Welcome back to Just Breathe.

I am so glad you are here.

You know, there was a time where we could at least pretend that there was a space between politics and the LGBTQ community, or any marginalized community for that matter.

But as of yesterday, with the swearing in of America's first convicted felon, adjudicated rapist, prolific liar, malignant narcissist president, well, all of the air was just sucked right out of that space.

So LGBTQ rights, specifically trans rights, are now being targeted right out of the gates.

There are many good people who are doing the work of fighting and providing information on a regular basis, and I will continue to be a conduit for all of that and more in the coming weeks while continuing to bring you helpful and timely interviews and resources to help you support the LGBTQ person in your life in the very best way.

Today is an example of just that.

Kristin Shustak is the Regional Assistant Vice President for the Renfrew Centers, with a bachelor's and master's in psychology and clinical psychology, respectively.

She has extensive experience in leadership and direct care serving those in recovery from eating disorders, substance use disorders, and co occurring mental health disorders.

She feels passionately about connecting with individuals and treating them as a whole person, not the sum of their struggles.

I learned so much from our conversation, and I am so happy to share it with you now.

Kristin, welcome.

Welcome to Just Breathe.

I am really, really happy that you are here with us today to discuss a topic that is so, so important, one that we have never really discussed in this kind of specificity before on the show.

And so I'm excited to learn from you and to hear just the information and the resources that you're going to bring to us today about eating disorders specific for our LGBTQ friends and loved ones.

So thank you so much for being here.

Thank you, Heather, for inviting me.

I'm very, very passionate about this topic, and I'm very excited to be a part of your podcast.

Thank you.

Thank you.

Well, let's start out, right, kind of really, really broad, and then we'll narrow in.

Let's talk about what the major eating disorders are and what some of the symptoms are or ways that you can recognize what those eating disorders are.

I love this question.

I love starting broad and then funneling down.

That's wonderful.

So through media, television shows, movies, the two that are predominantly known throughout this mainstream are anorexia nervosa and bulimia nervosa.

Anorexia is a restrictive intake disorder, and bulimia is often a binge purged the other.

And when I say binge purge, purging can be self induced vomiting, it can be over exercising.

It's, it's not necessarily the cookie cutter Hollywood depiction that most of us have grown up with.

It's a much broader spectrum.

One of the others is called binge eating disorder.

That is one of the most prevalent and the most under diagnosed eating disorder, which I can get more into that in a moment as well.

Yeah, and we also have a diagnosis called arfid.

That's the acronym.

It's Avoidant Food Restrictive Intake Disorder.

I have to think through that.

As I'm saying, make sure I get the words correct.

And that is usually an aversion to eating certain foods due to texture, flavor, smell, color, or there might have been some sort of trauma attached to a certain type of food.

Like perhaps someone choked on a veg, a certain type of vegetable in their earlier years and they have a core memory of some sort of fear response, but they can't really place it.

And then that can over time develop into an eating disorder.

So those are the.

And then there's a category, kind of a catch off category for anything that doesn't quite fit the diagnostic criteria but certainly still presents as an eating disorder.

Okay, wow.

Okay, well, let's dive into some of the symptoms and how to recognize each of those.

Certainly.

So starting with anorexia, since that was the first one that I had mentioned.

And I will actually let me preface this with, there is often a continuum of disordered eating.

It's not necessarily I'm, I'm perfectly fine and air quote normal one day and then tomorrow I'm in an eating disorder.

This, this is often a gradual progression from wellness to maybe a preoccupation with body shape and size, preoccupation with E, and then distress about body shape and size and eating.

And then if not caught at any of those points, it can turn into an eating disorder.

So starting with.

And eating disorders are treatable and there is a high probability of full recovery.

So they're not necessarily a chronic or doomsday kind of diagnosis.

Yeah, just take some of the fear out of it.

So starting with anorexia, as I mentioned, it is a, often a nutrient restrictive disorder.

Symptoms or signs that loved ones can be aware of are if you notice someone is starting to skip meals, oh, I can't make it to dinner because I need to do this other thing that I had scheduled.

Or you're noticing if they are in meals with you, they're not completing everything that they have and saying you know, well, I ate earlier and I'm just not quite that hungry.

But it's a gradual kind of restriction to what they're, they're consuming.

There might be an increase in secrecy around what they're doing when they're, what when they're doing with whatever they're doing.

More isolation, quietness, kind of depression.

Those are some of the earlier signs.

Other symptoms once it becomes more severe would be obviously weight, weight loss or body changes.

They might be cold all of the time because they're, they're just not getting the nutrients.

They need some hair loss.

That's more of a severe symptom and generally just a, a withdrawal from anything that is centered around food.

Especially in the holiday season because a lot of the American holidays are so food centric.

There might be a lot of anxiety or anger or just aversion leading up to anything that is a food centric kind of holiday of like I can't be there, I'm just emotionally, it's too much bulimia.

A lot of the same outward signs, either avoiding or leaving pretty much immediately after eating.

As I mentioned, the purging could also be excessive exercise.

So perhaps an uptick in going to the gym or noticing, you know, they're taking walks after a meal or you know, the dog really did need to go out for the 15th time today and I'm going to volunteer to take them out.

And it's, it's a lot of compensatory behaviors and a lot of it is driven by compulsion.

So it's, it's not always a conscious choice of I'm going to do this knowing it's going to cause me harm in the long term.

Sometimes it's really just reflexive in that regard.

And binge eating, the one that is the most prevalent and the most under diagnosed is pretty self explanatory by the title of it, that a person will consume food beyond the point of fullness to the point of discomfort, sometimes pain.

And it's.

All of these eating disorders are actually emotional disorders and the eating or lack of eating is an outward symptomology of an emotional disorder inside.

So it's really a form of, of self harm.

It can be, it's, it's almost like a, I need to do this to cope with something painful internally, externally.

Exactly.

Or it could be a control, something to that effect.

Fascinating.

I had never thought about it that way, but certainly each one of them.

But binge eating, as you said that, I thought, wow, that definitely could be just I'm emotionally I don't know how to handle this or I'm, I fill in the blank.

So this is the way that I can feel better right in this moment or I can numb the pain or I can make myself feel pain.

Yes, yes.

Almost like a, almost like a self punishment of X happened.

And then why is how I'm going to self punishment?

Right.

Right when I feel like there's been that little bit of glamorization of the, you know, something happened so I'm gonna eat a pint of ice cream or you know, Right.

Like there's, there is definitely that out there where that's made to look.

And it's so damaging.

So very damaging.

So true.

Like how many rom coms where there's a breakup and the female main character is on the couch with a box of donuts and a pint of ice cream crying into her, her bowl.

And you're right, it's so damaging.

That's a really good example.

Oh my goodness.

Okay, so tell me about arfid because I just learned about this maybe a year, year or two ago.

My daughter had a roommate at summer camp who had this and her mom was telling me all about it and I had never heard of it before in that way, like as a diag.

You know, I'd heard people who avoided certain things and all, but I mean, really was a great explanation.

So I'd love for you to share what this is and you know, any way that people can recognize and what to do.

Absolutely.

So the clinical definition of ARFID is an eating disturbance, like an apparent lack of interest in eating, an avoidance based on the sensory characteristics of the food, or concern about an aversive consequence.

Like, like I mentioned, maybe I choked on something at one point or whatever the case may be, and this is now.

It's manifested as a persistent failure to meet the appropriate nutritional or energy needs.

So it's, it becomes so aversive for whatever the reason is that it becomes a disorder in that the person is not able to consume the nutrients they need on a daily basis for proper functioning.

And it's different than the, than the anorexia or bulimia or binge eating disorders is in the fact that there's not a body image component.

The other three are a challenge with a relationship with food and a challenge in your relationship with your own body.

ARFID is specifically about the relationship with the food has absolutely nothing to do with how I look, how I feel in my body.

It's just I cannot eat anything.

But perhaps these three Foods that I feel safe with and that can create a nutritional deficiency.

It's often.

We often see it manifest either in populations that are on the asd, Autism spectrum disorder, or sometimes we have.

At the Renfrew center, we've encountered patients that the parents might say, well, they were a really picky eater when they were a toddler, and toddlers can be picky eaters.

And that's not to say that every picky eater is going to eventually evolve into an eating disorder, but sometimes we can trace it back to something might have happened in childhood that was initially presumed to be picky eating.

And it really could have been related to a sensory integration disorder or some sort of small trauma related to the food.

Wow, that's fascinating.

My other daughter has a roommate currently, who I don't think she's officially diagnosed with this, but certainly by all measures, she does struggle with this.

What can, you know, what could my daughter, for instance, do to support her?

Is there something that loved ones and friends, colleagues can do to be supportive?

Because certainly, as a person goes through being a teenager and into young adulthood and into the real world, they're going to be around more and more circumstances where they're like, I can't eat any of this, or I don't.

This is like, makes me sick or physically ill or whatever.

So what can somebody do when they are with a person who's struggling with that to support them and to help them through that.

So one of.

I love this question.

Thank you so much for asking that.

One of the first things that with any presenting eating disorder, what a loved one or a support can do and hopefully is doing, is normalize that it's okay to not conform.

You don't have to necessarily eat what everyone else is eating right now.

That's not shameful.

That shouldn't be embarrassing.

It's just.

It's okay if this just either you can't eat or this particular option is not for you, that's okay.

To align an ally with someone who may be struggling, whether it's.

It's an aversion to eating in general or an aversion to eating what isn't, what the group is eating, it may be helpful sometimes to say, you know what?

I think I'm gonna go off menu too.

I'm really not feeling this right now.

And even if I really wanted what everybody else was having, I'm gonna be supportive of my loved one.

My friend, in that moment say, hey, I'm gonna be the odd one out too.

And that's okay.

We can be the odd ones out.

It's really not that big of a deal.

So to really frame situations in a way that it is appropriate so it doesn't become conflated to that individual who's struggling.

Because oftentimes if someone is either in the throes of an eating disorder or is in early treatment and recovery from an eating disorder because their emotions have been so compartmentalized and so minimized for so long, when those emotions do come back, they're going to feel them at an amplified rate.

So what might feel like no big deal to you, or I could feel like the end of the world for that other person.

So the more you can align with them and normalize, it's really cool.

It's not that big of a deal.

Let's just, let's get something different than everybody else is having.

It will help them manage their own emotional response in the moment as well.

Oh, that's great.

That's really, really, really helpful.

Thank you.

Thank you so much.

One of the things that came up for me as I was reading through all of this is the phrase eating disorder.

But I've also heard disordered eating.

Is there a difference between the two phrases?

And if so, which I think there might be, can you explain what it is?

Certainly yes.

So the, the main difference is one is a clinical diagnostic criteria.

Eating disorder has certain traits that an individual has to meet according to the dsm, whichever version we're on now, I think five.

So it's a very strict clinical framework that the has to meet every point she be diagnosed with an actual eating disorder.

Got it.

Whereas disordered eating can.

That has a broader presentation, whether it be a person only eats orange foods or a person tends to carb load if they're an athlete, a student athlete, or whatever the case may be carb loading and then restricting throughout the rest of the week to make weight or whatever that that may look like for their sport.

Or there's a term that's.

It's not a diagnostic term, but it's newer, newish in the field called drunkorexia, where an individual will essentially restrict their consumption throughout the day in preparation for a party or an event that night to get drunk faster.

The, the few fewer calories I have in my system, the faster the alcohol is going to hit me.

So those are all forms of disordered eating.

And it's really essentially anything that disrupts what is a societal normal pattern of consuming three meals throughout the day, snacks throughout the day, and often results in some sort of harmful result.

Wow.

Okay.

Thank you.

That is very helpful.

Okay.

I would love to kind of narrow down and shift into talking specifically about the LGBTQ community, our friends and loved ones, and why we tend to see more disproportionately eating disorders within the community.

Let's start there and then we'll dive into the nuances of that.

Absolutely.

So we do see a higher prevalence.

As you just mentioned, about 87% of LGBTQIA youth have been diagnosed with an eating disorder.

That does not even count those that are struggling with disordered eating that have not yet evolved into the clinical criteria.

And about 21% of youth, when surveyed, feel that they have had some form of an eating disorder or disordered eating in their lifetime.

A lot of the factors that contribute to that we've found in doing the research so far, is a discrimination toward that community, both through microaggression and direct discrimination.

In trans individuals in particular, there's often a struggle with body dysphoria and dysmorphia, especially at.

At the point in transition that either a male to female or female to male wants to have a more appropriately presenting body for their gender, and sometimes that their body is just not.

Not coordinating with where they want to be.

So they may engage in some harmful behaviors.

And non binary individuals often want to have as few sex traits as possible.

So that can often lead to susceptibility for restrictive disorders as a result of that.

Also, just fear and anxiety about coming out, about being open, who do I trust?

Who can I go to?

Whom do I feel safe with?

And if I can't share that or I don't feel safe sharing that, I'm holding onto that.

And that in itself can create a lot of anxiety of am I being true to myself?

Am I denying myself by not living my truth?

And it creates a lot of internal conflict emotionally.

And then from that, if they do come out, or even if they're suspected and they're othered by their community, their peers, that can often result in either a lack of acceptance and.

Or bullying or violence toward them.

All of these are factors that really make this community very susceptible for eating disorders.

Wow.

Oh, my goodness.

Okay.

So, so many questions.

And that all makes sense.

And it.

I mean, this is stuff that I'm sure you talk about all the time.

I know I talk about all the time.

You know, reasons why.

Right.

And here's one, one more thing that might be used.

You know, eating disorders, disordered eating, too, just as a maladaptive coping technique.

And.

And I fear that we're going to see More of that as we move forward here in the next, the coming months, in the coming perhaps years.

So what again, the question, what can we do as whether it's a parent, a friend, a teacher, when we see a child who, whether they have.

Or just a human, whether they have come out to us or not, how can we really support them?

What can we, at what point do we say, gosh, I really feel like we need to get some professionals involved here?

And what are some really good questions to ask so we can find that information out?

That's really great question too.

So there are a handful of both recovery and protective factors that we can implement for our loved ones and even for ourselves, because our loved ones are also watching us.

They're watching what we're doing.

They're watching how we're interacting with our world, our bodies.

So from a self perspective, and this would be applicable to anyone in the community, but most specifically to transgender individuals, regardless of where they are in the transition.

Pay attention to how you're talking about yourself.

Pay attention to the words you use to describe yourself, the way that you're feeling, how certain clothes fit.

And instead of saying like, oh, I feel so large in this outfit today, or I feel like my jeans don't fit correctly today, focus more on, I'm feeling really energetic in my body today.

I'm feeling really like I'm very sharp.

And I feel like I could, I could beat any trivia that's thrown at me today.

Really shift the focus away from physicality and more to other factors about yourself that are much more interesting than the way you look because that may help them also start to think, okay, sure, maybe my body isn't where I want it to be, but my heart is, my soul is, my mind is.

I'm growing in other ways to be the person, my true self.

So that's one way in which we can influence a better image for them, whether they're in an eating disorder or not, just helping them with their own self acceptance by modeling our self acceptance and our self compassion.

Additionally, as far as what you can offer directly to individuals, I like your question about what to ask and how to ask it.

Always approach from a place of curiosity.

I've found in working with individuals within this community, there's a sense of guardedness, a sense of, I don't know how someone is going to come at me, so I need to prepare myself for the worst first and then slowly back into trusting that individual.

So approach from a place of curiosity.

More so than saying, hey, I'm I'm concerned about you because I'm seeing X, Y and Z.

What's going on More be like from curiosity, present more from a perspective of.

So I've been feeling that there's been a shift in our relationship.

We don't really talk as much as we used to.

I feel like we're not really connecting on the same level.

And I'm curious what, what you feel might be happening because this is what I'm feeling, feel is happening with us.

And I really want to bridge that connection, really reinforce I'm a safe person, you can trust me.

I do want to communicate with you about what's going on.

And that will eventually invite them into being.

Ideally, that will invite them into speak more openly about what it may be and whether it's I'm being bullied at school or, you know, I, I need to tell you that I'm ready to come out.

It could be anything.

Also, if you have any inclination that they're being othered in any other capacity in their lives as much as you might be creating that, whether it's a friend space, a home space, a parental space of true acceptance.

If you feel, if you're getting the impression they're being othered elsewhere, find areas in the community or resources in the community where you can help connect them to others like them.

So I'm being othered over here, but over there I'm accepted and that will make the other on this side feel less impactful because they'll have the support to fall into and it's especially peer support, others that are going through it or have gone through it, that can be really helpful and that can be found through community, through school, through any sort of LGBTQA plus networking, whether it's online, in person, um, just anything to connect to, to build that community out and especially with who knows what's going to be coming our way.

Even aligning as an ally and saying, hey, I, I found this community resource, would you let me to come with you?

I'm really interested in what I can do to be a part of this with you as well as you doing it on your own.

Right.

And, but also giving them the space to be like, no, this one, I'm, I'm going to do this one on my own.

Like give them space to be independent, but kind of checking in to know that you're always there too, right?

Oh, I love that.

I love that so much.

What I'm hearing too from you is just like that awareness, like being very, very present, being very aware and really Listening not only to the words that are being said, but the energy between the lines.

Right.

Taking those cues and really working from those also.

Being curious is such a, a key component of, of any of these things.

At the Renfrew center, you treat eating disorders.

Yes.

And you work with LGBTQIA plus people and you have a programming that's called sage, Is that correct?

Can you talk a little bit about what that is and, and what, what you do with that?

Absolutely.

So at the Renfrew center, we love our acronyms.

Almost everything has an acronym.

So the SAGE are SAGE groups that stands for sexuality and gender equality and they are patient support groups.

They're.

Well, we offer them in multiple places.

We have patient support groups.

So it's peer to peer support and those are facilitated by a clinician.

So there's always a therapist in the space as well.

We have, we offer that to alumni as well as community supports, often virtually.

So it's facilitated across the country.

At various points in time.

We may close the group for a bit, reopen it, but there's always information on our website about that.

And we also, at certain points in the year, as the population and census need presents, we will embed it into our treatment programming as well, for higher levels of care, understanding that the work that our patients are doing, whether they're actively in treatment with us or their alumni that have completed treatment and are just kind of maintaining at this point, all of the work they're doing is really, really hard.

And it takes a lot of emotional energy, it takes a lot of intellectual energy, and it requires a lot of support, because overcoming an eating disorder is not for the faint at all.

So we also recognize that the LGBTQI population is coming in with handful of experiences that a cisgender person may or may not experience in their lifetime, directly or indirectly.

So we want to honor that too.

And recognize you may have different traumas, you may have different experiences, you may have different questions about what recovery and healing is going to look like for you.

That may vary from your cisgender peers or even your bipoc peers, which is another subgroup we have for black, indigenous and people of color.

Right.

We really want to approach this as we are seeing you as a whole person.

And we want to do our best to integrate all aspects of who you are into your treatment for better chances for your long term recovery as you move through our system and then maybe move on to the next team that's going to work with you.

But we want to make sure that we're seeing all of you Instead of fitting you into our box, essentially.

Right.

Well, in a very specific piece of you.

Right.

Instead of you're really treating the whole person.

Yes.

And working with the whole person, which is so great and unusual.

I will say, having been through several different kinds of programs with my kids, that is pretty unusual.

So bravo.

Thank you.

I'm so grateful to know that there is.

Is some.

Something out there like you and, and that I can share with people.

I wanted to circle back really quick with.

Something just popped into.

Popped into my head as you were talking about modeling good self, basically self compassion and self love.

I think that that's not necessarily specific to my generation, but I think that we definitely are not violate that more and are now at this point in our lives where we're learning like unlearning and relearning.

And so certainly I know for myself and many people out there, I have not always been great with my positive self talk, whether it's internally or externally.

So as my kids were growing up, I know I can't even count the number of times that they probably heard me say, I feel fat.

I don't like the way I look in these clothes.

This talking about myself in a way that is not positive.

Once we realize that, obviously that is something that we can work on and own, and then it becomes like this active process or acknowledging to your kids like, hey, that was not great, right?

Like that I.

I'm bummed that I did that.

I'm learning and I'm shift and I want to share this with you.

Do you have any other suggestions for people who are in that space of like, ooh, yikes, I do want to work on this, or I'm in the process of working on it.

What can I say to my kids to be like, ugh, do what I say, not what I do.

I really appreciate that, that you're even willing to revisit that.

I think the biggest.

I think the first step is owning it.

Owning that, you know, I.

I am from a generation that grew up seeing supermodels always looking the same in magazines.

Body inclusivity, body neutrality wasn't a thing.

So I'm learning along with everyone else.

And I might be a bit further behind the eight ball than say, generate Gen Z or Gen Alpha right now, but owning that, like, yes, I see things that I need to reappraise, things that I.

Messages I grew up with, I need to reappraise.

I need to reprogram for myself another thing that I.

That nothing.

Another strategy that, that we really promote in the work that we do with families as well.

Because this is very much a family disorder and a family healing model.

So we want to educate the whole family is understanding and accepting.

Sometimes you're going to say the wrong thing and that's all right.

And it's a matter of keeping that communication open, that if you say something that the intention was good but it landed poorly with the person you said it to, that there's enough trust and openness in that relationship that the person receiving the message can say, that kind of gave me the ick.

Can we.

Can we revisit that?

Or I heard you say that you're going to have a salad for lunch so you can have dessert at dinner.

It doesn't really land well with me because I'm learning that you don't have to earn your food.

So just kind of keeping that open communication or even checking in of I caught myself saying this or doing this or acting this way earlier and in revisiting it, I realized that is not positive self talk for myself.

I want to check and see how that landed with you because maybe we can talk through that as I'm learning to view myself in my world differently.

One of the main components of the Renfrew center from a nutritional perspective is we follow the Hays model, which stands for healthy at Every size, body shape.

Body size does not always equate to health.

And we also look at food as fuel.

And your body needs certain components of certain foods, whether it's fats, starches, dairy, whatever the case may be.

In order to operate, your car needs gasoline.

Assuming you don't drive an electric vehicle.

Your car needs oil, it needs gasoline, it needs transmission fluid, it needs all of these things to run properly.

So do our bodies.

So try not another.

The last thing I can think of is try not to assign judgment to food.

The term junk food, the term I'm going to eat healthy today.

Food is food.

Food keeps us going, it keeps us operating, it keeps us functioning and healthy enough to be human beings that have the privilege of forming relationships and connections with others.

And if we're not properly fueling ourselves, those are the first things that are going to start to diminish because we're going to be tired, our mental capacity is going to decline, our mood is going to change.

So it's a matter of kind of reframing things in such a way to understand food is important, but should not be the focus.

The way that I feel in my body is important, but shouldn't necessarily be tied to how I Look and really kind of approaching it from that perspective of I'm going to start to change what I do, I'm going to start to deprogram myself from what I've learned and I am going to.

Even if you can't get the body positivity, that's okay.

I'm gonna at least try for body neutrality.

Self acceptance and neutrality.

Absolutely.

I think that is a good first goal because as we both know this, it is very difficult and it's something that I feel it's necessary to also say that give yourself grace as you're working through this because it is not.

A.

Week long process.

It is something that is, you know, it's like the process of unlearning and relearning anything.

It takes time and humility and grace and.

And again not things that the older generations were ever taught.

So these are all big pieces that I'm so grateful as I see my kids now being older teenagers and young adults that they have learned, you know, I have modeled enough, shifted and modeled enough that they are learning at much younger ages.

Do I wish that they had learned it at, you know, pre teenagers?

Absolutely.

But we can't go back and redo that.

So that's always.

I always feel like I like I'm a example of you can change when you're older.

Like you can shift these at any.

Your thinking, your thoughts, your, the way that you walk in the world, your belief systems.

Yes.

All be unlearned at any point.

And if I may add to that from a thinking and worldview perspective.

Absolutely something this generation, I'm of the generation that I started analog and moved into digital social media did not exist until I was in college, thank goodness.

So coming the other direction, I feel that's where supports could be really helpful in helping younger generations, even young adults at 25, 26 years old right now, really honing their critical thinking skills instead of just absorbing whatever media is throwing at them because media is always surrounding us now.

Learn to really think.

Is are all of these flashing lights and pretty colors and all of this that's trying to sell me this, this weight loss thing or this new trend is this, is this really something I want to invest in?

Right.

And realizing real life is real life social media, not real life.

People are not posting their worst.

I've had the flu for four days.

I've been in the same pajamas since last Tuesday.

They're not posting those pictures, they're right posting their best cells.

And in, in recent years, the introductions of filters.

I was just Gonna say.

And typically with a filter.

Yes, yes.

So really helping generations now that have have been inundated with all of this media, all of this Internet access, social media, etc, from birth, essentially helping them move through the sewage and the garbage that is social media.

And recognizing your self worth is not tied to how many followers you have at the end of the day, that's not a big deal.

Yourself is tied to who you are as a human being, right?

Absolutely.

And I find helpful to ask, like, when you're in those kind of the who, what, when, where, why.

Right.

Like ask those questions as your.

Where did this come from?

Or is there a way that I can verify this?

Or why.

Why would I think that?

Or why is that person thinking that?

Or like stopping taking that pause to ask critical thinking questions, like the basic.

So those are good things too.

Just the bare minimum of critical thinking.

Right.

To begin and build.

Absolutely, yes.

Oh, my goodness.

Okay, so I.

Is there anything else that I.

That you would like to share?

I should say that we haven't covered.

I feel like we've done a pretty.

Pretty good, broad job.

But is there anything more specific that you would like to share, either about eating disorders within the LGBTQIA community, how we can be supportive, and or about your work in the world?

Thank you for offering that space.

Yes.

I think one of the most important things that we can offer as allies, part of the community, whatever the case may be for LGBTQIA individuals, is remain flexible and remain open to the fact that those of us that might be on the outside looking in, we may think we understand what's happening, we may understand the pressures or the fears or even the successes within the community, we may not understand them to the extent that we think we do.

And just keeping in mind that an individual's perception of their reality is their truth.

So keeping the lines open for communication.

And like you had said earlier, listen, instead of just assuming I know how you feel or I know what you're going to say next, listen and try to become comfortable with holding an uncomfortable space.

Human beings just.

We're not comfortable with silence, but really practicing and listening, to use your term, pause before you respond, allow the other person to process what they just shared or what they're feeling before you jump in.

And also just keeping in mind it's not necessarily your job to fix, sometimes it's just your job to be there and segueing that into my work in the world.

I've been working with eating disorders for almost six years now.

Prior to that, I was working in Substance use.

And I think one of my biggest takeaways is there are so many assumptions made about individuals that as allies, as loved ones, as friends, as professionals, in my case, we need to maintain an awareness that those individuals are often coming into our space with the assumption we're going to put those judgments on them too.

And we need to give them the opportunity to show us who they are without making assumptions about them, without making judgments about them.

And that is one thing.

And I would say this even if Renfrew didn't sign my paychecks.

That is one of the things that I value the most about the work that I do with the Renfrew center is not only the integrity of the treatment model that we provide and the fidelity of the treatment model that we provide, but the genuineness of the individuals that I work with.

And even though we are a nationwide company, I often describe it as because we are family owned and have been family owned.

We're in our 40th year now of being in existence.

It feels like a small family owned company that just happens to be very large.

And I love that there's such a sense of connection and community and just checking in with each other professionally to make sure that we are our best selves clinically and professionally for the individuals that we serve.

And I feel like if I could just sprinkle some of that magic dust into the rest of the world, things would be a lot better.

So that's, that's something that I do share with the families I work with the individuals and even just with, with the individuals I supervise.

Just check in with each other, check in with yourself.

Because you can't provide for someone else if you're not providing for yourself first adequately.

Yes, yes and yes.

Oh my goodness.

So huge.

Where can people find you?

That's a great question.

Thank you.

So for information about all of our services, what we provide, all of our locations, the best location for that would be our website, which is www.renfrewcenter.com.

for individuals that are interested in exploring options for treatment may have questions about a loved one that they feel might need treatment or just general information.

They could call our program information department, which is 1-800-RENFREW.

We do try to keep everything very easy to find.

I love that.

That's awesome.

Well, I will put that all in the show notes as well and all the things that I send out into the world.

So thank you.

I'm so grateful that you are with today and just this was so clear and helpful and I'm just.

I'm very grateful.

So thank you.

Thank you so much for this opportunity.

I love to be a voice within the community as well as professionally.