Why are eating disorders and trauma often in the same conversation? What are the long-term effects of unresolved trauma on a person? Are you willing to do the work to reconnect with and help yourself? In this podcast episode, Dr. Cristina Castagnini speaks about how trauma relates to eating disorders with Joelle Rabow Maletis.


Joelle is a well-known author, keynote speaker, and psychotherapist. Her expertise includes trauma, PTSD, eating disorders, military psychology, and more. Her career highlights include being a guest speaker on ABC’s 60 Minutes: Beyond the Headlines, authoring a Ted-Ed video on PTSD, and several Outstanding Achievement Awards for Top Female Executive. Joelle's passion is helping people find empowerment by discovering how to be their best (not perfect) self through authentic skills-based, self-discovery. Her goal as a psychotherapist is to provide feedback and interaction that allows clients to grow through informed, healthy, and compassionate decisions. Visit Joelle's website and connect with her on Facebook, Instagram, Twitter, Youtube, and LinkedIn. FREEBIE: 7 Days, 7% Happier: A Guide For Better Self Care


  • The long-term impact of trauma
  • The difference between big and little trauma
  • Starting the work

The long-term impact of trauma

“Big” and “little T” refers to the levels and severity of trauma experienced by a person. An event could create a big trauma, while little traumas can occur over many months and weeks, but they both have an accumulative negative effect on a person.
[The little Ts] didn’t register as trauma at the time but they absolutely leveled my self-esteem. I had a lot of guilt and shame around not being good enough, letting people down, and not being able to be perfect. (Joelle Rabow Maletis)
If left untreated or unattended, they could develop into more dire illnesses, both of a physical and mental nature.
At the time, the fear was, “Well, if I’m not good at this, then what does that say about me? Am I going to be unlovable?” (Joelle Rabow Maletis)
Unresolved trauma can compromise a person’s ability to believe in themselves because it undermines their self-esteem and self-confidence. Even though there are multitudes of symptoms and scenarios that lead to the development of an eating disorder, they often come from places such as these, where a person feels extremely vulnerable and tries to maintain a sense of control.

The difference between big and little trauma

Trauma comes in different names, from relational to complex. It essentially encapsulates an event that has a profoundly negative impact on a person – whether in one moment or over some time – and as a result, that person develops coping skills, maladaptive or otherwise, and they become hyperaware of it in the future.
If somebody’s saying, “This [event] shaped my worldview” or, “this is painful for me”, or “this caused behaviors that I’m not proud of” … yes, that absolutely constitutes as trauma. (Joelle Rabow Maletis)

Starting the work

There are many different forms of therapy but don’t let that stop you, instead, just focus on finding a therapist that you feel connected to and want to work with.
I didn’t understand what I needed or what would be good for me and I needed somebody I could trust, and that was the best place to start. (Joelle Rabow Maletis)
You don’t have to know what you need, or even what you want. But if you decide to pursue therapy with the desire to get better, you’re ready to start the work.



I am a licensed Psychologist and Certified Eating Disorder Specialist. While I may have over 20 years of clinical experience, what I also have is the experience of having been a patient who had an eating disorder as well. One thing that I never had during all of my treatment was someone who could look me in the eye and honestly say to me "hey, I've been there. I understand". Going through treatment for an eating disorder is one of the hardest and scariest things to do. I remember being asked to do things that scared me. Things I now know ultimately helped me to get better. But, at the time, I had serious doubts and fears about it. If even one of my providers had been able to tell me "I know it's scary, but I had to go through that part too. Here's what will probably happen...." then perhaps I would not have gone in and out of treatment so many times. My own experience ultimately led me to specialize in treating eating disorders. I wanted to be the therapist I never had; the one who "got it". I will be giving you my perspective and information as an expert and clinician who has been treating patients for over 2 decades. But don't just take my word for it...keep listening to hear the truly informative insights and knowledge guest experts have to share. I am so happy you are here!


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Podcast Transcription

[DR. CRISTINA 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. Hello everyone. Welcome to this show. Today we have a really dynamic show. We have somebody here who's not only a professional, who helps people who have mental health illnesses, but somebody who has gone through a journey herself with mental health illnesses, and she is here to discuss openly her own journey and path. I think anybody who's willing to do that on this show, I'm really grateful to because, as I've said before, I think it's really powerful when somebody does that because anyone listening maybe can relate or it really can help somebody to understand that, oh my gosh, I'm not alone or oh my gosh, I didn't realize that what I was going through is actually something that I can get help for. So I really want to just delve in and introduce our guests and have her come on and talk about her own history, her past, and all the work that she's doing now to help people. So with that, I'll just do an introduction so you know who it is. Joelle Maletis is a well-known author, keynote speaker, and psychotherapist. Her expertise includes trauma, PTSD, eating disorders, military psychology, and much more. Her career highlights include being a guest speaker on ABC's 60 Minutes: Beyond the Headlines, authoring a TED-Ed video on PTSD and several outstanding achievement awards for top female executive. Joelle's Passion is helping people find empowerment by discovering how to be their best, but not perfect self through authentic skills-based self-discovery. Her goal as a psychotherapist is to provide feedback in your interaction that allows clients to grow through informed, healthy and compassionate decisions. Well, Joelle, welcome to the show. [JOELLE RABOW MALETIS] Thanks so much for having me. [DR. CRISTINA] You have a really interesting history and background. So I'm wondering would you mind sharing with us a little bit about yourself and how you ended up here as a therapist in this place in your life? [JOELLE] Yes, it's such a convoluted story, so I'll try and make it quick and concise. My background, actually, I was a ballerina by training and a dancer for over 20 years professionally. I worked on stage and then I worked in multimedia and film and commercials, so a lot of aesthetic-based pressures. I ended up teaching university, I had post-graduate degrees in education and dance and in those areas and had a lot of injuries and found myself newly divorced with a one- and three-year-old and went, okay, well, being a dancer and being at university is not necessarily going to pay the bills in Silicon Valley. I'm in California and went, all right, what am I going to do? I say, and therapy sounded good. There's truth to that. I think part of it was I was really doing some very intensive therapy for the first time. As much as I appreciated the process, it was a very painful one. I was also really interested in, okay, what does that mean and this idea of trauma and growth and how do I work with my own stuff? So I took a psych class and I ended up finding that I was in graduate psych school and spent a very long time there and parlayed into being basically a trauma expert. But my dissertation was working with broad spectrum eating disorders, PTSD, and trauma and from an addictions model. So that's what parlayed me into being a therapist. [DR. CRISTINA] Quite a trajectory. [JOELLE] Yes. I always joke and say we can draw the dots. I was a ballerina by training, and then I went to study eating disorders. I remember one of the very first clinical supervisors I ever had who I adored, looked at me one day and she said, "Are you sure that's the work you want to do? Can you manage all of your own triggers and responses and keep it about the patient and not about you?" I laugh about it now and I think at the time that was the biggest challenge for me was how do I separate out my own story and what I was going through, but also my healing journey with my clients were experiencing because in a lot of ways, I wanted them to have that same growth, and some did and some didn't. So that was a whole nother level of learning how to work with not only my own trauma and story, but also being able to sit with other people's. [DR. CRISTINA] That's, I think I've talked about this before on the podcast, but I think that's the one thing I was afraid of myself too, is that myth out there that we're all wounded warriors and we bring our own stuff into the room. That was my fear too. I said, I don't want to treat eating disorders. I thought that at first because of that but then I realized I want to be that therapist I never had when I was going through treatment, the one that I could relate to and really go, wait a minute, like, they get it. So I think there is power in the fact that you've had some experience yourself but being mindful, as your supervisor said, of like, making it about the person in the room and not your own stuff. So very wise. [JOELLE] Yes, and it helped, and I think that was the biggest struggle years and years ago when I first started, was exactly that, which is, I don't know how to do that and I wanted the therapist for my clients that I didn't have. I passed, I was a ballerina. So there was a lot of just this presumption of, well yes, she's this body type, oh, she looks like that, but this is what she does. There was a lot of, I think, denial and that possibility, where I could hide in the shadows and didn't get the care and treatment that I needed until I was starting to move out of my career and falling apart. Then all of a sudden it was like, oh, okay, there's so much more to this. In retrospect, I wonder what life would've been like if I had had different care as a young teenager and then through my career and through adulthood. Not that I think that that would've changed the injuries and the trajectory of where I ended up, but I did think about that in the beginning of what would that look like? [DR. CRISTINA] Interesting. So curious, like you were ballerina, looking back, do you think there was a lot of disordered eating and a lot of behaviors just with people who were around you in general that led to maybe you also struggling with that? [JOELLE] Absolutely, and without being triggering, for anyone who's listening it was also accepted. So there was a practice of taping and weighing in and food logging and what was acceptable based on height and the role of the show or the ballet. So there were many times, I joke, I'm five two and a half hippie and mouthy, and that doesn't necessarily make for really great ballerinas. There were a lot of times where I wasn't getting parts. It was always about, and I say always without being dramatic about the aesthetics and so I felt like there was this love hate relationship with ballet, but also with my body. I couldn't get be six inches taller. I couldn't be the certain dimensions that at times they wanted me to be and it felt like this constant battle. Then I felt betrayed by my body because it wouldn't do what I was being told it needed to do. I was having a hard time making it do that. [DR. CRISTINA] Do you think that that mentality or the messages you were being told, or the rejections in terms of not getting parts led to some of the injuries because you were trying so hard to be better or to match up with what you felt like was wanted or needed or the criteria that was set? [JOELLE] Yes, absolutely. I think part of that was that was also accepted. I actually was just having this conversation with, with somebody earlier today. We were talking about being an elite athlete and that pressure of every time you miss practice or every time you don't perform to the level that your coaches want you to. I remember being a child, and then again, as a young person entering in this field with a ballet Mr. saying if you miss a day, you miss a month. So if you're going to be sick for two days, don't bother coming back. I didn't log that as being traumatic for me until I was in therapy and starting, and it took even then it took a long time for me to un uncover that message of, wow, I have to be perfect and my body has to work all the time. So it was accepted to dance when you didn't feel good and if you had, I had stress fractures and broken toe, like that was just normal. It was part of paying your dues. The message was, if you can't do that, well, don't bother, not take the time to heal. I think the world of ballet has changed significantly since I was dancing. This was a long time ago in the late eighties and nineties. I think we know a lot more dancers seem to be healthier. As things are growing, I can't comment on what the messaging is now, but definitely when I was a kid and going through this, that was what was accepted. [DR. CRISTINA] Wow, as I'm listening to you, I'm just thinking, oh my gosh, the lack of self-care, the lack of compassion for yourself and just the ability to say, "Oh my gosh, I'm in pain. I'm hurting. I need to heal. I need to take care of myself." Wow, these standards, the perfection and that's so much a part of eating disorders as well, just needing to be perfect. You used this word trauma and for you to be aware of that when you started to go into therapy. I'm wondering if people listening going, wait, why does she use the word trauma? She's talking about this. Did you question that yourself too? [JOELLE] Absolutely. I had what we refer to as big T trauma. I had definitely had that going into therapy from some other things. I didn't understand the little t traumas. So there were all of these things, like that experience of being told, "Hey, if you're sick and you're going to be off for more than a day, don't come back." Or I would hear for every rehearsal you miss, it takes you four weeks to get back. So these things where, it didn't register as trauma at the time, but it absolutely leveled my self-esteem. I had a lot of guilt and shame around not being good enough, not letting people down, not being able to be perfect, not performing to the level that people were expecting. It sounds so narcissistic when I say that now. At the time, the fear was, well, if I'm not good at this, then what does that say about me? Am I going to be unlovable? So understanding that those things became very traumatic because it really compromised my ability to believe in myself and that that core ego strength. So I had a lot of these episodes, I always say they like our Legos, they just stack one on top of the other. So there are these little traumas that are very painful where that guilt, the shame, the blame, the betrayal came up and would bubble up. I didn't really know what that was, and I just equated that too, well, I'm just not perfect enough. So the eating disorders were a way to control feeling that guilt and shame. It's, well, if I can control one thing, I'll be successful at that, and I can, in air quotes, be "really good" at that. If I'm really good at that, then I don't have to feel all this other stuff. I didn't realize that all the other stuff, these little traumas eventually would stack up and the dam would break. Then all of a sudden, I was in the trauma, if that makes sense. [DR. CRISTINA] So I'm wondering if throughout your therapy, you started to identify what all these little ts, you call them little traumas were because it sounds like at the time you were experiencing them, you didn't really know what they were, what you were going through. [JOELLE] It's little t trauma in relation to relational things typically. Being yelled as a child, if that's somebody's experience, is traumatic for some people, not traumatic for other people. It's how we log these experiences as individuals. So for me it was, there were so many things that were multifaceted, that were these little traumas. Some of it was home, some of it was school, some of it was being in the dance world, and then some of it was stuff that I was doing to myself. That was the hardest one to really work through, is the eating disordered behavior, even though it was acceptable in the world that I lived in. My parents were not dancers, that was not their background and so I think they just, she's happy, she's performing at school, she's doing really well in life. She loves ballet. She's good at. I think they were just looking at this as well, there's nothing, the doctor isn't saying she's sick. This is part of being in that world. They didn't necessarily know what they were looking at. Again, it wasn't until years later where it was like, oh, okay, now, now all those pieces are starting to fall into place. So these little t traumas were, for me, relational, my relationship with myself, my relationship with me as an athlete, with my coaches with food. I felt betrayed by food. So I felt betrayed by my body. I felt betrayed by the ballet teachers. I felt betrayed by food. So this idea of victimhood really started to set in with that trauma. Again, those little relational things that kept chipping away at my resiliency, my ability to have this ego strength and not knowing what that was, just really not not being able to identify it, not having the language and the understanding for it until I finally did go to therapy and started working on it. Then all of a sudden it was like, ah, okay, this is what this stuff is. [DR. CRISTINA] Well, I would imagine it be hard if that's the world you're in. You're surrounded by everybody who's normalizing everything if everyone around who's doing everything the same? [JOELLE] It was common practice. That's what my friends were experiencing, the people, my mentors who I looked up to, the prima ballerinas of the world at that time, this was normal. Again, for me, I'd look in the mirror and I'd say, but I'm not that, so I'm not good enough. So I had that, the dysmorphia component that came with it too, where I don't look like that, and if I don't look like that, then I'm going to be terrible or it must mean that I'm not perfect. [DR. CRISTINA] So I'm just wondering for people who are listening who maybe didn't go through this experience and they weren't ballerinas or maybe even athletes If they're trying to differentiate for themselves, like, okay, how do I know if I experienced little ts in my life and have them accumulated. Because well, maybe we could even take a step back and say, how do we know the difference between like a big T, like a big trauma versus what little ts are because we talk about PTSD or trauma in psychology and maybe even differentiating out like the two so people can kind have an understanding. [JOELLE] Thanks for asking. For me as a clinician, I define trauma as trauma is in the eyes of the beholder. It doesn't have to be traumatic for me, if it's traumatic for my client. That's a little bit Avant garde. Clinically the definition of trauma is something that is horrific that somebody has experienced and or witnessed. Now we know with vicarious trauma or secondary trauma that could be me watching something that's happening on the news, could be extremely traumatic for me. So we're starting, we in the world of psychology are starting to expand this definition of what actually constitutes this trauma. What we do know now is relational trauma, so again, a child who has maybe emotional and verbal abuse from a parent or grows up with a lot of yelling, has relational trauma with toxic relationships and gaslighting that all of these things can develop complex post-traumatic stress disorder, which is different than a single episode. So typically, we thought about trauma as being, it has a single episode, it has a beginning, a middle, and an end. With more post 9/11 military focused research and PTSD and also research with law enforcement and first responders, we started to see that, oh, complex trauma can be a lot of different episodes that have beginning, middle, and ends. It may not be a relational or even that the incidents are related, but somebody who has more than one big T trauma right, could potentially have complex post-traumatic stress disorder. Then this idea of little t traumas, well, what happens to people when they've experienced relational events that they hold similarly as big T trauma? So being the difference between big T and little t trauma. So when I'm referring to it in my experience, it was all of these little things that now when I look at them, I don't think coaches for the most part trained children that way in sports anymore. But my experience was we have a little bit more education around how we work with kids but all of those things became these little t traumas that became a big trauma. So for people listening, I think, again, without being hyperbolic, if somebody's saying, this really shaped my worldview, or this is painful for me, it caused behaviors that I'm not proud of or that are harmful, then does that constitute as trauma and in my work, again, my opinion I say yes, that absolutely constitutes this trauma. [DR. CRISTINA] Okay, because I think there are new terms out there that people hear and they go, okay, what's the difference between complex trauma, PTSD, all these different new terms that are out there. It can get confusing for people to say, okay, so what is all of this and what does that look like if I were to go into therapy and get some help for all of this? What's the difference between treatment for, say complex trauma versus maybe like relational traumas versus like PTSD? [JOELLE] I don't think that there's a one-size-fits-all model. I really don't. I think that, I always say to people I talk with interview the therapist or the psychologist. If it's a good fit, sometimes it doesn't matter who I am and what I know. If it's not the right fit, the work isn't going to work for that person. So some of it is the ownership of the therapist to be able to explain, "Hey, this is what all of these things are, and if that's important to you, the client, then let's look at what that actually means." There's a lot of assessment that goes into these terms. They're not just flippant diagnoses. I think complex PTSD is something that we're looking more at. We still don't know a lot about it. We know that there are a bunch of events that stack up that each one could be a standalone event that's traumatic, but doesn't necessarily cause post-traumatic stress disorder, D being affecting your daily life in living or your functioning. So it may not classify as a standalone as something that would cause PTS or PTSD, but when we put them all together, it starts to have that same effect. So for my work, I really distinguish with post-traumatic stress. When something happens that's either big T or little t trauma, something happens and the client says, "This was traumatic for me," the body actually will respond with post-traumatic stress. That's a normal response. The idea is, does that dissipate over time and does it affect, or how does it affect somebody's level of functioning? So when we start to say, hey, this is not necessarily post-traumatic stress, but there's this disordered component really talking about how that's affecting their someone's functioning. It's the same thing with all of the little t traumas that stack up, do they start to affect your functioning? Then I think to answer your question sorry, it's such a long-winded answer --- [DR. CRISTINA] Not a big question, so, thank you for trying to break it down. [JOELLE] I think to answer your question, there's a lot of different kinds of therapies and models of therapies that work. So some of it is what does the client gravitate toward? Do they like skills-based models? So we would look at something like cognitive behavioral or dialectical behavioral, CBT or DBT, that's skills-based. Does that help alleviate the trauma symptoms or the effects of trauma? Other people have done a lot of therapy and they want to move into something where we look at somatic processing or EMDR, how the body holds the memory of the trauma and how we feel about the memory emotionally and also in our body physically. That's a different therapy. So that works for some people where they come in and they really want to work with what's going on in their body. They have more physical symptoms maybe or they feel it differently in their body than other people. That may work for some people. There's a theory called cognitive processing therapy or CPT, and that's a very linear model. It's short, it's 7 to 12 sessions, typically 12. It's very regimented. It has a system and we know it works. There's a lot of empirically-based information and that works for some people who like homework and they like to have that accountability. So I think that there's so many different approaches on how we work with trauma. For me, it's the relational piece, finding somebody that for me that I could trust because I felt like it was so much. And again, I know it sounds narcissistic or self-absorbed. I think I was so in the throws of how I was feeling in my body and that guilt and shame component of it that I didn't understand what I needed or what would be good for me, and I needed somebody I could trust. That was the best place to start. Through that work of really starting with skills of, I just want to feel better and I really went into therapy going, I don't even know what I need. I don't know what I want. I just want to feel better and I do not want to give up the eating disordered behaviors. So it took me some time to be willing to, one, trust, the process, two, trust my therapist and do the work. I am the worst client ever. She would say, "Here's the homework, here's the workbook." I'm like, "I don't want to do it," because it was so painful for me to actually have to really look at it. So it was like, "No, no, no, I'm okay. We'll just talk about it." Eventually she got wise to my antics and finally started to call me out on my own garbage and had some really, what I'd say lovingly and endearing some, just some moments with me where I remember I was ruminating going around and round and around on something that really didn't have a whole lot of significance. I had been doing this for months, so I would use that as a distraction. She'd want to talk about these deeper level things and see if we could get some movement and then I'd go back and I would talk about this whole story again. So she said to me one day, she goes, "You know what, Joelle, when you're done suffering, let me know and we can do some real work." It was one of those like, let me pull the knife out of my chest first. I laugh when I say it. I tell the story all the time, and I absolutely adore my therapist, who I still have. It was what I needed to hear in that moment, which is, ah, that's where I'm getting stuck. Okay, all right. Her response was can we do some work? Are you willing to be vulnerable enough and sit with it in your body long enough to do the work? It took me some time to say yes, yes, I can do that. So I always tell clients, start with somebody that you can trust. They will tell you if you need something more that they can't provide. A good therapist will say let's look at EMDR, let's look at somatic, let's look at CPT, let's try some other things that may mean that you are not with me anymore but it might be really helpful for you. [DR. CRISTINA] That's a great point. I love your story and the fact that you said you didn't want to let go of your eating disorder because it served a perfect for you, obviously. I don't think a lot of people really get that part. I don't know if you understood that back then or if that was more in hindsight now that you're looking back. [JOELLE] I think it's hindsight. I don't think I understood that it did three things. It allowed me to maintain control when I felt again, I felt out of control. I wasn't out of control. I felt out of control. So it did that for me. It allowed me to not have to pay attention or feel what was going on in my body, whether it was injury, illness, or emotion. So it kept me out of having to feel the really hard feels. It did that for me. I got a lot of praise, and so it filled my self-esteem. I didn't realize it did any of those things. I just said, well, this is what I have to do to be perfect. What do you mean I have to get rid of this thing? Even now because I don't, I think we recover and I think that there's a remission component. I also know for me personally, that I have moments where I still struggle. The difference now is it's easier for me to identify and go, ah, they're that things, again. I can lean into it and make choices that I know my body will not be happy with, and it won't help my emotional state. Or I can sit with it a little bit longer, be in the pain a little bit longer, talk to my therapist and make different choices. Sometimes still that acceptance piece is not there. Again, I should be able to do it all right. It's so unrealistic and I think that that maps what's happening in my life in those moments. Sometimes it still bothers me and other times it doesn't. It's just I feel like I actually now have control. So I didn't realize that my eating disorders were keeping me safe in the world. They were my coping mechanism and it was my way to actually function as dysfunctional as they were. [DR. CRISTINA] So, I mean, that's, I think so important to listen to, is that you felt like you were in control, but ultimately what was in control was the eating disorder. [JOELLE] Yes, and now when I think about it, or again, when those moments pop up there are these times where I say again, I'll say in therapy I feel crazy. I know I'm not crazy, and I know I'm not out of control. But without having those maladaptive behaviors and coping skills, I feel out of control and I feel crazy. I used that word intentionally. That's how my whole being feels, my emotional self, my physical self, my spiritual self, everything feels off. So starting to have some language helped because, I couldn't necessarily identify what I was feeling, but I was able to put some language to it of, is it this or is it that? Oh, it's this thing. Okay, well, where do you feel that in your body? For me, a lot of times was, well, I don't. I don't feel it in my body. I don't feel anything in my body. Then it's like, oh, okay, now we've got to do some work of learning how to be in the body, which is odd for a dancer to say. But that's part of what this maladaptive eating disorder behavior gave me. It gave me the ability to hide, hide from my body, hide from the world, hide from the perfectionism. This was much later in therapy that I was starting to uncover these things and then, okay, now what do I do with it? Not now, so what? who cares? That was this idea of post-traumatic growth for me as, okay, take a deep breath. Now what do I do? What do I want to do? can it be different? Well, sure, of course it can be different. So what's that going to look like? Can I try that on a little bit and sit with it? Okay, I can, Cool. Now can I try something else on and sit with that? It was just a slow process of learning. Those were the things that drove me into wanting to be a therapist and really understand trauma. Originally it was, I wanted to understand eating disorders. Then as I started to uncover with my own story and what my clients were experiencing, it was like, actually, I really want to know about trauma too. That was the part that was beginning to really excite me. [DR. CRISTINA] Well, it sounds like your journey through your own therapy you started to uncover the why of your eating disorder. Because I think that's the big misunderstanding for people who maybe don't have one, is they think it's about the food, it's about dieting, it's about all these other things on the surface, and it's so much deeper. Like you said, it's about trauma, it's about control, it's about not feeling good enough, it's about so many other things. [JOELLE] Interestingly enough, for me, food definitely played a part, but it played a part as a secondary, if that makes sense, it was so much more about the aesthetics and the pressure I was feeling. It's similar now with social media and airbrushed pictures and how people feel now when they're constantly bombarded with images. So it's similar in that sense where it was, for me, it was, I was looking at myself four hours plus a day every day in a mirror and in class and then trying to figure how to decouple that perfectionism what I look like with the behavior. So I thought it was about food. I thought it was about food and exercise, aesthetics and what I uncovered was it was way deeper than that. That was sort of the secondary components to it for me personally. [DR. CRISTINA] So now you're in your practice and obviously, you transitioned over into being a therapist from being in the chair on the other side which is great. So do you primarily work mostly with people who have trauma or do you, like, tell me a little bit, tell the audience a little bit about like what you're doing now and what your specialties are and all of that. [JOELLE] So in 2008 I started doing primarily therapy as my main source of income. It took me another year and a half to finally let go of dancing completely. So I was one of those that kept threatening to retire for 10 years. Then I finally like, okay, I've got to do it. My body is hurting. So I started working with trauma, then went back to school to do more specific training on trauma and trauma modalities of doing that work. Then in 2011 I opened up my own clinic. So now primarily I'm a PTSD expert. I got to work with TED Global, which was really exciting and do an animation for them about PTSD. So I've been very blessed and able to do some really cool things since then. Primarily my focus is trauma. With that came starting to work with very unique populations. So I started working with military first responders, law enforcement with complex PTSD, complex meaning not necessarily relational, but having multiple traumas not just a single episode. From there, got to do some research and some grant writing and have really worked more in the application of using multi-modalities to treat trauma and then doing education around what that actually looks like. So for now, that's what I primarily do. I have a clinic in the San Francisco Bay Area in California. I have an amazing staff. We work with people that are experiencing trauma. So from there, in 2011, started working with military, then law enforcement, and then from there, ICU nurses and doctors and refugees and immigrants. Then with Covid we've done a lot more work with first line responders. That's primarily our practice. Then because we're in Silicon Valley, we see a lot of the high-tech people. So we started to see in about 2018 content moderators that were coming in with complex experiences and a lot of exposure to content. We've started to see more and more of that. Again, it's just part of the area of the world that I'm in, but that's what I do. [DR. CRISTINA] Fantastic. Well, thank you so much for sharing all of this, and congratulations on such a booming practice and much needed, obviously. Any last, final words for anyone listening that you want to just make sure everyone knows about or anything to share? [JOELLE] Yes. I appreciate you asking, and thanks so much for having me on the show. It's been a real pleasure. That piece of interview your clinician and find the person, and it's hard. It is really hard work and being able to have the validation of doing therapy and starting to heal, whether you're in therapy or not, whether you pick up a self-help book or workbook, a journal, watch some YouTube, starting is hard and it's doable. So going slow and asking questions is helpful. So I always like to just tell people that it does get better, even though it doesn't feel like that and it's not easy. It's a hard process. So giving yourself credit for being able to even just be willing to explore the idea of what would it look like if I was willing to ask for help, what would that look like? Take courage and strength. [DR. CRISTINA] Absolutely. Very well said. Thank you for sharing that. All right, well if anyone does want to find you or get help through your clinic, how can they find you? [JOELLE] Oh, it's my name. So on Instagram, basically on social media, it's at Official Joelle Trauma Therapy. But if you put Joel Maletis in, you'll be able to find me. I know that you're going to drop all the links in below anyway. [DR. CRISTINA] Yes, absolutely. So anyone who wants to go to the website or find her, all the show notes, we'll have all the links and you'll be able to find Joelle for sure. Joelle, thank you again. It's been such a pleasure. Thank you for opening up and being willing to share your story and your journey. It's been amazing to hear. Thank you so much. [JOELLE] My pleasure. Thanks again for having me. [DR. CRISTINA] 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.