[CHRISTINA CASTAGNINI] Behind The Bite podcast is part of a network of podcasts that are good for the world. Check out podcasts like the Full of Shift podcast, After the First Marriage podcast and Eating Recovery Academy over at practiceofthepractice.com/network. Welcome to Behind The Bite podcast. This podcast is about the real life struggles women face with food, body image and weight. We're here to help you inspire and create better healthier lives. Welcome. . Well, hello everyone. I know firsthand just how difficult it can be to even acknowledge or admit to yourself that everything you're doing, thinking or feeling when you're struggling with an eating disorder is going on. There's so much shame and embarrassment over some of the behaviors that you're doing behind closed doors. And when I was going through it, I would've been mortified to have anyone know anything that I was doing. I was so silent and during that time I was more isolated and disconnected not only from myself, but from everyone else. And I really believed at that time that everything I was doing was normal. I thought that all the thoughts I had my head, they were real and I believed all of those awful nasty mean punishing eating disorder, thoughts in my head. And because I believed that that only served a few of my behaviors and kept me silent and it kept me more alone to be honest. Little did I know that in doing, I was only falling more and more under the control of my eating disorder and I was getting sicker. Even though there was some part of me really that knew something was off, that something was wrong I also thought that what I was doing was right, that I had to do all of these things because if I didn't, then somehow my life would fall apart, that somehow I would make life more of a mess and be even more miserable and I would never, ever reach my goal of being happy and having the life. I somehow convinced myself that I would one day have. I just needed to do it all so perfectly and stop failing. And then if I did that, I could start reaching out to people again and then I could finally to go out and be free to live this life I was imagining in my head. So if only I had known back then what I was doing, that what I was thinking was not the path to happiness and the life I wanted, if only I had known that my silence and secrecy was keeping me sick, it would've saved me a lot of struggle and a lot of time. So that's why I find it so important to open up about our experiences with one another, about what we're struggling with, what we're doing behind closed doors and really not to shame, judge or criticize one another for being vulnerable when we open up. Because when we open up, we can relate with one another and by hearing each other's stories, journeys, and experiences, we start to realize we're not alone. And maybe for the first time, even start to consider that there can be a different way to live. Knowing that someone else is out there or has gone through similar things can be powerful. It can help you feel less alone and maybe even normal. By hearing someone else discuss how they went from living a life that you may very well be living right now to a life free from all that it can start you down a path of questioning, questioning if what you're doing is really helping you, questioning if perhaps something needs to change or can change. And I think it can instill hope, hope that if they can change their life, that you can too. We need to know we're not the only ones out there struggling. We need to hear stories from other people who went through all of the pain and suffering and that they achieved recovery. If you're out there listening, and you're struggling, you need to hear that too. You need to know you're not alone, to know that you're not damaged to know you are good enough and that what you're doing, thinking and feeling is not bad. It's not embarrassing. It's not shameful, but it's part of an illness, an illness that is taken over your life, an illness that's not your fault, not your choice; an illness that cannot just go away through sheer willpower or through you trying harder; an illness that can be treated; an illness that does not have to continue to rule your life. So I love when I have guests on here who are willing to other stories, to share their experiences and to discuss where they are now. Our guest here today, Ivy Souters is currently a graduate student studying social work at Tulane University with aspirations of becoming a clinician that treats eating disorders. Her passion for this work grew from her own struggles with anorexia. She has been in recovery for two years and is open about her experience since her diagnosis. Because she found there was a lack of education around eating disorders and resources for recovery in her community and even around the world, advocating for herself at a young age with her family, friends, medical professionals, and insurance companies made social work an easy choice for her career path. [CHRISTINA] She looks forward to graduating this fall and beginning her new journey as a clinical social worker and continuing her passion as an advocate for mental health. Hi Ivy. Welcome to the show. [IVY SOUTERS] Hi, thank you so much for having me. [CHRISTINA] So it's always inspirational for me to have guests on the show who walk the log and have been in through everything including the road to recovery. And I'm just wondering if you would be okay sharing with the audience and everyone listening, maybe from the beginning, even how you even realized you had an eating disorder. [IVY] So I think I knew before I was diagnosed for sure. I'm not sure if I really, exactly knew it was going on, but I definitely knew that what I was dealing with wasn't my normal nor didn't feel like it was most people's normal. So I kind of was the one. So I was only 15, 14, well, 14, 15 when I was diagnosed, but 14, when I started kind of developing the anorexia. I was the one who kind of told my parents that I didn't really know what was going on, but I knew I needed help and I knew I needed support. So it wasn't something that was forced upon me or something that someone else kind of pointed out. I kind of recognized that what I was dealing with was becoming so emotionally taxing and exhausting that I needed some relief from that. [CHRISTINA] Which is not, I mean, I think sometimes it's people going to other like family or friends saying, gosh, I need help. Sometimes it's the way around where people are noticing some things and saying, gosh, are you okay? So, I mean, 14 years old, that's pretty scary to say like, gosh, I need some help. I'm wondering how did your parents respond to that? [IVY] I definitely think that they were grateful for the response, but I think in the moment they had been concerned for a while, didn't really understand what was going on, so kind of know where to go until I finally admitted that I just really wanted to seek help. So I definitely think that they felt some relief themselves, most likely that I had decided that I wanted help. Because before that it was like this push and pull and constant arguing surrounding food, my body, things like that. So I think they were probably grateful that I finally made that decision and realized that I had something that I was dealing with and I wanted to find a way to solve that. [CHRISTINA] So we go back a little bit, so when did you even start to maybe have thoughts about eating differently or even do you even remember having maybe thoughts about, gosh, I maybe don't like my body or I want to shift some things? How much before you were 14 did any get that start? [IVY] That's really interesting. I always, every time I had a conversation, a therapist or a nutritionist, or like someone on my treatment, a clinician it was always kind of I didn't really know a moment without feeling concerned about my body or food. I think it started when I was very young when I was just developing that conscious like awareness of self. I was a dancer since I was three. So I think that really played a huge part in it, you know just having that constant feeling of not being good enough compared to the other girls that I was at the studio with, things like that. And I used food as a form of pleasure, as a form of coping, maybe with anxiety, things like that. But before it turned into anorexia it was more of like the overeating, the binge eating. That became very significant or apparent to those around me probably when I was around 10 or 11. And when I was asked to go back and pinpoint a trigger, it was always, well, my parents got divorced when I was 10. So in order to control kind of what was going on or, well, the fact that I couldn't control what was going on around me, I needed something to control. And the only thing I knew was food. I didn't know any other way and I kind of had learned that from my own parents, that they had used food to cope with stress. So it felt like an easy solution at the time. And then that behavior kind of stayed for a while, but never became a concern of my parents. Instead of it being like, oh, she may have an eating disorder or she may have like a mental health problem, things like that, it was more of like, oh, well, she just needs to eat healthier and lose weight and work out. So that was their solution to the binge eating which later turned into the anorexia. And that's when it become concerning. [CHRISTINA] It's interesting. You said about your parents kind of using food in a certain way. Do you remember what you saw in the house in regard to how people ate or how meals were, or what kinds of foods were in the house for you? [IVY] Meals were very interesting in my house. We didn't eat around the table and as soon as I entered therapy and nutrition, they were like, that's a huge deal. We often see that when families are busy and things like that they don't really have time to eat on the table and that's really important in developing closeness as a familial unit. So we always just ate in front of the television. We ate out a lot. And that's, I feel like where I learned, like going out to eat was like a treat or something like a reward, something like that. So I think that's kind of where I learned when my parents were feeling upset, anxious, overwhelmed. It was like, let's go out for dinner. Let's reward ourselves with food. [CHRISTINA] So that's kind of interesting. I'm wondering is that the only time you all were together for a meal, when you went out to eat? [IVY] I would say when I was younger, my mom worked late. My dad was the one who kind of picked me up from school, brought me home, fed me. So often even if we did it at home, it was just the single parent. It wasn't all three. It was very rare that that would happen. [CHRISTINA] So were any siblings in the house or was it just you? [IVY] No siblings. I'm actually an only child. [CHRISTINA] Ok, so just trying to get the sense of what was going on in the house. So, and it's not about blaming. If anyone's listening, it's not about blaming anybody or saying, oh, it's because this was going on or that was going on. Again if anyone's listened to my podcast, it's a very complex interaction of lots of different factors, but in terms of, Ivy for you, it's like, how did you start to understand food and how did you start your relationship with food and learn different ways of coping. And so if you had role models for different things, obviously it's much easier. Or if you see people using food to cope or food became something of a companion or something like that, that it became that for you. And everybody's got a different story. It's definitely not blame on your family or your parents at all. It's just, I'm trying to understand, like, how did this all happen for you and get you to this point at 14, where like, in this turning to your parents saying, gosh, I need help. [IVY] No, definitely I always, you know the question of what caused your disorder or like why do you think you have an eating disorder or something like that. People around me needed to understand what it was like to have one, kind of would think that it was just one reason and I always had to tell them, no, it was just like, I like to call it like the perfect storm, just things compounding on each other, whether it's genetics, environmental factors, things like that. [CHRISTINA] Because it sounds like you were also in dances since you were three. Did you keep dancing throughout your elementary school, middle school, high school? Was that consistent throughout or were there other factors outside of the home that you think were also contributing? [IVY] So I did keep up with dance until I got very sick and I was asked by my nutritionist at the time to kind of step away from that. And I haven't been able to get back in it since I kind of just was out of it for so long that I kind of got old enough where I just didn't seem like something I would take back up. But yes, so I was into high school until I was 15 and was asked to stop dancing. [CHRISTINA] So I'm curious was that for you, since it was a big part of your life? [IVY] There was a lot of grief associated with it, I feel like. I did competitive dance for five years, kind of took a step away from that, because that was causing me increased anxiety. And then kind of just did it recreationally. But definitely would've stuck with it at least until I graduated high school, if I had that option. So I do remember a distinct moment where my parents were like, you probably shouldn't be dancing, but we're going to let you go to a class just to like see what your body can do or whatever. I went to the class and I just could not do anything. I couldn't jump off the ground, I couldn't turn and it became very frustrating for me. I had, like during the summer, obviously dance takes time off, so I hadn't been dancing all summer. So I came back that year and my body couldn't do what it used to. That was a really frustrating experience and I kind of realized that I needed to focus on my recovery before I could get back to dancing. [CHRISTINA] So I'm curious too, for anyone listening, what part of the country were you in at the time and just in terms of education and knowledge and awareness of eating disorders, what was there for you? So you were 14 going, I need help. What did you know? [IVY] So I'm from Louisiana and I still live there. I currently live in New Orleans, but I grew up in Baton Rouge, so just a short distance. And in the area, it was very limited as far as resources. In Louisiana, we only have one eating disorder treatment center and it was a very small treatment center and they only took very acute patients. Then outpatient providers were also very limited in the state in general, let alone in my city that I was living in and at 14, 15, it's very hard to be uprooted, to move to another state for several months to receive treatment. That just didn't really seem like an option for my parents. As well as at the time I was on government funded insurance and that limited my resources even more. Since it was like a state funded insurance, they refused to send me to treatment out of state. So I was kind of forced into these are your options, this is where you have to go. You don't have a choice. Otherwise I would've had to pay like completely out of pocket and that wasn't feasible for my parents at the time. Eating disorder treatment is really expensive, especially when you have to pay out of pocket. So that was just a very frustrating experience, 14, 15 and having to advocate for myself with providers, insurance companies, things like that who just would refuse to pay for the treatment. [CHRISTINA] Wow. So how did you get treatment? Because it sounds like there were lots of barriers and a lot of hurdles. [IVY] There definitely were. I'm definitely thankful for the inpatient treatment center that we did have there. I did meet criteria and while it is more of a short term, it was more of a short term treatment center, they only kept you there for a month or a little over a month. I think I was there for a month and a half at the longest but I was in and out of that treatment center because I had nowhere else to go and no one would pay for me to be in a residential treatment center for an extended period of time. So it was kind of like got a bandaid put on it and then I left and would relapse. And for about years while I was in high school, that was the narrative that was happening. [CHRISTINA] So, I mean, if you could think back to how that all was for you and getting treatment, what do you think was, well, how long do you, what were you actually in treatment? Because it sounds like it was kind of like in, you're out, you're in, you're out and it's kind of like you're being kind of shuffled all over the place? How was that for you? [IVY] It was frustrating. I often would get met with outpatient or treatment providers that would refuse to treat me because they were like, you need to be at a higher level of care, which I think is fair. You know, they only want to practice in their scope. And as providers they need to do what's best for their patient. I think that's definitely the truth, but when there is such a limited option for treatment, it is very frustrating. So I think the last time I was in treatment, I was only there for two weeks and insurance decided to cut me off because they were saying I didn't meet criteria anymore. I can't remember the exact reason, but that was kind of where my inpatient treatment stays kind of ended and then I was able to thankfully create a pretty stable outpatient treatment team as well as created a community for myself with girls who had recovered from eating disorders in my city or in my area and kind of had that support as well at the time. So it was kind of something that I had to do on my own and kind of bring together myself to really get the full extent of the support that I needed. [CHRISTINA] Wow. I mean, I was going through treatment too, and I just can't even imagine. It's just so exhausting in general and it's like, I don't know if anyone listening is going through this right now. I'm sure people are going, wow, that's a lot of work and that's a lot to take on when you are just trying to get through the day with an eating disorder. Like my goodness. So how long ago was that? [IVY] Well, I'm almost 23 now, so I guess math, I'm trying to think, probably about eight years ago or so, seven, eight years ago. [CHRISTINA] Okay. So in the eight years, since then, have you seen some changes in the area you live in or what have you noticed? [IVY] Sadly not really. I have been part of a more of a grassroots kind of organized group that has just wanted to bring something here. There are clinicians who were connected with a large nonprofit organization in Florida that are now in new Orleans. They are working to bring a treatment center here because sadly the treatment center that I was a patient at, which I'm actually interning at now, not on that unit, but I'm in that hospital. They have made their unit smaller. They don't take adolescents anymore. They only take 18 and over and it's a lot, they have a lot less beds than they did before. So if anything, we've seen it kind of get worse. If anything however, we have started a support group in Baton Rouge of new Orleans that is led by my therapist and another great and then two great therapists that are now in Baton Rouge that are leading a group. So I'm so grateful to have that. But bringing a treatment down here is something that is needed and it's just frustrating it's not coming to fruition at all. [CHRISTINA] Well. So for people who are just getting to know you obviously through the podcast, and I do want to kind of go back to when you were kind of in the thick of things, but kind of fast forwarding to now where are you in terms of your eating disorder? Sounds like you're doing some different kinds of work in terms of advocacy and making this a different part of your life. So if you could share that, that'd be great. [IVY] So I definitely had to kind of battle for a couple years when I was in recovery with wanting to maintain that sick role and wanting, because it was all I knew and it was kind of, had become my identity at that point. Especially as an adolescent when you're creating your identity and having your identity be like I'm a girl with eating disorder, you know that's what it was in high school. That's what people knew me as. That's what it was in college. So you knowing out that was really difficult and kind realizing I need to find things that I enjoy outside of this part of me and then realizing that the way that I wanted make a change in the world was by becoming a clinician and helping to treat eating disorders and be an advocate and kind of being the person on the other side. I kind of wanted to make that my new identity. So I think that's really what motivated me too put myself totally into recovery and not be held back by wanting to maintain that sick role. [CHRISTINA] So curious, I think that actually that is a huge grieving process for people's letting go of the identity. And I'm wondering, did you, at the time feel like that was the only way you were getting attention? [IVY] Definitely. And it's definitely something that those thoughts do come sometimes of at this point in my life I was getting this attention but I still do see a therapist on a pretty regular basis just to kind of maintain what I'm doing as well as starting to work in this field has been pretty draining in itself. So just having that support there for me has been really beneficial. So we've just kind of talked about what are the consequences that if you decide to fall back into this? What are you going to lose at this moment in your life, as well as realizing that at the time, things weren't as good as you may have perceived them to be. You know getting that attention was it really worth all of the things that you were experiencing with it? [CHRISTINA] It's interesting. I'm wondering like the 14, 15 year old you, what kind of attention did you feel like you were getting at the time that maybe looking back now, you go, oh, maybe that wasn't the kind of attention I really wanted or maybe it wasn't, I was perceiving it off. [IVY] I think the attention that I had been searching for at the beginning was definitely there. I was getting the compliments. I was getting attention from the opposite sex. I was receiving attention from girls that I had hardly ever talked to in school. But the compliments lasted and then they stopped because I think people realized this is not something that I need to be praising or complimenting. I was also open about what I was experiencing in high school. So I think that definitely allowed people to step back from complimenting me and praising me for my body, what I looked like. And I think that's definitely the biggest thing I can remember. Also the loss of friendships that kind of happened as a result of me maintaining my eating disorder and like staying in it. It was good attention until it wasn't. I got attention from my friends until they realized that it was a concern for them and it felt overwhelming for them. And then they realized that I couldn't really be in their life anymore. So losing those friendships, obviously, I'm still grieving those as well. Friendships that I could have probably maintained for the rest of my life were lost because of this. [CHRISTINA] And I think what you're saying is a trajectory a lot of people experience in the beginning. That's how I think the illness takes hold. It might start out with, oh, I just want to be "healthier." I just want to look a little better for an event or prom or something. And then people give these comments that feel really good and it feels very encouraging and really motivating. So initially the eating disorder voice kind of takes charge to go, Ooh this gives you some attention. This is amazing. This feels great. It's this high. That's very fleeting. And then like you said, the comments stop. And then it's interesting, I don't know if you found this, did you start kind of craving those again and keep going, well, maybe I need to keep doing more and maybe you're losing more and like these, the comments don't come again. It's like, they start in the beginning that you are chasing something that actually leads you down this horrible path. Like you said, you lost friendships and I'm wondering how do you make sense of why your friends were overwhelmed? Do you think there were certain behaviors you were doing, or do you think there was something about the eating disorder that overwhelmed them to the point where it just alienated them? [IVY] Definitely in both high school and college, actually. I would say I isolated myself. I tended to isolate myself a lot. So I wasn't really going out with friends. I wasn't attending events. And you know in high school and college that's the thing to do. And it wasn't until later on in college when I did grab onto my recovery did I begin fully putting myself in the moment when I was out with friends. So even when I did go spend time with friends, there was always, I was having anxiety attacks, being concerned with what I looked like. If we were to go to dinner I would refuse to eat with my friends because I felt social anxiety doing that. So all of that together, I think they just, even at an age where they're trying to find themselves too and they're probably dealing with their own experiences. I just think they didn't understand it and they felt that they couldn't fully be there to support me and they had to focus on themselves. [CHRISTINA] Do you think they knew what was going on with you or do you think it was just hard to be around you because your behaviors with food and the way you were talking about food and your body were just really hard to be around? [IVY] They did know. Like I said, I was pretty open about it. I do think maybe it felt like they felt exhausted that they couldn't help me and I'm sure that that felt overwhelming. I mean, obviously I'm my own person, I can only speak from my perspective that as if I was my friend at the time and my thought process would be. So I don't fully know completely why I lost of my friends that I did but that seemed to be what I came to conclusion. [CHRISTINA] It's such good insight. Like all the things you're talking about that the eating disorder kind of took from you and your life. Are there other things you felt like it robbed you from? [IVY] I mean, just in general, I've kind of touched on this, but just like a traditional high school and college experience. I have met people later after I've kind of come out of this a little more, who had, I don't want to say normal, that's not really the correct word, but more exciting high school experiences or they weren't really at like the, or they weren't really in the middle of this illness and they could go out with friends and have fun and go on dates and spend time with their family, go to parties and all those things without having to worry about food or their body or counting calories or exercise or all of those things, or being in and out of treatment and going to therapy every day. [CHRISTINA] So like at your, it sounds like at your worst, you were maybe not in school, not around your friends, not really engaging in life. So how long would you say it took you to get to a point where you would say I'm fully functional in my life I'm present, I'm not struggling with food or my body? How long do you think it got you from, or it took you to get to that point where now you're saying no, I've shifted my focus now to really wanting to help people and make this more of my career and advocate for people. [IVY] I would say it's probably been about two years, maybe two and a half. And there is always that point of the continuing self-awareness that recognizing maybe this I'm not completely where I once was, but maybe this certain behavior that maybe I'm still engaging in isn't functioning in my life anymore or isn't doing something for me anymore. So I would like to say that I continue with every day, maybe recognizing moments where I may be falling back into old patterns, not completely, but just like in different ways or maybe recognizing where the eating disorder still may have a small grip on my life. So I definitely think that I'm not, I haven't fully let go of the self-esteem and the body image, but continuing to maintain my recovery means going to therapy, making sure that I'm engaging in self-care and giving myself time to recognize maybe when I'm feeling a little off balance or not where I should be. [CHRISTINA] And I think that's great self-awareness because so often I hear people saying, "Oh, well, I'm following my new plan and I'm not over exercising. So I'm recovered." And I think just hearing what you're saying is like even two and a half years out, you still have this awareness, like, no, I still need therapy. I still need to have that awareness but maybe the thoughts are still not all gone. Like it's still a trajectory. It's still a process to get to a different place where maybe that's not going to be the case where it's a different phase and you're doing all this great work to propel yourself into a career where you can help people. And I found you on Instagram, love your your posts, and just wondering what got, I guess, what prompted you to start your Instagram? [IVY] Well, on Instagram that you actually messaged me on is actually my personal Instagram. But like I said, I have been so open about it in my life and I feel like I need to bring awareness around with the people that I know as well. So when I have done events or I've spoken on my campus before, well, not my campus any longer, but my undergraduate campus I've spoken on my campus before. And like I said, I just tend to advocate amongst people my age and my friends and family and people who I know because little do they know they could have someone next to them who may you struggling as well. So that's why I post on there, my story and just remind people that disorders are real and that they can have serious consequences. [CHRISTINA] I know we're getting out of time. Thank you so much for sharing. I know you do share, but it's always a joy to have somebody on the show that is willing because I know there's so much value and worth in hearing somebody else's journey and everything you've been through. Before we end, is there any one last message or anything you'd like to share with people listening today? [IVY] Just that you're definitely not alone and even if you're in a place where you feel like there aren't resources, access to treatment or people that are there to support you, find a support group, whether that's online. I know the support group that I've been doing in person does virtual nationally now. So if that is where you need to start by finding an online support group do so because like I said, even if you go there and you don't even talk. That's okay, just that you present and that you may find some words of wisdom and realize that you're not alone in this experience. [CHRISTINA] Very well said. Thank you so much. And if anyone wants to get some information that, I know you have lots of information and things that you're creating to help people, how can they find all of that? [IVY] So my business Instagram, or I guess I don't know what to call it, business, non-personal Instagram is Ivy.Souter So it is I-V-Y.S-O-U-T-R on Instagram. As well, I do also run a blog called Always Fully Dressed with a Smile. I've actually been running that since I was 15. So it has some older posts back there as well as some newer ones that I do have some resources on. I have some COVID resources on there for anyone dealing with any disorder while we're in a pandemic and also resources locally and nationally as well as treatment providers in my area. [CHRISTINA] Fantastic. And if anyone didn't get all of that, don't worry, it'll all be in the show notes. So head on over to the website and all of that great information will be on there. Ivy, thank you so much. This has been invaluable. Really appreciate your time. [IVY] Thank you so much for having me on again. I really appreciate it. [CHRISTINA] This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. It is given with the understanding that neither the host, the publisher or the guests are rendering legal, accounting, clinical, or any other professional information. If you want a professional, you should find one.