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256: Defeating An Eating Disorder In Midlife with Betsy Brenner - Seven Health: Eating Disorder Recovery and Anti Diet Nutritionist

Episode 256: This week on Real Health Radio I chat with Betsy Brenner all about her memoir The Longest Match: Rallying to Defeat an Eating Disorder in Midlife. We chat about her childhood, emotional trauma, profound grief, anxiety, depression, the development of an eating disorder in her 40s and everything she did to recover.


Sep 2.2022


Sep 2.2022

Betsy Brenner is an author, recovery speaker, and peer support mentor. In her 2021 memoir, “The Longest Match: Rallying to Defeat an Eating Disorder in Midlife,” Betsy details her life, one filled with blessings and privilege, but also with emotional trauma, and profound grief, anxiety, depression, and ultimately a diagnosis of anorexia in midlife. Her eating disorder became the catalyst for healing.

A former hospital attorney and long-time high school tennis coach, Betsy was also a hospice volunteer and speaker on grief, loss, and end-of-life decision-making. She has led a bereavement group in her town for nearly a decade.

Her primary focus now is on speaking, mentoring, and leading support groups. She is passionate about giving hope to and supporting those who are struggling with an eating disorder, especially women in midlife.

Betsy received her Bachelor’s degree in Psychology from Brown University and her Juris Doctorate from American University Law School.

Originally from Rochester, New York, she and her husband Jeff have resided in Barrington, Rhode Island for 30 years and are the proud parents of three grown children.

Here’s what we talk about in this podcast episode:


00:00:00

Intro

Chris Sandel: Welcome to Episode 256 of Real Health Radio. You can find the show notes and the links talked about as part of this episode at www.seven-health.com/256.

Before we get started, I just want to mention that I’m currently taking on new clients. I specialise in helping clients overcome eating disorders and disordered eating, chronic dieting, body dissatisfaction and poor body image, exercise compulsion and overexercising, and also helping clients to regain their periods. If you want help in any of these areas or you simply want support improving your relationship with food and body and exercise, then please get in contact. You can head over to www.seven-health.com/help, and there you can read about how I work with clients and apply for a free initial chat. The address, again, is www.seven-health.com/help, and I’ll also include that in the show notes.

Hey, everyone. Welcome back to another episode of Real Health Radio. I’m your host, Chris Sandel. I’m a nutritionist that specialises in recovery from disordered eating and eating disorders, or really just helping anyone who has a messy relationship with food and body and exercise.

Today’s show, it is a guest interview, and today’s guest is Betsy Brenner. Betsy is an author, recovery speaker, and peer support mentor. In 2021, she released her memoir, The Longest Match: Rallying to Defeat an Eating Disorder in Mid-Life. In it, Betsy details her life, which is one filled with blessings and privilege, but also with emotional trauma and profound guilt and anxiety and depression and ultimately a diagnosis of anorexia in mid-life. Her eating disorder then became the catalyst for healing.

She’s a former hospital attorney and a longtime high school tennis coach. Betsy was also a hospice volunteer and speaker on grief, loss, and end-of-life decision-making. She’s led a bereavement group in her town for nearly a decade. Her primary focus now is speaking, mentoring, and leading support groups. She’s passionate about giving hope to and supporting those who are struggling with an eating disorder, especially women in mid-life.

Betsy received her bachelor’s degree in psychology from Brown University and her juris doctorate from the American University Law School. Originally from Rochester, New York, she and her husband, Jeff, have resided in Barrington, Rhode Island for 30 years, and she’s the proud parent of three grown children.

I became aware of Betsy through a client of mine. She’d heard her on a podcast and mentioned her memoir, and I promptly ordered it and read it and invited her to come on the show. This episode is less of a conversation and much more me being an interviewer and allowing Betsy to tell her story. There can be many drivers with an eating disorder, and in Betsy’s case, it very much was a coping mechanism as a way of dealing with her traumatic childhood and her inability to feel and express her emotions.

The first half of this episode is all about all the things that led up to her development and diagnosis of an eating disorder in her forties, and then the second half is much more about her recovery journey. While we cover a lot in this conversation, it is no substitute for her book, so if you enjoy this interview and you get a lot out of it, then I would highly suggest checking out her memoir, The Longest Match.

So let’s get on with the show. Here is my conversation with Betsy Brenner.

Hey, Betsy. Thanks for joining me on Real Health Radio today. I’m really excited to chat with you.

Betsy Brenner: Thank you so much for having me. I’m thrilled to be interviewed today.

Chris Sandel: You are the author of The Longest Match: Rallying to Defeat an Eating Disorder in Mid-Life. It’s a book that I read and thoroughly enjoyed and have been recommending to clients. Really, our conversation today will be going through many of the areas that you cover in the book and using this as a jumping-off point. How does that sound?

Betsy Brenner: That sounds great. I’m thrilled to have the platform of my book to get my message across and share my journey to healing, and hope that it can help others and give hope to those who are struggling.

00:04:32

Betsy’s early childhood memories + early relationship to food

Chris Sandel: For me, one of the things that was most interesting about the book is that while it is about your recovery from an eating disorder, actually this is just the final third of the book. The first two-third of the book are all about your childhood and adult life and all the experiences that you had that led up to the development of the eating disorder later in life. So I think it would be useful to follow a similar trajectory with our conversation, starting at the beginning point and then moving along.

What do you remember from your early childhood, prior to the age of seven?

Betsy Brenner: I think it’s really important that you raise that, because I have had one negative review saying “This book isn’t about an eating disorder”, and I think it was really important to go back and share all the chapters of my life, because as I mentioned, the seeds were certainly planted along the way that developed and led to the diagnosis in my forties.

But I have very few memories from my very early childhood. It seems like everything really started when I was seven. I was fortunate to be born into a family where I was loved and wanted, and it was one of white suburban privilege. My father was a successful lawyer in our community, and my mom was able to stay home. I remember our first starter home, our small home, and then moving to a slightly bigger house. I remember playing with other kids and going to school. Nothing that stood out dramatically.

Chris Sandel: What was food like at this point, from what you can remember? How was your relationship with food at this very young age?

Betsy Brenner: At a very young age, I don’t remember anything specific about food. I do know looking back on my entire childhood, I never learned to eat intuitively. I love seeing children just naturally be able to eat when they’re hungry and stop when they’re full and not be so influenced by diet culture or what’s out there. So I definitely have memories later on in my childhood that certainly contributed to my lack of ability to eat intuitively, but the timeframe you’re talking about in my very early childhood, I don’t remember.

I do remember that I was always on the picky side. I remember specifically in first grade, when I had my first lunchbox, I wouldn’t eat sandwiches and my mom had to put peanut butter on crackers for my lunch. So I definitely was a picky eater from an early age, but I didn’t even know what intuitive eating was until I was an adult in my own recovery, and then I could look back and see that throughout my childhood, there was no opportunity for intuitive eating that so many children develop naturally and innately. My mom controlled everything – what I ate, when I ate, and how much I ate. There was no opportunity for tuning in to my own hunger and fullness cues.

Chris Sandel: Do you remember, with that kind of control, where you were feeling still hungry at the end of a meal and knowing that “there isn’t another option, Mum’s not going to give me anything more”?

Betsy Brenner: I have no memories of that as a very young child. Again, it was only after I was able to reflect years later that I saw how her controlling nature impacted my eating as an older child, and even as a very young adult.

00:08:22

How her parents’ divorce impacted on her

Chris Sandel: Then at age seven, your parents got divorced, and this was obviously a hugely important part of your story. Can you talk a little about this?

Betsy Brenner: Until the age of seven, we were living this suburban life. Like I said, my father was a well-respected lawyer in our community. This was the early ’70s, when divorce wasn’t nearly as common as it is now, and it turned out my father was having an affair with someone in the community. My mother had no idea. They went away for a weekend and my father told her during that time away that he no longer wished to be married to her.

So now I understand that this was a traumatic experience. I always thought that trauma had to be something substantial physically; I didn’t know that there was such a thing as emotional trauma. It really was the start, for me, of anxiety, depression, the beginning of the seeds being planted for my eating disorder. Because what happened was my mother went on as if nothing happened. Here her life was changed forever, her marriage of 12 years ended suddenly with no warnings.

She modelled for me – and at that point I had a baby sister who was only six months old – that when something traumatic happens, we just go on as if nothing happened. I never learned to express any emotions, feelings. I honestly have no recollection of my parents even sitting down and telling me that they were getting divorced. I do know that my mom said at first that my dad was on a business trip because it was plausible; he travelled a lot for work. So I believed her.

So I learned from an early age that we just don’t acknowledge our feelings. We stay positive and we go on as if nothing happened. She hid her own pain from us, and I learned later on that she would cry often after we went to sleep. But it was that mentality of “no matter what happens, we’re strong, we’re positive, we just go on as if nothing happened.” So that set the stage for a childhood of never allowing myself to be vulnerable, never allowing myself to identify difficult emotions, to feel them, to articulate them. I equated any kind of vulnerability with weakness. I thought I, too, had to be positive all the time and focus on the good things and not allow myself to feel any emotions connected to the difficult experiences.

That time really set the stage, and in those days there wasn’t the technology that there is today to keep in touch. My father ended up moving 1,000 miles away. He supported us financially, but we hardly ever saw him, and I do remember when he would come visit, he always seemed very distracted. He remarried several times.

So the three of us, my mom, my sister, and I, went on with our suburban life with my dad popping in from time to time. But I clearly remember them having significant fights on the phone, always about money. And I remember trying to protect my little sister, taking her up to my room and closing the door so she wouldn’t hear the arguments. But nobody protected me. Nobody asked how I was. Nobody acknowledged that this was a difficult life experience. Basically, that modelling that we just go on as if nothing happened, even when something significant happens, really continued throughout my childhood and young adulthood.

Chris Sandel: When I was reading it, reflecting on how much that is to deal with at such a young age – I think often when you’re younger or when you remember as an adult, you forget how young you really were, and it sometimes takes being in contact with someone who is six years old or eight years old to then be like, “Oh wow, that was the age at which I was when this really significant event happened.” I think sometimes you remember it as if you were older, even though you weren’t.

Betsy Brenner: Right. The only thing I remember from that time is I remember finally in third grade, which must’ve been about a year after, meeting one other girl whose parents were divorced and then meeting one other girl at a summer camp I went to. So in that whole period of time, I only knew two other kids whose parents were divorced, and I didn’t even really know their families. It was so different from today, where at least people I know who are divorced tend to stay in the same community, where their children are being raised, and they’re raised by both of them equally. If counselling is necessary, it’s available. It’s acknowledged that it’s a difficult experience for all involved. But there was no acknowledgment of that when I was a young child.

Chris Sandel: The book throughout contains excerpts from your diary. Do you remember what age you started keeping this? Was this connected to the fact that your parents got divorced and that then became your outlet?

Betsy Brenner: It’s interesting; I’ve never heard the question asked that way, but ironically or coincidentally, the first entry in my earliest childhood diary is about being very sad at Christmastime, worrying about my dad because he was going to be all alone in New York. I was probably eight or nine years old, and here I am, a young child, worrying about my father, who’s an adult. It was his choice to leave and move away, and I’m so worried about him being sad and alone. But there was nobody asking me how I was feeling with it.

So I do have a journal entry from that time, and I kept a childhood diary for many years. I didn’t write every single day till I was a little older, but it was those little journals with the little lock and key. I remember one with crossed tennis rackets and other childhood things. I wrote about a lot of things, and maybe I felt that was my only safe place. But looking back, to read all those diaries in preparation for writing my memoir, even in my diaries, I felt like I wasn’t able to express anything negative. When I was a little older and I would write something that was bothering me, I would counter it with “but I love my life.” I felt so guilty for having any kind of negative thoughts or feelings.

00:15:16

Her experience with anxiety in childhood

Chris Sandel: You mentioned that you were a picky eater when you were young; do you know if you were an anxious child before the divorce? I know a lot of anxiety is genetic, and obviously there are life events and situations that can make things a lot worse, but a lot of the anxiety or someone’s tendency towards anxiety can be genetic. Do you know any of that?

Betsy Brenner: I do now. There’s certainly a genetic component. My mother suffered from significant mental health issues that were never diagnosed. She thought she was perfect and that it was everyone else who had issues. My father definitely struggled with some mental health issues. I don’t know if it was anxiety so much; I know he went through periods of depression. My mom did as well.

I wasn’t diagnosed with anxiety literally till I was in my forties, but it absolutely goes back to the time when my parents divorced, and I think specifically – I remember very clearly early on, I’d go to sleep at night and pull the covers over my head, leaving just a very tiny space to breathe. I clearly did that because of anxiety and a need to feel safe when there were things that had happened in my life that I had no control over and no outlet for talking about. So I remember that, and that developed into anxiety surrounding anything related to health and safety – fears that are not common in young children who have a stable suburban life, as I did.

I remember when I was old enough to start babysitting for my sister, I’d be so worried the whole time my mom was out that something would happen. I would write in my diary – it almost came across as a prayer, but it wasn’t meant to be. It was sort of like, “I hope Mom gets safely home from her meeting and that nothing happens.” I mean, I lived in a very, very safe community. My mom was probably across town at some sort of women’s meeting, and here I worried. I worried when I went to the paediatrician. I would write things in my diary when I was just going for a normal well visit, “May nothing be wrong with me.”

So clearly I had significant anxiety and fears, but there was no diagnosis or acknowledgment or understanding at the time.

Chris Sandel: What about your sister? I know she was much younger, obviously, at the point of divorce. In terms of anxiety, are you guys similar in that way?

Betsy Brenner: We’re actually very, very different. Growing up, we were – we are still [laughs] – six and a half years apart. I was almost like a second mother to her. I was put in charge of her frequently. My mother liked to sleep really, really late on the weekends, and I was responsible for feeding her breakfast and playing with her and keeping her happy. I was almost like a second mother figure to her.

Our personalities are very, very different. She was only six months old when my dad left, so her issues were more about the loss of what she never had, whereas I specifically lost something. Both are important and significant losses, grieving what you never had and grieving what you once had. They’re both important. And then she had my mom all to herself once I went away to college. She was only 11. So I’m sure there were issues.

But I, as the firstborn, felt like the expectations for me were there sooner and more intense, and then I wasn’t around as much when my sister was older. I know my mom put a lot of pressure on her as well, but it would’ve been a different dynamic. But she was always the little sister when I was growing up, and obviously still very young when I went away to college.

00:19:21

Her experience at school

Chris Sandel: So then how were you at school as a child and then a teenager? Was school an enjoyable time or not? Was it easy for you to make friends? How do you think about your school time? Before you went away to college.

Betsy Brenner: Elementary school was a neighbourhood elementary school. I went to public school at that time. I remember clearly I had a best friend in elementary school. I was very shy, I was very quiet, I was very small for my age. But I had my best friend and her family. Maybe they felt sorry for me that my parents were divorced, but they included me on so many family day trips, and I remember a lot of sleepovers there. Just always felt comfortable there.

I switched to private school in sixth grade. My parents both valued a private school education. I’m sure it’s different in the UK than it is here, so I might be using terms that are different there, but I went to a small private school, very nurturing. I switched there in sixth grade. I had no trouble making friends.

But I learned early on that one way to make my mom happy was to earn good grades in school, and I fortunately was blessed with a good brain and intelligence, and I was a good student naturally. But I developed this fear of failure because I felt like whatever grades I brought him, it was never enough. It was never good enough. And I remember clearly, probably middle school / high school, my mom would pick me up after school, drive me to the tennis club, and ask me if I got my math test back. I would say, “Yeah, I did. I got a 94.” And instead of complimenting the good grade, she may’ve said something like, “Do you understand the things you got wrong?” So I always felt this pressure to excel, pressure to succeed, pressure to get as perfect grades as possible.

But I was very quiet. So almost every report card, I’d get a top grade, but then the comment would be, “Betsy did very well, blah, blah, blah, but I wish she would participate in class.” I was scared to use my voice. I didn’t have a voice. I was scared to disagree, I was scared to have an opinion. So I was always a good listener but I was not good at participating. I’m sure that was some of the anxiety that I didn’t know I had, fear of failure, fear of being wrong, fear of someone saying something to me that went against what I said. So I was very, very quiet in class.

But I always felt like I had friends. I never felt like I was an outcast in any way. I was never bullied in any way. I always felt like I did have friends, but I was always a quiet member of any friendship group or anything like that.

00:22:18

How tennis impacted on her life + on her body image

Chris Sandel: And then tennis. This has obviously been a big part of your life. When did you start playing tennis?

Betsy Brenner: I was very fortunate that both my parents loved tennis. Neither one was a tremendously talented player, but my mom had been involved in the tennis world, and when I first started taking lessons when I was about 10 or 11, I wasn’t a natural athlete; I wasn’t that good at it. I didn’t really like it.

But then my mother took me to what’s now the US Open, which is actually going on right now in New York City, and I just fell in love with the sport. I think I was 11 and my birthday was always around that time, and it was mother-daughter time, and certain tennis players became idols. I just decided that after that summer of taking lessons, I was going to put more effort into it. That was the beginning of a wonderful tennis career, and I’m grateful that my mom did support my dreams. I never became a professional tennis player, but I started focusing more and more on my tennis, playing several times a week and taking lessons from top coaches. I became ranked in New York State and then ranked in the United States and ended up playing Division I college tennis at the highest level.

So I am grateful that my mom supported my tennis career, and in my situation, it was a tremendous source of self-esteem. I learned how to set goals and work to achieve them, and when I did, I got so much positive feedback. I became known in our community for my tennis. I think given the situation with my parents and everything, it was really good for me. I was respected by my classmates. I would have to miss school sometimes to travel to far-away tournaments, and they really respected me for my tennis. So it really was a tremendous source of self-esteem and confidence, and it was another way to make my mom happy.

As the years went on, she became so controlling and rigid and moody, but in addition to bringing home good grades, when I did well in tennis, I saw early on that that made her really happy. In some way she lived through that. She loved being the tennis mom or someone saying to her, “That’s great that Betsy won that tournament.” My sister also became a tennis player with a very parallel tennis career seven years later, and my mom lived through our tennis and the attention that it brought to her.

It took sacrifices, missing some social events and things like that for my tennis, but I have zero regrets. It did so much for me as a person, and it was really the only outlet I had for those emotions that were stuffed inside that I never was able to articulate or express.

Chris Sandel: Obviously that comes up throughout the journey with you getting into tennis later on as well. It’s interesting hearing you talk about the tennis piece because obviously there is this genuine love for it and this real internal motivation for it, and at the same time, there was so much external validation that was then connected to this, making it a messier thing than it would otherwise appear.

Betsy Brenner: Yes, definitely.

Chris Sandel: With your tennis, did this also coincide with you then becoming more conscious or aware of your body and your eating habits?

Betsy Brenner: Absolutely. I think because I was an elite athlete, the connection between food and exercise was ingrained early on. Attitudes about nutrition and fuel and exercise obviously have changed over the years, but there was always that focus on being an athlete and eating a certain way. I have more memories of that from college. Our team used to almost joke, “If we win, then we can eat this.” There was definitely a connection between food and exercise. I was always in good shape because of my tennis.

I remember my first active memory of any sort of eating disorder behaviour was my first semester in college. I don’t remember anything like that in high school because my mom literally controlled what I ate, when I ate, and how much I ate. Because of her own issues – she had severe OCD, and one of her issues was with cleanliness, so we weren’t even allowed in the kitchen to help ourselves to a snack or a drink because we might leave a crumb on the counter. It sounds so crazy now, but at the time I didn’t know anything different.

Again, that contributed to not being able to be tuned in to hunger cues, because “Here’s your breakfast, here’s your lunch, here’s your dinner.” Maybe there was a snack after school that she brought me on the way to the tennis club, but there was no choice. There was no “I’d like a little more” or leave something on my plate. It was just, “Here’s your dinner. This is what you eat.” I didn’t have thoughts about specific foods back then; my mom didn’t love to cook, but she was a very wholesome, full meal every night and we were expected to eat it, including desserts. So I didn’t have a lot of thoughts about it.

But the issues really ramped up in college and then for whatever reason did not take hold and the diagnosis didn’t come till my forties. But I definitely was tuned in with things because there were many comments in my diaries as I got older, high school, college, about how certain clothes fit me and body image issues. So the seeds were definitely being planted throughout. And honestly, when I look back on my life, I am shocked that I did not have a diagnosable eating disorder sooner. Like I said, I wasn’t diagnosed till my forties, but clearly it was there on a different level. Definitely not a clinical level, but so many comments about “That makes me feel fat”, “I wear this shirt because I feel thin.” Even as a young adult, “I didn’t exercise today, so I shouldn’t eat this.” It was there, it just didn’t become full-blown.

So I definitely had that very strong connection between food and exercise early on, but my mother was so controlling that even when I was in college and I would come home for breaks, she would pour the milk on my cereal. I’m sure I thought, “I think I can put my own cereal in the bowl and put the milk on it when I’m 20 years old”, but I had no voice. I had to be this perfect good girl. I could never start arguments with her. She was so moody; I felt like I was walking on eggshells at times, so it was really all about keeping her okay and happy and not tempting her to explode or scream at me for no good reason, which happened from time to time. It was easier to just go along with her actions and behaviours than to try and stand up for myself.

00:29:59

Her college experience + changing relationships with her parents

Chris Sandel: Did the experience of going off to college give you more pause to reflect on the relationship you had with your mother? I think sometimes as you get older and you move out of home and then you come back, it feels like there’s a real strong contrast, so there’s more of a reflection of like “Okay, this is more odd than I would’ve remembered it being” or “This feels different now that I’ve had some time where this hasn’t been here.” What was the experience like by getting some separation?

Betsy Brenner: It was definitely a gradual loosening of the stronghold she had on me. When I first went off to college, I went further away from home than I probably would’ve, but I did that because I was recruited to play Division I tennis in the Ivy League. Otherwise I probably would’ve stayed closer to home.

So I was a long way from home, and that was hard for both of us. I wasn’t a risk-taker. I was going off for a completely different experience, but it was the best thing for me that could’ve happened – although that very first semester, I remember when I would talk to her – and in those days there were no cell phones; this was that once-a-week call, probably, after the rates went down, and I would always tell her what she wanted to hear. I would tell her how my classes were going, I would tell her how my tennis was going. But again, there was no place for expressing “I’m sad, I’m upset, I’m scared, I’m angry.” It was all telling her what she wanted to hear.

However, I also remember that fall my parents fighting a lot about financial issues, and I do remember in November of my freshman year feeling somewhat homesick after the novelty of college wore off. That is my first memory of restricting my food intake. Fortunately I went home for Thanksgiving a few weeks later and the eating disorder didn’t take hold.

But that is my first recollection of a behaviour with food that was potentially detrimental. It was at a time when my parents were fighting, I was feeling homesick, the novelty of college had worn off, fall tennis season was over. So clearly, I was using a behaviour with food to feel in control because all those things were happening, but I certainly didn’t have the insight or understanding to even know that that was something that could lead me down a very dangerous path. And like I said, it didn’t take hold.

For most of college, I ate fairly freely, but I was playing hours of tennis and running and conditioning and things like that. But there were always thoughts. The thoughts were there, but it didn’t take hold at that time.

Chris Sandel: I was just going to ask, at that point that you just referenced there where you said “This was the time where I first restricted”, did you remember that all through your life? Or it’s been more of a recent thing as you have gone back through your journals or your diaries that you’ve been able to pinpoint that time?

Betsy Brenner: That is actually something I remember without looking back at my journals. There are certainly issues related to food, body image, and exercise that I learned about myself from reading my journals, but I have independent recollection clearly. In November of my freshman year of college, I remember having thoughts that I was going to see how little I could eat each day. I didn’t skip any meals; I knew I needed energy for tennis because I still practiced every day, even when the matches were over until the next semester, but I clearly remember seeing how little I could eat in a given day.

When I first got to college and this all-you-can-eat dining hall, I loved the freedom of eating what I wanted, when I wanted, and how much I wanted. It was great. And then I must’ve felt like it was too much and I needed to rein it in for some reason and feel in control. It definitely coincided with the only time I remember feeling homesick in college, that November of freshman year. After that, I loved college and it was so good for me to get away.

Then later on in college, actually, I developed a good relationship with my dad for the first time. The details are obviously in my book, but at that point, there started to be a strain and stress in the relationship with my mom, where it was harder and harder to just fit into the web she had spun around me.

It was actually my father that helped me take moves towards my independence, but it was so difficult because, again, it was always easier to just do whatever my mom wanted to please her and keep her happy. So when I started to move away from that and my dad was the one making it possible, that led to so much stress in my relationship with my mom. But ultimately it was what I had to do so that I could become an independent woman.

Chris Sandel: I know at this point you were studying a bachelor’s degree in psychology. What was it about psychology that interested you? It seems like given your childhood, I can clearly understand why this would be of interest to you, but what was it in psychology?

Betsy Brenner: I was definitely interested in psychology, and I remember thinking clearly that I wanted to help other kids whose parents were divorced. Here I was never given any tools or outlet for handling it myself, but I remember wanting to be a psychologist so I could work with children whose parents were divorced.

But I wasn’t so set on that, and I knew after college that I wanted to take a break from academics and stand on my own two feet and work and support myself and figure out what I really wanted to do. I ended up going to law school. My father at the time, when I was in college, was diagnosed with colon cancer, and he unfortunately was dying at a time when we had just started to have a good relationship. He was a successful lawyer and he kept impressing upon me the value of a law degree and that it would open up so many doors, and there’s so many directions I could go, I wouldn’t necessarily have to work in a private law firm.

We had such a close relationship for only two years, and it’s really hard to go against the wishes of your dying father. So even though personality-wise, I think I would’ve made a really good therapist – obviously I had my own work to do first on myself – but I did go to law school. I loved law school and met my future husband the first day. I think life unfolds in certain ways for a reason, and I have no regrets. Like I said, I still think I would’ve made a good therapist, but I’m glad I went to law school, and I had a wonderful career before I had kids and, like I said, met my husband.

But I definitely was always interested in psychology, and even in law school, I worked my college summers at the American Psychological Association, so I was able to combine my interests in law and psychology. And then I was a hospital lawyer. So there was always that connected interest between law and psychology, law and medicine. It was the right path for me.

00:37:30

How her father’s death affected her

Chris Sandel: You mentioned there about your father’s cancer diagnosis and his passing. Talk a little bit about this experience.

Betsy Brenner: Once again, going back to my parents’ divorce, I’ve never learned to deal with difficult emotions. I’ve never learned that it’s okay to be sad. So when my father died, number one, my mother gave me zero support because all she cared about was her financial situation. I thought I just needed to focus on the two good years I had with my dad, so instead of allowing myself to feel sad, it was more like, “I’m so glad I at least had two good years with him before he died.”

What I know now in hindsight is that it would’ve been okay to focus on that positive two years but also feel sad because it was a tremendous loss. Especially at a time when we had become so close, he was helping me attain my independence. He was the one there for me during those years, whereas my mom, when I didn’t come back home after college, treated me as if I had divorced her, and here my dad was supporting my young adult independent life emotionally and understanding me for the first time.

So again, those feelings of tremendous grief and sadness stayed inside along with everything else. I didn’t know how to stop and allow myself to grieve. I had wonderfully supportive friends at that time, but again, I didn’t know how to be vulnerable. I thought I was always supposed to be positive and focus on the good, so that’s what I did.

Chris Sandel: Did you get to have a conversation, or many conversations, with your dad about the divorce before he passed away? Did you get that chance?

Betsy Brenner: A little bit, but not enough. Looking back, obviously there were a lot of questions I would’ve liked to ask him. But I also now know, as an adult looking back, they were together such a short time before engagement and marriage. I think they knew each other for a month and then were engaged for three months and then got married. And it was a long-distance engagement. Their personalities were as different as two people can be. I think on paper they checked off a lot of boxes that looked like they were right for each other, but honestly, looking at their personalities, the fact that they stayed together 12 years, I’m just shocked they ended up together and clearly did not spend enough time together getting to know each other and all that.

I wish I could’ve asked my dad more questions about that, but our relationship was very much in the present at that time when I was in my early twenties, and he was so sick, too. I never felt it was the right time or place to ask him about things that had been so long ago.

00:40:23

Finding her support system

Chris Sandel: You also mentioned about meeting Jeff, your to-be husband, on the first day of law school. How did meeting Jeff impact you at the time when you first got together?

Betsy Brenner: We just celebrated our 32nd wedding anniversary. [laughs]

Chris Sandel: Nice.

Betsy Brenner: I’m pleased to say Jeff has helped my dreams come true, literally. Even though I went to law school, I actually had very simple dreams. I wanted to have a happy marriage and a family and a house in the suburbs. I just wanted to have a happy home, unlike what I went through. But here I was so torn about law school – I worked for two years, went to law school. I literally met Jeff in line at registration the very first day, and we had a lot of classes together freshman year. We were both the type that got to class early, so we just started chatting, and our schools were rivals in sports, so we would talk about that.

My dad had died less than a year earlier at that time, and he had lost a fraternity brother who had taken his own life. We had very deep conversations, and I think that just solidified a wonderful friendship. We had both been seeing other people at the time, and I had had other significant relationships that always lost out to tennis and my mom. But we became such good friends and then started dating a few months into the year and were engaged the summer before our third year of law school, and got married a month after the bar exam, after we graduated.

Jeff and I are very different in a lot of ways, but so similar in many ways, and similar life goals. I’m so grateful that he came into my life. I believe a lot that things work out the way they’re meant to be, and I just sort of felt my dad’s presence; here he really pushed me towards law school and then I met my future husband on the first day.

I only regret that they were never able to meet, because I think my father would’ve been a wonderful mentor to Jeff, and I think he would’ve been a much better grandfather than father. He didn’t live to see me get married. He didn’t even live to see me go to law school. I could’ve really used his support during those years. But very grateful Jeff came into my life at that time.

Chris Sandel: You said there that you had some deep chats to start with about loss that you’d both experienced. How was Jeff at expressing emotions and talking about feelings? Because obviously you hadn’t, up until this point, had anyone be able to model that to you. Was Jeff the first person who was able to do that? Or I think you said you had some other friends who you were in contact with?

Betsy Brenner: Jeff had grown up in a family of all boys, and their family still is not big about talking about emotions or things like that. Maybe Jeff felt comfortable talking to me about his fraternity brother, so we had those conversations, but it took me a long time to really feel comfortable and let my guard down. I always had that wall, not letting people in too close emotionally, because I wasn’t in touch with my own emotions.

I met an attorney at the law firm where I worked for two years, and he and his wife became very dear friends. They still are to this day. My friend Steve walked me down the aisle when I got married, and he and his wife were the only ones who were really there for me when my father died. Here I was, 23, living on my own in a city, applying to law school, trying to figure out “What do I want to be when I grow up?” So I already had the very close friendship with Steve and his wife when I met Jeff, and I remember being so excited to introduce Jeff to them and get their approval. Of course, coincidences – Jeff grew up in the same area where Steve’s wife grew up, so they had a lot of connections.

Anyway, Steve was the first person who ever said to me, “Your feelings are your feelings.” He was probably the first person I was able to express things like “I feel guilty being sad that my dad died” or things like that. I always felt guilty for any emotions or feelings. But I didn’t know what Steve meant by “your feelings are your feelings.”

But Steve was the first person who really tried to help me understand that how I was feeling was okay. It didn’t have to always be positive. So I was already on that path with that friendship when Jeff came into the picture.

Chris Sandel: Were you able to take that on board, that it’s okay to feel your feelings? It sounds like that came a lot later in life, from reading your book, but how much did Steve’s advice seep in in that early stage?

Betsy Brenner: I definitely did not really get in touch with my feelings or all those layers and layers of suppressed emotions till recovery from my eating disorder. With Steve, it was more about someone I felt comfortable with. I felt unconditional care and friendship from both Steve and his wife. I stayed with them for several weeks after my father died. They were the ones tuned in to how I was doing while my father was dying, because I had zero support from my mom at home.

But I still at that point felt guilty for any negative emotions, even with Steve. He was the closest person I came to being able to talk about feeling sad, and I did go through a difficult depression after my father died. Fortunately it wasn’t severe or significant, but it was serious, and I’m grateful to have had them during that time in my life because I hate to think where things might’ve turned. Maybe I would’ve developed a full-blown eating disorder then, I don’t know. But Steve and Patty, his wife, were like an older sister and brother to me and really helped me through that difficult time.

So Jeff came on board and understood very quickly the closeness of that friendship, and they remain the closest of friends today.

Chris Sandel: Nice.

Betsy Brenner: Very grateful. But there was still so much guilt about emotions, and I never could admit anything about feeling sad. I just felt guilty for any kind of negative emotions.

Chris Sandel: Then just before you turned 30, you had your first child, Rebecca. How was your experience of motherhood in those early years?

Betsy Brenner: I always said I wanted to have my first child by the time I was 30, and I had Rebecca when I was 29, two weeks ahead of my 30th birthday. I was working as a hospital lawyer at that time. We had moved from Washington, D.C. up to Rhode Island, where we still live. And that was one of my dreams: to become a mom. Nothing made me happier than that.

My mom at that time still lived in Rochester, about seven hours away by car, and our relationship was still very strained. I went back to work part time after my maternity leave, but being the family of three that we were, Jeff, Rebecca, and I, nothing made me happier than that. We started putting down our own roots in our town. I just wanted to give Rebecca a happy suburban childhood.

00:48:06

How her mother’s death affected her

Chris Sandel: And then there’s another twist in the story in terms of your mom then having to move close by because of a dire financial situation, and then, like your dad, was diagnosed with cancer and passed away. Talk about this experience.

Betsy Brenner: Yes, my mother literally ended up on our doorstep. Rebecca was almost a year old. Again, I’d never really dealt with my father’s grief in a healthy way. I focused on the positive, that I was happily married, had a child, living a good life in Rhode Island. My mom went into financial crisis. Literally a family friend gave her a few thousand dollars to start a new life in Rhode Island.

There was never any discussion. It wasn’t like, “If you come to Rhode Island, then this.” It was more like, oh my goodness, I was told she was on a train headed our way. So here I am, a happy mother of a baby, and all of a sudden my mother – our relationship was so strained at this point. I had to put all that aside and help her find a place to live, a part-time job, a used car. We were living paycheck to paycheck at the time, so everything had to be within her means, which was this small amount of money that a family friend gave her.

She had been diagnosed with breast cancer when I was in college, but again, we didn’t focus on the difficult diagnosis and possible difficult prognosis. She had surgery and then we just went on as if nothing happened. There was never any celebration of her being a survivor or talking about it. But I do remember her saying that if she didn’t eat fat, her breast cancer wouldn’t come back. So I learned then that fat was somehow bad.

Anyway, she ended up in Rhode Island and two years after she moved here – and during that time, she actually sort of came down off her pedestal and for the first time came to appreciate me as an adult, let herself get to know Jeff, and loved more than anything being a grandmother. Rebecca was the only thing that eased the tension between us. She lived within her means, working two part-time jobs, simple apartment, car, whatever, but she spent time with us and really grew to appreciate us. And Rebecca adored her.

But then almost two years to the day after her move to Rhode Island – and it took a while when she got here for this transformation – her cancer came back literally in every bone in her body, and she was gone three months later. Once again, I focused on the two good years we had together. I felt like that was a gift I was given, and our relationship became better. Grateful that Rebecca had her as a grandmother and that she got to be a grandmother. Again, just stuffed all those emotions inside. My relationship with her was so complicated, so my grief was so complicated.

After that I just focused on being a good mom and never allowed myself to feel the tremendous complicated grief that was certainly brewing internally.

Chris Sandel: With your mum over those two years, did you get to a stage with your relationship that felt like the one you had with your dad, or was there still a level of control or it never felt quite that good?

Betsy Brenner: It was different. Again, it was all in the present. I never, ever took the opportunity to talk about how she had hurt me, the pain she had caused, her infelucne on me. We never talked about the past. Same with my dad. It was all in the presnet, and the focus was always Rebecca. We spent time together every week, but it was always about Rebecca. It was sort of like we swept all the difficult chapters under the rug and just focused on the present during those two years.

Chris Sandel: Then after she passed, am I right in thinking you worked with a bereavement counsellor at this point?

Betsy Brenner: Yes. I was having a really hard time, but I didn’t know it. I was going through the motions of life. Jeff noticed that I was very sad, but I just was withdrawn; I didn’t acknowledge that I felt sad. I didn’t know it was okay to feel sad. And the hospice program that my mom was on when she died, they had a bereavement counsellor who came to meet with us. I was all focused on Rebecca because she was a very sad little girl, having lost her grandmother, who she adored, and it was the counsellor who noticed that I might need somebody, it might be helpful for me to talk to someone.

So I did, and that was the first time that I ever talked about anything that I had been through, and she helped me to understand what my grief was really all about. But she moved away before we really were able to complete that hard work, and then our focus became on adding to our family and living the mom life.

00:53:27

How her asthma diagnosis triggered an eating disorder

Chris Sandel: You then had another two children; you had twins, so you then had the family of five. At least for me, when I read through the next pinnacle moment, it feels like it’s you being diagnosed with asthma. Do you want to talk about this?

Betsy Brenner: Sure. Again, I look back on my life and I’m shocked I didn’t develop a full-blown eating disorder until that time. When I was in my early forties, I’d always been in good health as an athlete. No medical issues. And all of a sudden one summer I started having significant episodes of shortness of breath. And don’t forget, my anxiety goes way back and it was always around health and safety issues, so it really scared me. At first I’m like, “Oh, it’ll go away. It’s nothing.” I eventually had to go to the doctor, had an asthma-like attack. It was so scary. They did all these heart and lung tests, and the diagnosis was asthma.

So here for the first time in my life, I had a significant health issue. I had to learn about a disease that I knew nothing about. I had to learn how to manage an illness that I knew nothing about. I had to take daily medication, lots of doctor’s visits. I barely ever took anything for a simple headache, so to take medicine, inhalers, every day, that was significant for me.

Now, during this time, there was nothing I liked better than being a mother of three. I was always on the go, taking care of my children’s needs, but yet my body was telling me at times that it needed rest. I would have significant asthma flare-ups that left me with zero energy, needing to just lie on the couch and do nothing, but yet I was used to always being on the go, being the mom I loved. Self-care wasn’t in the vocabulary. I would’ve felt like it was selfish. I didn’t know it would’ve been okay to take care of my own health and let myself rest and find someone else to help do whatever with the kids, so I just kept going and going and going.

Ironically, around this time, I had just gotten back into tennis. Now, I played through four years of college and then I didn’t play for 20-something years, during which time I worked and went to law school and got married and had three kids. I’d just gotten back into tennis around this time, and I’m very small to begin with, but I lost weight rapidly that I did not need to lose. I didn’t try to lose it intentionally; it just happened as a result of getting back into high-level tennis, and I got all these compliments. “Oh, you look so great, you look so fit, you look so muscular.”

I met this other mom of three and we started playing tennis together all the time, and I started playing competitively again. It was great. It once again became a source of self-esteem. It also became another outlet I had for anxiety that had yet to be diagnosed. So the perfect storm was really this diagnosis of asthma, not being able to be the mom I was used to being, and then getting back into tennis. When my asthma flared up, I physically couldn’t play tennis.

And during this time, I developed this intense fear of gaining weight because of all the positive compliments I got as a result of the weight loss from getting back into tennis. So it wasn’t intentional, but I lost too much weight and it was weight I couldn’t afford to lose, didn’t need to lose, but not being able to play tennis, which I loved, and I also got into coaching at that time. As my way of coping with feeling so out of control from the asthma flare-ups and not being able to be the good mom and the tennis player, I started restricting my food intake, and the eating disorder took hold at that time.

00:57:12

Receiving her anorexia diagnosis

Chris Sandel: You say in the book that you were shocked when you were diagnosed with anorexia. Talk about the shock and why this was a shock to you.

Betsy Brenner: I, like many, had preconceived notions that to have an eating disorder, specifically anorexia, you have to be a young, white, emaciated teenager. And here I was a middle-aged woman – yes, I’d lost weight I didn’t need to lose, but I was hardly emaciated. And I didn’t know I had a problem. I didn’t know anything was wrong except for the stress that having asthma was causing, and that’s how I was actually diagnosed with anxiety, because the asthma made me feel so anxious and depressed at times, and the eating disorder, I know now, came in as a way to help reduce the anxiety and depression.

But I’d gone to a regular doctor for an appointment who noticed the weight loss and called my primary care doctor and told me I should see a dietitian. It was at that very first appointment with the dietitian that I was diagnosed with anorexia, and I was like, “How could I have anorexia? I’m in my forties, mother of three. I’m a small person to begin with. I couldn’t have anorexia.” I had a lot to learn about my diagnosis, about the illness, and all that has been part of my recovery journey. I certainly wrote about it in my book.

But it was a dietitian who diagnosed me with anorexia and started me on a path to recovery, which I’m very thankful for because I was headed down a dangerous path, and I am so grateful that I got the help and treatment I needed before I got to a dangerous point. I was headed that way, but fortunately I remained medically stable and got on the path to recovery before the situation got more serious.

Chris Sandel: Once you’d heard the diagnosis, how long did it then take you to get on board with “Oh okay, I actually believe that this is true and what is going on for me”? How long did it take you to reconcile that?

Betsy Brenner: It was recommended that I go to residential treatment so the focus could be on my recovery and all that, but again, I never knew it was okay to put my needs first, and I absolutely refused to disrupt my family life.

So my dietitian referred me to a therapist who specialised in eating disorders, and I started travelling down these two parallel roads. There was this one road that was “Okay, I’m going to work on recovery, I’m learning about my eating disorder and I’m going to see my dietitian and therapist every week” and then this other road that never intersected till much later on: “I’m the mom of three, I play tennis, I coach tennis, I run a bereavement group, I’m a wife, I’m a friend”, whatever.

I think as we get older, there’s so much more shame and secrecy, and I didn’t want to let anybody in. Here I barely let my guard down anyway as far as emotions were concerned, so I didn’t feel comfortable talking about the struggle. I had to be reassured over and over and over, mostly by my dietitian, that the eating disorder was not my fault. It developed for a reason, it developed to serve a purpose, and she would say to me over and over, “This is an illness that is not your fault. You didn’t ask for this, you didn’t want this. But recovery is a choice, and you have to be willing to do whatever it takes. It’s not enough to want recovery. You have to be willing to do whatever it takes.”

Between meal plans that she put in place – and she always did it in a way that wasn’t overwhelming; I had support from her actually on a daily basis through emails – and then finally having a therapist who specialised in eating disorders, I came to understand that literally 40 years of internalising any and all difficult emotions and feeling guilty for any of them contributed significantly to developing an eating disorder as a way to cope.

So that was really the first safe space that I felt like I could start to let my guard down and really, for the first time in my life other than that short period of time with a therapist after my mom died, get in touch with some of those difficult experiences I’d been through and learn how and why they impacted me the way they did and how and why an eating disorder came into my life at that time and really took hold as a coping mechanism.

01:01:44

What her recovery journey looked like

Chris Sandel: I think it would be good to go into your recovery in a bit more detail and what that looked like, because there are so many different aspects of it. Just as a broad starting question, you can talk about the different aspects of recovery that you think are relevant, and then I can ask more specific questions afterward. But just talk a little about what your recovery journey looked like.

Betsy Brenner: One of the first things I had to do, which went against everything that was ingrained in me from a young age, is I had to allow myself to be vulnerable. But the only place I could do that was with my dietitian and my therapist. It was with them that I finally started talking about those difficult experiences, and that was a key to my recovery because I had to learn so much about eating disorders, just as I had had to learn so much about asthma.

I grew up thinking vulnerability was a weakness, and I had to learn from both of them that vulnerability was actually necessary for recovery. I had to let my guard down. I had to talk about my experiences. I had to talk about the feelings that I was never allowed to express, and the emotions. So that vulnerability was key.

But again, I couldn’t let my guard down with others. I was too embarrassed to admit that I was struggling with an eating disorder. Even with my own husband. We had always been true equal partners, and he had a lot to learn, too. He was supportive in his way, but we both had a lot to learn. I felt shame even with my own husband, talking about my struggles, which is why my dietitian had to reassure me so many times that this was an illness. It was a serious illness that was not my fault. It took a while for that to really set in.

I also had always been the one that cared for others, or friends came to me when they were struggling with something. I was never the one to be able to say, “Can I talk to you about something?” or “I’m having a hard time with this” or “I’m feeling this.” I was the one that was ‘always strong’, ‘always positive’, people felt comfortable coming to me. So for the very first time – and this was a huge piece of my recovery – I learned that I had needs of my own, that self-care was not selfish. Self-care was essential, and I had to figure out what I needed for my recovery journey and learn to ask for what I needed, give myself what I needed, give myself that care and compassion that I so freely gave to others but never myself.

It took so much because, again, I was in my forties. We’re talking decades of living a certain way, viewing life in a certain way. I really had to undo everything that had been ingrained in me. But I did it all outpatient over many years. My dietitian allowed me to email her every day, not just with what I ate that day – we focused on the meal plan, she might say something like “Could use a little more protein here” or “What happened to the afternoon snack?” or whatever – but with her, I was also able to express how I was feeling, and she was always very, very supportive and I felt like someone really cared and gave me that unconditional support that, looking back, I was really craving.

And my therapist was amazing. The insight she had into my life after hearing about it and knowing exactly where we needed to go as far as our conversations and helping me to understand why I reacted the way I did to the experiences in my life – so my recovery was all outpatient. It took several years. In hindsight, would it have helped to go to residential treatment? Absolutely. But again, I would never have known that it was okay to prioritise my recovery. I had to go live those two parallel lives, the one working on recovery and the one living my normal life, and it was years down the road before I could allow those two worlds to intersect.

Chris Sandel: I would also add that I’ve had many clients who’ve done residential treatment and then they’re coming to work with me because it has been a not-great experience for them. I think residential treatment could’ve helped if it was the right programme and you were ready and willing at that point, but as you’ve talked about, things happen for a reason. Maybe this was actually the right path that you needed to be following.

Betsy Brenner: I do, and especially because of my age, I hear from so many women in mid-life who’ve been admitted for residential care and they leave prematurely because they feel like they’re old enough to be everybody’s mom. So I think it is really hard for women in mid-life to find a higher level of care where they feel they can connect with the other residents or patients.

01:06:46

Becoming vulnerable with others + life beyond an eating disorder

Chris Sandel: You talked about how difficult it is to be vulnerable, to feel your feelings, to tell people how you really are doing, and yet here you are now, talking to me on a podcast, you’ve written a memoir. How long did it take for you to make that transition where you did start to open up, whether that’s to Jeff or to your friends or to your kids? How long did it take for you to start to do that?

Betsy Brenner: That’s a great question with a long answer. I was diagnosed in the fall of 2011, but I think my eating disorder was pretty serious for the year or two before that. I started the outpatient treatment in 2011, and then in 2017 my recovery was already pretty strong, but still working with my outpatient team.

I had a physical experience that was life-changing; I had a serious health scare, a potential cancer scare. I had major surgery to remove a tumour from my ovary, full hysterectomy, and thankfully learned that the tumour was in fact benign. But I had to go through two months of recovery, not able to do anything, and during that time – I always appreciated good health and, as you know, was anxious when there was anything but good health. But it just helped me to appreciate the fragility of life and understand that we have one body and we need to take care of it.

I had this tremendous health scare and I got good news, but realised my parents got bad news, and so many other people. That just propelled my recovery forward after that. Like I said, I was already in a pretty good place, and my recovery just got so much stronger after that that I actually wrote my recovery story and had the opportunity to share it at several treatment centres in the Boston area. So I was feeling really good about my recovery at that point. It was the first time I had actually written in detail about some of my experiences. Again, it was just my recovery story.

I had been told by a few people that my life story had the makings for a book if I were willing to put the time and effort into it. My husband told me that and some significant people. But I was like, who has time to write a book? I’m busy doing all these other things. So I never really thought seriously about it.

After I wrote my recovery story, that’s when my two worlds started to intersect a little bit, because I was finally able to share with a few people that I had recovered from an eating disorder. But I always made it as something in the past. I never was able to say to people in my life at that time that this was something I struggled with very recently and still was getting outpatient treatment and all that.

But it was really – as you know from all of this, I was always such a private person, and the process of writing my memoir and now literally being an open book – the word that comes to mind is freedom. I feel not only have I healed on the deepest level possible, I feel so free. I don’t worry about what other people think of me. I’m sure there’s people behind my back that are like, “Wow, that’s great she wrote a book, but I can’t believe all that stuff she shared.” I feel so comfortable being my authentic self, and I think when you’re able to do that, it takes vulnerability for that authenticity. I connect with those who make me feel good about who I am, and I don’t worry about the others.

More than anything, I’m fuelled by my passion to give hope to others, because honestly, if I can recover from an eating disorder, anybody can. And I’ll say that again. If I can recover, anybody can. I hear from so many people who the eating disorder is so much a part of their identity. Like, “Who would I be without it?” But right now, I’m living that next chapter. I’m enjoying the joy of discovering who I am without my eating disorder. People say, “Are you going to write another book?” I’m like, not now. I’m living my next chapter, and my next chapter is sharing my message. The most inspiring message I have to share is that it’s never too late to be a work in progress.

I don’t like it when recovery conversations are focused on semantics like ‘in recovery’ or ‘recovered’ or ‘recovering’, whatever it is. For me, recovering is about being fully present in my life, not spending every day completely consumed by thoughts about food and exercise. I’m able to be my authentic self. I’m able to use my voice to ask for what I need. I can connect with others in an authentic, real way.

The process of writing my memoir helped me to get there, and I’ve learned through writing about all my experiences that some of the things I went through were indeed trauma. I’m at a point in my life now, in my late fifties, where all the difficult experiences – they’re a part of me. I acknowledge them. I will continue to see my therapist indefinitely. I haven’t seen my dietitian in years; she’s retired. But I still see my therapist because I need to do whatever I need to do for me to be my healthiest self.

But I feel like I will always be a work in progress. Recovery doesn’t have to be perfect to be wonderful. It’s an illness that I have to manage, just like I manage my asthma. And I know what I need to do for me. But letting people know that we’re all a work in progress, and there is life beyond an eating disorder, no matter how old we are. All those difficult experiences – they’re still a part of me. They’re a part of who I am and why I am the way I am, but the difference now is I don’t give those difficult experiences power over me.

So many people at my stage in life, we’ve all been through something. Nobody gets to this stage in life without having been through something. But it’s finding a way to no longer give it power over our present lives. It doesn’t mean we dismiss it; it’s always a part of who we are, but it doesn’t have that power over me. Life beyond the eating disorder is wonderful because I can figure out who I am, and my identity is who I am now, with the past chapters a part of me but not controlling me.

Chris Sandel: That’s lovely.

01:13:41

How she learned to feel her feelings

From a practical standpoint, how did you get to that place, in terms of how did you learn to feel your emotions? Are there specific things that you can talk about that you did with your therapist or you did outside of sessions that allowed you to get to this place?

Betsy Brenner: My dietitian also, it was more than meal plans. Meal plans were obviously necessary to restore my weight, but she also talked to me about recovery and what was necessary for recovery and talking about the experiences in my life and all that. My therapist obviously took it a step further.

What I learned in the recovery process and about feeling my feelings – a lot of the hard work of recovery took place outside my appointments. You can’t look at the time with the dietitian or the time with the therapist as that’s where the hardest part of recovery takes place. That’s where you get the tools to help you recover. Like, I had to eat the food. My dietitian could put together the meal plan and talk about it, but I’m the one that had to eat the food, and I had to eat the food outside of that 90-minute appointment every week.

The same thing with my therapist. I mean, yes, I shed tears in those sessions and we talked about the difficult experiences, and she helped me understand how my mom’s ways impacted me, but I can remember so many times leaving those appointments, which are only 45 minutes, and I would feel like we had just touched about something, and maybe I’d tear up and then I’d be angry because I didn’t have enough time to continue the conversation and talk about it and had to wait another whole week. But then I would get into my car and just start sobbing.

So I learned through that process that that was the hard work of recovery. That was feeling the feelings. My therapist has guided me so professionally, skillfully, insightfully, compassionately, but I learned that a lot of that hard work of feeling the feelings takes place outside that safe space. But she knows and always knew what questions to ask and how to steer the conversation so that I would talk about those difficult experiences and feel those feelings that were internalised for so many years.

It really takes that professional support, and again, the specialisation with the eating disorders is key. But so much of the hard work of recovery takes place outside of treatment. It’s being able to focus on recovery and what’s necessary for recovery in the scope of your everyday life.

Chris Sandel: I’m in total agreement with that. When I’m with clients, yes, we can get into the things that we need to get into, but in the same way, I’m with them for 90 minutes and then, yeah, there’s some email support and there’s some messaging and whatever support they need, but the reality is, 99.9% of the time I’m not with them. It’s then them having to figure out how to do this stuff on their own.

Betsy Brenner: And that’s the hardest part of recovery: doing the hard work on your own. But you have to remember, you have support, and you need to share all aspects. There’s going to be steps backwards, it’s going to be difficult. The eating disorder voice is going to get louder before it gets quieter. But that’s all part of recovery, with the framework of support.

01:17:20

How her hospice work affected her

Chris Sandel: I know you’d worked for many years as a hospice volunteer and working with grief and loss. How much was this transferrable with your situation, where the way you’d been able to help others, you were then able to turn that inwards and help yourself?

Betsy Brenner: When I first got involved with hospice, I didn’t do it intentionally to deal with my own grief; it was more like wanting to be a psychologist, help kids who were divorced. I obviously had been through these very difficult losses, but at that point, I’d started accompanying the bereavement chaplain to groups and things like that. But again, I hadn’t really fully dealt with my own emotions yet. It was just like, “I’ve been through this, so I can help other people” without really understanding what the grief journey was truly all about.

I started a bereavement group in my town, actually at my church – it’ll be 10 years in November. So obviously this group has been going on through the whole time of my eating disorder recovery journey. There’s a lot of parallels. So much of grieving and my bereavement group was giving people a safe space to really talk about how they were feeling, and here I knew early on how to facilitate these groups. But running this bereavement group and working on my own eating disorder recovery, I needed to give myself that same space and time to feel and process and talk about emotions just like I gave that space for those in my bereavement group.

So it’s parallel in that if you don’t address and confront all the emotions, whether it’s because of grief or other trauma, it will come out in some maladaptive way. For me, it happened to be the behaviour with food and the eating disorder.

So anyway, I learned almost more about my own grief from my eating disorder recovery. I was certainly trained as a hospice volunteer and understood group dynamics and how to run a group, but even if I had had that safe space when I was in the throes of my grief, I wouldn’t have been comfortable. I would’ve been the silent one sitting there. For that reason, I never put anyone on the spot, because I was the listener. I was not the one who wanted to talk. For better or for worse, I found my voice. [laughs] Now I have no trouble using it.

But again, my eating disorder recovery journey helped me understand my grief and allowed me to do what I had done for others for myself.

01:20:06

What she learned from her relapse

Chris Sandel: And then I know in 2019, you had a relapse. Talk a little bit about this, but also what you learnt from that experience.

Betsy Brenner: One thing I will say is recovery is never linear. If someone has a linear experience, they’re one of the few. There’s always going to be steps backwards, setbacks, a full-blown relapse.

My relapse was not an intentional going back to my eating disorder; I ended up becoming way too dependent on my dietitian, and then she went through some trauma in her own life, and I basically had to learn to stand on my own two feet and not be so dependent on her. But in hindsight, it was the best thing for me because it really helped my recovery grow stronger and become more dependent on myself and knowing what I needed to do.

I would say I didn’t go back to my eating disorder, but I sort of became overly focused on ‘clean’ eating. I hate that expression. But I learned through that experience that I need to eat even when I’m not hungry, and I know what I need to do to maintain my weight. I also learned instead of beating myself up for having a setback, the key to moving forward after a setback is to learn from it and to understand why it happened, and to move on and use what you’ve learned to get back on track.

My dietitian always used to say to me when I was working with her, “Do the next right thing.” So instead of beating yourself up because you had a setback or a slip or a relapse, whatever you want to talk about, realise it happened for a reason. Something triggered it. What can we learn from that situation that set you back so that you can get right back on track and move forward?

For me, it was more learning about why that happened – and I do understand it now, very well – and also knowing what I need to do to maintain recovery from that physical standpoint maintaining my weight. Like I said, when I talk about managing my illness, that’s what it’s all about. The eating disorder thoughts aren’t there, but I have to work to make sure that I maintain my restored weight, if that makes sense.

Chris Sandel: It does. It definitely does. The eating disorders are so many different things. In terms of you for you, it was very much a coping mechanism, but there is also a physiology component to this. When weight drops below or drops down, the thoughts get louder again, and there is a physiological component that then drives this.

Betsy Brenner: Absolutely.

Chris Sandel: So it’s really understanding all of the different facets of the eating disorder so that you can be able to say, “Okay, I’m taking care of this one and I’m taking care of this one and I’m taking care of this one.”

Betsy Brenner: Exactly.

01:23:08

How her relationship with tennis changed throughout recovery

Chris Sandel: What about your relationship with tennis throughout this and how it is now? Obviously, this was something that was a very big part of your identity; it was something that you said gave you great self-esteem. There was obviously lots of positives from this, but from an energy perspective, when having an eating disorder, playing tennis is something that’s going to be having an impact on your physiology and your recovery. How was that as part of your recovery?

Betsy Brenner: My treatment team would’ve loved for me to stop playing tennis because I would’ve been able to restore my weight more quickly, but as I said, tennis became such a source of self-esteem and an outlet for me, and it also became a second career; around that time I became a high school tennis coach. I literally just retired from that last fall after 13 years to focus on the work I’m doing now as a result of my book. So I’m no longer coaching.

I wasn’t willing to give up tennis because of all the positive things in my life that it brought, but it also was so intertwined with my eating disorder. During the time I was struggling, I played as much as I possibly could. It helped my appetite, so then it was easier to follow my meal plan, but then I had to understand, “If I’m going to still play tennis, then I need to eat even more.” Tennis really reduced the anxiety about eating, but it was still hard to eat that much more.

What ended up happening with my team was putting limits on it. Yes, they didn’t take it away completely – which they could have had I been a child, a teenager – but it was more like, “All right, if you’re still going to play tennis, you can only play this amount and you have to eat this much more.” We were always tweaking that.

My life revolved around tennis – my own tennis, and obviously I was coaching and I loved coaching, but I would talk to the girls all about how they needed to fuel their bodies appropriately and all that kind of stuff. Meanwhile, I wasn’t taking care of my own body in the way it needed to be taken care of. I wanted to play as much tennis as possible, and I would feel if I played several days in a row, it was easier to eat A, B, or C, whatever. I would revolve things around tennis. If I was asked to play a certain match or on a team, everything else came second. It was all about that because it allowed me to eat with less anxiety.

So anyway, fast forward to recovery. I also learned, during that time when I was recovering from surgery and couldn’t do anything for two months, I learned an important lesson in that my body, my organs, needed nourishment even when I wasn’t physically active. So during that also was one way my recovery strengthened in 2017. I had to give my body the nourishment that it needed so that it could heal even when I was lying on the couch day after day.

Now I would say tennis has a much healthier balance in my life. I probably play half as much as I did. Another huge thing is that even on days when I don’t play tennis or exercise in any way, it doesn’t have a negative impact on my food intake. There’s no connection anymore. It was really hard to break that connection between exercise and food. That was a huge piece of my recovery, and now I’m grateful to be able to say that whether I’m exercising or not, I can eat what I want when I want and how much I want.

So tennis is still an important part of my life; hopefully it always will be. But it’s a much healthier balance. If I have a choice of a speaking opportunity or time with friends or whatever over a tennis match, before I would’ve chosen the tennis match. I didn’t have the speaking opportunities. [laughs] But I would’ve done everything around the tennis. Now tennis fits in nicely with the other things.

But when I don’t play, I don’t play. And I also enjoy going for a walk, or if I can’t do anything, that’s good too. I understand now that our bodies need rest and recovery, no matter how active we are. Even elite, elite athletes need rest and recovery, and our bodies need nourishment during that time no matter what.

Chris Sandel: Definitely. I know you said your treatment team would’ve liked you to take time off. Hindsight is a wonderful thing; if you could do things again, do you think that would’ve been a better option for you personally, or you’re still of the belief “It gave me so much that I don’t think I could’ve been able to take that time off”?

Betsy Brenner: It would’ve been really hard for me to take that time off just because tennis helped my mood. It helped me feel good about myself, less anxious, and I was so connected in the tennis community. I was coaching high school tennis. It would’ve been really hard to take a break from tennis, for some of the same reasons I wasn’t willing to go away to treatment. I didn’t want to disrupt this life that I was leading. I loved coaching, I loved my tennis friends, I loved playing tennis, I loved playing on teams and things like that.

The only thing it would’ve helped with was I would’ve restored weight much more quickly if I hadn’t been playing tennis. But I would’ve probably been crankier, more irritable, more anxious, all those other things. So the key was learning a healthy balance. Like if I were going away, my dietitian and I would talk about limits on if I was going to go to the gym, I couldn’t go for more than X amount of time. Or no double exercise, like if I play tennis, I can’t also go for a walk with a friend.

It was really just putting reasonable limits on it. it wasn’t realistic to take it away, and fortunately, like I said early on, I was medically stable, so there was no medical reason or need to take it away.

Chris Sandel: With obviously tennis being such a big part of your life and something you’ve been involved in from a coaching perspective as well, now that you’ve written this book, are you talking in the tennis world? Because I know with the work that I do, so many of the clients I work with are either athletes or hobby athletes. I think there is a real epidemic of eating disorders and disordered eating within pretty much all sports. So I’m wondering if you started to infiltrate some of that world and get your message out there.

Betsy Brenner: I would like to do more with athletes. Honestly, I do so much speaking these days, which I absolutely love, but it is mostly groups involving women in mid-life. I’ve also spoken to parent groups, parents of those struggling with eating disorders. I have done some with athletes. I would love to do more. There’s such a crisis in mental health with so many different populations, and eating disorders, as we all know, as a result of the pandemic, have just increased. So I would love to do more with that population. I think it’s really, really important and I have a lot to share from my own experiences.

My story is long enough, so many chapters of my life, that there’s different pieces of my story that can certainly help different populations. When I speak, obviously I focus on the audience as to what I emphasise and focus on. But I would love to do more with athletes.

Chris Sandel: Nice. I really hope that you can start to do more of that work, because I think it would be really, really helpful and valuable for more people within that area to be hearing your story.

Betsy Brenner: Thank you. I have done a little bit, and I wish – even in our local interscholastic system with high school sports, there needs to be more conversations about mental health and eating disorders with the athletes, because it’s happening way too soon. Just for coaches and teachers and everyone, knowing the red flags and understanding what to do if you suspect something. That training is essential, and there’s definitely not enough of it.

01:31:34

The work Betsy does now in the recovery space

Chris Sandel: Yeah. So what work are you now doing in the recovery space? I know you obviously touched on some of it there in terms of the speaking that you’re doing, but go into a bit more detail of what you are doing.

Betsy Brenner: My book came out actually about a year ago, and I never could’ve anticipated the opportunities coming my way. I’m so grateful. First it was a few book signings at local bookstores, but I really have found my niche. And I guess there wasn’t a lot out there memoir-wise for women in mid-life, especially diagnosed in mid-life. So I hear from readers mostly in the US, but literally all over the world, and I respond to every single email.

I’ve been doing some virtual support groups and book-related workshops / groups – really a creative way of doing a support group – through organisations here in the United States. ANAD and Chats in the Living Room, doing virtual groups for them. I’ve done in-person support groups here in Rhode Island and hope to do more of them as long as the pandemic cooperates. I had been doing a wonderful one with a therapist from Boston before Covid hit, and then that never started up again.

Hope to be doing – I don’t plan on writing another book, but writing some articles. I also do a tremendous amount of mentoring through the Eating Disorder Foundation and through ANAD. One-on-one mentoring. Again, mostly with women in mid-life. This is my first year not coaching, so I have a lot more time. But honestly, I haven’t had trouble filling it, and I’m very grateful.

Opportunities such as this to share my story and my message – I love this work. I feel like this is the perfect next chapter for me. My kids are away at college, my husband’s not retiring anytime soon, so this is my focus: really giving hope to and inspiring others that recovery is possible, even at the ripe old age of me in my late fifties and others who are even much older than I am, even who have been struggling their whole lives. Even if we’ve been through the worst of trauma, healing is possible.

I’ve been fortunate to speak at many conferences and to smaller groups. I love all the different settings and audiences and just hope to do more and more of it.

Chris Sandel: Nice.

Betsy Brenner: I’m finally starting to travel more now that the pandemic seems to be somewhat stable. I love now travelling and speaking in person and going to conferences, speaking at conferences. And again, the one-on-one work I do as a mentor is very gratifying.

01:34:21

Talking about her eating disorder with her kids + husband

Chris Sandel: One of the things I was thinking as well – and this is something that’s come up a lot with clients who are similar to yourself, who are dealing with eating disorders in mid-life and then also have children – how did you approach this with your kids in terms of either speaking about your eating disorder or not speaking about your eating disorder? What experiences have you shared and not shared? Obviously, you’ve now written a memoir, so it’s out there. But prior to doing this and through your recovery journey, how did you handle it with your children?

Betsy Brenner: That’s a really good question. I get asked that a lot, actually. My twins, who are now juniors in college, were in elementary school when I was really struggling. So it was easy to just not talk about it with them. But kids are really perceptive. I’m sure they knew more that something was going on. My older daughter was in high school at the time, and she certainly knew that something was going on. we were both really struggling with anxiety, had different triggers and different manifestations. So it was really, really hard.

But I wasn’t in a place where I could admit that I was struggling, so we didn’t really talk about it a lot. Most of my conversations – I would say almost all my conversations were exclusively with my dietitian and therapist and occasionally with my husband and my older daughter.

My memoir came out right when my twins had finished their freshman year of college. My book came out in May of 2021; they came home from college, I gave them each a copy of my book, and my daughter read it in a couple sittings and just cried so much. And she’s not a crier. I would say she knew a lot about these things, but she didn’t know the details. So it was a great way for her to understand my life’s experiences more than just ‘my parents were divorced’ or ‘my parents had cancer’. She learned every detail about it.

And of course, they got a kick out of reading about when my husband and I were dating and the good stuff. But that’s really when they, by reading my memoir, learned the most. I remember when they were in high school mentioning that I had struggled with an eating disorder, but again, making it sound more like it was something in the past than a current struggle. Because again, there’s so much shame and secrecy I think with any mental health issue, but especially as we get older and people just expect you – as if it’s our fault. I had a friend say to me, “Don’t let that happen” when I finally told her I had an eating disorder. Just a lot of misconceptions out there.

My older daughter obviously knew a lot and knew more sooner, and again, now knows every detail. I have no secrets. I am literally an open book. But it wasn’t always like that. I shared with very few, and as you know, did not allow myself to be vulnerable. So my family obviously now knows everything. They’re very supportive.

I think at first for my husband, when my book was coming out, his family doesn’t really deal with emotion, so it was a lot of like, “Oh my God, it’s going to be all out there.” But he’s been amazing and so supportive of the work I’m doing now and speaking and travelling. Just so supportive.

Chris Sandel: Nice. With your kids, subsequently to them reading the book, have you then had further conversations? Has that then started up? Or like “I’ve read the book, Mum, we don’t need to go any further”?

Betsy Brenner: I’d say not either extreme. I’d say sometimes they’ll ask – like my son will say, “How’s it going with your book?” And sometimes I’m the one sharing, “Gues what? I got asked to do this.” And then my oldest, on her own social media, it’s been wonderful. She shared a wonderful post when my book came out as an audiobook. She’s more likely to share something about it. But they both, when my book first was published, shared something on their Instagram about their mom being an author.

I wouldn’t say it’s a huge topic of conversation. They’re definitely proud of me and supportive. But I’ve sort of found my niche in the eating disorder community professionally and personally, and that’s where that energy goes.

Chris Sandel: What about for husbands who are listening? How did you deal with this with Jeff through that journey, and what advice would you have or reflections do you have as part of that?

Betsy Brenner: I wish when I was struggling that I could’ve said to my husband, “This is how I need you to support me. This is how I need you to help me.” But I wasn’t capable. I was ashamed by my illness. Like I said, I had to be reassured it wasn’t my fault. So I didn’t know how to ask for what I needed or ask for how he could support me. So my best piece of advice, if you’re the partner of somebody who’s struggling: tell them, “I don’t know. Please help me help you. Please tell me how I can support you. What would be helpful? What wouldn’t be helpful?” Because you can’t assume that they know everything there is to know and need to know about eating disorders.

Chris Sandel: Betsy, this has been such a wonderful conversation. I’m so glad that I’ve got this time with you today. What parting words would you have for listeners? If someone is out there who is like you and has developed an eating disorder, what would you want them to know?

Betsy Brenner: I would tell them that professional help and support is essential, and also that the eating disorder is not your fault, but recovery is a choice, and it is worth it, even when the days are long and dark and recovery doesn’t seem possible.

I just want them to remember my message: it’s never too late to be a work in progress. And recovery doesn’t have to be 100% perfect to be wonderful, and the journey is worth it. The twists and turns along the way – baby steps forward, and just keep doing the best that you can. But the key is having that support both professionally and connections with others with whom you can be open and honest about your struggles.

Chris Sandel: Where can people go if they want to find out more about you? I will put all the links in the show notes, and obviously, your book, again, is The Longest Match: Rallying to Defeat an Eating Disorder in Mid-Life. Where should people go?

Betsy Brenner: It is available on Amazon in paperback and for the Kindle. It’s available as an eBook in other places like Apple Books. It’s now an audiobook that I recorded myself. It’s 7 hours and 59 minutes. I recorded it at a studio in March, and that’s available on Amazon or through Audible. And my website, www.betsybrenner.com, shares more about me and shows all the speaking that I’ve been doing. I love speaking to groups big and small, conferences as well as small support groups. I appreciate any and all opportunities to help others and hopefully give hope to others and share my message. But my website shows a lot of the work I’ve been doing over the past year, and I’m just so grateful to be living my next chapter in recovery.

Chris Sandel: Perfect. I will put all of that in the show notes, and thank you so much for coming on. I’ve really enjoyed this.

Betsy Brenner: Thank you so much for having me. I’ve done several podcasts, but none in the UK, so this is just incredible. I hope I’ll be able to reach new audiences. I love hearing from people who either read my book or listen to me. I respond to every single email. So I’m just grateful for this time and this opportunity, and I appreciate your reaching out and having me on here to share my story.

Chris Sandel: So that was my conversation with Betsy Brenner. I am so glad that she has written her memoir and that she’s doing the work she’s doing. She’s a great example of someone who’s been able to learn to feel and express their emotions and to cope with difficulties in life outside of using an eating disorder.

As I mentioned at the top, I’m currently taking on new clients. If you are wanting to recover or are in recovery and needing support, then please get in contact. You can find out more about working together at www.seven-health.com/help.

I will be back next week with another episode. Take care, and I’ll catch you then.

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