Reclaim You- The Tangled Threads of Grief, Eating Disorders, Trauma & Body Shame
Season 1: Espisde 5- The Tangled Threads of Grief, Eating Disorders, Trauma and Body shame with Casey Koch
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Welcome back to Reclaim You with Reclaim Therapy!
In this powerful episode, your hosts Sarah and Casey dive deep into the intricate connections between grief, trauma, and eating disorders. Join us as we explore the experiences that intertwine these struggles and the often complex journey of recovery.
Throughout the episode Casey dives into the experience of grief, how it shows up throughout recovery from trauma and disordered eating, and how to care for yourself through it.
For more about grief and recovery from disordered eating, check out this blog post.
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To learn more about Reclaim Therapy and how to work with a therapist on the team, head to www.reclaimtherapy.org.
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Sarah: Hi there. Welcome to Reclaim You, a podcast published by the Reclaim Therapy team. Join us as we share stories, tools, and insights on how to reclaim you in the wake of trauma, disordered eating and body shame. Grab your coffee, tea, or your favorite snack and get cozy because we're about to dive in. Hi there and welcome back to Reclaim You, a podcast and a show for who have experienced trauma, disordered eating and body shame. Today we are talking to Casey again. Welcome, Casey Monday. Happy Monday. How are you doing this morning?
Casey: I'm good. How about yourself?
Sarah: Doing pretty well. We're so excited today we're going to be talking all about grief and how grief impacts literally all of the things. So, so excited to talk to Casey about this because this is Casey's jam. My jam, too. We love talking grief and its impact. So to start, Casey, tell us a little bit about grief and your interest in grief, how it evolved. Let's start there.
Casey: Yeah. So I get asked this question a lot from colleagues and just people in my life who go, how in the world would you be interested in that? Right? And I get excited. You've seen smile on my face. Right? And I think because my perception of grief through my own personal experience to where I am today has completely evolved. So when I was 19, I lost my father from alcoholism. And when that happened, I remember not having a lot of support, people not really understanding, not having a lot of people to commiserate with. I was very young, and so I remember that being really hard for me. And so when I went to college, my internship, my first internship was oncology and hospice, and I went, how in the world am I going to do this? How am I going to do this? I'm 20 at the time, right? And I was like, oh, my gosh, this feels really heavy. And I had the best supervisor in the world, Mario, shout out to you. She was fantastic. And she really taught me a lot about grief, about normalizing, what happens through loss, normalizing, the uniqueness of it for every situation. So I did that internship, and my whole entire perception changed. I loved it. I saw the spirituality in it. I saw the ritual in it. I saw the fact that when working in those environments, it was normal. Like, whatever it was, it was normal. Not in an invalidating way, just in a this is a safe place to do what you need to do, to process and all of those things. So then when I got into work as a therapist, that was what I always gravitated towards elizabeth Cooper Ross and David Kessler and all of the people who are really well known in the field and have done a lot of work, I just absorbed the information. And so then when I started working with body image eating disorders, I went that's in there too. Okay.
Sarah: Everywhere.
Casey: Everywhere. And so, yeah, it's just kind of been something I've stuck with because I think it's something that needs to be acknowledged and normalized and cared for in a community that doesn't talk about it. In a society that doesn't talk about it.
Sarah: I can so relate to part of that. When I first started as I guess, a baby social worker out of grad school, I started my career in hospice as well. And for almost a decade I worked in hospice working with families and folks who were dying and did work on the bereavement side of things. So the heaviness yeah. So real and what a just amazing and I don't know, humbling experience to take so much of that work into the work that we do now. It feels so important, such a wonderful foundation for the work that we do. Absolutely.
Casey: Yeah.
Sarah: If someone were to ask you what is grief? What would be your definition? It could be a lot. It's very short, I'm sure. Okay, good.
Casey: Mine actually is fairly short. Mine is and I want everybody to hear it a normal, normal emotional response to loss. That's it plain and simple. Normal. It's normal to grieve. It's normal that's what us as humans are naturally supposed to do and keep it simple.
Sarah: Tell us about the normal that feels so important. The normal maybe feelings or experiences that are associated with grief.
Casey: Yeah. So it really runs the gamut. Right? I mean, you can have shock, you can have denial, you can experience sadness, despair. You can feel relief, you can feel confused, you can feel lost, you can feel nostalgic. I mean, it runs from positive emotions to mild emotions to no emotion. Right? You can have numbness, you can have anger. It really does run the gamut. And with those emotions comes changes in sleep. You could be sleeping a lot or sleeping a little. Your appetite can change. Right? You can be more comfortable with isolating. You can be more irritable than usual. It's any fluctuation from your normal, your kind of status quo. And I think there is no definition for what that includes, really. I mean, you can look at any website that says what is grief and what are the symptoms of grief? And it's the symptoms of everything, right. Like every other thing.
Sarah: Right.
Casey: And I think that's what makes grieving almost beautiful is that there's so much freedom to feel and do whatever is needed. Now, some of those behaviors are not necessarily helpful in the long run, but again, if you need to do those things in your own time, that's fine.
Sarah: I think a lot of people, when they hear the word grief, kind of related to this deep sense of despair, which it can be, because that's also so normal and grief can show up in so many other ways. So I'm glad that you said all of those things that it can show up in so many different ways. Acceptance and relief. Relief I think we probably have seen a lot that people sometimes have a lot of guilt around in so many different ways.
Casey: We need to just highlight that one relief, any of the positive ones too, like nostalgia and those types of things and questioning, feeling lost. I think the thing about grief is that it does change you whether you want it to or not, right? And learning how to normalize that helps that process of that you're growing around it rather than just making go away.
Sarah: So when we talk about grief in the work that we do and we look at grief and how it shows up in trauma, in eating disorders and disordered eating, in body image concerns, tell us a little bit about how you see that. Maybe just like a bird's eye view of that intersection between the work that we do with clients and how grief can be present alongside that work or in that work.
Casey: Yes. So when I thought about this question, my immediate reaction goes to a quote by David Kessler that I absolutely love. And it says grief does not always have trauma, but trauma always has grief. And that alone, right? Just that idea that every traumatic experience that one goes through, one experiences grief and that can be through the loss of control, the loss of safety, the loss of community, the loss of a perceived idea, loss of confidence, loss of self esteem, loss of self worth. The list could go on and on. And on the flip side, when you reverse it, you have traumatic grief. So you have grief that is sudden or unexpected and that can be the loss of a loved one, but it can also be divorce, miscarriage, changing jobs even could be something of that nature. And so either way you flip it, there's something in there that intersections both of those. And so when we're thinking about how our work relates to those things, trauma in and of itself could, if we're relating it to eating disorders and disordered eating a body image, just the loss of safety in a world that's riddled with diet culture, with weight centered focus, with fat phobia, where people do not have that safety to walk into a store, walk into their job without knowing that something might not feel safe, right? It could be someone's natural experience and response to a traumatic event and using an eating disorder as a coping skill to find a sense of control or comfort or perceived safety or distraction. And then in body image, what I think of is trauma impacting our core beliefs which can be related to shame. And so changing our body is a way of kind of fulfilling those beliefs that we carry in our life. So yeah, it's a lot I mean, there's any way you do it right? I could imagine this as just a web that's just filled with tons of lines that go back and forth and all around.
Sarah: Yeah. So tell us a little bit more about, if you can, the impact that grief has on a person who has experienced trauma and is doing the really hard work of healing from those experiences or an experience yeah.
Casey: When you're thinking about trauma. Right. And this understanding that it's not the event itself, but it's how our body is reacting, and through years of having those reactions, we often carry core beliefs associated with those things. Right. And it can be a loss of identity, a loss of connection with yourself, whether that's through your body or through your mind or through your relation to the world around you. Right. And so that can be so many things that first we have to deal with. How do we connect to ourselves, how do we feel safe in doing that? Right. So doing a lot of somatic work and finding safety, because ultimately, I mean, let's be real, the loss you're grieving a loss of safety when you're talking about trauma, right. You just don't have it wasn't there. So we have to learn how to adapt. Right. How do we learn safety in other ways? Because based off of that experience back then, you didn't have it. We eventually have to lean to some acceptance that that's what occurred. But in healing from trauma, you realize that that doesn't need to stay there in this time and place. You can find meaning maybe around that experience, maybe you don't, and that's totally fine. But outside of that, adjusting to what safety now means for you, and that can start to change how you think about yourself and the world around you. And in those circumstances, maybe you're leaning towards that this has changed you, but it doesn't have to impact you in a negative way constantly.
Sarah: Yeah, absolutely. When you were talking, I also was thinking, too about lots of the folks that we work with have experienced complex trauma. And I'm thinking about the grief that's held in the loss of what they wish that they had or what even they deserved to have growing up. And the ripples of that grief just feel so huge to carry with you over a lifetime, really, and how that impacts, like you're saying, self belief and how people show up in the world as a result of that. Do you have any thoughts on that?
Casey: Oh, my gosh, do I ever. Wow. Do I ever. But that's so powerful. I think one of the hardest parts of doing this work is getting people to their grief, right. To what you're saying, like, it's safer for people to have this core belief, I don't deserve, I'm not worthy of whatever it is to make sense of the fact that they didn't receive something. So then when you start to dismantle that core belief, you're not getting to roses yet, you're getting to grief. And it's like, ****. And preparing clients for what that looks like is really hard because this work does get harder before it gets easier. It really is. Because you're unraveling all of these things that naturally you have protected yourself from. And shame is one of the thank goodness. Oh, my God. Yes. Survival skill. Your body and your mind is amazing and has been doing this to protect you and how brave it is for our clients to take those steps to try and explore and unravel some of that. It's not for the faint of heart at all. I tell my clients that all the time. And recognizing that our brain is so amazing that it will create different ways to talk to ourselves, to get us to not think about certain things, it just blows my mind. But yeah, that's one of those pieces. Right. That what those core beliefs to protect us from that thing we never had can also impact our relationship with food in our body. Right. How can we manifest those beliefs in those ways? And then you have a magazine telling you yeah, exactly. That's exactly what you need to be believing about yourself. Right. And then you're like, oh, there's no other way around it. So there's so many different layers of dismantling that diet, culture and fat phobia, then dismantling the protective factors within a safe container. And then what do you do with all of that, right? It's very tough. It's very slow and steady and very with a client's needs in mind. Right. This is a slow process, but what a rewarding process.
Sarah: Talk a little bit more, if you can, about that manifestation of unresolved trauma. This is a big question of unresolved trauma.
Casey: I'm ready.
Sarah: I know, right? The development of disordered eating and body shame and the grief that often we won't say all the time, but often, many times is just kind of like rumbling underneath.
Casey: Yeah. I almost have to picture this in my mind as an image. Right. I think of the world around us as this big circle, if you're watching the podcast, as the big circle of the beauty industry and the plastic surgery industry and the magazines and the social media and all of that, right. That's the outer circle and then the inner circle. You have family dynamics. You have generational trauma, which could be weight focused. It could be that everybody in your family talks about weight and diet and all of those things. It could also just be emotional trauma, childhood trauma, physical, sexual trauma, like whatever you're experiencing in that ring, almost. And then you have the ring of yourself, right. So you have to create a safety, whatever that looks like within those two boundaries. Right. And there are more if you get really technical about it. That's how I kind of see it. Really nitty gritty. Right. So when we experience trauma, right, we're trying to find safety. That's what we need to find in order to get through the moments, right? And so for some people, they need to not feel anything. For some people they need to manifest that core belief, continue to do that. And that can be it's only safe for me in a smaller body or it's not safe to think about other things than doing better in my eating disorder or with my body. There's comfort when it comes to food and seeking that, especially if you're experiencing trauma that is centered around weight and diet, right? It just kind of catches there and then the normalizing of all of those behaviors, whether you're in a diet focused community or school or whatever, where somebody can't tell based off of your behavior that you're in pain and that you're suffering. And I think those two things is why, unfortunately, a lot of people come to this healing journey later in life. And it's really a shame that and I hope that people hearing this can see that eating disorders and disordered eating and body image is not as simple as I saw a magazine and I wanted to look like that. It's so much more it's so much more complex and you can't just read it off of one behavior.
Sarah: The safety, how you're talking about safety. Yeah, that's so impactful because thinking about body image and folks who are struggling with body image in particular folks right now, what I'm thinking of is folks who are struggling with weight gain and recovery and the grief that's so heavy for most people. Most people to say goodbye to a body that was probably undernourished, that was maybe disconnected from and trying to be embodied in a new body in whatever shape and form that is. And the grief involved in saying like, that was a body that I lived in and it no longer is and I may still want it. There's so much grief in that.
Casey: Yes, body grief. I mean, the things that eating disorders and disordered eating and focus on weight and body is really this desperate attempt to avoid that grief because that grief is associated with possible judgment and possible invalidation and possible questions and what that means for that core belief inside of you. And I think some people can assume that in eating disorder recovery that your mindset about your body is going to change before your behaviors. And that's not always the case, right? Most people wish it was and I wish it was some linear process, but we're therapists and nothing is linear. That **** doesn't exist, right? So you're changing these behaviors and it's almost like you're holding onto this rope and it's just like your hands are raw from holding on to that and then you're starting to let go, but you're not quite there. So it's still extremely painful. And I'm sure with I know in my work, the pressure from support sometimes this is okay and it's fine and it's almost like the same as like if you lost somebody, it's like, but they're in a better place. But your body's in a better place right now. But it's not in all circumstances, right? It's not always safe to be in a bigger body or even in a changed body, depending on your family dynamics, the society you live in, whatever the case may be. So I think I'm so glad you brought that up. Because normalizing, that grief can be very long. It can be very long. And in moments in your healed, maintaining recovery, you can say, oh, it was nice to be there for a while, right? It was safer. Sometimes it was more comfortable. So, again, I think that like I always say, with grief, grief is always going to be there. So trying to push that away and get over it rather than just, okay, that's here, it's reminding me of a time that maybe my perception of safety was different or my need for that was more important than it is today. And just like everything else in therapy, I feel like a broken record. And it's like normalize the **** out of what is happening doesn't mean it's good, doesn't mean it's comfortable, doesn't mean everybody around you is going to love how you're presenting right now. Right? But that's a part of the process. So when people come in and they're like, I don't want to get rid of this body totally, I get it. What do we need for you to be comfortable taking that one step? What do you need? And being able to acknowledge that the fear of that is really that need for something comforting, something safe, and being supported through that. Oh, I love that question, such a good one.
Sarah: Are there any other thoughts you have on body image?
Casey: Do I?
Sarah: I always have so many thoughts on body image, on grief and body image, I do.
Casey: The one that I'm thinking of right now is the intersectionality between grief, medical model and body image. I've had a lot of people in the work experience a loss. The big ones, cancer, diabetes, strokes, those are like the main ones usually, or like during surgery. And the medical model can fear monger us into saying, like, oh, if you don't do something, it's going to happen to you. And then that intersectionality of it's a traumatic experience, some of those can be traumatic, right? We can't label something as never being traumatic. Somebody having a loved one dying of cancer, you're going to be afraid. That is a normal reaction. And so you're going to maybe, right, this is not always, but maybe you're craving some safety in your health and in your health in society today, it is diet and exercise and be small. So that's how some people show up in this journey. And if that is you, that is understandable in the society that we live in. So I've seen that intersectionality a lot, and I don't think that one is talked about as much in these spaces. So very important.
Sarah: And I'm thinking, too, since you brought up the medical model, about the loss that can come along with not having medical providers that are body affirming or all body affirming, and how, just like you said, like we've talked about on the podcast for the past month, how pervasive diet culture and influential diet culture is in the medical model. So to lose the safety and having providers that are going to honor you and honor your body in all forms, that's huge. And it prevents people from getting medical care and from finding providers who are going to be able to support them because their experiences are that it's just not safe to do that.
Casey: Yes, that inconsistency where I think the brunt of that loss that I've experienced in working with folks is like, they see a problem, right, whatever their health concerns are, and we muster up that support and courage to go and that doctor is like, oh yeah, we'll make that appointment, we'll do this, we'll do that. And then you go there trauma and grief, like coming into intersectionality here. You go in with the hopes that like, hey, maybe this one's going to be different, right? They seemed interested in having me here. And then you go in there with a closed door and you freeze and you go, oh, another loss, right. That expectation went away and then eventually people do stop going. And so getting people to get medical care in our work, it takes a long time, rightly. So that trust needs to be earned and medical providers just aren't doing that these days yet. And they are, but not in the grand scheme, right.
Sarah: If anyone's listening in there. In the Philadelphia area, we have a couple and there should be more of course there should be more safe doctors for folks really prioritize having people feel safe in their offices who are rooted in health at every size and yeah. So if there's anyone in the Philadelphia area looking for a doctor, shoot me an email. Shoot Casey an email. We'll give you a couple of doctors who are wonderful to work with.
Casey: Yes. And just that alone, like hearing that right, even doing this work for a little bit, and hearing that my nervous system kind of calmed down a little bit. Like when I heard that come out of your mouth, I was like, oh, right. And that's what we do every day with clients is like, here is choice, here is autonomy, here is the permission to be yourself and what you need and want. And connecting all this with trauma, that is safety and that's what really brings all of these things together, right? Body image, eating disorders, grief and trauma is the idea of needing safety and what that looks like.
Sarah: Yeah, let's just talk about eating disorder symptoms or symptoms of disordered eating that can be so hard to move through to kind of let go of where, you know I mean, I have so many thoughts, as usual, but in terms of grief and letting go of some of the symptoms that folks experience when they're struggling with food or deep in their eating disorder. Can you talk a little bit about that?
Casey: Yeah, I think the one that really sticks out to me is this mental piece that is if I do anything different, whether it's a change in my restriction or my binging and purging or my body checking, if I change that, that means that I'm going to lose something. It's never I'm going to gain something. Ending disorder, suffering, it's I'm going to lose something and it's going to be unsafe. So that whole kind of mental marathon, what is that really giving you? And how can we find that in different areas? Right. But it doesn't make that go away. To look at it in a grief model, just purely grief, there's a lot of mental superstition that comes through. Right. If I change the sheets on the bed means that I don't love them as much or if I don't visit their grave as often as I do, that means something. When we're looking at eating disorders and grief, I feel that coming up somewhat of like, if I do this or don't, it means this. It turns into a meaning. If I restrict today, then I did a good job and I'm a good person, and everything's going to be okay. If I binged at the end of the night, after that, I'm a bad person and ****'* going to be bad. And realizing that all of those things are because in some way, we've lost safety, we've lost control, we've lost comfort. And so it's kind of changing those behaviors while also recognizing the reactions that come out of those and then finding safety in dealing with it more. So the thing that I always want people to understand in this work is it's not one before the other. It's literally working with things simultaneously with the autonomy of the client to see what grief is coming up. Right. Is it the lost focus on the body, or is it the loss focused on what you've been doing to calm your nervous system all these years?
Sarah: Absolutely. And it can be really painful and confusing to start to find other ways to work with your nervous system and to find a sense of regulation and ease and calm. It's not an easy fight. It's a hard to get there.
Casey: Yes. And anybody watching who resonates with any of this, like Sarah and I, both validate the **** out of you. This journey is hard, and things will pop up that you didn't even think were going to pop up. And like we do with all of our clients, it's like endless permission to feel what you need to feel. And if you feel any type of feeling right now, it's okay. This journey is really hard. Really hard, but rewarding at the same time.
Sarah: Yeah. Recovery isn't linear, and it's going to ebb and flow and you're going to probably experience lots of different emotions along the way. And it may feel resonant of, I think, Kubler Ross's grief model of the different stages of grief. And it may not even feel related to those stages of grief, but to know that you can experience something like one day and something else the next day, and desire to engage in recovery one day and then complete denial that you have an issue the next day, it all just feels really normal.
Casey: Yes.
Sarah: Any other thoughts, Casey, that you have?
Casey: I mean, I think we covered a lot today.
Sarah: I know it was a lot. I know this is a big one.
Casey: But I think keeping it simple in terms of, like, at the end of the day, trauma, eating disorders, grief, it's not about getting rid of any of those things in its entirety, right?
Sarah: Yeah.
Casey: It's extremely invalidating to expect that of yourself. People have lived many experiences and have endured lots of emotions and situations that these things have been put in place with a reason. So grief is not about never experiencing it. It's adjusting around it. And sometimes trauma looks like that, and sometimes eating disorders look like that, and giving yourself permission to feel. And if that's not possible, right, because there are reasons why that's not possible is seeking out safe support, whether that's a support group or a therapist or a safe person in your community. That's the first step, is finding some form and semblance of safety to then feel. Because that's what's not happening in a lot of traumatic grief and eating disorders. And we honor everybody who's experiencing those things today. It's extremely hard. And we see you and we hear you, and we're here to support you.
Sarah: Yeah. We stand in reverence to your experience in the world. Really?
Casey: Yes, absolutely.
Sarah: Well, thank you so much, Casey. I love this conversation. And I'm sure we could do lots more episodes.
Casey: We could.
Sarah: And the particulars, this was kind of a bird's eye view of it all. So if you all are interested or have any questions or anything, please reach out and let us know. And if anyone's in need of support around grief or trauma, complex trauma, eating disorders, body image concerns, head to www.reclaimtherapy.org and check us out and learn a little bit more about working with us. Casey, thank you for chatting this morning.
Casey: Thank you. Thank you so much.
Sarah: Okay, everybody, we'll be back next week for another episode. Until then, take good care. Thank you so much for joining us on this episode of Reclaim You. Be sure to like and subscribe to the podcast and check us out on YouTube at Reclaim You. We'll be back next week with another episode. So until next time, take good care of yourself.
Reclaim Therapy provides specialized eating disorder therapy in Pennsylvania, trauma treatment and therapy for body image issues in PA.
Our therapists provide in person sessions at our Horsham, PA office and online therapy for Pennsylvania residents. We are passionate about supporting people to Reclaim their authentic selves after experiencing trauma, disordered eating and body-shame.