In this podcast Tabitha chats to Dr Colleen Reichmann about her recovery, health at every size, body diversity, and advoacy and activism.

instagram: @drcolleenreichmann

The Eating Disorder Recovery Podcast transcript (Thank you Marie!)

Tabitha: Hello there welcome to this weeks podcast. This week you are going to hear a conversation that I had with a lady called Colleen Reichmann and she is a licensed clinical psychologist. She has also recovered from an eating disorder herself, so this sort of fits into the recovery stories theme that I have been running throughout the beginning of this year. We are going to hear about her recovery, what lead her to be working in the field of eating disorders after having recovered from one. We talk about Health At Every Size and the importance of accepting body diversity for clinicians and just about everybody else in the world. And also activism around that.

Here’s Colleen:

C: My name is Colleen Reichmann and I’m a licensed clinical psychologist. I work at the college of William and Mary down here in Williamsburg, Virginia. I also have a private practise called Wildflower Therapy. I specialise in working with people who struggle with eating disorders and body image issues.

T: And how long have you been doing that?

C: Let’s see, I’ve been in Virginia for the past year and a half. But I’ve been working in the field for about 5 years.

T: So what lead you to be interested in working with people with eating disorders and body image issues?

C: Well the interesting thing is I recovered from an eating disorder. I struggled all throughout high school and college. I definitely wanted to go into psychology and I wanted to be a clinical psychologist but I was really certain that I never wanted to work with anyone who had an eating disorder.

T: Oh really?

C: Yeah, I told everybody that. I was kind of still not at that point where I am today in terms of recovered or recovery. So I just thought it would take me to a really dark place and I wanted to put all that behind me.

T: Yes, I know exactly what you mean. I did the exact same thing.

C: Really?

T: Yes, just really close after recovery I was like, I don’t want anything to do with eating disorders. I went and got myself a marketing job, I really got into that. I was working in tech. But then a couple of years later, I was just, I do have something to give here and so I came completely back around, quit my tech job (laughs) So it sounds like something similar with you, you needed that space?

C: Yes I love hearing when other people have a similar trajectory because sometimes I feel like the odd person out who wasn’t sure they were going to work with eating disorders and make a difference in this field after recovery. So I love hearing that you also similar.

T: I was pretty sure that I wasn’t going to at that point and what you said was really interesting as well, that I just felt like it wouldn’t have been for me even in the first year. I needed a couple of years.

C: Yes, same. I needed space from it and actually I was OK doing research in the area but I just thought I can’t make a difference, that’s not something that’s going to be helpful to me or anybody else. But I definitely had it in my mind for whatever reason that I was still going to work with people who struggle with body image. When I got into the whole practical experience, when I actually started providing therapy, when you specify that you want to work with body image issues, eating disorders just come along with the territory I think. So I just kind of got thrown in and I realised as soon as I started doing actual therapy and actual eating disorders therapy that I loved it and that I had empathy for this problem unlike any illness that I’d ever worked with. So I just kind of clicked in and felt like I have to do this, I’m at the place now where I can and I have too.

T: Yes and I think it’s wonderful because I think that there is so much insight in there as well. It’s a really tricky field I think, we’ve just spoken about having that necessary time to be fully recovered and have that space away from your own experience. To be able to give back to other people in a healthy way for everyone involved. I think some people are quite suspicious of people who have recovered themselves, but the problem is a lot of the time people who have recovered themselves and then go on to treat other people as therapists or dietitians or anything actually aren’t fully recovered themselves. And I agree that, that can be problematic.

C: Yeah, I worked on two inpatient units since I started working in the field. And I disclosed to one group that I had a history of an eating disorder a group member was like, talk about triggering! Working here, what is that like? And in my mind I could see how it would be very triggering and also unethical to try and do it if I was still very much in the eating disorder.

T: Exactly, Yes yes. And that’s confusing as well. When someone says that and I’m like, well I’m fully recovered and have been for a while. So….no it’s not triggering that’s the whole point of being fully recovered, I don’t get triggered by this stuff.

C: It definitely made me take a step back and feel gratitude. Oh my gosh I am not triggered at all, I am so far away from that I tend to feel grateful every day about that.

T: Yes I know, I usually feel grateful every day about a lot of things. So, tell me a little bit about your journey, your story and what you learnt along the way.

C: Sure, I started struggling with an eating disorder in high school. I think that I really had the perfect storm, the genetics, the environment, the temperament, a family history of eating disorders. I had all of it come together a perfect storm. I was definitely a real perfectionist, highly strung kid. My mum always tells this story, I was also in ballet lessons when I was younger. When we were really little, like 4 years old taking these ballet lessons. There is this story of me, I guess a ballerina fell over or something during a recital and audience started laughing because it was cute, and I turned to the audience and put my hands on my hips and glared at them. I was like, take it seriously!

So that was my demeanour. Super perfectionistic, very achievement oriented and then also I just had really low self esteem. I don’t remember ever not, whether I was in elementary, middle of high school, I don’t ever remember not having that low self esteem. I also was very sensitive, it was the family joke that I was hyper sensitive and people would always tell me, stop being so sensitive and I was always like I don’t know how, I feel everything. Everything, I feel it. All the time. I don’t know what you mean when you say stop being so sensitive. So that was me. Which I know I sound like a really fun little kid (laughs) I promise I was also fun, I had fun qualities. But! I wasn’t just a bundle of nerves and low self esteem and a ballet dancer getting angry at the audience.

My family was always interested in exercising and clean eating and things like that. My mum, this was totally her trying to be super helpful to all of us. Anytime somebody was struggling with their mood or something she would suggest exercise. So I think it all just clicked in. I joined the track team when I was in high school and immediately started losing weight. It just took off from there. I got great feedback about it and for me there was a really quick escalation into running and then just other behaviours. It was almost like I went down the rabbit hole and there was no gradual shift into an eating disorder. It was really quick down the rabbit hole. All sorts of behaviours. All throughout high school and into college. College everything got worse because there I was still super low self esteem, using all these eating disorder behaviours and then of course, drinking my body weight in alcohol 4 or 5 times a week. As you can imagine things did not go well.

Everything just kind of progressed throughout college. I usually don’t talk publicly about levels of care and things like that of my own personal journey, because I notice that my work with clients and I remember this myself when I was struggling there’s often a symptom that is a kind of competition. To see who got the sickest. I don’t think levels of care are even indicative of who is quote unquote sickest.

I typically like to leave that out of the discussion and say, I tried different things. I tried all sorts of things, I was very very resistant for many years. I was definitely a problem client. I had no interest into recovering, I was being forced into it. So I was very mean to therapists.

T: (laughs) Oh dear!

C: Yes I was definitely, I was defiant to say the least. And I think in terms of a turning point it was kind of back and forth, weight gain and weight loss, behaviour usage, not using behaviours. It was like that all throughout college. And I really think the problematic part was everybody who knew my struggle in college once I tried something else and weight restored, all the support and comments, concern and things like that dropped away. And it was, she’s better, she’s all good. So that prolonged the recovery process for me. And me not being able to, I just didn’t have the tools to verbalise that that was not helping.

T: Yep

C: So that kind of went back and forth all throughout college and then I always say in terms of what actually flipped the switch for me, it as just ambivalence. It was like I guess maybe a little more than ambivalence. I was sick of being this sick girl. I guess.

T: Yes, Sick and tired of it!

C: So it wasn’t this grand beautiful light bulb moment, it was just getting sick and tired of being sick and tired, honestly.

T: Yes. So what was some of the most useful parts after you started to get sick and tired of your eating disorder. What were the useful parts? What helped you get to where you are now?

C: Well I guess behaviourally. Abstaining from exercise for a while was very helpful and just in general I think putting distance between myself and the behaviours I think that that was huge. You can talk the talk and probably even get to the point where you can teach the coping skills and things like that but if you’re not behaviourally implementing and actually trying to make these changes it doesn’t happen.

T: Right, right.

C: So that distance I think was really helpful. The longer I went, the longer it was like, I don’t want to do that now. It’s been weeks. That was huge and I was still moving along in that recovery journey and because I started graduate school right out of college. Learning and being introduced to Health At Every Size and that whole new paradigm about thinking about our bodies and our relationship with food, that was a revelation for me.

T: So when did you first learn about Health At Every Size and what was it that sort of  clicked with you about it?

C: I first learned about Health At Every Size about half way into graduate school. What clicked with me was it bizarre trying to recover from an eating disorder where I was terrified of weight gain and in a really fat phobic culture. I just think it wasn’t named for me and it felt unnatural and unbelievably difficult. So Health At Every Size helped me to name that. Yes our culture has a great deal of fat phobia and a lot of it is unfounded and by the way, here are the roots of how that started.

Unearthing the diet culture mentality that lead to us demonising, focusing on larger bodies for no reason reason besides moneymaking behind all of it. And that was really helpful I think to be able to learn about that and have the knowledge and then move to start challenging, first of all my own biased of other people in larger bodies. To really start challenging that, I don’t know how you fully recover from an eating disorder while you are still terrified of weight gain and terrified and really biased of other people in larger bodies. I don’t know how that could actually work.

So starting to challenge that was super helpful and also my internalised weight stigma. And fear. Another thing with Health At Every Size or the idea behind, or maybe this is more a different movement, I stopped trying to be obsessively in love with my body. I stopped trying to acknowledge, I’m beautiful and I love the way my body looks and just move towards viewing it more as a tool that I respect and I can get around the world in. But I don’t have to make myself love my appearance so to speak because it’s going to change anyway.

T: Yes! Yes and this is one of the sort of problems that I have with the body love type memes and things. Like we all have to find this jumping through sunsets, relationship with our bodies and it’s like, yeah….it doesn’t have to be like that and I think that sometimes people think that when they don’t have that then they aren’t achieving something that they should be achieving.

C: Right!

T: Yeah we don’t all have to be sort of like, Instagram crazy, in love with our bodies to accept and respect them.

C: Yes because the thing is, I was always like, I could work hard to love my body as it is now, but what about down the road, if I get pregnant it’s going to change, after I’m pregnant it’s going to change for ever. What about when I’m 50, 60 you know? I’m living and ageing my body changes every single year, that seems exhausting to try and be really unicorns and sunshine about appearance when I could shift to focusing my time and energy on to what I’m giving to this world and other traits that I know will be there when I’m 90.

T: Absolutely, it’s like falling in love with a person isn’t it? If you fall in love with a person for their looks it’s never going to last past the age whatever.

C: Yes, so true!

T: So you mentioned body diversity and accepting people in larger bodies. Something that interests me that I think is a trap that I maybe fell into and other people do as well. That thing of, I accept all body sizes, it’s fine for other people to be in larger bodies, just not me. That kind of thing.

C: Right

T: Which is really sort of quite ugly. And it was an ugly thing that I had to call myself out on and be like, I am doing this and that’s hypocritical actually and I have to sort that out.

C: Me too

T: It’s about, I wouldn’t make a fattist comment about anybody else in the world but I would have those thoughts about my own self which is still those thoughts.

C: Yeah and I think calling that out for yourself, it really takes guts. It takes an immense amount of courage to finally turn and say, I’m saying this but I don’t know if I’m actually walking the walk so to speak.

I actually did a presentation at the BEDA conference back in November about therapists and dietitians addressing their own internalised weight phobia before working in the field, or as you’re working in the field being sure to do that. Because all of those sub conscious or even conscious feelings and beliefs you have about people in larger bodies you’re going to bring that in the room. And whether your client is in a larger body or in a smaller body it’s still in the room. So you have to do the work to call yourself out and challenge it. Put dogged effort into eradicating that for yourself.

T: Yes, I didn’t go to that talk, how do you think that was accepted at the conference?

C: The BEDA conference is a pretty great group of professionals in that they are very much aware of the social justice element of the eating disorder profession and Health At Every Size is very much  embraced. We don’t even use the words of overweight or obese. These medicalised terms for people in larger bodies and at that conference we were expressly told not to. So I think people were open to it.

I sensed that elicit emotion because we did some experiential exercises where we asked people to reflect what it would be like if they gained x amount of pounds. A really high number of pounds. How they would feel in terms of their family life, their romantic relationship how they might feel at their place of employment. And then we asked people to share and I do think it elicited some emotion and it was probably enlightening for people. Just like it was enlightening for me to have to do that work myself. I really had to challenge my own weight stigma to reach that turning point in recovery. I truly believe that was one of the main pieces for me.

T: I agree and I think that it’s one of the hardest parts as well. It’s usually one of the final things to change for many people, it takes consistent and uncomfortable work with your own  mental processes and calling out your own biases and being very honest.

C: And being honest with yourself if you have privilege. Thin privilege. I’ve definitely had to show up and acknowledge that. I remember at the BEDA conference saying that when we introduced ourselves I said, I acknowledge the privilege that I have talking about marginalised bodies as a thin cis woman who’s not marginalised in the same way as some body who for example is in a larger body.

And understanding that and understanding the privilege that you do have moving around in the world without having a doctor for example telling you when you come in for an ear infection that you have to lose weigh and that’s the cure as somebody in a larger body does every time they go into the doctors office. That’s important to understand.

T: It’s so difficult though. Because I know that you as a Health At Every Size activist or therapist. Probably faced with that, people looking at you like you’re completely crazy when you try and explain that weight loss is not the cure for all ailments. If somebody is in a larger body. It’s so entrenched that people look at you as if you’re completely…like no, how could that not be the answer?!

C: Yes it’s like swimming upstream the whole time. Sometimes I get in a little bubble where I am surrounded by these Health At Every Size professionals and advocates so then I forget and I have a rude awakening when I’m just talking to a doctor or someone who I work with who isn’t Health At Every Size reformed and I discuss how I don’t believe in intentional weight loss, I get a rude awakening of like, well you don’t make any sense. You sound like you don’t know what you’re talking about at all.

T: It can get to the point where it’s so obvious to somebody who understands Health At Every Size that for an ear infection, weight loss should not be the go to thing. But then, it’s so alien to somebody who isn’t, it’s like of course you have to lose weight because every body knows weight is the enemy and causes all illnesses in the world. It’s sometimes seems that the mindsets are so far apart that it’s difficult to even find a place of understanding.

C: Yes, that common ground and also I find it’s difficult if you only have a minute or two. To really plant that seed and get in there and help that person make that shift. I’ve had some successes in using a really quick,

‘you know I’ve read a lot of research on how this social justice issues and the marginalisation that people in larger bodies face on a daily basis, contributes much more to health problems longer term problems than just weight as it’s own stand alone variable does.’

I’ve had some success in just saying that sentence. Just getting that in there and hopefully planting that seed but it definitely took some trial and error and stumbling.

T: I think it’s often difficult to in a limited amount of time have that conversation. But it’s also difficult having that conversation but not end up talking about something like diabetes. You could start off talking about an ear infection and then you mention that weight loss is not the answer to every health issues and then suddenly people come back with, but diabetes?! Or something like that when we weren’t even talking about that. It’s a bit like when you’re talking to someone who has strong vegan beliefs and they are like, you’re either vegan or all you do every day is eat McDonald’s. It’s like no there’s…

C: Yes, I think there is a little bit of boundary setting that we have to do ourselves when we are swimming upstream like this. I’ve had to tell myself I’m not going to change everybody’s mind and the diabetes comment is definitely, I get similar retorts so often. Which I’ve learned to say, back to that, with the diabetes if we were to look at people with yellow teeth and lung cancer and not look any deeper into things. We would assume that yellow teeth causes lung cancer but there are variables we need to take into account and some of these things like diabetes may be similar to that. We are saying that weight gain causes when there are likely a lot of other factors.

T: Absolutely yes. Yes OK so you work in this field and you have done for a while, what is in the next couple of years? What are the main things, you sound like you are kind of activist, what are the main things you are hoping are going to change in this field?

C: I really hope to incorporate more activism first of all, into my work because I think sometimes when you are training graduate school, it’s either activist or therapist and you can’t be both because you shouldn’t be sharing your personal beliefs and I reject that mentality.

But I want to continue to reject it and incorporate activism and social justice into my every day work and I think that the eating disorder field for a while has had professionals colluding with eating disorder mentality. When it comes fat phobia by first of all focusing the by and large on anorexia and using weight as a barometer for recovery and managed care colludes with that. Some of that can’t be avoided but I think continuing to work to raise awareness about that and professionals our own blind spots when it comes to what we’ve been taught DSM whose about eating disorders and what is actually applicable and what we are saying and doing that is colluding with eating disorder mentality versus helping.

I think is definitely something that I want to continue to work on and help others to work on as well. And then just getting the Health At Every Size message out there. Eating disorder or not, the field of psychology needs to hear this message and I think that we need to shout it from the rooftops and do everything we can to do as much seed planting as possible so that hopefully one day that person in a larger body is not going into the doctor’s office for the ear infection and getting told to lose weight. Hopefully one day there is more of a less demonising world for all body types.

T: A less demonising world for all body types is certainly something that I’m interested in working towards. Thank you to Doctor Colleen Reichmann for coming to talk to me on the podcast. I will link to information where you can find Dr Reichmann on the show notes for this episode but if you want to know right now, it’s www.colleenreichmann.com and she has a website called Wildflower therapy and she also has an Instagram account which is Doctor Colleen Reichmann. Thank you for listening to this weeks podcast. Until next time, cheers and cheerio.