Understanding Disordered Eating: Eating Disorder Recovery and Body Image Healing

From the Vault: Eating Disorders and the Mind/Body Disconnect with Danielle Novack, Ph.D [Episode 27]

We’re diving into the archives this summer to bring you some of our most memorable and impactful conversations — and today’s episode is just too good to pass up. While we take a short summer break, we’re re-sharing these standout episodes. So stay tuned all summer long for these gems! This week, we’re bringing back Episode 27 with Dr. Danielle Novak — a deep and moving conversation that fuses psychoanalytic insight with the complexities of eating disorders. Dr. Novak, a clinical psychologist with over 20 years of experience and currently in psychoanalytic training at NYU, joins us to unpack one of the most elusive and critical aspects of disordered eating: the role of dissociation. This isn’t just theory — it’s a raw, compassionate exploration of how symptoms aren’t random, but deeply protective mechanisms developed from unspoken, often unconscious emotional pain. If you’ve ever felt disconnected from your body, confused by your reactions, or wondered why food has such a powerful grip in moments of distress, this conversation will resonate deeply.  In this episode, we’re talking about: How eating disorders develop and are maintained as protective responses, not simply destructive habits. What dissociation really means and how it can show up subtly or severely in our everyday lives. How trauma — both big "T" and small "t" — plays a central role in dissociation and the onset of eating disorders. The ways emotions get stored in the body and expressed through symptoms when they can’t be spoken. How restriction, binge-purge cycles, and overexercise act as coping mechanisms for overwhelming feelings. Why symptoms may provide temporary relief, but ultimately prevent us from connecting with our emotions and others. How building awareness and creating a “pause” between urge and action can begin to reconnect dissociated parts of the mind. The vital role of the therapeutic relationship in healing dissociation and restoring emotional expression. Why treatment often begins with symptom stabilization but must eventually move into deeper emotional territory to be truly transformative. Tweetable Quotes "I tend to believe that eating disorder behaviors are often sort of stand-ins for feelings that cannot be felt as feelings or expressed through words or through other means." - Dr. Danielle Novack "People don’t learn how to regulate emotions. Emotions are just put away in a box and not looked at and not dealt with, and become separated from what’s conscious." - Dr. Danielle Novack "Often people describe restriction as giving them a sense of like numbness and detachment that often feels preferable and safer than actually feeling their feelings." - Dr. Danielle Novack “Without knowing what’s going on in our body, we can’t possibly create important connections.” -Rachelle Heinemann Resources Dr. Danielle’s Website It Takes A Village By Dr. Danielle Novack Grab my Journal Prompts Here  Looking for a speaker for an upcoming event? Let’s chat! Accepting new clients in July - Find out if we're a good fit!   LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at rachelle@rachelleheinemann.com

From the Vault: The Connection Between Trauma and Eating Disorders with Heather Ferguson, LCSW [Episode 57]

While we take a little breather, we’re diving into the archives to bring you some of the most powerful, thought-provoking episodes from the past. These conversations are just too good to leave behind—and today’s is no exception. We’re throwing it back to Episode 57, a deeply moving and intellectually rich conversation with Heather Ferguson, one of the most respected voices in trauma-informed psychoanalysis and eating disorder treatment. Heather’s insight into the nuanced connection between trauma and disordered eating is unmatched, and in this conversation, we scratch the surface of a topic that could easily fill a semester-long course. From childhood trauma and body memory to dissociation, shame, and the slow, compassionate path to healing, this episode is a must-listen whether you're a therapist, a survivor, or simply curious about the deeper psychological layers behind disordered eating. In this episode, we’re talking about: What trauma really means—including the difference between "Big T" and "small t" trauma—and how it shows up in unexpected ways. How the context and response to a traumatic event can shape the severity and meaning of the trauma. How eating disorders can act as survival strategies: tools for self-soothing, control, and numbing. What it means when an eating disorder serves both soothing and self-punishing functions. Why the healing process must include not just the mind, but the body—and how we create space for that in therapy. How early trauma and misattunement can shape our beliefs about ourselves and our bodies. How intergenerational trauma, secrecy, and silence can pass psychological pain down through families. Why creating a coherent narrative and reclaiming agency are essential to healing. How somatic awareness and slowing down automatic behaviors are key to shifting patterns of disordered eating. How cultural, familial, and historical narratives about food and bodies impact how trauma and eating disorders manifest. Why curiosity, compassion, and shared storytelling are central to transformative healing. Tweetable Quotes “The eating disorder became a self-management tool, a self-regulating tool, a strategy to manage states of hyperarousal and anxiety, to have a sense of efficacy and control.” – Heather Ferguson “Most of us with a psychoanalytic frame of mind think about eating disorders serving both functions, that is, they can both downregulate and soothe the nervous system, but it can also be self-harming and self-punishing.” – Heather Ferguson “That’s part of what gets mapped around trauma – ‘I’m bad, I deserve punishment.’ It’s illogical, it’s sort of how the psyche makes sense of this – that you are the bad one, and you somehow induce the traumatic event.” – Heather Ferguson “The eating disorder, in a way, can be a window into understanding the trauma.” – Heather Ferguson Resources Heather’s Website  Heather’s email: heatherfergusonlcsw@outlook.com   Grab my Journal Prompts Here! Looking for a speaker for an upcoming event? Let’s chat! Accepting new clients in July - Find out if we're a good fit!   LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at rachelle@rachelleheinemann.com

From the Vault: Examining the Harmful Implications of the AAP's Guidelines on Weight Loss Medication and Surgery for Children with Jessica Setnick, MS, RD, CEDRD-S [Episode 72]

We’re continuing our summer throwback series with a powerful episode that’s simply too important to leave behind. While we’re taking a short break this summer, we’ll be resurfacing some of our most impactful conversations — the ones that made us think, challenged the status quo, and sparked meaningful dialogue. Today’s rerun is one of those episodes. Originally aired as Episode 72, this conversation with Jessica Setnick dives headfirst into the controversial 2023 guidelines issued by the American Academy of Pediatrics (AAP). These guidelines made headlines — and not in a good way. Recommending behavioral interventions and even weight loss medications and surgery for children as young as 2, 12, and 13, respectively, the AAP ignited a firestorm of concern within the eating disorder treatment community. Jessica, a fierce advocate and long-time voice in the eating disorder field, joins me to unpack what these guidelines really say, why they’re so troubling, and how they reflect a deeper cultural problem rooted in weight stigma. We question authority, untangle complex motivations (hello, pharma profits), and explore what weight-inclusive, ethical pediatric care should actually look like. In this episode, we’re talking about: Why the AAP’s new guidelines on pediatric weight management are sparking outrage in the eating disorder community. The alarming recommendations to introduce weight loss medications by age 12 and surgery by 13. The pervasive weight stigma built into these guidelines, including the problematic use of BMI as a screening tool. How profit motives, particularly from big pharma, may be influencing the creation of these “medical” guidelines. The real consequences of these interventions: malnutrition, stunted growth, cognitive impacts, and the risk of lifelong eating disorders. The false logic that shrinking a child's body will reduce weight stigma and why that belief is not just wrong, but dangerous. The importance of separating weight from health, and why any medical concerns should be treated based on symptoms, not size. How weight changes can be relevant when viewed contextually, but should never be the sole focus of medical intervention. Why trusting your gut and challenging medical advice is not only okay, but it might be necessary for protecting your child’s wellbeing. Where to find weight-inclusive providers and what to ask when choosing a new pediatrician. Tweetable Quotes “Anyone who works in the eating disorder field at all – and probably many humans – knows multiple people, if not themselves, who have had failed weight loss interventions when they were children that then resulted in bigger problems.” – Jessica Setnick “The key is not to just single out the big kids. Any kid with an eating disorder should be evaluated. Any kid with a medical condition should be evaluated.” – Jessica Setnick “Shrinking children does not change their medical conditions.” – Jessica Setnick “‘Does my child have a medical condition, or are you saying my child is too big? Because if it’s a medical condition, we’d like to get treatment independent of his size. But if you’re saying his size is a problem, that’s not a conversation I’m willing to have.’” – Jessica Setnick Resources AAP Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity News release for the AAP new guidelines Understanding Disordered Eating, Ep. 30: Eating Disorders are the Solution Not the Problem with Jessica Setnick, MS, RD, CEDRD-S Jessica on Facebook  Jessica on Instagram  Jessica Setnick: Understanding Nutrition Jessica’s Website Grab my Journal Prompts Here! Looking for a speaker for an upcoming event? Let’s chat! Accepting new clients in July - Find out if we're a good fit!   LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at rachelle@rachelleheinemann.com

From the Vault: Food and Desire with Dr. Judith Brisman [Episode 73]

We’re kicking off our summer throwback series with an episode that’s just too good not to share again. While we take a little summer break, we’ll be rereleasing some of our most powerful and thought-provoking conversations—and this one tops the list. Originally aired as Episode 73, this conversation with Dr. Judith Brisman is one of those rich, soul-stirring interviews that stay with you long after it ends. Dr. Brisman is an icon in the eating disorder treatment world. With over 35 years in the field and deep roots in psychoanalytic thought, she brings both clinical depth and human compassion to the most complex questions about food, desire, and emotion. In this conversation, we explore why we turn to food to manage our feelings, how disordered eating often becomes the language of our unmet emotional needs, and what happens within family systems when an eating disorder is present. Dr. Brisman helps us understand not just the "what" but the "why" behind it all, offering a compassionate and grounded approach to recovery that emphasizes self-discovery, choice, and relational repair. In this episode, we’re talking about: How Dr. Judith Brisman became a pioneer in the treatment of eating disorders by blending behavioral work with psychoanalysis. How food becomes symbolic for desire and the complex ways we try to manage our wants and needs through eating behaviors. The link between emotional regulation and disordered eating, including compelling patient stories that bring theory to life. The role of family dynamics in shaping (and healing) disordered eating patterns. How feelings like anger, helplessness, and fear often get hidden behind food behaviors—and how therapy can bring these to light. Why recovery is not just about stopping behaviors, but about uncovering the inner voices and desires we’ve been afraid to face. What family-based treatment looks like and how parental roles and patterns can both support and hinder recovery. How to use moments of emotional overwhelm—like the urge to binge or restrict—as doorways into deeper self-understanding. How simple questions like “What do you want to eat?” can begin the process of helping someone find their voice again. Tweetable Quotes “Families all get into patterns, some of which work, some of which don’t work. An eating disorder in the family is an opportunity to say, okay, what might need to be changed right now? What might need to be inspected?” – Dr. Judith Brisman “We don’t just see a parent in their role, and a child in their role; we see everybody in their roles, and how the dynamics come together.” – Rachelle Heinemann “Knowing [your emotions and patterns] allows for choice.” – Dr. Judith Brisman “It’s not so important to identify the cause of the eating disorder… maybe it’s interesting, but that's not going to end all or be the key… It’s more about what’s happening today, the identification, and what choice that provides.” – Rachelle Heinemann Resources Dr. Judith Brisman’s Website Surviving an Eating Disorder: Strategies for Families and Friends Grab my Journal Prompts Here! Looking for a speaker for an upcoming event? Let’s chat! Accepting new clients in July - Find out if we're a good fit!   LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at rachelle@rachelleheinemann.com

173. Being Present and Eating Disorders

Let’s be honest—most of us would love to be the kind of person who “lives in the moment.” You know, one of those magical unicorns who wakes up excited for the day, mindfully savors every bite of their avocado toast, and breathes through stress like it’s non-existent. But instead, we’re over here eating lunch in front of our inbox, wondering why we feel like a disembodied ghost hovering somewhere between a meeting and a meltdown. Tweetable Quotes "I just don't wanna feel like I am dissociating my entire life." - Rachelle Heinemann "Food is inherently soothing, and it works because it's distracting and soothing at the same time." - Rachelle Heinemann "Without practicing in very neutral low-stakes moments, it's gonna be almost impossible for us to notice when we're triggered." - Rachelle Heinemann "We really have to think about all of this in the context of our specific lives and what we need so that we can work toward a version of ourselves that lives in however much of the present moment we actually want to live in." - Rachelle Heinemann Resources Bergen Mental Health Group Inc. is hiring! If you think you’d be a great fit, check it out! Grab my Journal Prompts Here! Looking for a speaker for an upcoming event? Let’s chat! Now accepting new clients! Find out if we're a good fit!    LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at rachelle@rachelleheinemann.com