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An Acceptance Based Approach to Working with Eating Disorders with Giulia Suro, PhD · The Trauma Therapist

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  Speaker 1: Trauma Theaverist Podcast Plus listeners can listen to episodes early
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  Speaker 1: and signing up today. Welcome to the Trauma Nevers Podcast,
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  Speaker 1: a show about the incredible people dedicated to helping those
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  Speaker 1: who experienced trauma. My name is got macpherson, and my
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  Speaker 1: mission is to raise awareness of trauma and to inspire
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  Speaker 1: each of us to help those around us. We are
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  Speaker 1: all right, uh, Julian, here we go. So five or three,
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  Speaker 1: two and one, our folks, welcome back to the podcast.
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  Speaker 1: Very excited to happen with my guest today, Doctor Julia Soro.
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  Speaker 2: Julia, welcome, Thank you for having me so.
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  Speaker 1: Doctor Soro is a psychologist, author, and researcher in Washington,
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  Speaker 1: d c. Specializing in the treatment of eating disorders and trauma.
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  Speaker 1: In addition to our outpatient clinical practice, she is also
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  Speaker 1: the director of Research and at Montando, a leading eating
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  Speaker 1: disorder treatment conglomerate. Her twenty nineteen workbook, Learning to Thrive,
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  Speaker 1: is highly regarded in the field. She regularly contributes to
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  Speaker 1: the Journal of Eating Disorders and European Eating Disorder Review,
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  Speaker 1: as well as publications like Psyche and Thrive Global on
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  Speaker 1: the intersection of eating disorders and trauma. Welcome to the podcast.
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  Speaker 2: Thank you, thank you for having me. I'm excited to
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  Speaker 2: be here.
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  Speaker 1: Awesome. So, before we get going, share with the listeners
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  Speaker 1: where you're from originally and where you are currently.
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  Speaker 2: I that's the one answer for both. I moved around
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  Speaker 2: in between, but I'm the DC area. Originally left for
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  Speaker 2: school and jobs, and then came back right before the pandemic.
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  Speaker 1: Okay, all right, so really interesting field you're in, specialization
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  Speaker 1: you're in. I'm going to start with a broad question here,
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  Speaker 1: but how the heck did all this start for you?
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  Speaker 2: Yeah, it's a great it's a great question. I was
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  Speaker 2: initially very geared towards having a career in the VA.
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  Speaker 2: I studied trauma in graduate school. I did some clinical
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  Speaker 2: rotations in the VA. Was wanted to be a VA
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  Speaker 2: clinicians or I saw myself working for the government.
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  Speaker 1: Professional Why why why the VA?
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  Speaker 2: Why the VA? I am okay, look a little bit
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  Speaker 2: of a longer story. I initially my first interest that
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  Speaker 2: sort of got me into psychology was severe mental illness.
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  Speaker 2: I have some personal familial connections to severe mental illness
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  Speaker 2: like schizophrenia, bipolar disorder, and so I did some work
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  Speaker 2: in that area, and I found the settings to be disheartening.
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  Speaker 2: I found the clinicians to be a bit apathetic, and
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  Speaker 2: I really wanted to work in an area where I
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  Speaker 2: felt like I could accomplish something, that there was more hope.
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  Speaker 2: I really fell in love with trauma. This was in
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  Speaker 2: the early two thousands, Like CPT, cognitive processing therapy was
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  Speaker 2: sort of gaining traction. I was trained in prolonged exposure.
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  Speaker 2: It's like you do these protocols and see improvement, and
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  Speaker 2: so it just felt very hopeful for me, and I
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  Speaker 2: really loved my trauma cases that I had early on.
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  Speaker 1: So the experience you mentioned, familial experience with severe mental
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  Speaker 1: illness and trauma, what inspired you? You felt you were
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  Speaker 1: you could make a difference. I had a similar experience myself.
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  Speaker 1: Was was it always becoming a psychologist or therapist or what? Yeah?
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  Speaker 2: So uninteresting, But I feel very lucky in that I
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  Speaker 2: knew what I wanted to do pretty early on. I
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  Speaker 2: have been I think a bit of an mpath as.
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  Speaker 2: I'm sure maybe you can relate many of your listeners right,
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  Speaker 2: sort of like into feelings, interested in therapy and psychological approaches.
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  Speaker 2: I knew honestly before I graduated high school that I
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  Speaker 2: wanted to do clinical work. So I was sort of
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  Speaker 2: a straight shot through undergrad getting experience, and then applying
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  Speaker 2: to graduate programs.
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  Speaker 1: So you get into graduate programs, you're passionate about learning
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  Speaker 1: about trauma. You want to your gear towards the VA.
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  Speaker 1: What unfolds, yes.
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  Speaker 2: So what unfolds is very coincidental. I needed to sort
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  Speaker 2: of diversify my CV. I was getting ready to apply
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  Speaker 2: for internships, and I wanted to sort of broaden my experiences.
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  Speaker 2: There happened to be a very small at the time,
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  Speaker 2: very small residential program for women with eating disorders, like
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  Speaker 2: two miles from my graduate school. And so I thought
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  Speaker 2: I had no training in eating disorders. No, not a
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  Speaker 2: single class in grad school. Maybe it hadn't been mentioned
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  Speaker 2: in sort of a diagnostic class, but no, no experience
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  Speaker 2: at all. And so I did sort of a two
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  Speaker 2: rotation there and really not only just really fell in
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  Speaker 2: love with that population, but I found that the clients
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  Speaker 2: were honestly just as traumatized as the individuals the veterans
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  Speaker 2: I worked with at the VA. In terms of their
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  Speaker 2: symptom presentation, their trauma exposure obviously very different than combat.
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  Speaker 2: But treating and eating disorder in those higher levels of
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  Speaker 2: care was is trauma treatment, It just wasn't named that.
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  Speaker 2: And so I got to sort of get a lot
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  Speaker 2: of really rich clinical experience of these very complex diagnoses
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  Speaker 2: doing doing really intensive trauma work.
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  Speaker 1: What was it about the clients there in the sort
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  Speaker 1: of clinic that struck you?
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  Speaker 2: Yeah?
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  Speaker 1: You know?
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  Speaker 2: I have found that certainly, like trauma comes with shame, right,
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  Speaker 2: That's that's known, And I knew for certain that the
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  Speaker 2: veterans I worked with were overcoming a lot of shame
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  Speaker 2: just to ask for help and get the help that
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  Speaker 2: they very much deserved. I found that my clients with
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  Speaker 2: eating disorders experienced such a gaslighting experience sort of of
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  Speaker 2: what their symptoms met and even within the mental health field,
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  Speaker 2: like I still feel like we have a long way
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  Speaker 2: to go in terms of talking about what an eating
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  Speaker 2: disorder is, what drives it. Many of them had had
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  Speaker 2: such a failure experience time and time again of not
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  Speaker 2: sort of getting over their issues. Why can't you just
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  Speaker 2: stop this ditting like this very toxic messaging even from
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  Speaker 2: their primary care providers and therapists, you know, like the
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  Speaker 2: trauma's just raging, it's not even been touched. Many of
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  Speaker 2: them didn't even identify with like having PTSD. It wasn't
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  Speaker 2: something they felt that they could own. And so it
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  Speaker 2: really like the need really spoke to me, like being
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  Speaker 2: able to just attack these individuals, attack in a positive way,
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  Speaker 2: attacking therapeutically. These individuals are just really extensive need that
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  Speaker 2: just was not getting met at the time. And really
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  Speaker 2: it hasn't been until recently that the intersection of eating
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  Speaker 2: disorders and trauma has become more well known. But I
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  Speaker 2: still don't think it's trickled into the mainstream.
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  Speaker 1: Just so crazy, I mean, it's just so crazy to
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  Speaker 1: realize that that is the reality that we're living in
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  Speaker 1: right now. Okay, so you have this incredible experience. What
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  Speaker 1: happens after that? What do you do?
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  Speaker 2: I stayed. I couldn't leave. I stayed. I really fell
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  Speaker 2: in love with it. I stayed. I came back as
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  Speaker 2: a post doc, I was a therapist for several several years,
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  Speaker 2: I became a clinical director, and then now I'm in
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  Speaker 2: sort of this interesting position of gathering research on individuals
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  Speaker 2: who are experiencing eating disorders from like the full spectrum
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  Speaker 2: of in patient, really really severe throughout patient and trying
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  Speaker 2: to understand what is driving these behaviors. And for many
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  Speaker 2: of them, I think much more than any of us
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  Speaker 2: even realize, it is trauma.
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  Speaker 1: We're talking. It's safe to say, yeah, it's high.
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  Speaker 2: I mean in higher levels of care, it's the majority
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  Speaker 2: or close to the majority. Right, And we know people
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  Speaker 2: under report. We know the more severe and eating disorder is,
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  Speaker 2: you're more likely to have a co occurring diagnosis of
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  Speaker 2: PTSD the earlier you're eating disorders start. So like when
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  Speaker 2: we see individuals that start engaging in eating disorder behaviors
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  Speaker 2: at younger and younger ages, like early adolescents, late childhood, like,
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  Speaker 2: it's more likely to have PTSD. Marginalized community so BIPOC,
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  Speaker 2: LGBTQIA the experience eating disorders at the same rates, but
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  Speaker 2: they are more likely to have PTSD, right, So it's
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  Speaker 2: it's pervasive.
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  Speaker 1: Let's take a side step here. How would you define
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  Speaker 1: anything disorder? What is it?
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  Speaker 2: It's a really good question. It's a term that is
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  Speaker 2: broad and it speaks to a very diverse range of
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  Speaker 2: behaviors that speak to a fractured relationship with food and body.
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  Speaker 2: Right on the surface, that's what it looks like, right.
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  Speaker 2: And I sometimes describe eating disorders as an iceberg, right,
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  Speaker 2: Like we have the things above the surface that catch
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  Speaker 2: people's attention, that catch your parents' attentions, providers, things like binging, purging, laxatives, abuse,
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  Speaker 2: food rituals, all that stuff. Like, underneath there are these
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  Speaker 2: massive systems that are driving them, nervous system dysregulation, attachment wounds, dissociation, right, perfectionism,
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  Speaker 2: control right, and often what is pressing those levers is
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  Speaker 2: an origin of trauma.
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  Speaker 1: So let's talk. I want to jump here and talk
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  Speaker 1: a little bit about your book Learning to Thrive. What
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  Speaker 1: was the impetus for that.
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  Speaker 2: I had found a lot of difficulty understanding what does
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  Speaker 2: the evidence show is an effective treatment for eating disorders? Right,
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  Speaker 2: So CBT at the time, and I think still remains
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  Speaker 2: the gold standard. But like efficacy rates are, I think
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  Speaker 2: it's sort of like tossing a coin, right, It's very
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  Speaker 2: difficult to study these illnesses. So I was looking for
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  Speaker 2: approaches in therapy that were trans diagnostic, meaning they could
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  Speaker 2: be applied to any human who's struggling with challenges, right.
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  Speaker 2: And so for one person with an eating disorder that's
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  Speaker 2: very like restrictive controlled rituals, thinking numbers, keeping food logs,
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  Speaker 2: you know, very tight, emotionally restrained. Right. And for someone
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  Speaker 2: else it's like more cha impulsive binging, purging self harm. Right.
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  Speaker 2: And they both are diagnosed with an eating sort and
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  Speaker 2: they could be treated in the same place. So I
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  Speaker 2: was looking for approaches that could be applied to anyone, right,
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  Speaker 2: And I found acceptance and commitment therapy as a really beautiful,
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  Speaker 2: holistic approach that I thought was effective not only for
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  Speaker 2: eating sort of behaviors, but symptoms of PTSD and trauma response.
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  Speaker 2: So Learning to Thrive is the first workbook for lay
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  Speaker 2: people that anyone could pick up from Barnes and Noble
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  Speaker 2: or Amazon and apply it to themselves in a self
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  Speaker 2: help format.
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  Speaker 1: Is there a particular demographic that targets in eating disorders?
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  Speaker 1: Would you say?
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  Speaker 2: What do you mean?
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  Speaker 1: Well? Is it just across all the spectrum of individuals, white, black,
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  Speaker 1: you know, bipop, whatever, doesn't matter. It claims no specific
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  Speaker 1: target in the sense.
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  Speaker 2: Yes, yes, that's exactly right. Can we see consistent rates
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  Speaker 2: of eating disorders across race and ethnicity? LGBTQIA men although
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  Speaker 2: very understudied account for potentially one third of all eating
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  Speaker 2: disorder diagnoses.
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  Speaker 1: Surprising, but yeah.
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  Speaker 2: Yes, but of course, like there is such a big
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  Speaker 2: gap to fill in terms of who's getting the treatment right,
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  Speaker 2: there's there. We are not reaching all the people who
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  Speaker 2: need it. And I think many of the people who
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  Speaker 2: need it may not even know they have an eating
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  Speaker 2: disorder because they're not They don't fit what they maybe
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  Speaker 2: see as sort of a stereotype or meme of what
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  Speaker 2: an eating disorder looks like.
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  Speaker 1: So give us an example of that.
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  Speaker 2: Yeah, I think, I think to be honest, and I
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  Speaker 2: interact with a lot of therapists or people in my
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  Speaker 2: neighborhood who ask me who I treat right, and when
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  Speaker 2: I say eating disorder, like I still see we're sort
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  Speaker 2: of collectively stuck in a lifetime movie CONCEPTUALI is a
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  Speaker 2: like going back to the nineties of a young white
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  Speaker 2: woman college student who starts to diet and it goes
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  Speaker 2: too far. Right, what we know that sort of that
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  Speaker 2: restrictive eating disorder in it that exists in a smaller body,
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  Speaker 2: someone who's undernourished or underweight is actually it's much less
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  Speaker 2: common than someone who struggles with an eating disorder in
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  Speaker 2: a larger body who engages in binging, that is much
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  Speaker 2: more common. Right, but those individuals are more likely to
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  Speaker 2: receive weight counseling. Weight stigma be overlooked by providers. Right.
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  Speaker 2: There's still actually a long way to go in terms
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  Speaker 2: of educating medical providers around eating disorders. So this statistic
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  Speaker 2: might be a bit outdated, but at one point in
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  Speaker 2: time in the last ten years, the average psychiatric resident
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  Speaker 2: received less than two hours of training on eating disorders.
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  Speaker 2: So we like, we still have to, like, there's a
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  Speaker 2: lot of education that we need to sort of get
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  Speaker 2: out there.
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  Speaker 1: Yeah, stereotype that you gave was exactly the one I
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  Speaker 1: had in my mind. I think a lot of us
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  Speaker 1: a lot of us do, so, Julie, give us an
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  Speaker 1: idea here. And I know every case is different. But
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  Speaker 1: how do you and you mentioned act do you work
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  Speaker 1: in groups at all?
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  Speaker 2: Not currently, but I did as when I worked in
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  Speaker 2: treatment centers.
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  Speaker 1: Yes, okay, how do you know? And you mentioned trauma
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  Speaker 1: of course as a kind of underlying foundational issue in
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  Speaker 1: many of these instances, how do you begin to work
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  Speaker 1: with a client? And I know that's a broad question,
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  Speaker 1: but yes, where do you what do you do, I'm
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  Speaker 1: really curious.
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  Speaker 2: Well, the first thing I'll say that if anyone like,
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  Speaker 2: here's ten seconds of this, the first thing I feel
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  Speaker 2: strongly about sharing is like a thorough assessment. So any
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  Speaker 2: client I see for the first time, I'm doing a
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  Speaker 2: thorough trauma history acting asking directly about sexual trauma, and
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  Speaker 2: anyone who has a trauma history, I'm asking about your
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  Speaker 2: relationship with your body. Do you ever tried what does
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  Speaker 2: your relationship with food look like? Have you ever binged
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  Speaker 2: and purged? And really probing for those behaviors? As I said,
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  Speaker 2: many of the mental health field don't receive any training
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  Speaker 2: on eating disorders. So like making sure you get the
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  Speaker 2: full lay of the land, right, because what accept as
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  Speaker 2: a commitment therapy. The beautiful thing about it is sort
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  Speaker 2: of like the behaviors in and of themselves don't matter.
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  Speaker 2: If the thoughts the content of them doesn't matter, we're
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  Speaker 2: understanding the function. Right, So when you binge, is it
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  Speaker 2: a manifestation of wanting to feel numb or wanting to
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  Speaker 2: feel is it the sort of the manifestation of restricting restricting, restricting,
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  Speaker 2: being in control and then losing control? Right? Like those
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  Speaker 2: are two drift different drivers. Of behavior and act really
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  Speaker 2: gets under the surface. So let's understand what these behaviors
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  Speaker 2: are doing for you and then find more flexible, balanced
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  Speaker 2: ways to meet them. And we're doing sort of similar
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  Speaker 2: things with thinking. So are your thoughts about food I
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  Speaker 2: need to push my body to the brink or the
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  Speaker 2: less I eat, the more in control I am, Or
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  Speaker 2: if I'm in a larger body, I'll be more safe
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  Speaker 2: from predators, right, Like, what are your thoughts about food?
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  Speaker 2: And then what is the function of them? Are they
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  Speaker 2: keeping you safe? Are they making you feel protected? Are
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  Speaker 2: they making you feel in control? Right? And how can
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  Speaker 2: we change your relationships with those thoughts so that you're
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  Speaker 2: holding them more lightly, you're not so attached to them
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  Speaker 2: taking them to be truth? And how can you find
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  Speaker 2: other ways for you to meet your needs?
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  Speaker 1: When you first started, I'm curious about what your stance was,
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  Speaker 1: some of the maybe errors clinical errors you made, what
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  Speaker 1: those look like? Yes, what you learned from those?
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  Speaker 2: Yeah? Yes, yeah, there's certainly money right. I first of
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  Speaker 2: goot like stepping into this world with a lot of
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  Speaker 2: personal biases about what an eating disorder looks like and
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  Speaker 2: what a person in an eating disorder, what their body
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  Speaker 2: might look like, or what behaviors look like like. Lots
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  Speaker 2: of that early on, But what I think I think
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  Speaker 2: most about, and sometimes I honestly like have real regrets
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  Speaker 2: about these clinical experiences. The way I was trained, and
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  Speaker 2: many in the eating disorder field we were trained was
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  Speaker 2: if there's trauma, don't touch it until they are their
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  Speaker 2: eating disorders under control. Get the eating disorder under control first,
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  Speaker 2: and then deal with the trauma. Because if you start
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  Speaker 2: doing trauma work and their eating disorder is still raging,
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  Speaker 2: the eating disorder will flare up. It'll be too hard
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  Speaker 2: to manage both. So just like, don't do trauma work.
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  Speaker 2: That has now been really debunked. Some of our own
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  Speaker 2: research has shown that sequential treatment, so doing eating disorder
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  Speaker 2: first and trauma work, actually leads to increased relapse. Right,
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  Speaker 2: And it makes sense in intuitively, like if you take
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  Speaker 2: care of someone's eating disorder in treatment and then you
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  Speaker 2: sort of send them on their merry way back to
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  Speaker 2: their world where there's triggers and stress, right like, they're
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  Speaker 2: going to feel activated and use their old coping skills,
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  Speaker 2: and it just results in individuals going through the treatment
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  Speaker 2: cycle again and again and feeling like a failure and
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  Speaker 2: becoming very discouraged. Right. What we know now is if
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  Speaker 2: you can sort of provide some safety and containment in
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  Speaker 2: an intensive therapeutic setting, right, do the trauma work even
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  Speaker 2: if there is still active eating disorder symptoms. Do the
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  Speaker 2: trauma work right, like run, don't walk? And if you
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  Speaker 2: do that, there can be this ripple effect where the
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  Speaker 2: eating disorder symptoms also go down as the trauma symptoms
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  Speaker 2: are responding to treatment.
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  Speaker 1: That's really interesting. How long ago we talking decades when
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  Speaker 1: that was kind of the state of the art that long.
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  Speaker 2: Ago, and I think I still yeah, I still interact.
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  Speaker 2: I sometimes give talks and presentations about this to eating
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  Speaker 2: disorder professionals who they are hearing this for the first time, right,
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  Speaker 2: or they're sort of challenging their stamps currently.
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  Speaker 1: You know, when I'm listening to you talk welcome, I'm
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  Speaker 1: reminded of something that Wormatas says kind of what she's
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  Speaker 1: famous foreign a sense is where you see addiction, you
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  Speaker 1: inevitably see trauma. The people coming to you, are they
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  Speaker 1: a lot of them, some of them none of them
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  Speaker 1: aware that there's trauma. I mean a lot of people
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  Speaker 1: don't even know what what do you mean? Traumatized? I
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  Speaker 1: have been traumatized. This is the way I was born, right,
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  Speaker 1: I mean with domestic violins, et cetera, et cetera, et cetera.
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  Speaker 1: This is this is how I grew up. It's not
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  Speaker 1: trauma to me. But I'm just curious if if you
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  Speaker 1: found a lot of people are like, well, I never
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  Speaker 1: thought about that. You know this?
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  Speaker 2: So yeah, it's it's your You're spot on, right, Like
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  Speaker 2: we only know the water we're swimming in. And many
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  Speaker 2: of my clients, if not most of them, have experienced
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  Speaker 2: like a discrete traumatic episode, and the majority of the
• 20:00
  Speaker 2: time it's a sexual assault, right, sexual trauma or childhood
• 20:04
  Speaker 2: sexual trauma. Right. But many of them grew up in
• 20:06
  Speaker 2: early childhood environments that were dysfunctional, that we're toxic, that
• 20:09
  Speaker 2: were abusive, that were invalidating, right, And then they emerge
• 20:13
  Speaker 2: from them feeling detachedched, not having a relationship with their bodies,
• 20:19
  Speaker 2: feeling out of control. That all gets played out with
• 20:21
  Speaker 2: a food, right, and that's what they're sort of like,
• 20:23
  Speaker 2: bad girl, bad girl, get the food under the control.
• 20:26
  Speaker 2: You have to leave college for treatment, right, Like that's
• 20:28
  Speaker 2: what they're sort of punished for. That's what people are
• 20:30
  Speaker 2: responding to and Meanwhile, like this whole context that brought
• 20:34
  Speaker 2: them to this point gets a bit overlooked. So sometimes
• 20:37
  Speaker 2: I do feel like I'm sort of presenting a new
• 20:39
  Speaker 2: view for the first time for a lot of these clients.
• 20:42
  Speaker 1: So people listening to this therapists of all kinds consumers
• 20:47
  Speaker 1: as well. Is there how would you ask if when
• 20:52
  Speaker 1: you're doing that assessment, how would you ask about a
• 20:55
  Speaker 1: needing disorder?
• 20:59
  Speaker 2: So my go who My first question, just to sort
• 21:01
  Speaker 2: of like ease in a little bit, is tell me
• 21:03
  Speaker 2: a bit about your relationship with your body, right, like,
• 21:06
  Speaker 2: how would you describe it in a couple adjectives? Are
• 21:08
  Speaker 2: you guys, friends, enemies? What has it been like over
• 21:11
  Speaker 2: the course of time? And then tell me a bit
• 21:16
  Speaker 2: about your relationship with food. And if I were to
• 21:18
  Speaker 2: watch you eat in a day to sort of observe
• 21:20
  Speaker 2: you eating, what are some things I might notice?
• 21:23
  Speaker 1: Right?
• 21:23
  Speaker 2: And I think another, yeah, another misconception about eating stores
• 21:28
  Speaker 2: like there are so many individuals, highly functioning, ambitious, fully
• 21:32
  Speaker 2: fully formed adults out in the world, adults right like parents, grandparents,
• 21:37
  Speaker 2: who are binging and purging, who are counting calories, who
• 21:41
  Speaker 2: are skipping meals, right, and we don't think to ask,
• 21:43
  Speaker 2: because they're coming to treatment for anxiety or depression or
• 21:46
  Speaker 2: other things, and these sort of feel many of these
• 21:48
  Speaker 2: behaviors are normalized. Right. You look on Instagram and you
• 21:51
  Speaker 2: see fasting, You see a lot of this stuff that's
• 21:53
  Speaker 2: sort of adjunctive or adjacent to it, and it feels normalized, right,
• 21:57
  Speaker 2: And so we want to get a sense of like
• 21:59
  Speaker 2: what what is the way you eat look like? And
• 22:01
  Speaker 2: I asked directly about you, have you ever purged or binge?
• 22:05
  Speaker 1: If you look at it as a continue wom you know?
• 22:08
  Speaker 1: When is counting calories something to be concerned about? I mean,
• 22:12
  Speaker 1: one could easily say, well, if you're binging or purging,
• 22:15
  Speaker 1: that just seems to automatically be in the red zone
• 22:18
  Speaker 1: of concern. But counting calories, I mean, I think a
• 22:21
  Speaker 1: lot of people do count calories. When does it become concerning?
• 22:25
  Speaker 1: Should it be? Yes?
• 22:27
  Speaker 2: Yes? Good question? So I will sometimes ask what percentage
• 22:30
  Speaker 2: of your head space does this take up? Right? Like
• 22:33
  Speaker 2: how much time you know, if we were to create
• 22:35
  Speaker 2: a pie chart of your mind, Like how much time
• 22:37
  Speaker 2: is spent focusing on food? And does it get in
• 22:40
  Speaker 2: the way right? Like are you not at a birthday dinner?
• 22:43
  Speaker 2: Are you not eating cake or are you not at
• 22:45
  Speaker 2: an Italian restaurant? Are you like not letting yourself get postive?
• 22:48
  Speaker 2: Are you holding yourself back? Are you limiting yourself? Or
• 22:51
  Speaker 2: if you do indulge, are you compensating in a way
• 22:54
  Speaker 2: that's not helpful to do you? Those are some of
• 22:58
  Speaker 2: the questions I might ask.
• 23:00
  Speaker 1: All Right, so we talk about this other project you
• 23:06
  Speaker 1: have you're working on or is that we don't want
• 23:09
  Speaker 1: to talk about that. We're not going to talk about that,
• 23:14
  Speaker 1: all right, So Learning to Thrive? Who's it for? Would
• 23:20
  Speaker 1: you say it's for anyone?
• 23:22
  Speaker 2: Yeah, it's for anyone. It's it is a self help book.
• 23:25
  Speaker 2: So it's meant to be for someone who does not
• 23:28
  Speaker 2: currently have the time or resources to find a therapist
• 23:32
  Speaker 2: who specializes in acceptance in commitment therapy, which does require
• 23:35
  Speaker 2: some training. Right, it's a bit of a specialized approach.
• 23:38
  Speaker 2: This is something you can take and you're getting sort
• 23:40
  Speaker 2: of your own act therapist at home.
• 23:43
  Speaker 1: And you as we kind of close out here, you know,
• 23:46
  Speaker 1: in the beginning you said you were like born to
• 23:49
  Speaker 1: be a therapist in his sense. But what is it, Julia,
• 23:53
  Speaker 1: that allows you to do this work you're doing? I
• 23:57
  Speaker 1: mean obviously you have a passion for this field specialization.
• 24:02
  Speaker 1: What is it about you that allows you to do it,
• 24:06
  Speaker 1: that makes you good at it? We'll probably great at it.
• 24:10
  Speaker 2: Oh, I appreciate that. I that's a really good question.
• 24:15
  Speaker 1: I think.
• 24:16
  Speaker 2: I I think it's very tough to be a girl
• 24:23
  Speaker 2: in the world right now, and eating disorders affect people
• 24:26
  Speaker 2: of all genders, right, But I do have I think
• 24:28
  Speaker 2: a personal identification with the challenges that can come with
• 24:32
  Speaker 2: just being female in today's world and all of the
• 24:36
  Speaker 2: messages that are sort of thrown at you about what
• 24:39
  Speaker 2: your body should look like, how you should express yourself,
• 24:42
  Speaker 2: how you should express your sexuality, right, and the toll
• 24:45
  Speaker 2: it can take to be honest, think, on some level,
• 24:48
  Speaker 2: being an adolescent, young female, young woman in today's world
• 24:52
  Speaker 2: is like, in and of itself, a little bit little
• 24:54
  Speaker 2: t traumatizing, right, And.
• 24:56
  Speaker 1: So I would agree. I mean, I have a nine
• 24:59
  Speaker 1: year old girl. What do you say to Sue, a
• 25:02
  Speaker 1: nine year old girl who says, you know that diet
• 25:07
  Speaker 1: am I skinny?
• 25:09
  Speaker 2: Yeah?
• 25:10
  Speaker 1: How do you respond to that?
• 25:12
  Speaker 2: Yeah? Great question? So I have a three year old girl.
• 25:14
  Speaker 2: This becomes becomes more personal to me too, right, So
• 25:18
  Speaker 2: I my go to right, like all all of the
• 25:22
  Speaker 2: stuff that's thrown at girls today and all of stuff
• 25:24
  Speaker 2: that an eating disorder puts on you, disconnects you from yourself.
• 25:28
  Speaker 2: You're not hearing yourself, you're not feeling yourself, you're not
• 25:30
  Speaker 2: feeling your emotions, you're not feeling anger, You're feeling disconnected,
• 25:34
  Speaker 2: you're not feeling hunger, right, and so directing the attention inwards.
• 25:39
  Speaker 2: And so what I say to my daughter is like
• 25:41
  Speaker 2: I could get emotional saying it, but you are Hazel.
• 25:44
  Speaker 2: Know that you always need to know Hazel. Go back
• 25:46
  Speaker 2: to Hazel. How does Hazel feel? What does Hazel think? Right?
• 25:50
  Speaker 2: Like staying connected with yourself.
• 25:52
  Speaker 1: Right as opposed to what the external cultural, social environment.
• 25:59
  Speaker 2: Yeah, yes, exactly right.
• 26:01
  Speaker 1: In other words, what is Hazel feeling? How to right?
• 26:05
  Speaker 2: Yeah? What does Hazel feel? Right? And like when Hazel
• 26:09
  Speaker 2: is full at dinner, it doesn't want to eat something
• 26:11
  Speaker 2: like I'm like, that's awesome that you feel full in
• 26:13
  Speaker 2: your Tommy, great job that you feel that. Keep feeling
• 26:17
  Speaker 2: what your Tommy tells you, right like, Or when Hazel
• 26:19
  Speaker 2: feels angry, like don't lose that it gets lost so
• 26:22
  Speaker 2: much noise, so much crap. I don't know if I
• 26:26
  Speaker 2: can curse here, right, Like, this gets so much trap
• 26:30
  Speaker 2: gets layered on and it gets harder to know what's
• 26:34
  Speaker 2: real for you, and we start our attension becomes so
• 26:38
  Speaker 2: external facing towards getting reinforcement, towards getting likes on social media,
• 26:42
  Speaker 2: towards being sexually appealing, right, And we want to bring
• 26:45
  Speaker 2: attention back to the self and those internal cues, right,
• 26:48
  Speaker 2: And that is what eating disort of recovery is. In
• 26:51
  Speaker 2: large part, it's feeling your feelings, hearing those feelings, responding
• 26:54
  Speaker 2: to them in a way that helps you. And also
• 26:57
  Speaker 2: there's that parallel process between emotions and your hungerfulness cues.
• 27:01
  Speaker 2: So just as we want you to feel anger, feel sad,
• 27:04
  Speaker 2: we want you to feel hungry, feel satiated, feel full.
• 27:07
  Speaker 2: Those are equally important.
• 27:09
  Speaker 1: I mean, I'm just thinking about how just intense that is,
• 27:14
  Speaker 1: and how oftentimes we don't want to feel. People don't
• 27:19
  Speaker 1: want to feel. I don't want to feel what I'm
• 27:22
  Speaker 1: feeling because of A, B and C. And then just
• 27:26
  Speaker 1: to work with people to allow them or create a
• 27:31
  Speaker 1: allow them to feel that is so powerful. It's so inspiring.
• 27:38
  Speaker 1: You know you can feel it.
• 27:39
  Speaker 2: That's really you're you know, I agree. I agree, And
• 27:41
  Speaker 2: that's really like more than anything, I think the greatest
• 27:44
  Speaker 2: toll of an eating disorder is it disconnects someone from themselves.
• 27:48
  Speaker 2: It is a numb state. I mean, I think another
• 27:50
  Speaker 2: misconception is people who don't eat, they must be hungry
• 27:52
  Speaker 2: all the time. Like the metabolic system, it shuts down.
• 27:56
  Speaker 2: It is numb. It is a numb state. There's no
• 28:00
  Speaker 2: there's no full, it's just blank, uncomfortable. Anything is overwhelming, right,
• 28:07
  Speaker 2: there's just like a real loss in communication with internal cues.
• 28:10
  Speaker 1: Yeah, fascinating, R Julia. I really appreciate you coming here.
• 28:16
  Speaker 1: I mean, this is obviously, this is so complex and
• 28:19
  Speaker 1: it's it's hard for me to approach this in this
• 28:22
  Speaker 1: time allotted. But what's the best way for people to
• 28:26
  Speaker 1: reach out and contact you?
• 28:27
  Speaker 2: Yeah, you can reach me. I have a website that
• 28:30
  Speaker 2: will connect you to my email. It's Julius Soro dot
• 28:32
  Speaker 2: com and my name is Felled the Italian way g
• 28:34
  Speaker 2: i U l i A sys and sam u are Oh.
• 28:38
  Speaker 2: I'm also newly on Instagram at Julius Soro PhD.
• 28:42
  Speaker 1: Okay, we'll look that up here at the show notes
• 28:44
  Speaker 1: page at the froma theys podcast dot com. Love to
• 28:47
  Speaker 1: have you back and again, thank you so much. Who's pleasure?
• 28:53
  Speaker 1: Thank you, take care.
• 28:54
  Speaker 2: Nice, many common