On today’s episode, Dr. Karen Nelson is joined by Dr. Amanda Delsman licensed clinical psychologist here at Melrose. Karen and Amanda will discuss a topic that impacts almost everyone... body image. They'll discuss the impact of body image and give suggestions of how someone can start developing a better relationship with their body.
On today’s episode, Dr. Karen Nelson is joined by Dr. Amanda Delsman licensed clinical psychologist here at Melrose. Karen and Amanda will discuss a topic that impacts almost everyone... body image. They'll discuss the impact of body image and give suggestions of how someone can start developing a better relationship with their body.
For a transcript of this episode, click here.
Dr. Karen Nelson 00:01
Eating Disorders thrive in secrecy and shame. It's when we create a safe space for honest conversation that will find the opportunity for healing. Hi there. I'm Dr. Karen Nelson, licensed clinical psychologist at Melrose center, welcoming you to Melrose heals, a conversation about eating disorders, a podcast designed to explore, discuss, and understand eating disorders and mental health. On today's episode, I'm joined by Dr. Amanda Dousman, licensed clinical psychologist here at Melrose, Amanda and I will discuss a topic that impacts almost every one body image, we'll discuss the impact of body image and give suggestions on how someone can start developing a better relationship with their body. Now, before I begin, I invite you to take a deep breath, and join me in this space. Well, welcome to the podcast. Amanda, I'm absolutely thrilled to have you here with me today.
Amanda Dousman 01:09
Thank you so much for having me, Karen. It's really exciting to be here and to get to talk about body image.
Dr. Karen Nelson 01:14
Well, before we get started, I would love it if you could introduce yourself, and tell us about your role here at Melrose.
Amanda Dousman 01:21
Sure. So again, my name is Amanda Desmon. I'm a doctoral level clinical psychologist here at Melrose. And I work in our outpatient level of care. So my role entails doing initial assessments with patients who are just coming in coming into the door, helping them to understand whether or not they meet criteria for an eating disorder. And if so the kind of treatment that we're recommending. I also do individual therapy, mostly with adults, I do work with some adolescents and their families. And then I facilitate some of our binge eating disorder group programs as well.
Dr. Karen Nelson 01:57
Let's set the stage a little bit. Why is it important for us to talk about that intersection between body image and eating disorders? Thoughts on that?
Amanda Dousman 02:08
It's a great question. I think it helps to first understand like, what do we mean when we're saying body image. So the way I define that with my patients, and the way we talk about it in the eating disorder treatment set world is that body image is the way a person experiences and perceives of their own body. So to be very clear, it's not the way their body actually is, it's the way they experience it or see it or think about it. And so, this often ties into then a person's eating disorder, because so often folks who are engaging in eating disorder behaviors at some point in, in their eating disorder history, often will do so because of trying to change their bodies. And and because they have body image distress or negative body image. Thoughts. That's not always the case for everybody. And I want to be clear, when we're talking about arfid, which I know you've done another episode on, folks with arfid may have some body image stuff because we live in a society where just about everybody has some body image stuff. But the the function of their eating disorder is very different. So it's not everybody with an eating disorder will automatically have body image distress or be using their eating disorder symptoms to change their body in some way, or how they feel about their body in some way. But, the majority do.
Dr. Karen Dousman 03:35
Absolutely. Well, and I think you know, you and I have had conversations Amanda and I have had the benefit of enjoy of working with each other over the past seven years. And we've had a lot of conversations about the kind of evolution that we have watched as we're, you know, watching people move through eating disorder treatment, that body image often is a topic that shows up again, and again and again. And if we're not deliberate about talking about it, it can be a missed piece of treatment, that it is really important to help our clients and patients understand how body image can be impacted. Let's maybe first kind of start exploring; I love it how you were describing what body image is right our own perception of our body. Tell us how might a person's concept of their body begin?
Amanda Dousman 04:35
Yeah, I mean, I think it starts from very, very like, like precognition, right? It starts from infancy and and I love what you're saying caring about like this is something that comes up over and over again in treatment, like there might be times in treatment where we aren't focusing on body image because we're trying to focus on say refeeding and weight restoration or something like that, but, but this is always present and a person's concept of their body and how they interact with their body begins really, really early on in terms of like, what are my body's needs? And does my body deserve to get those needs met. So, in infancy, you know, a bit of teeny tiny little baby right there just like an eating and pooping little machine. And right, as long as there's somebody there who can attend to those needs, they start to develop a core belief that their body deserves to be fed, that their body deserves to be taken care of, and treated with respect and kindness, right? And so for those really unfortunate people who don't get to that stuff, in early infancy, it starts to shift the way a person perceives their body, like, what does my body deserve? How does my body deserve to be treated, so it starts really, really early on. And it gets impacted through really everything we come into contact with in life. So it's, it's, again, how are we treated in infancy and childhood, and so on and so forth around getting our body's needs met, but also what are the messages that I receive throughout my experiences in my family of origin, or wherever I've been raised, you know, in my peer group, at school, so on and so forth, through relationships, I mean, any of those pieces, any sort of experiences, we have start to shape, that perception, and then our own experiences with our own bodies. So the different changes that bodies go through at different stages in life, and how how those shifts and changes get navigated is really important for body image development.
Dr. Karen Nelson 06:43
Well, I love your description, and it really helps us understand how multifaceted it is. Right? That it it often isn't just one thing. I think sometimes people will come to us and say like, you know, I may have a poor body image or a poor concept of my body. I wonder what that one thing was that kind of tipped it off? And our conversate? Or our conversations usually are like, well, it depends. Yep, and everything and all the things right, like, Culture, Media, society, family. I mean, let's maybe take a pause and talk about cultural influences. Thoughts on that, like, what do you notice in doing this work about cultural impact of body image?
Amanda Dousman 07:28
Yeah, that's just such a huge, huge ask.
Dr. Karen Nelson 07:35
Do we have a whole nother right? 57 minutes to talk about this? Yeah, go Amanda. Go.
Amanda Dousman 07:40
I'm ready. Society and culture, really give people broad messages about what's acceptable, right, in order to be loved, get a relationship, I have to look a certain way or you or I have to have certain parts in certain places or, you know, do wear certain things, do certain things with my body in order to kind of be accepted or loved or, okay, even. And so those messages come from all kinds of places, you mentioned, media. There, it's not just media, it's I know, you talked with Dr. Funk about Health at Every Size, and how, like the medical community can often contribute to this. So it's also messages that we receive from, you know, like, groups of experts out there. Things like that about, like, what makes a body okay, or healthy or any of those things?
Dr. Karen Nelson 08:45
You got it? Well, and I think that conversation about the impact of all of these aspects of our world in life, right? You know, family, friends, culture, media, it sends a lot of messages. And if we aren't cautious or deliberate or intentional about how am I taking in that information, it can be really confusing and sometimes even detrimental is potentially what I hear you say? Absolutely.
Amanda Dousman 09:17
I talk with folks all the time about being an informed consumer of information. So whether we're talking about being an informed consumer of media, so social media and curating your your feeds and things like that, or whether we're talking about being an informed consumer of, you know, the chitchat that happens in the lunchroom at work and hearing people talk about food and then realizing like, Wait, that's not that's not what I what I know to be true if I'm working with my treatment team. Absolutely. Well, maybe it might be helpful for our listeners for you and I to have a discussion about healthy positive body image in In contrast to what a potential negative body image might look like, so let's maybe start with that first idea of like, a positive or healthy body image, how might one begin to cultivate or create that or help us understand what that might look like? Yeah, so I often talk about trying to find a place of neutrality, so it's not so much like, you know, I see, like positive thinking about my body as the flip side of the same judgment coin, that negative thinking about my body exists on. And I would prefer, if we just like put that coin down completely and don't have judgment. So neutrality would really be about embracing my body as it is understanding that my body exists in the way it exists for so many factors that are outside of my control, and that it is in my body's best interest, if I respond to its needs. Because it just has them and not try to control those needs, or change those needs, but acknowledge them. So if my body is tired, I get to give it rest. If my body is hungry, I get to feed it, if my body needs to kind of move around, it's feeling a little stiff, I get to move it, right. So it's, it's listening to the body and responding to those needs, in a way that isn't judging it or telling it, it should be different. And then with regard to my appearance, trying to be neutral about it, trying to recognize like, um, you know, for people who have really judgmental thoughts about specific parts of their body, I'll often coach them and just naming that part. So it might be, you know, if I happen to catch my reflection in the mirror, and I see my stomach, and if that's a part that I might really struggle with, instead of going through the litany of all the negative thoughts, I would say, well, there's my stomach, and then move out of the mirror, right? And so it's, it's not so much body avoidance, that's not helpful either. So it's not never look in the mirror, or never think about my body, it's thinking about my body in a way that allows it to exist.
Dr. Karen Nelson 12:11
I love that. Well, I talk a lot with my patients about the power of internal talk, right? The power of how we talk to ourselves about ourselves. And it makes a lot of sense, right? If if I spend most of my day every day, picking up out, picking out parts of my body that I'm dissatisfied with, and I'm, you know, critiquing them, and almost yelling at myself, well, yeah, I'm probably not going to feel very good, which then kind of actually is a pathway. And you and I will talk about this later. It's a pathway of why I potentially might want to engage in eating disorder behavior. And so that power of just without judgment, kind of naming and just labeling this is my body, I have legs and thighs and a stomach that can be really, really important. It's actually interesting thinking about that idea of dissatisfaction with body, there was actually a 2016 study in the Journal of Pediatrics. This is fascinating and heartbreaking all at once. That found more than half of children, ages nine to 16, are dissatisfied with their body shape. Right? I mean, it just breaks your heart to think about young children already starting potentially, in that place of negative internal talk about their body cam that set someone up for negative body image as they progress through life thoughts, what do you think
Amanda Dousman 13:46
1,000%. And that is such a heartbreaking statistic. And we know that eating disorders develop out of a place of intense dissatisfaction. With lots of things, oftentimes, body dissatisfaction is wrapped up in that. And so, you know, starting off early on with negative body, internal talk and messaging around you can absolutely be one of the factors that can trigger the development of an eating disorder.
Dr. Karen Nelson 14:20
Absolutely. I think about you know, I think you and I potentially both have heard stories from patients that have had those experiences of being shamed, in a space and in maybe almost a public space about you know, needing to get weighed. And that aspect of shame, and this desire, this intense desire to not feel that shame, potentially can push urges to start to engage in some disordered eating. If I am sent the message. My body is wrong or bad. Of course, I don't want that. And so It can be a risk for those messages to be coming in to young children, and then potentially wanting to, you know, use eating disorder behavior to try and shift or adjust body. Absolutely.
Amanda Dousman 15:13
I want to add a little bit to that, Karen, because it's, it's not just the message that your body is wrong. It's also the message that and you should be able to control that.
Dr. Karen Nelson 15:26
Oh! So Ah–yes! My hands are in the air like praise. That's it, isn't it?
Amanda Dousman 15:31
Yeah. And that is a massive myth that exists in our society that is perpetuated by the diet industry. I'm going to call that diet industry out as much as I can today. That we as human beings have some sort of control over our biology, and we just like never have, and never will. And yet, it is a firmly held belief in our society that we do. And so this is where the shame comes from. Right? This is like, I should be able to control this, and I can't, I don't. So now there's something wrong with me. It's not just the message, it's not the message. The reality is the message is wrong, but the person internalizes, I am wrong. And that's where this comes from. And that's how, where are these behaviors stem from, for many people, one of the places, it's, this is not the only place that eating disorders can come from, but this is one of the most common.
Dr. Karen Nelson 16:23
I think that's a beautiful, you know, point that we do want to make in no way is this discussion saying, you know, a negative body image is the only contributor to an eating disorder, or it absolutely will develop into an eating disorder. We're talking about one of the contributing factors, that we know that eating disorders are a combination of so many factors, social, biological, psychological, all of these spaces that intersect in body image is one of those factors.
Amanda Dousman 16:57
And I think, you know, we live in a society, as you pointed out, like children between the ages of nine and 12 are highly impacted. Excuse me. But it's broader, I think, you know, a recent statistics that I had read is like 85% of people experienced body dissatisfaction. And so it's, this is not just people with eating disorders that's in the general population. I mean, this is a rampant issue. And so yes, we want, obviously, on this podcast to focus on those with eating disorders, cuz that's what we're here to do. But this is, this might be kind of just the average person walking down the street might be struggling just as much with this.
Dr. Karen Nelson 17:36
Well, Amanda, let's maybe talk about a term that actually often comes up when we talk about eating disorders and body image is the clinical term that we use is called body dysmorphia. And some of our listeners may know what that is, but I would love it if you could give a description of it. And then you and I can talk about how that does show up for our patients who are struggling with eating disorders and potentially low body image or negative body image.
Amanda Dousman 18:06
Yeah, so Body Dysmorphia is referring to a phenomenon that can happen where a person perceives a body part or their body size or shape in a way that is just not reality. And so, you know, oftentimes, like, for example, in people with anorexia, we see how if you were to ask them to draw a realistic, like what they see as their body shape and size, kind of a self portrait in that way. What they draw is nowhere near what their body actually looks like. So that's one example of dysmorphia there is, there's a separate clinical diagnosis called body dysmorphic disorder, which can exist in people with and without eating disorders. So that's not necessarily what we're talking about here. That dysmorphia exists in people with body dysmorphic disorder to
Dr. Karen Nelson 19:05
Well, let's transition and talk about, you know, this intersection between eating disorders and body image. Let's talk about the process of recovery from an eating disorder when someone is struggling with a negative body image. Tell me about a starting place for someone who may be struggling with eating disorder behavior and negative body image. What might some of that recovery, discussion or process look like?
Amanda Dousman 19:37
Yeah, and again, this is going to vary depending on the individual and what they're struggling with or what they're coming to. What symptoms are present for them when they first come in. But in general, typically people come to us when life is not in a good spot, right? So there's just going to be distress across the board and You know, the treatment team can help assess what what's pressing right now what do we really need to be focusing on primarily, it's too much to try to address it all at once. So we got to start somewhere. Oftentimes, as this is the case with therapy in general, it feels worse before it feels better. That's right. And still come to therapy can tell you in the long run, right?
Dr. Karen Nelson 20:21
That's right.
Amanda Dousman 20:24
And, it does feel better, right? That that time does come, the longer that the person is doing the work of nourishing their bodies of interrupting the symptoms. So for people who are binging, they may need to be eating more regularly through the day, so as to reduce their vulnerability to binge eating. And they may experience their weight fluctuate as a result of those changes in their eating. And so there can be that distress around seeing weight go up even more, if they came in, in a larger body size. For example, there's often conversation around so how are you thinking about this? How are you feeling about this, doing that fact checking, helping people to understand the importance of nourishing their body and treating their body with respect. Shifting that language, like you pointed out before, language is so powerful, the words we use within ourselves and without ourselves are so strong and really color the way that we experience life. And so if we can help people to choose language, that is more neutral, more compassionate, more accepting of, of self, and therefore of their body as part of self along the way, then what starts to happen is they there starts to be this shift in reducing the importance of my appearance. And, and instead looking at my life as a whole, and realizing, you know what, it's not worth it. So we start to see that because people start as they, as they recover from their eating disorder, they get to like engage in life.
Dr. Karen Nelson 22:03
Again,it's a process, right? That it's this kind of evolution of healing, that, you know, healing, starts that first therapy session, but then it might feel hard or challenging it we might be asking you to do the things that you absolutely have not wanted to do, or the eating disorder tells you to absolutely avoid. But it's through that discomfort that we often find freedom, tell us about how Melrose might use growth charts or determine someone's kind of weight range.
Amanda Dousman 22:35
A growth chart is like pediatricians used growth charts, which is a standardized kind of normal growth curve that has been developed over time looking at the research on children and adolescents. So a growth chart kind of plots out expected growth, based on where a person starts in life. So what kind of whatever percentile they use percentiles. So whatever percentile their weight and height were at birth, we sort of can plot out some expected patterns of growth over the years between the ages of birth to I think they go through age 22. We don't have any really good information out there for what happens in the normal lifespan developmental way with weight beyond age 22. Because quite frankly, too many people have messed around with their weight at that point, that we don't know what like normal, natural human growth looks like. And we and humans made the mistake of thinking that you stop at the age of 22. And we likely don't do it like we know that there are expected weight changes down the line they can in people who have uteruses and ovaries, we know that when menopause happens, there are expected weight changes. Like that is natural and normal, even though women are maybe led to believe that it's not, and it's a range, right?
Dr. Karen Nelson 24:03
So we're not saying you have to, you know, weigh this exact a number. It's about a range of again, and I like how you use the word kind of optimal functioning, that, you know, we're feeding our body consistently. And another way that we talk about kind of weight range, or kind of natural body weight is your body is designed to find a natural space of homeostasis when we feed it consistently. And when we move at moderately, without using any eating disorder behaviors, our body will find this lovely rhythm. And if the way that I'm maintaining a weight is through eating disorder behavior, then that's probably not my natural body weight.
Amanda Dousman 24:47
Absolutely. We talked about that as setpoint, setpoint theory. So you know, a natural setpoint that your body has already like pre programmed right and setpoint can be adjusted. Like a body can adjust it’s own set point based on what it's been through. And so, you know, when a body has been exposed to famine, whether that's intentional famine through restriction or not, then sometimes a body can move that point up to a higher weight because it now understands, oh, there might be famine, we need to be able to survive that. So this is why diets fail, right? Because a diet is a self imposed famine, and the body doesn't know that. And so the body try it thinks like, wow, we might come up short with food again in the future. So we've got to prepare for that. So this is why we often see people have that yo-yo weight pattern when they've been restricting where, yes, they might lose weight initially. But because bodies are really, really cool and fight really, really hard for survival, they regain and restore that way, and usually, then some, and so then we'll see bodies kind of reach homeostasis and a little bit higher than they were before they went through that.
Dr. Karen Nelson 26:00
Absolutely, absolutely. And I think, again, that idea that we can kind of outwit our body that we can, and we're talking about, like biology, right? Like, like brain functioning, like, you know, we're starting to talk about like, you know, insulin and hypothalamus and like really big words that I start to sweat and that I, you know, freaked out in, in, you know, like anatomy. So it's not just about following the right diet, right? Like this is actually hardwired into our body functioning to protect us that our bodies were created to have a natural setpoint. And that our body is going to work really hard to get back to it.
Amanda Dousman 26:47
Yeah, yeah. I will often say to my patients, like you are trying to fight biology and biology will always win.
Dr. Karen Nelson 26:53
That's right. Right? Yeah, absolutely. How might you talk about setpoint with patients? Maybe that can feel kind of scary or hard to hear? Or what have you noticed, as you maybe start to bring up this idea of setpoint theory?
Amanda Dousman 27:10
Oh, absolutely. It. I mean, it's a conversation, I often enter into slightly begrudgingly like, Okay, we're gonna go, right. And this gets back to the messages that we get from society that, you know, the diet industry wants us to believe that if we just work hard enough, we can be at whatever weight we want to be at. And the reality is, that's not true. It is not true. It's a lie. Right? It's a lie. It's a myth. And so oftentimes, that's how I'm coming at the conversation is saying, like, I have information for you, that is based in the science it is, it is proven in the science over decades of research, that this is how it works. And I know that you have been led to believe that this is not how it works. And yet it does. Sometimes I am met with resistance, right? Where people want to say, but like, what about this? And what about that? What about this thing that I read once in that thing? And yep, I hear I know that that's out there. I know that that's out there. And yet, this is really what it is. I will often direct people to the Health at Every Size book, to really kind of read through that information and hear it from another source. It's not just me. And, and it's a repetitive conversation. So so much of what we do in therapy is kind of repeating ourselves, not in a frustrating or frustrated sort of a way but with the understanding that with repetition comes learning, right? And if if my patients are out in the world, and they hear all the other lies 100 times a day, but they only hear me say it once Well, what what are they going to believe right? How often this like sense of grief that can come with this conversation? Because sometimes people when they really start to embrace the the new knowledge about setpoint and about bodies and about body image. They for some people, depending on how long they've struggled with these thoughts, they might start to realize like, wow, I've lost a lot of years to this way of thinking.
Dr. Karen Nelson 29:17
Well, and again, I think you bring up a good point that this can feel like almost a radical way of thinking even even if it is based in science. In fact, it's not kind of pop pop culture thinking right pop culture is try keto. Try paleo. You know, you can shift and push your body if you just try hard enough into really kind of any size or shape if you just have enough quote willpower, and I love how you use the word grieving of it can feel it was interesting. It makes me think about a conversation that I had with a patient and she said I think I I am going to turn my recovery into activism. And she said, I think now, it will be my life's work to help people know the myth that we're trying to that we're sold all the time, that our bodies aren't good enough inherently the way that they are. And that felt so powerful to me.
Amanda Dousman 30:19
I just got goosebumps, yay.
Dr. Karen Nelson 30:22
Yes, like, I'm gonna pass out Health at Every Size to people, and I'm gonna let people know all bodies inherently have worth. And no wonder it can feel radical.
Amanda Dousman 30:32
I'm sorry, totally talked over you there? No, I think this gets into kind of a bigger issue, which is there's there is real and true discrimination of people in larger bodies. Right. And so for our patients who are in larger bodies, or patients who are not, but are terrified of being in a larger body, there is real and true discrimination and real and true barrier to living the kind of life a person might want to live. And there's no acceptance of all body sizes, and right out there that it that does not exist. Currently, it's better. I've been working in the field of eating disorders for 12 years. And I will tell you that there is more inclusivity now than there was when I first started this work, but the inclusivity level currently is not good. It's minimal. Right. And so there is this need for activism, both from people who are, you know, living in larger bodies, but also any anybody else any sort of ally out there to say all bodies deserve to be treated with respect. All that every person deserves to walk into a restaurant and not be terrified of where they're going to be seated. Because they might not fit. That's right. Or every person deserves to be able to say I want to engage in this hobby, but not be pushed out. Because I don't I my weights too high. And there aren't things to accommodate me, it's an issue of accommodation in our world, not the person in larger bodies issue to change their body so that they fit. That's right. But that's the message that we are all given is that we have to make our bodies fit. Instead of realizing like actually, we can just like do better with making chairs. And I mean, it's not just chairs, right. But we can all the things.
Dr. Karen Nelson 32:25
Well, let's transition and talk about, you know, if I'm listening to this podcast, and potentially my loved one is going through eating disorder treatment, or my child is working on eating disorder treatment, how might I support them in eating disorder recovery, and kind of maintaining a neutral or even positive body image?
Amanda Dousman 32:48
Yeah, so I think the first thing that I would have just invite everyone to do, who's listening to this, no matter where they're at, like who they are in relationship to all of this, is to take some time to really ask yourself some questions about what biases do I have about bodies and about weight. Because it really stems from that. So if if any of you have listened to or been involved in thinking about like, social justice around racism, a lot of the same principles can apply to this, where it's about kind of learning your own, like assuming that you have racist thoughts, right, and then trying to figure those out, so that you can dismantle them, start there with with this, right, assume you have sizes to thoughts, and try to uncover them, try to identify them. Try, I mean, it's so implicit, it's so insidious in our culture, and and in our within our own selves. And so start there, right, start with our own self awareness. Because if you like, for example, for somebody who is a loved one of somebody who's struggling with an eating disorder, you might be sending messages that you have no clue you're sending. And, and not because you're malicious, or you're trying to do harm, or any of those things, but just because this is kind of how this all works. So let go of the judgment of yourself for having these thoughts. And instead, acknowledge their presence. Acknowledge the behaviors that you might be engaging in, like maybe you do make comments about people that you see at the fast food restaurant, or maybe you have said things about, oh, that person needs to go to the gym or whatever. You know, there might be things like that that have come out of your mouth in the presence of other people. That, that having that awareness helps you to catch it. So you're not making comments like that. Because what we know is that really any sort of focus on body appearance increases focus on body appearance, like the more I think about it, the more I think about it, right? That's right.
Dr. Karen Nelson 34:50
It's just that's how that equation works.
Amanda Dousman 34:54
Yeah, and the more I do stuff, like the more I engage in mirror checking, or body checking or any of those things, the more I'm going to be thinking about this stuff. And so, so So start with your own stuff and and start to think about okay, what are some changes that I can try to make that might help support my loved one? who's struggling struggling with their own negative thoughts about body?
Dr. Karen Nelson 35:17
I love it. Well, it can be such a distinct difference between kind of looking or being curious versus being judgmental, right of saying, like, Oh, interesting, I guess now that I'm looking at, you know, how I view bodies or how I talk about bodies? Yeah, I think sometimes I do have some negative comments. And, you know, if, if I, if I'm unaware, I cannot change it. And so that awareness, yes, it can be uncomfortable. But what does Karen say? Through pain comes growth, right? All that gross therapists talk, but like straight up true. I mean, if I don't acknowledge it, I cannot change it. And that is such a beautiful form of support is to, you know, say, Hey, I love you all so much in your working on, you know, challenging your eating disorder. I am going to take a minute and kind of think about how I might show up with you in relationship when I talk about other bodies. It, I mean, really, there's sometimes no words for that level of support that loved ones can offer by kind of checking their own behavior and thoughts.
Amanda Dousman 36:29
Absolutely. Karen, those words that you just said, like how you said, that is the way I hope people can really frame it for themselves. Because to be incredibly clear here, yes, the things we say to our loved ones impact them, but nobody is at fault for the development of eating disorder. Right. So you know, it's not about shouldering responsibility for the fact that my loved one is now suffering or hurting. That's not what this is. What this is, is, is acknowledgement of how we all exist in relationship and in systems and through connection and how I connect with others impacts them, and, and vice versa. And so can I take some responsibility for what's mine, and make some shifts in that to benefit your loved one, but also to benefit yourself? Right? Like, the beauty of this is that through supporting your loved one, you get to also feel better about your own self and your own body and grow. So cool. So cool.
Dr. Karen Nelson 37:27
Well, Amanda, I can't even begin to tell you how much I've enjoyed our conversation today. I'm just so appreciative of you sitting with me and having this super important conversation. Thank you. Thank you.
Amanda Dousman 37:37
Well, I just feel so honored to first of all, for people listening, Karen is amazing. And you want to be her when I grow up. Thank you so much.
Dr. Karen Nelson 37:47
I'll take it.
Amanda Dousman 37:48
But I just really appreciate this. I think the work that you're doing on the podcast is beautiful. And I feel really honored to be included in this. So thank you so much for having me.
Dr. Karen Nelson 37:59
That's it for today. Thanks for joining me, we've covered a lot. So I encourage you to let it settle and filter in. And as I tell my patients at the end of every session, take notice. Pay attention, and we'll take it as it comes. I'll talk to you next time. Melrose heals a conversation about eating disorders was made possible by generous donations to the Park Nicollet Foundation.