieting.
30:01
And it's really hard to really look at exercise as the intention to move the body where I think that word movement really focuses on what the purpose of it is and the intention to change the body.
30:14
I think exercise is really,
30:17
that word is really connected to changing your body in some way,
30:21
which brings me to my next question.
30:23
Um because I know that there are folks who will maybe have a one on one consult with you and they have this plan in place and then they're out in the world and trying to reintroduce movement into their lives.
30:37
What do you think are some of the tricky things about doing that?
30:43
Um,
30:43
because I know sometimes diet culture and the fitness culture can,
30:47
like,
30:47
pull you in,
30:48
in a sneaky way.
30:49
Like,
30:49
you know,
30:50
we brought up earlier about like body rec composition and sort of like,
30:53
well,
30:53
I'm gonna build muscle,
30:55
that's gonna be my new thing.
30:56
And we hear a lot about how,
30:59
um,
30:59
sort of your relationship with movement,
31:03
you think it's healthy.
31:04
But actually when you take a closer look,
31:06
it's just kind of shape shifting.
31:09
I just wanted to get your thoughts on that.
31:11
Yeah.
31:12
So I hear that a lot,
31:13
you know,
31:14
a lot of times when we talk about this,
31:16
you know,
31:16
if my body never changed,
31:17
would I still do it?
31:19
Sometimes I'll get that,
31:20
that second question of like,
31:21
well,
31:22
I wanna build strength,
31:23
you know,
31:23
and I'm just,
31:24
you know,
31:24
working on my muscle endurance and,
31:26
you know,
31:26
part of that like you said,
31:28
it could just be shifting,
31:29
right,
31:29
that mindset around that.
31:31
So,
31:31
is it necessarily something that's going to be helpful for someone,
31:36
you know,
31:36
when you're going home?
31:38
It's hard.
31:39
There are so many different media outlets that are,
31:43
you know,
31:44
having trends and recommending different things or just conversations,
31:48
you know,
31:48
I feel like it's so common in the world that people are talking about exercise in a pretty disordered way and it makes it really hard to hear,
31:58
you know.
31:58
So I think when you're first going home and you're reincorporating this in again,
32:03
your energy levels are going to be so much higher.
32:05
You're gonna be so excited to do it and you're gonna wanna just get back to everything and I think it's gonna be so important to really check in with yourself and your body and notice,
32:16
you know,
32:16
how does this make me feel and what is my intention going into it?
32:20
Why do I want to do this right now?
32:22
You know,
32:23
and if it feels more eating disorder,
32:26
then what I would say is to try opposite action and,
32:30
and do something else differently and that's ok if you don't get to it today,
32:34
you know,
32:34
that's what tomorrow is for next week.
32:36
And being flexible with that typically,
32:39
what will start to happen in,
32:40
in those scenarios is if you're not able to be flexible,
32:43
then,
32:44
then I would say something else is going on there.
32:46
Mhm.
32:47
Mhm.
32:48
That makes a lot of sense.
32:49
Excuse me?
32:51
Um,
32:51
Kristen,
32:52
I'm curious.
32:53
So when our clients go back home,
32:57
how can their loved ones,
32:59
their family members,
33:00
their partners,
33:01
their friends,
33:02
how can they support them?
33:05
Um,
33:06
and do you,
33:07
do you offer any of those,
33:09
like,
33:09
you know,
33:10
family components in your consults?
33:13
Um,
33:14
but yeah,
33:14
just essentially how can the surrounding support systems help our clients as they leave res and coaches too?
33:22
How can?
33:22
Oh,
33:22
yeah,
33:22
and coaches?
33:23
That's a great one.
33:25
Yeah.
33:25
So I think first step,
33:27
um typically when I am meeting with someone,
33:30
if their family is really,
33:32
you know,
33:32
an active family or they're really worried about,
33:37
you know,
33:37
discharge and movement,
33:39
typically they'll vocalize that with the primary therapist and I will jump on a family session and help,
33:45
you know,
33:45
kind of guide that conversation when I'm thinking,
33:49
you know,
33:49
someone's going home.
33:51
I imagine the fear,
33:52
the fear of the family,
33:53
you know,
33:53
taking in all of,
33:55
you know,
33:56
the aspects of your loved one coming home,
33:57
not knowing what to say.
33:59
What can I say?
33:59
What can I say?
34:00
What's gonna be helpful versus what's gonna be harmful?
34:04
So I would say the first step is to really just listen,
34:07
listen to your,
34:08
what your loved one is sharing about exercise,
34:11
the philosophy will look very different.
34:14
Hopefully when,
34:15
when they're heading home and,
34:17
you know,
34:17
also being mindful of their talk about exercise and their talk on you know,
34:24
physical composition or,
34:27
um,
34:27
just their relationship with exercise.
34:30
I think,
34:31
um,
34:32
you know,
34:33
a nice activity that a lot of the families will do with their loved one when you first go home is like walking a family dog.
34:40
I think that's like the nicest way for everyone to connect.
34:43
You can connect with each other,
34:45
you can connect with the pup,
34:47
you can connect with nature and it just really allows you to,
34:50
to practice that mindful walking that they would have learned here.
34:54
Yeah,
34:55
that's really helpful.
34:56
And I'm thinking for like,
34:57
support people to,
35:00
you know,
35:00
they weren't necessarily the ones that were in program learning all of this changing and growing so rapidly and intensely.
35:09
And I'm,
35:11
I,
35:11
I like how you say listening at first is really helpful because I'm just putting myself in the place of a support person and thinking like,
35:20
what if I don't know the right thing to say?
35:23
And,
35:24
or what if diet culture has been a voice in my own head?
35:30
Right?
35:31
And so like,
35:33
I'm imagining that our family units and support people might also have their own journey of unlearning and relearning um alongside of their loved one.
35:47
Yes.
35:48
It's really like letting go of some of those old beliefs,
35:51
you know,
35:51
and those old philosophies and things that you have grown up to,
35:55
to know,
35:56
right?
35:57
And being flexible in learning new things and,
36:00
and learning to look at it in a different way.
36:03
And a lot of times,
36:04
you know,
36:05
even for the loved ones and the supports,
36:08
it might be nice for them to try to find new things that they enjoy to,
36:12
to do too.
36:13
Yeah.
36:14
Mhm.
36:15
So true.
36:16
And I have so much compassion for athletes who are,
36:19
you know,
36:20
leaving residential and wanting to get back in their sport.
36:23
How can teammates and coaches help and support,
36:28
you know,
36:29
each other when someone's recovering from an eating disorder and compulsive exercise?
36:35
Yeah.
36:36
You know,
36:36
I'm thinking when,
36:38
you know,
36:39
as a coach,
36:40
I'm imagining,
36:41
you know,
36:41
there are things that need to be done,
36:43
right?
36:43
You need to go to practices and you need to,
36:46
you know,
36:46
do the best that you can in competitions and sports teams and things like that.
36:50
And there's always an emphasis on practice,
36:53
you know,
36:54
and making sure that you're practicing those drills or whatever it may be.
36:58
And I find that,
36:59
you know,
36:59
that secondary question of,
37:01
make sure you,
37:02
you're getting adequate nutrition or you're staying hydrated doesn't happen as often as it should.
37:08
And I feel like that's something that is really missed.
37:11
And I would really recommend as coaches,
37:14
um,
37:15
you know,
37:16
health care providers,
37:17
whatever it may be to just also start to ask that question as well.
37:20
You know,
37:21
because they're going to be doing a significant amount and making sure that they are getting adequate nutrition that they're staying hydrated and if their body is sore and it,
37:31
it hurts or there's an injury,
37:33
it's ok to take rest.
37:35
Mm.
37:36
Mhm.
37:36
Right.
37:37
I,
37:38
I remember,
37:39
um,
37:40
I think I was,
37:41
uh,
37:41
writing a blog about this but I,
37:43
I remember in the blog,
37:46
um,
37:46
just things coaches could look out for and,
37:49
um,
37:50
you know,
37:50
training and going to practice is one thing but when you are over training and doing things so far outside,
37:58
you know,
37:59
what really is expected for that sport,
38:01
um,
38:03
you know,
38:03
I think it's so important also that coaches,
38:05
you know,
38:05
have a good eye for some of the really unique signs and symptoms that athletes struggle with because it can be really hard to catch unless you're looking for it.
38:15
Absolutely.
38:16
And it's hard because for some,
38:19
this ties into scholarships,
38:21
you know,
38:21
this ties into careers for them,
38:23
you know,
38:23
so there's all these underlying factors as well that someone wants to do the best that they can.
38:29
And you're right.
38:31
I think when you have the sport,
38:34
it should really just be the sport.
38:36
I wouldn't have someone doing more than that.
38:39
You know,
38:39
if there's practices and you have to do that,
38:41
that's a different story.
38:43
But typically,
38:44
like you said,
38:44
they'll start to do more,
38:45
you'll start to see that.
38:46
Ok.
38:47
Well,
38:47
that doesn't count because that's not part of my sport and that's not part of practice.
38:51
That's just what I like to do.
38:52
And then all these different activities start adding up and then this person's doing more activity than,
38:58
than they're home.
39:00
Exactly.
39:02
Oh,
39:03
this is such good information for,
39:05
for families,
39:06
for,
39:07
for really anyone.
39:08
Um,
39:08
thank you so much,
39:09
Kristen.
39:10
I'm wondering also,
39:11
um,
39:12
for folks listening in,
39:14
I feel like whether you have an eating disorder or not,
39:17
I think there's always room to improve your relationship with movement.
39:20
And what do you think are some simple steps people can take to have a more peaceful relationship with exercise.
39:29
Um Are there things that they could do every day or every week or what would you recommend?
39:37
Yeah.
39:37
So what I would recommend is one to really ask yourself what your intention is.
39:42
Why do I wanna do what I'm doing?
39:44
You know,
39:44
I,
39:44
I've kind of said that a few times today and I think that's so important to really evaluate,
39:50
you know,
39:50
when you're thinking about incorporating movement in again.
39:53
Um or even just,
39:55
you know,
39:55
reevalue the relationship as a whole,
39:58
ask yourself,
39:59
you know,
40:00
am I getting adequate nutrition?
40:02
Am I willing to add more to my meal plan?
40:05
If you're not,
40:06
then I would say,
40:07
then maybe we need to take some time off of that and really work on the nutrition component.
40:12
Am I hydrated?
40:13
Making sure that they're staying hydrated and have fun with it.
40:17
Find something new,
40:19
try new activities.
40:20
If there was like that Zumba class,
40:22
you wanted to try or dancing with your friends um Trying those different things you know,
40:29
I think a structure schedule is helpful,
40:31
you know,
40:32
structure can always be helpful for someone,
40:34
however,
40:35
don't be too rigid with that structure,
40:37
make sure there's some flexibility with it,
40:40
you know,
40:40
tuning into your body and,
40:42
and noticing,
40:42
you know,
40:43
what your body can and can't do and,
40:46
and being ok with that and knowing that as we age,
40:49
our bodies are going to be changing,
40:51
right?
40:51
Our,
40:51
our muscle strength and things like that will change.
40:55
Um Taking time off rest days are so important and I feel like that's something that not many people talk about is how important rest days are.
41:05
You know,
41:05
if there's gonna be something that's consistent in a schedule,
41:08
there needs to be rest days.
41:09
Um because the body is doing so much physically,
41:13
your internal organs,
41:14
all of that are running every single day for us.
41:17
So just making sure that that you're getting the rest that you need and do things with other people.
41:24
I would try to add some social interaction in there and some participation.
41:29
Um because I feel like a lot of times,
41:33
especially since COVID,
41:35
a lot of things are on an individual basis.
41:37
You know,
41:37
there's things that you can access from your home,
41:40
that you could do in your backyard or outside and it starts to take away that social peace that's making me think.
41:48
Um When you,
41:50
when you mentioned specifically like have fun,
41:52
like in my mind,
41:53
I'm like it's OK to do something that like literally makes me smile,
41:59
you know,
42:00
that like,
42:01
I can feel that and notice those moments when like,
42:05
I'm not smiling at all,
42:07
right?
42:07
Like when I'm just like grunting myself through this,
42:11
right?
42:12
Like is there something to that particular thing?
42:16
Um And I'm,
42:17
I'm just thinking like,
42:18
I'm just a ma do you guys remember the um dance dance revolution?
42:23
Yeah,
42:24
it's like a video game with like certain steps you have to hit.
42:27
You would like,
42:28
but there was like two different mats and you can,
42:30
you know,
42:30
compete and do that.
42:31
I just,
42:32
I just remember doing that,
42:34
you know,
42:34
back in the day a little while ago.
42:36
But how that was just so much fun and like finding,
42:40
when we talk about movement,
42:42
like finding ways to move our body that we truly and genuinely just enjoy,
42:48
you know.
42:49
And so um anyway,
42:51
I just liked that when you said Kristen,
42:53
like it's OK to have fun with it.
42:55
Like that makes me happy.
42:57
Yeah.
42:58
And to remember that there's so many different ways to move your body.
43:01
I think the fitness industry sort of makes you think that there's,
43:06
you know,
43:06
it's,
43:07
it's like these workout programs exist and that's it.
43:10
But walking your dog or dancing to dance dance revolution or y you know,
43:16
it,
43:16
that movement doesn't have to happen in a gym,
43:21
in a class with an instructor um that it can happen in so many different ways and it can be joyful.
43:28
I think the trick is checking in with yourself and asking yourself,
43:31
am I actually enjoying this?
43:33
Is this feeling good to me and good for my mental health?
43:39
Yeah.
43:40
Well,
43:40
Kristen,
43:41
thank you so much for being with us today.
43:43
It was really a pleasure getting to connect with you and,
43:46
and hear from you.
43:47
Um I,
43:48
I'm,
43:49
I just really think that um truly hearing from somebody that is an occupational therapist,
43:55
somebody that really understands your background and um you know,
43:59
physical health.
44:00
And um I just think it,
44:01
it is so beneficial for our listeners.
44:04
And um y'all,
44:06
you know,
44:07
listeners,
44:08
thank you for joining us today and I hope that you are able to find um kind of that peace and that balance with movement and I hope that it um puts a smile on your face and brings joy to you instead of,
44:22
you know,
44:22
kind of taking that away.
44:24
So thank you all for being here with us.
44:27
Um And we hope to have you back on another episode of All Bodies All Foods.
44:35
Thank you for listening with us today on All Bodies All Foods presented by the Renfrew Center for Eating Disorders.
44:42
We're looking forward to you joining us next time as we continue these conversations.