Latest / All Bodies. All Foods. / Renfrew Conference Mini-Series Episode 2: The Pleasure is Mine: Sexual Satisfaction & Eating Disorder Recovery with Kate Dorrough, LAPC, CRC, NCC
Transcript
- 0:00Hey,
- 0:01I'm Sam.
- 0:02Hi,
- 0:02I'm Ashley.
- 0:03And 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.
- 0:29There seems to be one thing we're not talking about enough in eating disorder treatment and body image,
- 0:34work sex.
- 0:36Despite the need for a broad approach to support ongoing eating disorder recovery,
- 0:41many mental health professionals feel really uncomfortable talking about the relationship between eating disorders,
- 0:47healthy relationships,
- 0:48body image and sex.
- 0:50Kate Dore is our guest today at the Ren for conference this year.
- 0:54She gave a fascinating presentation on this topic.
- 0:57She helped attendees understand the relationship between sexual satisfaction and eating disorder recovery and even included strategies to help clients explore their current relationship with their body.
- 1:09Let's talk more about this today.
- 1:14Welcome back to all bodies All Foods.
- 1:16I am thrilled to be here today with Kate Dore L PC.
- 1:20CRCNCC Kate is a clinical case manager and counselor at Kennesaw State University's Counseling and Psychological Services.
- 1:30Kate is Ks U's Healthy Eating and Living team,
- 1:33facilitator,
- 1:34a multidisciplinary team that specializes in working with students with eating disorders,
- 1:40disordered eating and body image concerns.
- 1:42Welcome to the show.
- 1:43Oh,
- 1:43it's so great to be here.
- 1:45Thanks for inviting me.
- 1:46So you were a speaker at the conference and we were thrilled about your topic.
- 1:51Yes.
- 1:51So the title of your workshop,
- 1:54Cultivating Sexual Satisfaction while in recovery from eating disorders.
- 2:00Yes.
- 2:00Uh myself and my co presenter,
- 2:03Ariana White.
- 2:04Um That was something that we wanted to propose.
- 2:07Um She's,
- 2:08she's a sex therapist.
- 2:10And so,
- 2:10and I specialize in working with eating disorders.
- 2:12So we came together and we proposed this workshop and here we are.
- 2:18Dare I say we do not talk about sex enough in the eating disorder world.
- 2:23Yes.
- 2:23Do you agree?
- 2:24Yes.
- 2:24And that was why we proposed it.
- 2:25And that's actually something that we wanted to broach because I think it's,
- 2:30you know,
- 2:31it could be taboo for some folks and especially when we're talking about,
- 2:34you know,
- 2:35body image and body shame and you know,
- 2:37what does that look like when we're wanting to satisfy ourselves or being with other people?
- 2:43So we just wanted to bring that and highlight it,
- 2:46bring it to the forefront.
- 2:47Why do you think it's so important that we are talking about this having trainings about it,
- 2:53why is sexual satisfaction an important component of eating disorder?
- 2:57Recovery?
- 2:58Well,
- 2:59and,
- 3:00and I've definitely listened to many of your episodes and,
- 3:03you know,
- 3:03one of the things is with eating disorders is that it's a disconnection from one spot,
- 3:08right.
- 3:09So,
- 3:10you know,
- 3:10bringing in the work of reconnecting with your own body and what does that look like?
- 3:16And sometimes the literature is about how well does your body perform?
- 3:20And you find that too when it comes to sex,
- 3:23like how well are you performing?
- 3:25And so really the focus,
- 3:27we want to bring the focus on more of like what brings you satisfaction,
- 3:30not at a performance level,
- 3:32but really getting to explore what that meaning is for you.
- 3:36And I think when you're an eating disorder recovery,
- 3:39you're finding those reconnections with your body.
- 3:42So I think this is an element that's just integral to who we are as human beings and needs to be discussed and in a way that's open and compassionate and fun,
- 3:55right?
- 3:56Sam?
- 3:57And I were just kind of discussing this prior to you coming in and we were talking about the idea of pleasure and satisfaction and thinking about someone that has an eating disorder or is in recovery from that and the disconnect,
- 4:14right?
- 4:15Do you,
- 4:16what,
- 4:16what has your has been your experience when you've worked with a client that you are helping them to rediscover their sense of pleasure and satisfaction?
- 4:26But that might also feel really scary.
- 4:30Yeah.
- 4:30Yeah.
- 4:31Yeah.
- 4:31Well,
- 4:32you know,
- 4:33it's interesting being at a college counseling center because our model is brief therapy,
- 4:38which doesn't really quite sometimes go hand in hand when someone is in recovery from eating disorders.
- 4:44But we also have,
- 4:44we,
- 4:45we get,
- 4:45you know,
- 4:46the pleasure of sometimes working with clients long term.
- 4:49So,
- 4:50you know,
- 4:50to answer your question about,
- 4:52well,
- 4:53how do you develop that tolerance at first?
- 4:57Right?
- 4:57To then explore this idea of what is satisfaction mean to me.
- 5:03And you know,
- 5:04it can look a lot of different ways,
- 5:06you know,
- 5:06when it comes to even food of like what's satisfying or when it comes to even like doing some values exploration,
- 5:14right?
- 5:15I I work with clients about what are the ed values and what are your values?
- 5:20Right?
- 5:20And that can center around.
- 5:22OK.
- 5:23This is something that is a little scary but it's worth going in direction because it's aligned with my values.
- 5:31And so,
- 5:32and some of it also looks like some body work too,
- 5:35you know,
- 5:35like riding that wave of maybe some discomfort.
- 5:39But then maybe on the other side of that,
- 5:41there's actually like,
- 5:43oh,
- 5:44well,
- 5:44that wasn't as scary as I thought it was going to be so walking them through that.
- 5:48So then there can be a place of finding that satisfaction and and doing some experiments and you know,
- 5:57um brainstorming what could be some ideas to try and I'm just thinking about like,
- 6:04so for example,
- 6:06I,
- 6:06we had a client,
- 6:08um,
- 6:08one time who she was sitting on the couch in our group room and was kind of,
- 6:15you know,
- 6:15curled up,
- 6:16had her knees up and had a pillow on her.
- 6:19And,
- 6:19you know,
- 6:20we were processing,
- 6:21um,
- 6:21asked her what she was experiencing,
- 6:24what was coming up for her in the moment,
- 6:25asked her if she could talk about that and put her feet on the floor and take the pillow um off of her because she deserves to be seen essentially.
- 6:35Um and to not hide and I'm thinking about that with someone um saying to them like you deserve to feel pleasure,
- 6:46you deserve to feel satisfied,
- 6:48you deserve to taste food and enjoy it,
- 6:53right?
- 6:54Um And I'm just thinking like what a shift that I can't imagine the freedom that someone is going to feel when they can finally have that shift.
- 7:08Now,
- 7:08I also imagine that that takes a lot of work.
- 7:12Yeah.
- 7:13Yeah.
- 7:13Well,
- 7:14and I think something that you speak to Ashley is permission and sometimes that permission,
- 7:19we want it to come from within,
- 7:21right?
- 7:22We want it to come from our clients,
- 7:24but sometimes it is witnessing someone and seeing them noticing,
- 7:29noticing,
- 7:30I notice the pillow,
- 7:31I notice,
- 7:32I wonder what it would be like to put the pillow down to put the feet on the floor.
- 7:37And that's,
- 7:38that's a place where you can find sexual satisfaction,
- 7:42like,
- 7:43I wonder what it would be like to try this toy or I wonder what it would be like to be in front of the mirror or?
- 7:49I wonder.
- 7:49Right.
- 7:50So there's a lot of wondering and,
- 7:52and yeah,
- 7:52and like being with the client in these moments of,
- 7:55you know,
- 7:56having like um activating some emotional experience,
- 8:01right?
- 8:01And the safety of,
- 8:02of the counselor,
- 8:04client relationship and using that as a template,
- 8:07right to go out.
- 8:08And so when I say,
- 8:09you know,
- 8:09having some emotional activation,
- 8:11it's like,
- 8:12ok,
- 8:12so right now we might be having a snack together,
- 8:15for example,
- 8:16and this is bringing up a lot of thoughts and feelings and images and then,
- 8:20oh wait,
- 8:21I can eat the snack and I,
- 8:23you know,
- 8:23there was some fear,
- 8:24there was some racing thoughts and I was able to do it.
- 8:28So it's kind of using that idea and saying,
- 8:32ok,
- 8:32let's use that and what could it look like for you and exploring those?
- 8:37Um you know,
- 8:38sexual satisfaction,
- 8:39there's so many parallels when you think about it.
- 8:42Yeah,
- 8:43when I'm curious,
- 8:45folks and eating disorder,
- 8:46recovery,
- 8:47folks with eating disorders,
- 8:48what are they,
- 8:49what are the themes?
- 8:50What are they struggling with when it comes to sexuality?
- 8:53Well,
- 8:54you know,
- 8:54I think for some it's feeling stuck,
- 8:59you know,
- 8:59because their bodies have responded to restriction in a way.
- 9:03So they might feel stuck in maybe even though they're 19 or 2022 and 24 they feel 16.
- 9:12And so they're in that place of,
- 9:14well,
- 9:14what does it even mean to,
- 9:16for me to know myself in a way of like,
- 9:19what would be satisfying to me sexually?
- 9:22Um,
- 9:22and I think,
- 9:23you know,
- 9:24and depending on the presentation for some,
- 9:26it's,
- 9:27it's been,
- 9:28sex has been a means for self worth,
- 9:31but it's in performance for others.
- 9:34And that is a high correlate with eating disorders.
- 9:38Like,
- 9:38how do I appear?
- 9:40How,
- 9:41um is this rigidity or lack of control?
- 9:45Um How is it being perceived because I don't want anybody to know,
- 9:49right?
- 9:49The eating disorder breathes silence,
- 9:51right?
- 9:52And so I think there's um a lot of parallels as far as,
- 9:59you know,
- 9:59with folks with eating disorders that disconnection from body and,
- 10:03and,
- 10:04you know,
- 10:04bringing that back.
- 10:05Um and what does it look like when we're stepping away from performing for others and performing even for this,
- 10:15this ideal and getting to the core of what it means to be me.
- 10:20So there's a lot of,
- 10:21um looking at,
- 10:24you know,
- 10:24what are the parts of me,
- 10:25right?
- 10:26The authenticity.
- 10:27What are,
- 10:28you know,
- 10:28and even dare I say,
- 10:30which,
- 10:30you know,
- 10:31in some fields and eating disorders,
- 10:35there's a sense that you don't say that eating disorder served you and I actually come from that place of OK,
- 10:41it served you up until this point and now you're noticing that it doesn't serve you anymore,
- 10:46you know,
- 10:47in this place of recovery.
- 10:49So,
- 10:49how do we recover?
- 10:51What is ours and not the eating disorders?
- 10:54And so that's kind of some of the work that I do.
- 10:58Yeah,
- 10:58I love that.
- 10:59I'm curious,
- 11:00I imagine there are times you bring partners in other folks in sometimes.
- 11:08Now,
- 11:08see,
- 11:08it's,
- 11:08it's a little based on our university setting with a couple.
- 11:13If it was like couples or anything,
- 11:14they would have to be a KSU student.
- 11:16So they'd have to be like the,
- 11:17the,
- 11:17the partner would have to be um like if we wanted to do ongoing or something now,
- 11:23as far as consultations now,
- 11:25yes,
- 11:25like if there was a one time like this person is exploring,
- 11:28you know,
- 11:28like what's OK to share,
- 11:30what's not OK to share.
- 11:32Um How do you create a place of some comfort because there will be discomfort.
- 11:37So how can you,
- 11:38like,
- 11:38I remember doing that with one client who was in recovery?
- 11:42Um And,
- 11:43you know,
- 11:43sex was kind of painful and it was like,
- 11:46I don't,
- 11:47I don't really know what is pleasing to me.
- 11:50I feel like walking through some things of like these are things you can do to help her feel safe.
- 11:56Um And you know,
- 11:57and able to communicate that in the counseling space.
- 11:59So then,
- 12:00you know,
- 12:00it's not necessarily about ok,
- 12:02what are,
- 12:03what are some of the fun things that you can do to find that satisfaction again.
- 12:07But it's really about that intimacy and creating safety.
- 12:11So you do feel like you can risk a little bit.
- 12:13Yeah.
- 12:14How do you create safety?
- 12:15I mean,
- 12:16what are if,
- 12:16what's some of the guidance you give to partners to create that emotional safety?
- 12:20Yeah.
- 12:21So um you know my to them about choices.
- 12:26So you know,
- 12:27especially like not that everyone who has an eating disorder or is in recovery from an eating disorder necessarily has a trauma history,
- 12:36but in the course of eating disorders,
- 12:38trauma happens,
- 12:39right?
- 12:40So,
- 12:41and there can be a sense of a loss of choice and so creating some choices around,
- 12:48you know,
- 12:48would this be OK or would this be OK?
- 12:51Right.
- 12:52How does that feel?
- 12:53What are some of the sensations that are coming?
- 12:57Not for you right now?
- 12:58Like,
- 12:59or if you know,
- 13:00doing something like taking the finger and just stroking it across the arm,
- 13:04like what feelings are coming up for you.
- 13:06So it's like starting in those places where it's like the these pieces that are really important for connection.
- 13:13Um But like it's like,
- 13:15ok,
- 13:15ok,
- 13:16this feels a little uncomfortable but I'm feeling some warmth here.
- 13:19So giving them some language about like warmth and tingling and so like some of those physical sensations.
- 13:27Um So those are some of the things and then,
- 13:30you know,
- 13:30and then a choice too is a big one.
- 13:33I'm just thinking like,
- 13:35we talk about um safety and choice and,
- 13:41and language really like somebody with an eating disorder learning how to take back their voice.
- 13:49Um and being the one to say the thing that they need,
- 13:54right?
- 13:54And not,
- 13:55not saying the thing that somebody else needs so that they can please that other person not saying the thing that they think that they should say,
- 14:02not saying the thing that,
- 14:03you know,
- 14:03the world thinks that they should say or the eating disorder,
- 14:06but like what they need and the work that you're describing feels so it feels so empowering to me,
- 14:13like I'm over here and I'm like,
- 14:15I'm so glad that you exist and that you're creating this space because sex is so vulnerable.
- 14:24It's such,
- 14:26I mean,
- 14:26it is,
- 14:27oh my goodness.
- 14:28It's such like a an intense space for people to experience.
- 14:34And if I've been disconnected from myself and my body and my,
- 14:39my wants and my needs for so long,
- 14:42like I can't,
- 14:44I just feel like that's got to be such um a confusing message for me to hear that.
- 14:49Like I can have ownership,
- 14:51I can have choice.
- 14:53I can have my voice and say this.
- 14:55And so I'm,
- 14:56I'm very thankful that this space exists for someone to be able to work through some of that stuff in a safe manner and begin to,
- 15:08yeah,
- 15:08empower themselves and start owning their voice again.
- 15:12I think that sounds incredible.
- 15:14Also how it can generalize to other areas of their life because needs are needs,
- 15:20whether it's physical needs or emotional needs and teaching partners how to talk to each other and,
- 15:27and create choice and checking in with how does this feel?
- 15:31I mean,
- 15:32that,
- 15:33that applies in so many situations and it's so nice,
- 15:37isn't it when you can do that with your partner and when they can hear you and you can check in with each other and yeah,
- 15:46it's just so nice.
- 15:49We need that.
- 15:50It's how you deepen intimacy in relationships.
- 15:53And I think too,
- 15:55you know,
- 15:56sometimes we don't have this language because it's about,
- 15:59well,
- 15:59this feels good or bad.
- 16:01It's very black and white where it's like,
- 16:04OK,
- 16:04let's look at giving you more language to practice.
- 16:09You know,
- 16:09it's like,
- 16:10oh,
- 16:10this feels warm or this feels tingly or I feel uncertain about this and I'm willing.
- 16:17Like so,
- 16:18right?
- 16:18Because the eating disorders gives us very few options if any at all.
- 16:23Right?
- 16:23It takes her voice.
- 16:24So this is about OK,
- 16:26so this is some language to help you reclaim and then you can start to make it your own,
- 16:31right?
- 16:31It's sort of this invitation and then answering to that invitation,
- 16:36it reminds me of emotions wheel out.
- 16:39The it's sort of like,
- 16:40you know,
- 16:40how are you feeling bad?
- 16:42Here's an emotion wheel.
- 16:44What is bad?
- 16:46But it's like,
- 16:47is there a Sensations Wheel?
- 16:49I love it.
- 16:52It's an emotion Sensations Wheel.
- 16:54I'm trying to,
- 16:54I need to remember.
- 16:56It's a counselor out of,
- 16:59I believe Seattle Washington.
- 17:01Um Brahmin,
- 17:03like Lindsay Brahman and she did this like emotion Sensation Wheel and she also made a pillow.
- 17:07So like I,
- 17:08so the clients will sometimes I've seen that.
- 17:11I've seen that.
- 17:12Yes.
- 17:12Yes.
- 17:13Yes.
- 17:13Well,
- 17:13and I'm just thinking about like,
- 17:15um,
- 17:16the idea of shame with eating disorders and how that it is such a theme that we play out,
- 17:24we see play out with someone with an eating disorder and how when you're talking about sensation,
- 17:31words and the words like warm or tingly,
- 17:34like in my mind,
- 17:35I'm like,
- 17:36is there also a shame component maybe associated with certain words?
- 17:42Right?
- 17:42But then being given permission to explore what those words mean and then being encouraged to test it out with yourself,
- 17:52like check in with yourself.
- 17:54How do you actually in a safe space?
- 17:57Respond to that word?
- 17:58Is that word an OK word.
- 18:00So I just love the language of that,
- 18:02of the sensations?
- 18:03Definitely.
- 18:04Yeah.
- 18:05Yeah.
- 18:06Well,
- 18:07this has been a stimulating conversation.
- 18:11Thank you for being here.
- 18:12Thanks for having me.
- 18:13This workshop is going to be so helpful to so many clinicians and I just want to thank you for your work.
- 18:21Will you come back?
- 18:22Can we do a full episode?
- 18:24That would be cool.
- 18:25Let's do that.
- 18:26That would be great.
- 18:27Yeah,
- 18:27that'd be really fun.
- 18:28Awesome.
- 18:29Thank you.
- 18:29So much.
- 18:30Thanks for having me.
- 18:30Thank you.
- 18:36Thank you for listening with us today on All Bodies All Foods presented by the Renfrew Center for Eating Disorders.
- 18:42We're looking forward to you joining us next time as we continue these conversations.