Latest / All Bodies. All Foods. / 36. Breaking Free of Systems & Symptoms: A Conversation With a Certified Eating Disorder Specialist
Transcript
- 0:01Hey,
- 0:01I'm Sam.
- 0:02Hi,
- 0:02I'm Ashley.
- 0:04And you're listening to All Bodies All Foods presented by the Renfrew Center for Eating Disorders.
- 0:09We 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.
- 0:19We believe that all bodies and all foods are welcome.
- 0:23We would love for you to join us on this journey.
- 0:26Let's learn together.
- 0:29Hello,
- 0:30everyone and welcome back to another episode of All Bodies.
- 0:33All Foods.
- 0:34Sam and Ashley are here and today we are joined by a special guest,
- 0:39Doctor Catherine Devlin.
- 0:41She,
- 0:41her,
- 0:41hers,
- 0:42she's a licensed clinical psychologist,
- 0:45certified eating disorder specialist supervisor and the owner of Birch Tree psychotherapy.
- 0:52She opened her practice in the Lakeview neighborhood of Chicago in 2012.
- 0:57She maintains her small group practice focused on providing personalized outpatient care to people with eating disorders,
- 1:04disordered eating and body image concerns and now has locations in the Chicago Loop and the Northwest Chicago suburbs.
- 1:12She provides individual group and family therapy student training,
- 1:17supervision and professional lectures.
- 1:20In her clinical work.
- 1:21Doctor Devlin focuses on applying behavioral therapies within an eff feminist and help at every size or Hayes framework.
- 1:29She has a strong interest in women's relationships with their bodies and the relationships among childhood experiences with food,
- 1:37social learning and weight concerns.
- 1:40She works with a feminist lens to help people understand both social and personal contributions to these relationships and create meaningful change within them.
- 1:50As a haze therapist and advocate for size inclusivity and body liberation.
- 1:55She is passionate about helping people with eating disorders and body image concerns,
- 2:01learn to love and accept their bodies.
- 2:03She is also particularly interested in working with clients with co morbid eating disorders and diabetes.
- 2:10Both type one and type two.
- 2:12Doctor Devlin has had type one diabetes since childhood and also identifies as living in a larger body.
- 2:19Doctor Devlin,
- 2:20thank you so much for being with us today.
- 2:23Thank you for having me.
- 2:24I'm so excited to be here.
- 2:25Yeah.
- 2:26So we met earlier this year at a conference and um I think you may have attended one of the events we were hosting and um and it was so nice to meet you.
- 2:36And after connecting,
- 2:38I knew that um it would be awesome to have you on the show.
- 2:41So thank you for joining um us and being willing to come on and talk to us.
- 2:47Um And I am curious if you can share with us a little bit about your professional background and,
- 2:56and what got you to where you are today?
- 2:59Sure.
- 3:00Um So as you stated,
- 3:02I'm a psychologist.
- 3:04I,
- 3:05I kind of always knew from adolescence that I wanted to be a therapist.
- 3:10I had my own therapist.
- 3:12I really liked her.
- 3:13She was like one of the best things in my life and I really wanted to like,
- 3:19give that to other people.
- 3:22Um And I thought I wanted to work with adolescents.
- 3:25Um And my whole idea back then was I really wanted to focus on working in families in which the kids were demons kind of borderline type characteristics and work on studying the role that uh family therapy would,
- 3:46would play in kind of preventing some of the um negative mental health outcomes later on.
- 3:53So that was my vision and it's been a sharp left turn,
- 3:56but that was kind of where I started.
- 3:59Um But I sort of serendipitously happened upon working and eating disorders.
- 4:06Um And then I,
- 4:08I just kind of found I really fell in love with the work I loved doing the family work that I was able to do.
- 4:15Um I loved kind of working with people on like behavior chaining and figuring out like what,
- 4:22what's the function of this behavior and working with real tangible skills on like,
- 4:27how do,
- 4:27how do we change this behavior?
- 4:29It really appealed to my um my analytic mhm inclinations when I went into private practice,
- 4:40I,
- 4:41I started with kind of like a broader framework of like,
- 4:46I'll try like eating disorder,
- 4:48self injury,
- 4:49kids,
- 4:50adults,
- 4:51like,
- 4:51let me kind of see where,
- 4:52where I end up landing.
- 4:54I really did enjoy still working with,
- 4:56um,
- 4:56people with borderline personality traits and bringing in a lot of D BT and doing some training in that area.
- 5:03And then at some point I just started focusing more on eating disorder work and I really liked working with adults.
- 5:10I,
- 5:11I felt like I,
- 5:13I actually think I'm better with adults than with teens.
- 5:16If I'm being totally honest,
- 5:17I think I might be good with little kids and with adults.
- 5:20Um,
- 5:21but,
- 5:21you know,
- 5:21teens generally I think,
- 5:23find me a little cringe and nerdy and not in an endearing way.
- 5:27So I,
- 5:28I have some who I still see that I really like so early in my training and eating disorders they really talked about in working with like binge eating,
- 5:39how you work on stabilizing it and then once their binge eating is stable,
- 5:44then you can focus on weight loss.
- 5:46And so that was kind of the framework I'd been provided with sort of early on.
- 5:50And,
- 5:51you know,
- 5:51I kind of like chatting with colleagues,
- 5:53like,
- 5:53but no one really ever gets to the point where they're like,
- 5:56quote,
- 5:56ready to work on weight loss and quote.
- 5:58And when they do,
- 5:59they seem to relapse like,
- 6:01what,
- 6:02what is this?
- 6:02I,
- 6:02I like what we're being taught kind of seems wrong.
- 6:06I don't know.
- 6:06And then I heard Margaret Berman speak.
- 6:09She does this like full day training at A P A on using acceptance based interventions for people with weight concerns.
- 6:18And that was when I learned about health every size.
- 6:20And I felt like in the way she like laid out all of the data step by step,
- 6:26I think it was like a whole day long workshop.
- 6:29Um and like why weight loss interventions are ineffective and why they're unethical and what you can do instead to help these clients just like a light bulb would offer me.
- 6:42And it was so nice to finally have like a framework or like what I kind of knew but didn't have words for and also pushed a face a lot of pushback in the community about.
- 6:56Um So that's when I kind of brought Hayes into my practice and,
- 7:04you know,
- 7:05just started focusing more and more on eating disorders and open the second location.
- 7:11So that's not very like linear,
- 7:12but that's Yeah.
- 7:14No,
- 7:14that's great,
- 7:17the growth,
- 7:17the growth of it.
- 7:18All right.
- 7:20Um So for our audience members who are hearing this word haze and probably seeing this word Hay H AES on um the profiles of clinicians and they might be wondering,
- 7:32what is that?
- 7:34I was wondering if you could say a little more about Hay and um and also body liberation because I know those two concepts are really important to you and embedded in your work.
- 7:45Yeah,
- 7:46absolutely.
- 7:47So you know,
- 7:48I think growing up in diet culture and just sort of having the lived experience both with myself and with my clients of weight loss interventions just don't work.
- 8:00I really resonated with um with these types of frameworks and what health at every size is.
- 8:08It's a,
- 8:09it's primarily a social justice paradigm.
- 8:12It was developed by the association for Size,
- 8:15diversity and health.
- 8:16I think it was in the eighties or nineties.
- 8:18It's been around for a while longer than it's been kind of a public um buzzword.
- 8:24And basically,
- 8:27it was based on the idea that fat people deserve the same rights as everyone else deserve access to health care,
- 8:35uh deserve to be treated as human beings and don't deserve to be subjected to weight discrimination.
- 8:41So it is above all else,
- 8:43a social justice movement.
- 8:45And then within that framework,
- 8:47there are um certain principles like uh that everyone has the right to access health care interventions,
- 8:57independent of their body size,
- 8:59respectful care,
- 9:01um uh intuitive movement,
- 9:05um eating for well being et cetera.
- 9:09And so this is kind of the framework through which I think it's helpful to provide care and also think of our own lives in terms of like I can work to improve my overall well being,
- 9:24I can pursue my goals and I don't have to lose weight to get there.
- 9:31And so,
- 9:32you know,
- 9:32whatever you're wanting from your life,
- 9:36if you view weight as the barrier,
- 9:39then that just becomes insurmountable.
- 9:41But if we view weight stigma and oppression as more of the barrier,
- 9:48like those are actually things we can work around to figure out how to,
- 9:53how do we get the life we want.
- 9:54And so a lot of it's figuring out how to like work in the current system or resist the current system to the degree that it's helpful in the body.
- 10:04You have to get the life that you want and to be sort of more agnostic towards changes in body size.
- 10:11So I tell people all the time they're like,
- 10:13you know,
- 10:14my clients are often afraid I'm gonna make them fat.
- 10:16Um Or if I eat this,
- 10:17I'm gonna get fat and like,
- 10:19well,
- 10:19you know,
- 10:20I,
- 10:20I don't know,
- 10:21I don't know,
- 10:21you might lose weight,
- 10:22you might gain weight,
- 10:23you might stay the same.
- 10:25But I think that what we really need to focus on is like your symptoms,
- 10:28your well being.
- 10:28Are you nourishing yourself?
- 10:30Are you doing what you want to do?
- 10:32And if your restrictive diet,
- 10:34for example,
- 10:35is making it so that you're so busy counting points,
- 10:37it's hard to focus on work that's not really moving you towards the life you want.
- 10:42Um And then that word body liberation,
- 10:45I think for me,
- 10:46particularly women's bodies get hit with so much uh objectification and where our value really comes down to how we look and just sort of generally our ability to appeal to the male gaze.
- 11:02Um And that's not really what people are about.
- 11:10Like our worth is not in how pleasant it is to look at our bodies,
- 11:15our bodies are like a tool through which we live and experience our lives.
- 11:21And so for me,
- 11:23body,
- 11:24body liberation and this probably isn't like,
- 11:27uh you know,
- 11:28I don't know,
- 11:28someone else might have a different definition,
- 11:30but for me,
- 11:31it's sort of a social justice movement and philosophy in which we let go of this idea of objectification,
- 11:39work on freeing and respecting our bodies.
- 11:43Um And not feel like we have to align with expectations for how our body should look.
- 11:53Mhm Yeah,
- 11:55I'm hearing you talk and I'm thinking like how I'm,
- 11:59I'm wondering about your clients and maybe if this is the first time that they're hearing some of this material and you mentioned,
- 12:06like,
- 12:06you might have somebody in here quote unquote that comes in and says you're gonna make me fat,
- 12:11right?
- 12:11And I'm using the air quotes and it's like even with that concern,
- 12:16if you will like a teaching them about what weight stigma is and what body liberation is.
- 12:25I mean,
- 12:26even that concern of theirs,
- 12:28I think shows how much weight stigma directs our culture and informs us about,
- 12:36you know,
- 12:37really everything.
- 12:38And so I'm just curious how your clients like,
- 12:42do you see these like light bulb moments go off?
- 12:47You know,
- 12:47when you start explaining what haze and body liberation is to them.
- 12:53I do.
- 12:54And I also see a lot of fear.
- 12:57Yeah,
- 12:57because I think that what we really ask our clients to do is let go of the fantasy of being thin.
- 13:02And I think there's a lot of grief and a lot of fear that comes with that.
- 13:06And if someone is in a smaller body and they have a lot of access to privilege from living in that body,
- 13:13I think there's a fear of losing access to privilege,
- 13:16which is fair and it's reasonable and sometimes there's a grief process.
- 13:22Um but it,
- 13:24I wish it were as clean as like you just explain it and they're like,
- 13:27oh OK,
- 13:30I would,
- 13:31I would throw out my diet,
- 13:32but I do think it's,
- 13:33it's definitely a process and you know,
- 13:36we always say in uh the recovery world uh progress isn't linear.
- 13:41Right.
- 13:43Right.
- 13:43I think so.
- 13:44It's,
- 13:45it takes a while to really kind of not only internalize it but then let that internalizing match with your actions.
- 13:54Right.
- 13:55Right.
- 13:56I mean,
- 13:56it's shifting.
- 13:58I,
- 13:58I love what you said it,
- 13:59it there's so much value in that it is shifting our entire framework,
- 14:04stuff that we've been taught our entire lives and,
- 14:09and I can imagine it not going from like,
- 14:12right,
- 14:12like if,
- 14:12if we're talking about body positivity or body liberation or anything,
- 14:16like it might be really hard for someone to go from like I hate my body too.
- 14:21I love my body.
- 14:22Right?
- 14:23And,
- 14:23and so there's so much in between there and that's what the healing journey is and that's what the the supportive journey is that you're taking your clients on.
- 14:33I,
- 14:33I feel like,
- 14:34yeah.
- 14:35And you know,
- 14:35for me,
- 14:36I really don't love the word body positivity either.
- 14:40Yeah,
- 14:40I think that when I say love your body,
- 14:43I don't mean like love,
- 14:44like feel a lot of fondness towards it.
- 14:47I,
- 14:47I more,
- 14:47I think I maybe respect and care for would be more appropriate.
- 14:53Um Just because I think a lot of clients expect as I work in treatment,
- 15:01I shouldn't have negative feelings about my body anymore and everybody has negative feelings about their buddies.
- 15:10And so we can't have the expectation that those feelings are gonna be removed.
- 15:15And it's more like how do we not let those feelings control us?
- 15:20I think that's kind of the liberation of like we all have this really internalized fat phobia and how can I let go of the hold that has on my life?
- 15:29Mhm So when you're teaching this kind of framework to your clients,
- 15:35um do you ever have moments where you incorporate this within the family?
- 15:40Like if they're bringing in their support people?
- 15:42Um or,
- 15:44or yeah,
- 15:45their partners.
- 15:46Is there ever an opportunity for you to kind of explain this new framework to the family system?
- 15:51And,
- 15:52and if so how does that help your client,
- 15:57I try to and my clients try to um I think certain folks are more ready to hear it than others.
- 16:07And certainly for support people kind of understanding set point and help at every size and the the importance of letting go of weight loss interventions.
- 16:21I do think it helps them support their family member more,
- 16:24especially because you know,
- 16:26people who are struggling,
- 16:27they will tend to go to their family members and say like,
- 16:30oh,
- 16:30I feel terrible about my body if I could just lose this,
- 16:33if I could just do that.
- 16:35And the it's really helpful if the family members can say,
- 16:40oh,
- 16:40it sounds like you're eating disorders really loud today or I'm really sorry,
- 16:44you're struggling with these thoughts today as opposed to like,
- 16:47well,
- 16:48have you thought about,
- 16:49you know,
- 16:49asking your doctor for a prescription for whatever or going to Weight Watchers or like those comments are not helpful.
- 16:58So to the degree that family members are open to hearing the information,
- 17:03I do think it helps them support their,
- 17:05their family member or loved one a lot more.
- 17:08I think it can be hard.
- 17:10You know,
- 17:10a lot of family members have a lot of their own eating disorder issues or body image issues.
- 17:17You know,
- 17:17we're all drinking the same fat Phobic Kool aid and it's gonna be hard to support a family member if you haven't done the work yourself.
- 17:27Uh And so sometimes,
- 17:29like when working with teens,
- 17:31a big part of it is trying to get the parents to do their own work on their own mental health and relationship with food.
- 17:40And I've actually had some cases where a kid was uh demonstrating some disordered eating behaviors.
- 17:49And I just really focused with the parents on um like implementing more of the,
- 17:58like Ellen Sat's work with the um division of responsibility in feeding at home and adopting a more weight neutral attitude at home and actually having pretty good outcomes without even seeing the kids and just kind of doing parent coaching in that way.
- 18:15That's great.
- 18:16Yeah.
- 18:17Mhm But these are parents who are looking for it and want to hear it and I think that makes a huge difference.
- 18:23Yeah,
- 18:24I'm so curious about all the different interventions that you try with your clients.
- 18:30Um and families too.
- 18:33I saw that you offer an intuitive movement group.
- 18:38Is it a group or is it a intervention,
- 18:41a group?
- 18:43And I was hoping you could say more about that.
- 18:45We talk a lot about intuitive eating on this podcast,
- 18:48but intuitive movement,
- 18:49what is it?
- 18:51And how does it help with body image or disordered eating or mental health?
- 18:57So great questions.
- 18:58This is,
- 18:59this is a project that we were so excited to roll out this year.
- 19:05So one of my um clinicians on staff,
- 19:08Kimmy Morrison,
- 19:09who's amazing,
- 19:10was really interested in starting up this group so many of our clients struggle in their relationship with movement.
- 19:18And the most common thing I see is this that especially if they have a history of being like a division one athlete or a teen athlete and then they abandon movement completely or sometimes over exercise.
- 19:34And so just as we see in clients,
- 19:36the binge restrict cycle,
- 19:38I see a lot of cycling between overdo it with movement and complete avoidance.
- 19:45And then particularly for people who have lost some physical fitness,
- 19:50who may be in a larger body whose um physical fitness ha has really changed since their athletic days,
- 20:00there can be so much shame around that.
- 20:03And then every time you try to move,
- 20:05every time you try to do something,
- 20:07it's uncomfortable that triggers the shame.
- 20:10And so you avoid doing it.
- 20:12So I would say the intuitive movement group is kind of a,
- 20:15a work in progress where we're working on kind of that joyful movement component of um of intuitive eating.
- 20:26And initially,
- 20:28we had called it the Joyful Movement group.
- 20:30But then,
- 20:31uh we haven't got the feedback that this wasn't actually very joyful because it was actually really uncomfortable to slow down and focus on breathing in our body seal.
- 20:40Um And so in that group,
- 20:42we partner with a personal training studio in Chicago and then Kimmy and the personal trainer facilitate the group and it's really focused on like doing some movements being mindful of how it feels processing how it feels coping with the emotions that come up and working on trying new things.
- 21:06And I know Kimmy's got like big goals for the group we're planning on like she wants to do it more like a rotation style where each week has a different theme.
- 21:17Um like where some weeks we might do like salsa and another week we might do like uh roller skating,
- 21:25for example.
- 21:26Um These are just like the random examples don't hold me to any of those.
- 21:30But so we're,
- 21:31we're really,
- 21:32we're kind of working on how we're gonna do it.
- 21:34And I think we're probably rolling out another version sometime next year will be our next section of it.
- 21:41And how do you think this group changes your client's relationship with movement?
- 21:46I mean,
- 21:47what's,
- 21:47what are your hopes?
- 21:49Well,
- 21:49my hope is that people will get more comfortable slowing down and learning what makes their body feel good,
- 21:58what helps them with some of their functional movement goals?
- 22:01What brings them joy and instead be able to find like some,
- 22:06some balance in their life and enjoyment.
- 22:09And hopefully the goal is that they will be able to connect with the joy of movement,
- 22:13but it might not be there at the beginning.
- 22:16I think that's so important when we're up against the fitness world that's telling us what we should and shouldn't be doing.
- 22:23And,
- 22:24um,
- 22:24it's sort of like we forget are what's going on internally for us.
- 22:31You know,
- 22:31how does this actually make me feel physically and emotionally?
- 22:34Is this something that I enjoy or is making me feel good?
- 22:38Uh,
- 22:38I think we lose sight of that in this culture.
- 22:40100%.
- 22:41Yeah,
- 22:42I think a group like that would be so valuable.
- 22:45Yeah.
- 22:45My hope is that it'll really help a lot of people with that and that they'll be able to kind of repair some of that damage done.
- 22:54Yeah,
- 22:56that ability to learn how to sit with their bodies and be with their bodies while their bodies are moving.
- 23:07Um I can imagine that that can be so scary.
- 23:13Um But also such beautiful,
- 23:15beautiful work because bodies deserve to take up space and to exist.
- 23:20And so um I think that that's a really cool offering that you all have.
- 23:26Oh,
- 23:26thank you.
- 23:28Yeah,
- 23:28we're pretty excited about it,
- 23:30especially because the so for so many people,
- 23:34the idea of movement and weight becomes so intertwined that it's like,
- 23:39well,
- 23:39if I'm not trying to lose weight,
- 23:40why am I gonna move?
- 23:41And we know that movement has so many benefits for physical and mental health and movement is really essential if you want to continue to maintain the functioning that you have enjoyed.
- 23:59Um And so when we avoid movement,
- 24:02like there can be real decreases in our ability to just kind of go about our daily lives.
- 24:06Like people,
- 24:08you know,
- 24:08I get out of breath when I go up the stairs to take the train or I wanna be able to play with my kids or like,
- 24:14I wanna be able to hike and not be in a lot of pain.
- 24:17And so I think that if we focus on like,
- 24:19well,
- 24:19what can movement actually bring you in your life and that you can get that without,
- 24:25you know,
- 24:26getting your heart rate and whatever zone.
- 24:29If your goal is you want to be able to hike.
- 24:32Ok,
- 24:32we can work on like strengthening your legs and back and building endurance the way that you're gonna be able to do what you wanna do.
- 24:39Yeah,
- 24:40but you might not lose weight.
- 24:42And so you have to let go of that for it to feel worthwhile to try it.
- 24:48Um,
- 24:48so Doctor Devlin,
- 24:49I have another question,
- 24:51kind of about comorbidities and eating disorders specifically.
- 24:56Um,
- 24:57you mentioned that you've worked um with the diabetic community and that you yourself have experience with diabetes.
- 25:04And so I'm curious just kind of how you work with those clients that you might encounter that both have the diagnosis of diabetes and an eating disorder.
- 25:16What comes up for them,
- 25:17especially if like a medical provider is putting them on a particular meal plan.
- 25:22And we're trying to incorporate all foods fit and help at every size,
- 25:26you know,
- 25:26and kind of kind of all of that.
- 25:28I'm just curious if you could speak to,
- 25:31um,
- 25:31someone who might have that experience.
- 25:34It reminds me also of the hot topic that we hear in the media so much,
- 25:38uh,
- 25:38dim,
- 25:40which is not,
- 25:41uh,
- 25:41it's not in the DS M necessarily,
- 25:44but so many folks struggle with it.
- 25:46And I was wondering if you've had experience working with folks who in restrict insulin as well.
- 25:54Yeah,
- 25:55I have,
- 25:56I've worked with people,
- 25:57uh,
- 25:57with,
- 25:58you know,
- 25:58various presentations of diabetes and it is a really,
- 26:04it,
- 26:04it is a very,
- 26:06uh,
- 26:06near and dear to my heart topic.
- 26:08We do know that people who are placed on restrictive diets,
- 26:12even for medically necessary reasons are at a higher risk for developing eating disorders.
- 26:19And I think particularly among the type one diabetic community or type one diabetes community,
- 26:25um,
- 26:26there can be a lot of fat phobia because being in a larger body is often associated with having type two diabetes and particularly as people with type one,
- 26:38start to age into adulthood,
- 26:41there's a lot of fear of the stigma of type two diabetes being put on them.
- 26:46And so I think that can lead to even more fat phobia.
- 26:50Um,
- 26:51now it's actually kind of a misconception that you can't eat whatever you want with diabetes.
- 26:58Like there,
- 26:59there are no restrictions on what you can eat with diabetes.
- 27:03Like you can have anything.
- 27:06They,
- 27:08the thing that I really work with clients on is it's the,
- 27:11the when and the how and with what that we focus on.
- 27:15And so I think a lot of people think I got type two diabetes because I ate too much sugar.
- 27:21Or if I have type one diabetes,
- 27:24I can't eat sugar.
- 27:26And,
- 27:26well,
- 27:26first of all,
- 27:26these are two,
- 27:27like really different disease processes.
- 27:29So it's a little cumbersome that they both have the same name.
- 27:32But you know,
- 27:33be that as it may,
- 27:35people with type one diabetes can absolutely eat sugar.
- 27:38You just have to take insulin to cover it and you have to know your body enough to know how to take that insulin appropriately.
- 27:45And then with type two diabetes,
- 27:47you can't get diabetes from eating sugar.
- 27:50That's not how it's caused.
- 27:52It's,
- 27:53it's a hormonal issue,
- 27:55it's insulin resistance.
- 27:57Um,
- 27:58and it's,
- 27:59it's a very complex issue but people didn't do it to themselves.
- 28:03And I think we over focus on behaviors and when we're talking about type two diabetes.
- 28:10So going back to like,
- 28:12so how do we manage then?
- 28:14What can feel like restrictive meal plans?
- 28:17I think we like Michelle May talks about it in her.
- 28:20She has a book on,
- 28:21um,
- 28:21like intuitive eating with diabetes and you're bringing it back to that intuitive eating piece.
- 28:27And when you have diabetes,
- 28:29you have to add into it.
- 28:30How does this food in this way at this time,
- 28:34et cetera,
- 28:35um,
- 28:36affect my glucose.
- 28:37How does my glucose feel right now?
- 28:40What are my numbers?
- 28:41And so being able to like,
- 28:44spread your carbs out throughout the day rather than restricting them is actually really consistent with what we work on in intuitive eating.
- 28:52And then a big,
- 28:53another big thing in diabetes management is food pairings and that helps with blood sugar stability.
- 28:59Well,
- 28:59it's the same thing we work on in intuitive eating,
- 29:01right?
- 29:02Like any,
- 29:03anything that's just like one type of nutrient is not gonna bode well for blood sugar and it's probably not gonna bode well for most people in terms of like the sensory experience of satiety and sustaining your energy.
- 29:19Um The one thing that's hard for people with type one is you have to carb count and that's kind of one of those things you can't get away from.
- 29:27And so I do find that a lot of folks with type one end up having a lot of shame and judgment about eating higher carb foods.
- 29:35And so we have to work a lot on like viewing it with neutrality and like you just have to take enough insulin to cover it.
- 29:42And there is like the full diagnosis of diab and then there's also like some people who just underdose themselves with insulin because either they're afraid of low blood sugar,
- 29:53the number that they feel like they need to take seems too big or carb counting is overwhelming and so they don't do it.
- 30:00And so they end up underdosing um which can be a problem.
- 30:06Thank you for explaining all that.
- 30:08I,
- 30:08I think it's so helpful to our audience.
- 30:11Um,
- 30:12diab ia the media picks up stories about it all the time.
- 30:16I think it's really,
- 30:17we don't talk about it enough and I think it's misunderstood and I think it's very helpful to think of this on the spectrum.
- 30:23I mean,
- 30:23these are behaviors that,
- 30:25um,
- 30:26can show up in a lot of different ways.
- 30:29It,
- 30:29it reminds me I'm thinking of other co occurring disorders.
- 30:34I know you also work with eating disorders and O CD.
- 30:38And um this is another very common um comorbid diagnosis.
- 30:43What have you noticed working with folks with O CD and eating disorders.
- 30:49How do you,
- 30:49how do you work with it?
- 30:51So,
- 30:52you know,
- 30:52as I said earlier,
- 30:54I really come from a very strong behavioral training.
- 30:57And so I think that's what kind of attracted me to working with O CD.
- 31:00A lot of the like,
- 31:01er P response Prevention Act stuff.
- 31:03It's all very behavioral.
- 31:04It makes a lot of sense to me.
- 31:06I love doing it with people and when we really distill down eating disorders and O CD to their components,
- 31:14there's sort of a common underlying process of difficulty with distress,
- 31:20tolerance and engaging in a behavior or absence of behaviors to try to mitigate that distress,
- 31:31that behavior ends up creating a problem.
- 31:34And so foundation,
- 31:35a lot of what I work with when folks who have and a lot of people with eating disorders,
- 31:42their eating disorder would also be O CD,
- 31:46like they're kind of like there's a very huge functional overlap.
- 31:52Yeah,
- 31:53they may also have O CD about other things.
- 31:55But a lot of times,
- 31:56you know,
- 31:58if we think about like a very classic anorexia picture like that in and of itself is indistinguishable from O CD in terms of like the why and the how and there's actually a really high comorbidity.
- 32:10Um There are certain personality traits that tend to go along with that type of presentation.
- 32:15Um And so,
- 32:16like,
- 32:17it's really about in both or all of these diagnoses just working with a person on like,
- 32:26how do we tolerate feeling uncomfortable and how do we not engage in self destructive behavior when we feel uncomfortable and how we make choices that move us towards our values when we feel uncomfortable.
- 32:39And there are a lot of different kind of techniques to get you there.
- 32:43But I,
- 32:43I like to think,
- 32:44I like to really make sure that I understand the whys and the hows and what's the common thread.
- 32:50And it also helps a lot with,
- 32:51you know,
- 32:52symptom swapping,
- 32:53which we can see a lot in different conditions.
- 32:57And it's like,
- 32:57well,
- 32:57all of these symptoms all have the same function.
- 33:00And so if we kind of know what that function is,
- 33:02we can,
- 33:03we can really attack it.
- 33:04And so I would say like in treatment,
- 33:06it's really important that everyone work with their therapist and understanding like what's the,
- 33:11what's the core issue here?
- 33:12What's my,
- 33:13what's the common function of this and why am I not able to meet that need in a way that's more healthy and adaptive for me?
- 33:21Targeting that common denominator,
- 33:24you end up treating a lot of different things across the board.
- 33:28Yeah.
- 33:29Mhm.
- 33:31So Doctor Devlin to um kind of circle us back to the body liberation piece and the Hayes framework that you spoke about at the beginning of our episode,
- 33:42if someone is interested in,
- 33:46in learning more about this or like it,
- 33:49it really piqued their interest.
- 33:51Where,
- 33:52where would you suggest they start?
- 33:54What materials would you suggest someone look into and,
- 33:58and maybe even giving you guys a call?
- 34:01Um But where,
- 34:03yeah,
- 34:03where would you suggest someone starts?
- 34:06So I think there are a lot of really great resources,
- 34:09you know,
- 34:09definitely ASDA is a great resource.
- 34:12Um They have a lot of research and um resources available on their site to check out.
- 34:22I also think that like I,
- 34:24I love Reagan Chastain Substack.
- 34:27Uh She especially like I love data and science so much.
- 34:33And so her,
- 34:35the fact that she actually brings in uh citations and debunks articles,
- 34:40I,
- 34:40I really love and that appeals to me a lot and I think a lot of our more analytical clients too.
- 34:46Um and then,
- 34:48you know,
- 34:49just kind of a good primer right now.
- 34:51I'm really loving recommending Christy Harrison's book,
- 34:54Anti Diet.
- 34:56I think that's a good one.
- 34:58I also,
- 34:59I love Laura Thomas's,
- 35:03uh,
- 35:03just eat it book and then her workbook that she has coming out or that she's come out with.
- 35:10We really love that.
- 35:11Um,
- 35:13and,
- 35:13you know,
- 35:13some of the ones that,
- 35:14that I really enjoyed when I was trying to dig into the literature,
- 35:17like,
- 35:18lessons from the Fatos Sphere.
- 35:19I forget the names of the authors on that.
- 35:22But that was a,
- 35:23that was a really good one.
- 35:25Yeah,
- 35:25that's a great title.
- 35:27Yeah.
- 35:28And we have a lot of them linked on our resources page too on our but therapy website.
- 35:35Awesome,
- 35:35which we were,
- 35:36we will share your um your socials and resources when we put the show out.
- 35:42Yeah,
- 35:44I'm so glad you brought up Reagan Chastain because we're so lucky to have her as one of our,
- 35:49you know,
- 35:50panelists this year at the Renford Conference.
- 35:52So,
- 35:53um yeah,
- 35:55we,
- 35:56we agree with you wholeheartedly.
- 35:58I'm wondering in closing,
- 36:01what might be a takeaway you would want our audience members to receive.
- 36:10There are a lot of takeaways but I think for the,
- 36:13for the sake of uh parsimony,
- 36:17just remembering what your body is here for why it exists and that it's not your body's job to look a certain way and that your body is here for your life and that you have to take care of it.
- 36:32And treat it with love even if you don't always feel love towards that,
- 36:37to make it through this life and to get what you want out of it.
- 36:40Hm,
- 36:42I love that.
- 36:43How can our audience members connect with you?
- 36:46Um So they can follow me on uh the social medias,
- 36:53the,
- 36:53the socials if they want to.
- 36:55Um They can also email me at C Devlin at Birch Tree,
- 37:00psychotherapy.com or check out our website.
- 37:04Uh There's also a contact form on the website.
- 37:06They can fill out.
- 37:08Thank you so much for being with us today.
- 37:11Doctor Devlin.
- 37:12This was so informative and I think our audience members will really appreciate all of this information,
- 37:17body liberation.
- 37:18We talked about comorbid diagnoses so much.
- 37:22So,
- 37:22thank you for sharing your wisdom with us today.
- 37:26Thank you for having me.
- 37:27I really appreciate it.
- 37:30Thank you for listening with us today on all Bodies,
- 37:33all Foods presented by the Renfrew Center for Eating Disorders.
- 37:37We're looking forward to you joining us next time as we continue these conversations.