Last Updated on July 29, 2024 | Published: July 12, 2024 published by Jenny Tomei
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Neurodiversity and Eating Disorders
Speaker A [00:00:10]:
Welcome to the Jenup podcast. If you’re struggling with an eating disorder and feeling lost, you’ve come to the right place. We’re both former sufferers of eating disorders, myself and Becky Stone, and we understand the challenges that you’re facing. So join us for inspiring, educational, and relatable content. Whether you’re seeking support, guidance, or just someone who understands, we are here for you. So today we have Doctor Marianne Miller on the show who has been in the mental health field for 27 years and has specialized in eating disorders for the past twelve years. She was a full time academic for twelve years and had a part time eating disorder practice for much of that time until she left the university and went into private practice full time in 2018. Doctor Marianne loves working with eating disorders.
Speaker A [00:01:09]:
As a therapist and a coach, she takes a non diet feminist approach that helps people of all genders live empowered, authentic lives. She embraces the health at every size model, and she is also neurodivergent and LGBTQIA plus. Affirming. Over to you, Becky, to ask our amazing guest the first question.
Speaker B [00:01:40]:
So what triggered your eating disorder? And do you think that being neurodiverse sped up, maybe fueled the eating disorder?
Speaker C [00:01:50]:
That is an excellent question. I think what triggered the eating disorder was the diet culture in my family, because there was such pressure to look a certain way to be thin. And so I, uh, developed the eating disorder very young. I probably was around eight or so when the symptoms started and then eventually started dieting. And how it was in my home growing up is that, um, the food was very controlled because, you know, my mom wanted only specific foods in the house. And so we didn’t have, like, all the sweets, all the desserts, all of the snacks, kind of things that my friends had. And so I would, you know, feel very restricted. I would be eating a lot of rice cakes, which I can’t stand to see the sight of today.
Speaker C [00:02:57]:
And. And I would go over to my friend’s house, and then it was like a free for all with eating the candy and their cookies. And I would be like, how could you have a cookie jar just there? Just like there all the time? And you have extra pizza. What? And people aren’t gorging themselves on it because it’s not going to go away anytime soon. That was just mind blowing for me. So I look back on my pictures, and I didn’t have a bigger body. I never had a pediatrician tell me that I had a larger body and that I needed to lose weight. And that was the message I got from my family and I internalized that and started dieting.
Speaker C [00:03:53]:
And then when I started dieting, I got a lot of positive feedback. And then it just kind of built from there, where in middle school, I developed full blown anorexia. And I think that being neurodivergent was a big part of it because there was just a part of me that never felt like I could really fit in or connect with people. Um, and I, part of my flavor of neurodiversity is having sensory processing sensitivity. So, uh, what that means is, like, if all human beings were bugs, and, uh, most bugs, neurotypical bugs, have, like, two to four antenna, and they’re just, um, you know, gathering data and using their senses through that. Um, people with sensory processing sensitivity have, like, a hundred antennae. So we’re just, we feel overstimulated over, like, kind of assaulted with a lot of our senses. And I I was a very deeply emotional, like, sensitive child.
Speaker C [00:05:15]:
And then I have some other flavors of neurodiversity as well. And so I had trouble with friendships. I did have some friends, but it was just very difficult. And then I had a lot of pressure from my family to be neurotypical, although we didn’t know what that was at the time, to be outgoing, extroverted, when in reality, I was very highly sensitive introvert. So that dissonance of, like, I was supposed to be this one way, this extrovert, this popular kid, which is what my family wanted me to be, versus what I really was, was this introverted, highly sensitive, neurodivergent kid. I internalized that dissonance and then developed very. Or self esteem. And so I think that contributed to me looking how to cope with the dissonance and cope with the pain of all of that.
Speaker C [00:06:26]:
And so, and I was being restricted from food. And so food that was on the, quote, bad list for my family became something that I was very. That they put up on a pedestal. And so when I had access to that food, I would overeat it or sometimes binge on it. And then I. And then it eventually switched to anorexia, and then it switched. I would, like, go back from restricting to binge eating, kind of restrict months at a time, and then binge eat months at a time in high school because I had more access to food because I had my driver’s license. So, yes, absolutely.
Speaker C [00:07:11]:
I don’t think anyone has asked me that question, Becky. And so I’m really glad that you did, because it completely is intertwined.
Speaker B [00:07:20]:
I was going to say, do you think having a diagnosis has helped. And has it boosted your confidence and understanding who you are?
Speaker C [00:07:30]:
Yes, absolutely. In the nineties, when I was in graduate school, I saw a therapist who said, I think you’re a highly sensitive person. And a book came out by doctor Elaine Aron called the highly sensitive person based on research. And it had just come out and I read it and I said, oh, my goodness, this is totally me. And what that was is kind of the precursor of what is now considered having sensory processing sensitivity. And so that, that helps. And then recently, really, ever since the pandemic, I have been exploring more about neurodiversity. And I realize that I have other characteristics of being neurodivergent as well.
Speaker C [00:08:23]:
And being able to say that I am, it’s like, okay, this makes sense. Sense. It’s not because I’m not working hard enough at relationships. It’s not because I, you know, something is wrong with me that I get overstimulated by crowds or like at restaurants and things like that. It’s just the way that my brain works. My brain works differently than other people. It’s, it’s like being a Macintosh computer in a PC world. It just, I just need to figure out, and that’s not original.
Speaker C [00:08:55]:
I got that from a friend of mine that it’s so, it’s like you need adapters and things to help you function in this PC world.
Speaker B [00:09:09]:
I love that. That is a good analogy.
Speaker C [00:09:14]:
Yeah. It came from doctor Panicha Maguire, who was actually a former student of mine and a friend now. And she works with a lot of neurodivergent people.
Speaker B [00:09:26]:
That’s a good analogy that I will use with my clients. Thank you.
Speaker C [00:09:29]:
Awesome. You’re welcome.
Speaker A [00:09:32]:
Oh, I love that. And in terms of like, you know, what, what do you think, you know, was your turning point for recovery?
Speaker C [00:09:40]:
Oh, wow. I think. I think there were several attempts at recovery and I just didn’t find the right help. So I realized I had an eating disorder when I was at university. And there was a guest speaker on campus who was an author who wrote about eating disorders. Now, this was in the early nineties, and people just didn’t talk about eating disorders very much. And so for her to come in, and I remember it was a very crowded, like, lecture hall, and for her to share about her experience and her journey, I vividly remember sitting in the audience going, oh, my goodness, I thought I had an eating disorder. Well, there was no one on campus who could help me.
Speaker C [00:10:34]:
Like, I, I was at a christian university and I went to, you know, some people and talk to them, and they said, oh, just pray more. Just pray more and you’ll get better. Yeah. I’m like, yeah, that’s how it works. And then because we were in a small university town, the closest, like, support group for eating disorders was an hour and a half away, and I didn’t have a car, and so I had to have, like, friends drive me. So it’s very difficult. So I ended up transferring to a larger university in my home city of Denver, Colorado, and was able to get a, quote, eating disorder therapist. And I’m putting it in air quotes because she really didn’t know what she was doing.
Speaker C [00:11:25]:
Like, looking back at it, she branded herself as an eating disorder therapist, and she really didn’t have the training. She just, she took our insurance. And so I really didn’t get the adequate help. And then, so what ended up happening is that I ended up pivoting to just having, like, you know, going from restricting to binging to going from binging to over exercising. And then I thought that, oh, my eating disorder is done. It’s, it’s finished. I’m recovered. You know, I’m just very healthy.
Speaker C [00:12:06]:
But I was over exercising to the point where I was injuring myself repeatedly. I was completely obsessed about food and calories and all of those things, but I was like, no, no, I’m recovered. I’m just a very healthy person. And I would get so much positive your feedback, oh, my gosh, you’re so healthy, and you’re so fit and wow, wow, wow. And that was, like, the ideal of what my family had taught me that I needed to be is very, very fit and very healthy. And quotes, in quotes, I was very, actually sick. I was actually very sick. And so I, throughout graduate school, I had this raging eating disorder and didn’t know it.
Speaker C [00:12:58]:
And it wasn’t until a month after I got my PhD that I injured my back. I ran a race on New Year’s Eve, and then on January 1, I went snowboarding, and I was learning how to snowboard. And if anyone knows about snowboarding, it’s very difficult to learn, especially as an adult. I’ve been skiing my whole life, but it was very difficult. And so when I learned how to snowboard or what that happened that day is, I had a bunch of very bad falls, and I ended up injuring my back. And then I couldn’t exercise at all and had a lot of problems and chronic pain. Two surgeries. It was, it was a mess.
Speaker C [00:13:48]:
And then it became a full fledged binge eating disorder because I couldn’t use exercise to compensate. And then I got the university position in San Diego because all of that happened in Texas, where I did my graduate school. And I eventually realized, like, after I moved here, that I needed. I needed real help. And I found out that real help with, with very well trained, experienced professionals were, they were available in San Diego. And I found, like, the person, perfect person for me. And it really wasn’t until I worked with her that I started to recover. So it was like, a lot of fake recoveries does that, if that makes sense.
Speaker C [00:14:38]:
You know, where I was, I thought there was. I was recovered, but I really wasn’t.
Speaker B [00:14:43]:
It’s really scary that you had the courage to go and seek therapy by somebody who said they could work with eating disorders. And it’s the same over here. There’s a lot of therapists out there saying they can work with eating disorders and they are not trained. It’s such a complex area, and it’s so. It sounds like there was part of you that knew something wasn’t quite right, but you kept going with it.
Speaker C [00:15:09]:
Yes, absolutely. There was a part of me, and I, like, buried it down deeply for a while, but it eventually floated up to the surface and like, yeah, I need to do this. And it, because it was affecting everything. It was affecting my ability to connect with my husband, you know, my relationships, my daily functioning, everything.
Speaker B [00:15:36]:
Do you think your experience helps benefit your clients in recovery?
Speaker C [00:15:43]:
That’s a great question. So I don’t always disclose to my clients that I’ve recovered from an eating disorder because I want to focus more on them. Although now, because I’m so much on social media, a lot of them know already, and some of them ask me about it, and some of them don’t care. They’re just like, I just. I just need your help and your expertise and training, I think, with. So that’s my therapy clients now, for my coaching clients, which I work with people in the UK and people in other states where I’m not licensed because I’m only licensed as a therapist in California and Texas. And people who go through my binge eating recovery program are people with whom I work with as a. With whom I work as a coach, and I do disclose, and I am very open about my own experiences because it’s more.
Speaker C [00:16:45]:
It’s less of a. I mean, it isn’t a therapist client relationship, it’s a coach client relationship. And so I can be more open and transparent and. And just share. Yeah, yeah. I totally struggled with this specific thing, and this is what it was like, for me versus with therapy, I have to be very careful about self disclosure. It’s just. It’s just kind of about the importance of providing ethical therapy and how I was trained.
Speaker B [00:17:21]:
Do you want to go, Jen, on the next question, or do you want me.
Speaker A [00:17:24]:
Yeah, no, I was just processing what you said, because I think that I’ve had. Sometimes I’ve had clients ask, if your client asks you, oh, did you ever suffer? Or, like I say, yes, don’t go into a lot of detail about it. I just focus on the client. I don’t like talking about me much.
Speaker C [00:17:39]:
Yeah, yeah. And, I mean, it’s all about your level of comfort, like, as a coach, too. I mean, I didn’t go public with my eating disorder. I went public two years ago. It seems like it’s been much longer because so much has happened since then. So I kept it very quiet for a long time, and then I realized I could really be helping people by sharing that I’ve recovered and that it’s possible. And I was like, okay, let’s do this.
Speaker A [00:18:09]:
Yeah, exactly. I think also they can. Obviously, they can relate to you as well. There’s a lot of. I think that people like that. They’re like, oh, like, she gets me. She understands what I’m going through.
Speaker C [00:18:23]:
So, yeah, she’s felt the pain. She knows how, like, all consuming it. Yeah, yeah.
Speaker A [00:18:32]:
So with, obviously, the binge eating disorder. So what strategies and coping mechanisms have you found most helpful for you, obviously, to help manage the binge eating when you were going through that? Because I think that that would help a lot of people listening to this who may be struggling with, like, binge eating.
Speaker C [00:18:53]:
So I think having a support network is really important. Having a therapist or a coach, having literature, like, in my courses, in my program, there’s a videos and worksheets that people go through that I wish I had had. You know, back. Back in, when I recovered, I mean, I had. There were books, but sometimes the books weren’t good. I finally found Chris Fairburn’s work, who has done a lot of research at Oxford on binge eating and how to help people stop. And that’s probably what I found the most helpful on my own, because he does exposure work with people’s fear foods. And so my therapist told me, she said, you can just don’t worry about what you’re eating right now.
Speaker C [00:19:59]:
We’re just going to focus on the underlying things. Just eat whatever. And that still brought me a lot of anxiety. And what I ended up doing is buying a fair bones book overcoming binge eating. And he talks about, like, making a long list of your fear foods, and then every time you go to the market or the grocery store, buying one of them and then having it at home and eating it. And then the second time you go to the grocery store, you buy your first fear food and then you buy your second for your food. And then you eventually build up to where you are able to have your fear foods around the house all the time. And what that does is that takes the food off the pedestal and makes it more neutral.
Speaker C [00:20:58]:
And that was very helpful. And even before that, I think a helpful step was really leaning into mechanical eating that my therapist encouraged me to do. So because I had the eating disorder for like, nearly 25 years. My hunger and fullness cues were all messed up. So, like, I didn’t always feel hungry. I didn’t always know when I was full. So what we did is we got me on a regular schedule of eating where I was eating breakfast, lunch, and dinner, and like, a cup, like a mid morning snack and a mid afternoon snack. And sometimes when I taught night classes, I would have, like, two snacks and then I would have dinner when I would come home, like after nine.
Speaker C [00:21:50]:
And so having that regular schedule really trained my brain and taught my brain that, okay, you’re going to get regular nourishment. And that just wasn’t what it was before because I, you know, I was restricting bingeing, restricting binging. Because anytime there’s binge eating, there’s restriction. And so getting that regular nourishment, I, I really have this crystal clear memory of sitting down at the table and eating lunch and just sitting there and going, I am nourishing myself right now and just feeling so, like, loving toward myself as I was nourishing myself. And it is an act of love to have regular scheduled meals and snacks or do mechanical eating. So the mechanical eating and then the exposure work with your fear foods, I probably think that those were two of the strategies that really helped. And then when I felt the urge to binge, I had coping skills and that I built up. And I probably one of the most helpful ones is I built up a network of friends who I could reach out if I felt the urge to binge.
Speaker C [00:23:13]:
So if I felt the urge to binge, I would just text them and they would, you know, respond and encourage me. And that helped. That helped. And then I was getting feeding regularly throughout the day. So I didn’t have that glucose deficit that builds up when you restrict for a long period of time. So.
Speaker A [00:23:37]:
Thank you so much for sharing that. Everyone listens to find that super useful. I think a lot of the struggle with the hunger and fullness cues, I see that a lot in patients with disorders for a long time because they just, they just get messed up. And like you said, the regular eating and the patterns is the way to bring it back and to regulate it. But that’s the hardest thing today.
Speaker C [00:24:00]:
Like, oh, it’s really hard.
Speaker A [00:24:04]:
It’s really hard.
Speaker C [00:24:04]:
Really hard. Yeah. And especially with people who are neurodivergent because like I experienced the hyper fixation on things and so I could like get hyper fixated in something and then hours go by and I’m like, you know, what day is it? I don’t, I think I had to go to the bathroom like 2 hours ago. I don’t know, you know, and so I think that having the schedules and knowing the times when I was eating, regardless of whether I was feeling hunger and or fullness cues, that helped a lot. And I suggest my clients to set alarms on their phones or on like their apple watches to help them.
Speaker B [00:24:51]:
It’s a good trigger as well because I can hyper focus and lose time. Or if I’m on the phone doom scroll and then I’m like, how wasted time doom scrolling. So having that trigger, there’s a really good app called structured. Yeah, I love it. One of my clients is neuro spicy. She recommended it to me. It’s one of the best things I’ve ever used because it doesn’t just give you one alarm. Because one alarm I tend to ignore as a reminder.
Speaker B [00:25:22]:
It gives you a few reminders and actually it pulls me out of the hyperfocus, which is really good because it either vibrates on my phone or vibrates on my watch.
Speaker C [00:25:34]:
Yes, I’m familiar with the structured app and yeah, I’m so glad that that’s helpful for you. I tend to forget about recommending it to my clients, but I need to, especially the neuro spicy ones.
Speaker B [00:25:53]:
I love that. One of my clients said that to me the other day about being neuro spicy and I was like, do you know what? I like that. I’m going to take that on.
Speaker C [00:26:01]:
Yeah, yeah. There’s this whole neurospicy corner of TikTok that’s just like, you know, using that hashtag that’s like, there’s all kinds of like crazy cool stuff and funny and affirming. It’s nice.
Speaker A [00:26:16]:
That’s going to feel normal.
Speaker C [00:26:19]:
Yes it does. It does. You may see like it normalizes. It’s like, I’m not alone, definitely.
Speaker A [00:26:26]:
Obviously, talking about binge eating. Like, so what advice would you give to someone who’s currently struggling with binge eating, and how would. How would. How would they go about help?
Speaker C [00:26:40]:
Great question. The first thing I would say is that there is hope. I know that things may feel very dark right now, and you may feel like you’re walking through a long, dark tunnel that is never going to end. And I want to say to you that there is light at the end of the tunnel. There is, and there is hope. And it’s just really getting the right help from people who really know what they’re doing. And also that people who have a lot of compassion and non judgment, because people with, I think, binge eating disorder, especially, just experience so much shame. Like, when I first saw my therapist, I was just this ball of shame.
Speaker C [00:27:31]:
And so finding someone who was not judgmental and accepted me for who I was and cared for me, you know, in, like, in a therapeutically appropriate way and was compassionate, that meant the world to me. And especially because I never felt like I got that kind of caring and compassion from my family of origin. And so having that person in my life and having multiple people like that in my life, it was really, really helpful. And I am a very caring, compassionate person. And so I really give that to my clients. I mean, I don’t over function for them. I’m not, like, codependent or do any of all that. That’s not helpful for them or me.
Speaker C [00:28:23]:
I am a very steady rock. Like, we can do this. There is hope. Here’s the path. And so for people to reach out to those people who I would say, have a lot of experience with binge eating, specifically, like, at least three years, preferably five, and where I would say at least a third, preferably 50% of their clients struggle. Struggle with binge eating. So, I mean, I have really high standards, and it’s because I had bad therapists. And she, that therapist who didn’t know what she was doing was not the only therapist I saw during the time.
Speaker C [00:29:13]:
And none of them knew anything about eating disorders. No. So, yeah, so you really have to find people. People who know, therapist, coach, online program, whatever.
Speaker A [00:29:28]:
I think that’s very. Just an important point. I just want to, you know, reiterate is that if you find someone that’s trained in eating disorders, that just worked for it, you know, like, you know, in it.
Speaker C [00:29:39]:
Exactly.
Speaker A [00:29:40]:
Yes. Because otherwise, you know, if something goes wrong and it just kind of puts you off, like you had a bad experience, and that just makes it worse.
Speaker C [00:29:48]:
And then I. Oh, yeah. Then you internalize it and think that it’s your fault.
Speaker A [00:29:53]:
Yeah.
Speaker C [00:29:54]:
If there’s something wrong with me, you know, or there is no hope, there’s like, there’s no way I can get over this, you know, it’s. It’s hopeless. And that’s just not true.
Speaker B [00:30:06]:
There’s always hope with the right therapist, right?
Speaker C [00:30:10]:
Absolutely.
Speaker A [00:30:13]:
Before we wrap up, Becky, is there anything. One last question you wanted to ask?
Speaker B [00:30:18]:
No, I’m all good. I think what we’ve covered is so important. I think that the stressing about making sure that the therapist is actually qualified and trained in the area, and also the courage it takes for clients to come into therapy in the first place, I think that shame, which you touched on is the biggest bit, is the biggest block of coming into therapy.
Speaker A [00:30:42]:
Yeah, no, definitely. I just want to thank you so much for coming on. I really enjoyed listening to your. Your story and your journey. And I know sometimes it takes a lot of courage to sort of speak about it, so I really appreciate you coming on here and doing that. So thank you.
Speaker C [00:30:59]:
Oh, it’s my pleasure. This has been a blast.
Speaker A [00:31:04]:
Honestly. It’s been great to have you. But, yeah, thank you so much for listening to the JenUp podcast. Um, I’ve been your host, Jenny Tomei, and we’ve had the great Becky stone, who’s been my co host. So obviously, please subscribe and share this podcast so others can benefit. You can find us on Facebook and Instagram at asking up and on the website at www.genup.com. if you visit the website, you’ll find lots of different resources available there. Of course, of course.
Speaker A [00:31:34]:
Please, like, subscribe and share the podcast so we can keep creating this amazing content. Thank you, guys.
How to get help?
Jenny Tomei is a Nutritional Therapist and Eating Disorder coach. See all her credentials on her About Jen page and then should you need help then make contact with her today. Your road to recovery can start now!
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