Claudia: Please note this episode contains some emotional content, including discussion around disordered eating and may not be suitable for all listeners.
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Rhian: I suppose. It's just making that connection really from like you said, being the child that wants to make sure everyone's okay. And that sort of followed me into adult life.
Claudia: [00:00:29] Hello and thank you so much for dropping by. This is How Did We Get Here, I'm Claudia Winkelman. I'm here with my fantastic friend clinical psychologist, Professor Tanya Byron. As you probably know, by now, we look at some of the difficulties life can throw people and then discuss how to tackle them. Tanya talks to people in one-to-one sessions whilst I'm listening in from another room. In the break [00:00:51] And at the end, I asked her Tan a bit about her process and we explore the issues that are raised.
This time we meet Rhian, who has had disordered eating for as long as she can recall. She remembers being teased by her parents about being fat and she attended a weight loss clinic age, just 14 
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…said here she comes now walking down the stairs, [00:01:11] great big belly and a lot of hair. They didn't think, Oh, this is going to stay with her and create an eating disorder years later. 
Claudia: What you're about to hear the key parts of a one-time unscripted session with a real person, we follow up with our guests after the recording, passing on links and contacts, some of which you will find in the program notes of this episode. Let's go and meet Rhian.
Claudia: [00:01:42] Tell me why you’re here?
Rhian: Well I was thinking about the title of this podcast and I thought that is exactly, really why I'm here to figure out how I got here. Basically. I kind of feel like for a long time, I've known a lot of my reasons for disordered eating
Claudia: Right. 
Rhian: And yet. It never seems to get any better. 
Claudia: Yeah. And that must be horrible.
Rhian: [00:02:06] I'm 43 now. And I think, Oh, for goodness sakes. When am I going to get over this? It's been over 25 years of. This being my first thought, every time I wake up in the morning, how heavy I am. And my husband laughs because we've got a mirror in the bathroom and I'll tilt it because I have to check my stomach all the time, you know?
[00:02:28] And he makes a joke of it. Cause he's lovely and he couldn't care less one way or the other. 
Claudia: They genuinely don't notice. 
Rhian: He's, he's really lovely and kind and supportive and very rational. And he'll tell me what, you know. Oh, you're. You know, you're lovely and you've got good qualities. And I know he believes that, but I feel if I don't accept that, I'm almost like undermining him. [00:02:52] And I don't know whether I'm overthinking it. 
Claudia: We all know how we feel. Right. And somebody's just going no, no, but it's perfect. Yeah. You go, Oh, do you know what? Give it a break. I don't like this dress. I'm taking it back enough. 
Rhian: Yeah. 
Claudia: Talk to me. If you don't mind about how, how it manifests itself. 
Rhian: I've either really, really, really restricted my eating.
[00:03:12] I mean, there was a period when I was a lot younger in my teenage years where I, I didn't eat anything for two weeks. I just drank Earl gray tea. And I go from that to then having a crazy binge where I leave all the food in the house and everywhere in between. Got you. Why am I constantly trying to get to this magical [00:03:34] you know, number two stone lighter all the time. And even when I was two stone lighter than I am now, it was always, Oh, I want to be another half stone. And it just, it never ends. It's like a carrot on a stick, round a corner.
Claudia: And how were your family and friends either when they're with you? On a day where you want to eat everything all, when they're with you on the day where you're being restrictive.
Rhian: you know, they just know me as one of our crazy diets.
[00:04:00] So I ate vegetable soup at beginning of lockdown. I hate vegetables for three months. 
Claudia: Three months!
Rhian: Oh, I know. 
Claudia: Sorry for shouting, I thought you were going to say three days. I was like, you know what it would have been hard but-
Rhian: And I did like hit workouts. That was a bit depressing. Cause nothing even really happened. 
Claudia: How were your parents, how were they around food?
Rhian: [00:04:20] They're quite normal around food, but when I was growing up, my grandma looked after me and she was a big feeder and my grandma would give me sandwiches and cakes, biscuits, dinner, pudding. Yeah. And just, she would sort of almost force it on you sort of thing. So she, my mum would pick me up from her house and I, I didn't know this until years later she said, and I'd feel your tummy to see how much food you eaten.
[00:04:44] And then she'd be really cross with my grandma. And I think somewhere along the line, I've picked up that up. 
Claudia: Are you kidding? Sorry Tanya will do this in a much better way, but yeah
Rhian: When she was explaining it I knew obviously she wasn't cross with me when I was a little girl for eating too much. She was crossed with my grandma, but yeah, I think it all got a bit mixed up.
Claudia: [00:05:05] So you want to leave here today with an understanding maybe of what's led to the disordered eating and maybe a different feeling about it when you go home and you're making lunch or you're having supper tonight with your husband, you just want to feel slightly different around food. 
Rhian: That would be really nice. [00:05:23] Yeah. 
Claudia: Thank you so much. We're so grateful and Tanya will come in.
Rhian: Okay.
Rhian: [00:05:32] I think my obsession comes from being quite little and I think I've just sort of grown up with it. 
Tanya: Your mum used to sort of check your tummy. I mean, was that the extent of, of, of what the, no, you're shaking your head. 
Rhian: I was thinking before I came in, I, I'm not looking to blame anyone about my issues because I'm grown up enough to, to be able to deal with things.
[00:05:56] And none of us have come from a perfect background, but my mum bless her and she was quite young when she had me. But I, I remember it strange a couple of years ago. I remembered a song that my mum and dad sang about me being. Did you remember it? Can you say it to me? Can you say, yeah, there was only like, Two lines or something.
[00:06:17] It said here she comes now walking down the stairs, great big belly and a lot of hair. I did speak to my mum. She was really apologetic. She said, I'm so sorry. And she does take some responsibility. I don't know. Do I need a two? I'm not sure…
Tanya: but you're crying. Yeah. And when you told me the song, you were smiling, but tears just started pouring down your face and they are now.
[00:06:43] And. You do not want to blame your parents because they loved you and they still love you. And I totally respect that. But talk to me a bit about that part of you that you've just connected with. When you told me what they were singing, when you walked down the stairs.
Rhian: Even now I associate being a little bit heavier with being naughty and I'm 43 years old.
Tanya: [00:07:06] You carry guilt and shame around food, which given that food is something we need to do every day. That means you feel guilty and ashamed a lot of the time.
Rhian: I suppose so yeah
Tanya: So you're very upset now, aren't you? Yeah. You really are.
Rhian: Surprisingly Yeah. I wouldn't expect to be. 
Tnya: It's interesting how you smile and [00:07:25] cry at the same time. I think you're trying not to. I'm sorry. I can see you getting more and more upset. Yeah. If you feel okay with it, we should explore this feeling. Now you are still a very ashamed, embarrassed wounded child when it comes to food. But what you just described to me, if I imagine a child walking down the stairs and their parents singing here, she comes, you know, big belly and lots of hair.
[00:07:55] I imagine that child feeling very sad and possibly feeling a bit bullied you have from then to now you bully yourself around food and weight from the minute you get up in the morning. Yeah. Tell me about the sadness.
Rhian: Apparently I catastrophize everything. So if I can't get in touch with my husband for 20 minutes, he's dead somewhere in my head.
[00:08:23] It seems strange. Now that I said to my friend a few months ago, Oh, I've never suffered from anxiety, but I think because I've had anxiety maybe for so long, and maybe that sadness that you're talking about for so long, I didn't even know it was there, which seems a bit. I mean, how can you be so out of touch with your own self
Tanya:  you know, I wonder[00:08:48] whether that's because you, you narcotize, it really effectively, if I'm anxious and preoccupied with my weight and what I'm eating all the time, it's quite good distraction is I don't really have to think about what I'm really anxious about, which is how sad I feel and possibly how angry I feel with my parents.
[00:09:04] But I love them so much. I don't really want to feel angry with them because I know that they're good people and it's, it's very confusing. Let, we'll go back to that because anxiety often most of the time, I would say underpins, disordered eating. When you think about it from the minute you wake up, you've got these intrusive thoughts banging through your head.
[00:09:28] If that's not anxiety, what is it really? Yeah. I used the word narcotize before. Have there been any, any other ways that you have tried to narcotize feelings in your life? Have you used?
Rhian: Yeah with alcohol that, I mean, I don't drink now.
Tanya: so you're sober you don't drink at all, 
Rhian: Yeah I don’t drink at all, my dad's an alcoholic, right.
[00:09:50] I suppose I started drinking about 12, 13. 
Tanya: Um, gosh, that was quite young. Yeah. Well, I, I grew up in a, in a village where there was the only thing to do is hang outside the bus stop and drink cider and smoke cigarettes. 
Rhian: By the time I was 20 and I was working. So I drink between a bottle and two bottles, normally about a bottle and a half.
[00:10:14] But looking back, that was an awful lot for a 20 year old to be drinking on a work night, you know? And I think if I'd have carried on. I mean, looking back, maybe I wasn't alcoholic. I don't know. 
Tanya: But, um, it sounds like you were alcohol dependent in the sense of it became something you would dependent on your daily function.
Rhian: [00:10:34] Yeah. Even with my husband, my husband say, well, why don't you just have a glass of wine? I'm like, well, if I have a glass of wine, I'll want another glass and then I'll get really devious. And I'll start sneaking around drinking, which I've done in the past. Um, so it's best if I just don't do it at all.
Tanya: [00:10:50] It's interesting. Isn't it. When you talk about the alcohol use back in those days, and you talk about food, use it, the parallel is with you it's all or nothing. 
Rhian: Yeah. Completely. 
Tanya: The difference between people who have. Uh, difficulty managing alcohol and people who have a difficulty managing food is that we don't have to drink alcohol.
Rhian: [00:11:12] No
Tanya: but food is something we have to do every day. Yeah. 
Break:
Claudia: Okay. It's me Claude. Um, I noticed something you asked Rian, uh, whether she had any other narcotizing behaviors. So disordered eating is also numbing. This is revelatory. 
Tanya: When I say narcotizing behaviors, I mean, behaviors that we can use to numb the pain that we're feeling about something that's completely unrelated.
[00:11:40] So whether it's, you know, excessive drinking, self-harm drug abuse, you know, obsessive eating gambling. Sex addiction, whatever it's it's behaviors that we will engage with, which will enable us to distract ourselves away from whatever it is. That's really the problem to narcotize ourselves from the pain of reality, if you like.
[00:12:06] So when. You work with people who have difficulties with any of the behaviors I just listed, you will often ask, are there any other ways now, or in the past, you may have, you know, try to narcotize your feelings. And it was interesting that she then tells us about which I found really heartbreaking actually this 12 year old girl at the bus stop[00:12:29] finding that alcohol made her feel less stressed and then alcohol becoming a problem into her twenties. And then amazingly she said, right, that's it. I can't do it anymore. But then she's now got the issue with food. 
Claudia: Thanks for that. Let's carry on with a conversation. 
Tanya: How did your father's alcoholism impact the family growing up?
Rhian: A huge amount [00:12:50] Really. When I was a kid, if the tiniest thing happened in our house, There would be a huge route with my mum and dad. We didn't have a calm sort of upbringing. I mean, I did have a lovely childhood and I remember some really, really nice things about my childhood, but it was quite fractious. And I remember trying to keep the peace.
[00:13:14] Um, I remember one time, my dad, he had a really bad hangover and my mom said she felt really sad for me because I went and run my dad a bath thinking that would make him better. She was sad because she knew it almost took my innocence away in, in,-
Tanya: Were you very little.
Rhian: I think I must have been quite little. Yeah. [00:13:32] It was quite, um, stressful environment sometimes to be in. 
Tanya: So as a child, you would feel anxious at times and maybe a kind of hypervigilant thinking. Does that sound like he's getting angry. Is he going to start shouting? 
Rhian: Yeah. Oh, definitely. Yeah. 
Tanya: And again, you look sad when I say that you just remember that part of you just…
Rhian: Well, I still do that a lot [00:13:56] now. 
Tanya: Tell me about that.
Rhian: Yeah. So my, my auntie said to me, once she said she felt really sad and angry once, because I insisted for some reason on carrying everybody's bags, which is a bit strange. She said to me afterwards, she said, “You're not pack hours, people can carry their own bags, you know?” Yeah. I, I feel this need, particularly with my mum to completely look after her 
Tanya: Protect her.
Rhian: [00:14:23] Yeah. Yeah. And she's not. You know, she's, she doesn't demand that of me by any means. 
Tanya: No. But do you remember times when you fell even as a young child, that she bought the brunt of your father's behavior? If he'd been drinking.
Rhian: I knew if she was really upset about the way he was being, and he's not, he's not a bad bloke, so yeah.
Tanya: [00:14:44] Let's get back to what you answered. I think that's really interesting. You don't have to carry everybody's bags. I mean, if that isn't a sort of. You know, symbolically illustrative of something more about you. What do you do for a job?
Rhian: I don't know why that made me feel like cryin’ then I don't know why.
Tanya: [00:15:00] Don't push it away. 
Rhian: I’m a support worker.
Tanya: You're a support worker for?
Rhian: So I work with, um, adults with special needs and disabilities in a day center. Very vulnerable. Yeah. And actually probably marginalized in society. Not really seen, not really cared about not really loved enough often. Oh, you're crying. Tell me about the tears.
Rhian: [00:15:22] Yeah, it's sort of surprised me. I don't know. Where they've come from, I suppose it's just making that connection really from, like you said, being the child that wants to make sure everyone's okay. And that sort of followed me into adult life. Just putting myself to the bottom of the pile, I suppose.
Tanya: 100%. You really do. You really matter, but I don't think you [00:15:51] You, you see that sometimes.
Rhian: I am very fortunate though, in that my husband treats me like, um, you know, a princess or something. He's just amazing. So I'm very lucky in that regard. But then again, I have felt guilty about that because I've got, uh, really lovely relationship with him. And my mum doesn't have that with my dad.
Tanya: [00:16:15] So there is something around you and your mum that's, you know, you're very, very sort of identified with her in a very protective, anxious way. 
Rhian: Yeah. Yeah. That's, that's very true. My husband actually says when we go to my mum's, he says he can feel me as we're driving, getting more and more anxious. 
Tanya: Why do you think that is?
Rhian: [00:16:37] I don't want her to be upset. Because if she gets upset, I get, I get angry. 
Tanya: So you're really good at looking after other people. 
Rhian: Yeah.
Tanya: Who are you? Not very good at looking after, huh? 
Rhian: Myself. You know, it's a good quality, isn't it to be, to put others before for you, you know.
Rhian: But we also live in a world where it's, the instruction is very clear. [00:17:03] Put your own oxygen mask on first. 
Tanya: And why is that an important instruction would you say? 
Rhian: If you're not looking after yourself, you can't look after anybody else.
Tanya: So how do we then take that narrative into what we're thinking about with you?
Rhian: prioritize things about myself more? I, I don't really know how to start doing that because I've lived like I have for so long [00:17:29] Um, I don't really know what I like or what I want or. 
Tanya: I don't think you do.
Rhian: I have no idea. 
Tanya: I don't think you notice what you need. What you notice is how your stomach looks in the morning. So you place your needs, your self-care needs around your weight and around food. And how's that working out for you? 
Rhian: Not well. I'm tired of it.
Tanya: [00:17:58] You're really tired. Yeah. You know, you've got great body. You'll you look healthy, you that fit, you’re a healthy weight. So your body image is distorted. Your relationship with food is distorted. So that's one way your anxiety manifests itself. And the other way is an extreme, catastrophic thinking generally around separation anxiety.
[00:18:19] And those both linked back to childhood don't they? So the food anxiety is coming down the stairs and your parents singing about you having a fat tummy and being hairy. So that's where that I think is rooted. And the separation anxiety, I think is probably something about feeling like you had to be close to your mum just to make sure she was okay, because you worried about her so much.
X Promo
CS: A[00:18:49] Also from Somethin’ Else... 
KP: Katie Piper's extraordinary people with me, Katie Piper, every episode I'm joined by a guest who tells their incredible and inspirational story, revealing how they face adversity and came through the other side, including Great British Bake Off judge Pru Leith:
PL: I mean when my first husband died, I think that next two years were the worst two years of my life, because I really loved him deeply.[00:19:17] And he died about 18 years ago now. But what kept me going was that I had all this work that was nothing to do with him. 
KP: Do you think independence is key to resilience? 
PL: Yes. A degree of independence, I think to put all your eggs in one basket is dangerous because it's just, it's just so awful when you're left on your own.
KP: [00:19:45] You can find a link to this particular interview in the episode notes of the show, you're listening to subscribe now on Apple podcast, Spotify, or wherever you get your podcasts.
Tanya: [00:20:01] We could argue that you're quite self-harming in your relationship with food. In order to be able to free yourself up enough, to look at that part of how you care for yourself differently what do you need to separate it from?
Rhian: Anxiety.
Tanya: Yeah. In order to detach it from that, what do you need to focus on when it comes to the anxiety that you still hold on to as a 43 year old woman
Rhian: That that anxiety comes from being a child 
Tanya: Who felt what?
Rhian: [00:20:35] Disappointed and that I couldn't make everything perfect.
Tanya: Disappointed in herself? 
Rhian: Yeah. Oh yeah. Yeah. 
Tanya: You've nailed it. You still can't forgive yourself for the fact that you couldn't make things okay in your family when you were growing up. 
Rhian: That's what I've been missing. And every time I'm horrible to myself and bullying myself
Tanya: you really bully yourself.
Rhian: [00:21:01] But learning that it's linked to me being a, that little girl, trying to make everything right. It makes perfect sense. And it, it gives me somewhere to go the optimistic hope that I might possibly get over it. 
Tanya: Of course you will!
Rhian: Can you imagine being 80 years old and still worrying about eating a cake or the…
Tanya: Can you imagine the levels of flatulence when you're doing your vegetable soup diet?[00:21:31] I mean, literally if you know, that would probably threaten your marriage as well. Yeah. So, but nothing else, we really have to sort this out. So you don't want to, you don't want to fart your way to a divorce do you? (laughs)
Rhian: (laughs) No. No. 
Tanya: Okay. Right. Well, lets have a think then because we could make a bit of a plan couldn't we for the break? [00:21:51] Thinking about tackling the anxiety from childhood, thinking about some here and now stuff around self care. I want you just to think really broadly, what are the things that I think could be fun? I've kind of glimpsed at, but never really thought about?
When it comes to food and how to feed yourself [00:22:09] could you just write down all the questions you've got now, based on what confuses you about that? So I can just have a conversation with you about food and healthy eating and stuff. Cause I think you're very confused about all that. And then I would like you to write to yourself as that child telling her what you've just worked out today with me about [00:22:36] anxiety, explain it to her. Could you do that? 
Rhian: Yeah.
Claudia: [00:22:56] You're like miss Marple or Poirot if you prefer, Where you find these clues. And when did you go? This is about anxiety. I mean, what I thought she was coming in because she's been dealing with disordered eating? How you get to anxiety?
Tanya: Disordered, eating, eating disorders, alcoholism, alcohol dependency, drug dependency, drug addiction, gambling addiction, sex addiction, shopping addiction, self harm. [00:23:25] These are all behaviors. That are ways of coping with how we feel. And in psychology, we call them maladaptive coping strategies. Adaptive is healthy. Maladaptive is unhealthy, so they're not healthy. They may in the short term, have a function and provide relief in some way. Starving yourself and feeling light and happy and euphoric. [00:23:55] Cutting yourself. A lot of people talk about, you know, a sense of, Oh, just right, release, drinking, a bottle of whiskey, whatever. In the short term, this may make me feel buzzing in control. I can do this. Everything is fine, but in a long-term all these behaviors do is really narcotize us from the actual pain that we're [00:24:22] struggling with and in, and of themselves create more pain because they create more problems. When somebody comes in for mental health treatment for a specific problem behavior as a clinician, it's very kind of you to call me Poirot or Miss Marple, but as me, Tan, in my, in my clinical work and with my colleagues, our question is: [00:24:52] What does this behavior mean? What is the function of this behavior? Because if you don't understand why someone is doing what they're doing, change will only ever be superficial. 
Claudia: Tell me about the work that you want her to do. And what I loved was your confidence when you went, no, this can be dealt with.
Tanya: Any issue can be dealt with, if you have [00:25:13] enough understanding of yourself and enough compassion for yourself. It is about her just really understanding the place that less comes from, which is a place of anxiety and a place of guilt and shame and fear. That's a legacy she's carrying. That legacy she needs to be able to locate where it belongs and have support to address that and to think about how she felt as a child and to process that. [00:25:45] But it needs to be sort of disconnected if you like from now. And I suppose what also needs to be thought about is the impact on her marriage, because she has a really lovely husband. Clearly they have a great relationship.
Claudia: I was going to ask about that because he, I understand, you're living with somebody, [00:26:04] this is the love of his life. Yeah. And all you'd want to say is you look great!
Tanya: When Rhian regresses to that anxious child. And then that gets played out around her body and food insecurities and anxieties. That's where she's placed it all. In his loving support of her, he may be inadvertently maintaining a dynamic between him and her, which feels more like a parent child dynamic.
Claudia: [00:26:31] Yeah. 
Tanya: She needs not to be enabled to stay in the reassurance seeking child place that she'll get into. So he needs support to understand that he needs to step away now. This conversation needs to not happen between them. It needs to happen between her and her therapist and her and herself. 
Claudia: I'm going to go and get her I cannot wait to hear the letter
Tanya: [00:26:59] You are bullying yourself from the minute you open your eyes. Imagine that there are people standing in your room around your bed. And as you open your eyes, imagine people are shouting at you. 
Rhian: Oh
Tanya: But that's what you're doing to yourself and not only are you doing it, but you're enabling it because you're now supporting it through crazy diets and obsessive thinking about weighing yourself and this ritual [00:27:28] you've now got this anxious, almost obsessive ritual where you tilt the mirror. What do we say to children when someone's being mean to them? 
Rhian: You get away from them. You walk away, you say. I don't like the way you're talking to me. I don't want to listen to you anymore. Goodbye. 
Rhian: Yeah. 
Tanya: Now I need you to get to that point in yourself. [00:27:55] Let's just go through some of the other things very quickly set, and then we'll get to the letter and then we can talk about that. So point number one was any questions about food?
Rhian: I wrote, would it be detrimental to follow an eating plan? Would that fuel Mike sort of obsession or would that give me an element of [00:28:13] control. 
Tanya: It is very clear that your relationship with food is highly anxious. Your relationship with your body is highly anxious and therefore it does clearly indicate that you do need support just in terms of understanding how to eat healthily throughout the day. And allow yourself to do that and let go of feeling anxious.
[00:28:38] I think if you were to go onto a sort of eating plan like the groups that set up to help people with weight loss, although a lot of them are good and they educate people how to eat healthily in order to lose excess weight and to feel healthier and better in themselves. I think for you, anything that has a context around weight loss is completely missing the point.
Rhian: [00:29:00] Yeah. 
Tanya: And actually the reality is you're going to find this quite difficult because you are basically eating yourself to being overweight. Now, what I mean by that is because you're restricting and then binging and restricting and binging, you are absolutely completely annihilating the effectiveness of your metabolism.
[00:29:21] When we starve ourselves, our metabolism will then. Adjust itself in order not to burn calories because there's very little coming in. So it's got to be very, very effective in terms of how it uses it otherwise we go into a state of malnutrition. So people who restrict and then Benjamin straight to them binge their metabolism is so lowered that when you start eating again, you will gain weight, which is why crash diets never work.
Rhian: [00:29:48] I found that to be the case. Yeah, definitely. We all know that for people with a sensitivity to eating disorders, they then can trigger much more disordered eating/ You haven't learned how to feed yourself in any way, other than restrictively. So when you stopped restricting apart from your metabolism, then being in a very different place, you're in a very different place [00:30:09] and that's why most people lose weight fast and gain weight faster and more weight than they lost. So it is what it is. So my advice would be that you would see somebody who had, who was a nutritionist or dietician, who also has a specialization in people with disordered eating. Right. Okay. You want a skilled professional who can really educate you to understand food and how to feed yourself.
[00:30:30] There are all sorts of things like. You have to have breakfast. Most people with issues with food, won't have breakfast research, research, research shows if you don't eat a good breakfast, you're more likely to show a disordered eating pattern throughout the day. Right. Cause you're you start your day starving because you haven't eaten for eight, ten, twelve hours because you've been asleep and then you don't eat breakfast, but then you'll snack because you'll need a bit of sugar or a bit of something [00:30:54] cause you're, and then the snack will then make snack again and then you'll go, Oh, I'm not going to have lunch because yeah. And the whole thing is chaos. So there are certain things that you need to understand that will be very triggering for you for your anxiety. So you'll need someone to support you with that.
[00:31:09] Yeah. But you're, you know, vegetable soup high-intensity training, but you know, you've done this many times. You'll gain it again. Yeah. And. Jump on the scales and lo and behold, it's all back on again, plus a bit more and self hatred here I come. And you said your husband, why do you love me so much? I wanted to ask you about that, [00:31:36] Is that not kind of. Does that I'll do his head in a bit sometimes. 
Rhian: Oh, he's so patient, I don't know how he copes with me. And I said, dude, do you not get tired? Does it not irritate you? That I'm like this? And he said, no, it's just, you have issues. And he just supports me with it. He's-
Tanya: Okay. So I'm going to say something that's going to sound really brutal here. [00:31:55] So if we just reassure someone, we don't enable them to work out how to manage for themselves. What is making them feel anxious? We're just telling them, Oh no, no, you'll be fine. It's fine. You're lovely. It's great. You know, you're gorgeous. I love you. Your body is great. Of course. I love you. Don't say that, that's awful. And that's kind, but we're still enabling them to continue to be a victim because what we're not doing is enabling them to work out for themselves [00:32:30] how to not be a victim and to challenge- internal in the case of you- bullies. This has to stop being a conversation between you and your husband. 
Rhian: How, how would that work with my husband? And I would I maybe stop conversations about diets and about weight and about food?
Tanya: Have those with the people that are helping you.
[00:32:53] So with the dietician nutritionist that you're going to engage with and with the. Psychotherapists that you also will spend time talking to. If I was your therapist, I'd want you to start doing some things called response prevention, where you stopped doing the thing with the mirror. You get rid of the scales, you change your morning routine.
[00:33:15] You wake up straight away, you plug into Headspace or calm you do a meditation, or you just go for a run or a really great walk, or I'd get you to start looking at how you could shake your routine up. So when that bully is there. You know, you're thinking, okay, I'm going to outwit this and I'm going to, I'm going to do things differently.
[00:33:37] As we would say to the child, find other friends, find other people to play with, do other things. Then the bully can't be around anymore. 
Rhian: Yeah. 
Tanya: Standing why that bully exists means listening to the child. He still lives inside you, who is still very sad. And you wrote that child a letter. Do you feel able to read it?
Rhian: Yeah, I will probably cry.
[00:34:04] So it says: Dear younger self. I know that you're trying so hard to make things nice, but it's really not your job as a little girl, you're not responsible for the feelings of your parents. It's too big a job for anyone, especially a child. Trying to make everything right will only lead to disappointment and feelings of worthlessness.
[00:34:25] So just try and focus on being a child and doing things children do such as playing and having fun. Love your older self. 
Tanya: I didn't cry because you read it in a very disconnected way. When we're anxious, you see this in children who have told hoods with abuse, neglect violence, we cut off from our feelings.
Rhian: [00:34:44] Ah
Tanya: So dissociation is a common response to anxiety. Read it to me again and really think about what you mean by every word. 
Rhian: I did cry while I was writing it actually.
Tanya: But I think it's quite difficult for you to get in touch with that. Isn't it? 
Rhian: Yeah. Yeah. Okay. Dear younger self. I know that you're trying so hard to make things nice, but it's really not your job as a little girl.
[00:35:11] You're not responsible for the feelings of your parents. It's too big a job for anyone, especially a child trying to make everything right. Will only lead to disappointment and feelings of worthlessness. So just try to focus on being a child and doing things. Oh, I'm sorry. 
Tanya: It's all right. [00:35:41] This is okay, this is fine. This is healthy. This is all right. 
Rhian: Try to focus on being a child, doing things children do such as playing and having fun. [00:35:59] Love your older self.
Tanya: [00:36:04] Just take a moment. Just cry. It's okay. Okay.
Rhian: I don’t know where that came from.
[00:36:15] It’s the first time you've probably ever been really kind to yourself, acknowledging that he was really hard and it was really difficult trying to be a little grownup when you just wanted to be a little girl. 
Rhian: I think it was the, the bit at the end where, cause I'm not very good at having fun now. I don't know. [00:36:33] It's like I don't allow myself to, to have fun. I don't understand why or, or do nice things like I've written down as one of the, the, the, um, one of the things, uh, in regards to self care, it's my, husband's always up for doing things and going away and, and I'm always like, Oh no, let’s not bother, but I actually really enjoy being [00:36:59] near the sea. Cause I was brought up near the sea. I love being near the sea. I thought, well, why don't I just suggest that we go and spend a weekend near the sea and do some walking around there. I think it's connected somehow to that, which makes me sad to think of a little girl being so preoccupied with adult responsibilities that she can't have fun.
Tanya: [00:37:22] Um, in terms of next steps, then that gives you something quite practical you can really discuss with your husband and you can think together about ways to address that. 
Rhian: Mm it'll actually be a relief. When I say to him, look, I'm not to talk to you about my way, my diet, what I'm eating, what I'm not eating. [00:37:42] It will be, take the pressure off in a way I think. 
Tanya: But what you can talk to him about is when you were in the car driving somewhere or whatever you can say to him, I'm feeling anxious. I think that's because I really want this, but I don't know how to do it. That's a really great conversation to have with your husband, for him to listen and for you to speak- that child, [00:38:07] so she gets heard, right. And the more she gets heard with your husband with trusted friends, with your therapist, she will be soothed and you can learn to live with her, rather than allow her unmet needs due to her anxiety cause this relentless self hatred that you carry to this day. For me, I just imagine you opening your eyes first thing in the morning and nasty people, screaming at you around your bed.
[00:38:42] You're disgusting. You're fat. Tell them to piss off and you and the part of you that needs to be understood, the anxiety needs to be heard and the fun needs to be had. That's what you prioritize. And by prioritizing that there is less time to sit down and work out some crazy diet that is going to make you feel miserable.
[00:39:10] All those behaviors. You've got to make a list of them and catch them. Do not angle the mirror, get rid of the scales. Notice them and change them. And if you. Need to say to your husband, you know how every night I do this, I'm going to find it really difficult, not to do it, but I generally do it at this time when I'm cleaning my teeth, can we clean our teeth together?
[00:39:30] Can you just be there so I can give you a hug? If I get an urge to do it? That's the conversation you do have. 
Rhian: Yeah.
Tanya: You just don't ask him to tell you that the bullies are wrong because you're now going to start doing that for yourself. 
Rhian: Yeah. I literally feel like a weight has been lifted all these years.
[00:39:48] I've been. Trying to figure out what is it? What is it that's holding me back. I suppose, if you, if you always have a backpack on and you never take it off, you only realize how heavy it is once you've taken it off, don't you, you only realize the difference. 
Tanya: Um, I'll tell you what, leave that backpack now with me and Claude. We will be privileged to take it from you.
Rhian: Thank you.
Tanya: [00:40:12] And as you leave here today, see… see, this is the beginning to not just be the one that looks after everyone else, to look after yourself. Thank you so much for sharing your story. I absolutely know that you've got this. 
Rhian: Thank you
Claudia: [00:40:31] Tan is just extraordinary, but the image of look from the moment I wake up. 
Rhian: Yeah. 
Claudia: And the way she described it was people around your bed shouting, you're rubbish! You don't, you know, don't get on the scales or wait until you've sit or whatever.
Rhian: Yeah. I've never thought of it like that/It’s horrible isn’t it? Why would anybody put up with that? Yeah. Throw ‘em out!
Claudia: [00:40:49] That's horrible. Isn't it horrible. Yeah. Bye. Get up. Have a nice breakfast. Definitely go to the seaside. 
Rhian: Yes
Claudia: Tan And I will come! Be a bit weird for your husband, but we'll keep a two metre distance just behind waving at you. It's all going great.! Um, thank you so much for coming. Thank you for having me and yeah.
Rhian: [00:41:13] Probably life-changing
Claudia: [00:41:20] talk to me about dissociation. That was the, to reading. Can you explain that? What that is? 
Tanya: If you work with children who have had really traumatic events in childhood often. When you're talking to the child, or maybe when they're slightly older or even when they're an adult, often those experiences can be recalled in quite an emotionally cutoff state initially.
[00:41:48] And often people will say when this was happening, I actually, although it was happening to me, I was actually. I was standing somewhere else and watching it happen. That's the experience that they would describe as part of the memory. Yeah. It's a way to deal with trauma and we talk about trauma a lot in this podcast. [00:42:10] And we talk about the brain, the amygdala, and that the, that area of the brain where trauma memories are stored. And it's really a, it's a psychological sort of defense mechanism. Really. It's a way of remembering something without connecting with the pain of that memory. So when Rhian read that lovely letter, she wrote to her younger self.
[00:42:32] Initially, it was almost like she was reading me, her shopping list. Yes. Um, and she'd pushed her tissues away when she was sitting here. And, and, and you could see she'd got into that. Right. I'll tell this, but I, I won't feel it, which is precisely, I suppose, the theme of my discussion with her today and you know, how to narcotize yourself, alcohol or food or whatever.
[00:42:55] And when I asked her to read it again, obviously she allowed herself to feel it. And although that was painful, you then afterwards saw that she felt quite relieved. Yes. Cause there was such a sob. Well, thank goodness she met you. No civilian, no normal human being would have made that leap. I'm going to do some therapy on you now Claude
Claudia: go on do it do it do it, do anything.
Tanya: (laughs) you’ve closed your eyes
Claudia: [00:43:19] It's my favorite. God, ask me anything 
Tanya: And think before you respond, can we end series too with you acknowledging that we are a team. 
Claudia: No, thank you for asking. We'll be back for series three. Thank you very much for listening. No, I'm just here to ask you, it is a privilege for me, our producer, and everyone. [00:43:44] who's listening to listen to you work, but thanks you.
Tanya: I need to come up for series three because there is so much work to do on you. And I literally, I need a break just to work out how I'm going to, how I'm going to do it.
Claudia: When we do it can I lie down? 
Tanya: Only if you don't fall asleep. 
Claudia: Ah, so on a nap, let's have a nap together, social distance nap
Tanya: [00:44:03] Okay. 
Claudia: Welcome to my world. I have two a day. 
Tanya: I know you do.
Outro
Claudia: [00:44:12] This is the last episode of this series. Please do subscribe to receive new episodes. And in the meantime, feel free to listen to past episodes, share them with your friends and family, rate and comment. Thank you so much to all our wonderful guests for taking part. This simply couldn't happen without them.
[00:44:30] If you've been affected by any issues in this episode, please see our program notes for information about further support and advice. And if you're interested in taking part in future episodes of How Did We Get Here please email briefly describing a ratio to how@somethinelse.com. That's how@somethinelse.com.
[00:44:50] Without the G this podcast was made by the team at Somethin’ Else. The sound and mix engineer is Josh Gibbs. The assistant producer is Grace Laiker. The producer is Selina Ream. And the executive producer is Chris Skinner with additional production from Steve Ackerman. Thank you so much for listening.