273: The Fundamentals Of Full Recovery Details

Chris Sandel: Welcome to Episode 273 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/273.

Hey, everyone. Welcome back to another episode of Real Health Radio. I’m your host, Chris Sandel. I’m a nutritionist and a coach, and I help clients to fully recover from disordered eating and an eating disorder so that their days are no longer governed by fear and anxiety, and instead they can live a meaningful life that is in alignment with their values.

Today on the show, I want to talk about a new programme that I’m running. I’ve mentioned this in the last episode; I’ve also sent a couple of emails out about it. This is something that I’ve been thinking about doing for a really long time now, and in many ways is rather overdue. I’ve been working with clients for 15 years now, and this has been one-on-one work, but for a long time I’ve wanted to start doing group work, and this is where I see more of what I do heading. I know there are a lot of people in my audience who read my blog posts or listen to the podcast like you’re doing now, and they want to move beyond simply getting more information, getting more facts, and learn how to take that theory and translate it into action.

This programme is called The Fundamentals of Full Recovery. It’s a beta, and what that means is that it’s essentially the first time that I’m running the programme. It’s an opportunity for you to do the first run of the programme without me charging the full price of it and for me to test out the material of the programme with you.

And when I say ‘test out’, it simply means testing it out in this format. Everything that I’m going to be covering in the programme are things that I already work on and work through with my one-on-one clients.

The goal is to then turn this programme into something that I run a number of times a year, allowing me to serve and help more and more people than just the one-on-one work. I know that there are lots of people who have expressed interest in working with me and they haven’t been able to do that because of either limited spots available when I do take on one-on-one clients or because of financial reasons and just not being able to afford to work with me one on one.

So what I want to do today as part of this podcast is just detail the programme and give you a chance to join if it’s something that would b helpful for you in your current state of recovery. Last week from when this is going out, I did a webinar. I know that there were lots of people on the webinar and lots of people watched it live, but also watched the replay, and I also know that there are a lot of people who either (a) aren’t on my mailing list, do didn’t even know about that, or (b) just aren’t going to sit down and watch a webinar. So I wanted to include the content here so that you can listen to it, so if you’re used to listening to podcasts, you can get that information without having to sit down and watch a webinar.

00:03:26

Three fundamental areas for recovery

As part of the programme, I guess one of the easiest ways for me to talk about this is one of the frameworks that I use and one of the frameworks I’m going to be teaching as part of that programme. This is something I thought about more recently in the last six months: everything that I work on with clients is connected to these three areas. These areas are interconnected and have a knock-on effect on one another, but everything that I work on and teach with clients is about these three areas – and I really think that these three areas are fundamental to recovery, hence the name of the programme.

The three areas are state, story, and structure. I’ll walk through each of these.

State is the state that your body is in, the physical state. How is your body functioning? This can be impacted upon by the energy that you have coming in today, but also the energy that has been coming in over the last weeks, months, years. How much have you been meeting up with the needs of your body? The state can be how much recovery or healing needs to take place, so if there has been restriction that has gone on for 5 years, 10 years, 20 years, there’s a lot of recovery that needs to take place.

The state of your body links to the kinds of symptoms that are arising in your body. State is also looking at your nervous system and how your nervous system is affecting how you experience and perceive yourself and the world around you. State is incredibly important.

The next one is story. Story looks at the kinds of thoughts that you have, the kinds of beliefs that you say that you believe, the meaning that you attribute to various things that happen in your life, the kinds of emotions and sensations that arise. Story is really the feedback that you’re getting from your mind and body, so the kinds of thoughts that arise or the kinds of sensations that arise. It’s then what you do with that information. Some of it will be stuff that you act upon; some of it will be things that you ignore; some of it will be things that you can discern about and say, “Even though I’m registering this sensation, I know better than this.” It’s looking at, what is the feedback or what is the information that you’re getting, and how do you then relate to that?

Then the final piece is structure. Structure is really looking at, what does your day to day look like? What are your day-to-day habits? How does your day flow? What time are you getting up? What are you eating across the day? When are you doing that eating? What’s your sleeping like? What are your social connections, your hobbies, your job, your movement or exercise? Are you doing journalling? What is going on in your day, and how is that then having an impact on state, on story, and how all of these things are interconnected?

I believe that, as I said, all of these three have a knock-on effect on one another, and they can either be helping you to create an upward spiral because of the things you’re doing to support your state, story, and structure, or they can be having a downward spiral because of the things you’re doing to support the state, story, or structure.

If I think about this from a recovery standpoint, recovery is about action-taking and about doing the things that are pro-recovery that are going to then support you to move forward. I really believe that eating disorders are anxiety disorders, and anxiety disorders like OCD or other anxiety disorders, the gold standard for helping these and for moving through them is exposure. And exposure means taking action. It means doing the things that are uncomfortable.

Success with recovery is then all about taking positive action to help you move forward. The opposite of that is avoidance. It’s avoiding eating the food that you need to eat, or it’s avoiding having the rest that you need to have, or it’s avoiding setting the boundary that you need to set. It can be avoidance in lots of different ways. But eating disorder recovery is about taking action, and that is really the basis of this whole programme, and it’s the basis of how I work with one-on-one clients: looking at all of the areas where action needs to be taken and doing that. And it can be in a systematic way; it can be looking at the easier things to do or the things that are going to have the most amount of impact, but where you’re working towards taking action on a consistent basis that is moving you towards recovery.

Every part of this programme is built on those ideas of, how can we be doing things to be supporting your state? How can we be doing things to be supporting the story that is arising and how you can relate to that story? And then how can you be structuring your days and your weeks so that it’s moving you in the right direction?

00:09:00

What I cover in the first 6 weeks of the programme

I want to go through the different weeks as part of the programme. I’m teaching this over 12 weeks, and I’ll go through what is covered in each of the modules.

In Week 1, it’s really an introduction to the programme and looking at what causes eating disorders and why they persist. I really like the biopsychosocial model of eating disorder recovery and eating disorders, so we can talk about that. I talk about, as I alluded to there, that I believe eating disorders are anxiety disorders and are about avoidance and how to overcome that through action-taking. I’ll talk about Health At Every Size and an anti-diet approach, as this is very much the way that I think about recovery from eating disorders, and the approach that I take is very much from this lens.

I’ll look at different frameworks and metaphors to support mindset in recovery, because I think this is really important and I think this then can link in to expectations. And I think expectations play a big role in how someone recovers because if you’re expecting it to be easy or you’re expecting it to be this thing or that thing and that’s actually not the reality of the situation, that has a very big impact on how you feel about how things are going. So different frameworks and metaphors to really look at, what’s a good way of framing this so that I can do the difficult things?” Because with recovery, it is very challenging. It’s not an easy thing to do, and so how are you still able to take action when that is the situation?

We’ll also have an introduction into self-compassion. I think self-compassion is hugely important in recovery. As I just said, it’s a really difficult thing to do to recover, and if the self-compassion piece is missing, it makes it nigh impossible to do it. So we start to look at what self-compassion is, and it will be something that comes up again and again throughout the course.

In Week 2, we’re looking at the importance of energy for the state of the body and for recovery, looking at what happens when there’s not enough energy coming in and how this affects the body and how this affects the mind. We’re going to look at the different types of restrictions that can occur. Then also looking at the importance of nutritional rehabilitation – why is this so important? What happens as part of nutritional rehabilitation? We’re going to look at what recovery eating can look like, because there isn’t one size fits all and one way to do this. I think there are different approaches, and talking about what that can look like.

Then we’re going to look at how to create space between yourself and your thoughts. This is known as ‘diffusion’. One of the central tenets of the work I do with clients is looking at the fact that you are not your thoughts. You’re a witness to your thoughts; your thoughts naturally arise. So looking at different techniques to start to create that distance between yourself and your thoughts. This is really an introduction into acceptance and commitment therapy, and this is something I use a lot with clients. It’s something we’ll go into in more detail in the programme as we go through. But this is one of the starting points with acceptance and commitment therapy that I think is really important.

In Week 3, it’s looking at how your nervous system impacts on your state. This is really an introduction into polyvagal theory. As part of this, we’ll look at what are the primary states, what are the mixed states, looking at building a window of tolerance, coregulation, self-regulation, the awareness building of being able to notice, “What state am I in and how is this affecting how I’m perceiving the world, how I’m perceiving myself, how I’m having certain beliefs arise to my mind in this moment?” Polyvagal theory, in the same way as acceptance and commitment therapy, is really the basis of so much of the work that I do with clients. So it’s giving you that introduction into this. And again, we’ll look at it in more detail as we go on.

Then in Week 3 as well, we’re looking at a further exploration into self-compassion and recovery and looking at an exercise called the Fears of Compassion Scale and having a talk about a lot of the research connected to self-compassion and recovery. The thing with compassion and self-compassion is it is a learnt skill. It’s not that this is something you either have or you don’t; this is something that is learnable. So we’ll talk about how to make self-compassion a practice.

Week 4 is a really practical week. This is looking at different ways of managing story and state and lots of different exercises and techniques that you can do. A lot of this is pulling from polyvagal theory, but also acceptance and commitment therapy, so looking at ways of how you can create safety and safety anchors, how you deal with difficult thoughts and feelings and sensations as they arise, how to recognise certain emotions, how to label certain emotions. This is very much, as I said, practices and a practical week where we’ll be going through different ways of dealing with this.

Week 5 is a live Q&A week. With each of the weeks there will be questions and answers that are done at the end of each of these calls, but this is a week that the entirety of the call will be about questions. This one gives you a chance to ask questions, especially after that Week 4 with a lot of the practical exercises that you’re then going to go off and start to implement and see how they work for you. It will then be answering questions around that or any of the content that we’ve covered up until this point in the course. It also gives you a chance to catch up, so if there have been weeks where you haven’t been able to do everything, this week there’s going to be no new content; it will just be the Q&A, so it’ll give you a chance to catch up.

Week 6 is looking at the impact of exercise on your state. Exercise is a really big one that I work on with clients. It can be just as hard, if not more hard, to deal with than changes with food. We will look at navigating exercise in recovery – reduction or abstinence. We’ll look at the importance of psychological flexibility, because I think this is often a missed piece. It can be “Well, I don’t know if I really need to cut out my exercise or change my exercise for physical reasons; I think my body’s able to repair without doing that”, and yet actually, from a psychological standpoint, it’s really important to be able to be flexible. So we’ll talk about that.

Looking at other coping strategies, so if you’re not able to exercise or not able to exercise to the degree that you were previously, how do you cope? For a lot of people, it is their way of dealing with stress or it is their way of dealing with uncomfortable feelings. So looking at other coping strategies outside of exercise or movement.

We’ll talk about fitness and health and really defining these things, because I think often, exercise and fitness and health go hand in hand, and there can be these very narrow definitions of what it means to be fit or what it means to be healthy. So having a discussion about this and exploring this as a topic.

And then as well in Week 6, we’re going to be looking at grief and how grief is connected to recovery. I truly belief that recovery is a grief-filled process. There’s grief about a changing body. There is grief about losing this way of getting control, or at least the illusion of control, this way of feeling safe. So there’s lots of reasons why grief comes up, and being able to see the seven stages of grief – and it’s not that you go from one stage to the next and the next and it’s linear; you can go back and forth with this. But recognising, “Okay, it makes sense that I’m feeling anger here” or “It makes sense that I’m bargaining here” or “It makes sense that I’m feeling quite low and depressed here.” Looking at the different stages of grief and what is then going to be expected as you go through this journey.

00:18:17

What I cover in the second 6 weeks of the programme

In Week 7, we’re going to be exploring body image and fears connected to weight gain. Kind of like with exercise, this is something that comes up a lot with clients, so it’s an area that I want to be able to focus on. Looking at lots of body checking and weighing and other methods of control, but just really starting to explore, what does body image mean? Because again, I think it’s much broader than what most people think about, and actually the solutions are much broader than what most people think about. So starting to really understand that.

We’re also going to look at how trauma and neurodiversity and anxiety affect your state. Each of these are very big topics that you could do a whole programme on separately, so it’s not going to be a real deep dive into all of them, but these are areas that come up a lot with clients. Often, especially with the neurodiversity piece, it’s through my work with them that they start to explore this for the first time, and it wasn’t something that was even on their radar. So starting to recognise if this is something that’s important and needs a little bit of attention or some further exploration.

Week 8, we’re going to be looking at identity and values. I have a pretty long writing exercise that will be done in preparation for this one, and this is one that I use a lot with clients, really with every client that I work with, starting to explore what someone’s identity is. What are your values? Looking at things like meaning and purpose and really being able to use these ideas as a guide, as something to help you navigate recovery, where it’s “If this is what I say my values are, what kind of decision would I make in this moment?” So really using this as a North Star. We’ll look at beliefs and mindset as part of this, and how much they can be affected by the state that you’re in and the kinds of beliefs that come to mind because of that.

We’ll also look at other ways that state is impacted upon – namely, sleep and digestion. These are things that can improve with recovery, but they can also get worse with recovery, especially in the short term. So just understanding this is what is likely to happen or could happen as part of this. I think often there can be this feeling of “I must be doing something wrong with my recovery if certain things are getting worse”, and actually that’s not the case. It can be common that your energy gets worse as part of recovery before it gets better. It can be common that your sleep gets worse or your digestion gets worse or lots of symptoms get worse before they get better. So just giving that information so you understand why that is the case and that this is likely to occur or could occur.

Week 9 is a break week. There’s going to be no call, there’s going to be no new content during Week 9. Again, this is going to be a chance to catch up on anything that hasn’t been caught up on. It could be a chance to do some more of the practical exercises that we’ve talked about throughout the course.

In Week 10, we’re going to look at weight setpoint and the body’s ability to regulate itself and regulate its weight. I think this is kind of a double-edged sword; I think it’s really useful to know this information, and I think this can be something that becomes focused on way too much. So we’re going to look at it and I’m also going to talk about why it’s best not to focus on this piece too much and the downside when that starts to happen.

We’re going to look at setting up structure for success and setting yourself up for success. A lot of this will be looking at how you do action-taking versus delaying or avoiding, and this can be for lots of different things, whether we’re talking about eating, exercise, clothes shopping. We’ll look at things like fear foods and fearful eating situations and really how you can start to figure out “What are all the things I’m avoiding and what are all the things I need to do as part of my recovery?” and then start working through this. As part of this, looking at recovery goal-setting and what that looks like and how it’s best to be doing this.

In Week 11, we’re going to look at intuitive eating in recovery. This is towards the very end of the course for a good reason. I think a lot of the time in recovery, people try and use intuitive eating, or at least try and use hunger and fullness as the only parts of intuitive eating that they’re trying to apply. And because so much of the body’s feedback has been messed up as part of recovery – and I say ‘messed up’, but I mean in a temporary sense; I think this is all things that can come back and you can learn how to navigate this. But in the beginning, trying to use hunger and fullness isn’t necessarily the best option and the best approach. So I’ll be going through the 10 principles of intuitive eating and how they can apply for recovery and where they’re appropriate or not appropriate.

We’ll look at things like relapse and the ups and downs of recovery, because I think that recovery is not linear. I think there can be this real misconception about what recovery can look like based on different stuff online or different books that people read. So I want to have a real honest discussion about this and about what recovery really looks like, because it’s not nice and clean and straight forward in the way that most people think it may be.

As part of this as well, we’ll look at what full recovery looks like and how long it will take to get there. The spoiler alert with this thing is how long it takes to get there is ‘it will depend’. It will depend on how long the eating disorder has been going on, how you’re approaching recovery, how much things are changing, how quickly things are changing. So it will depend.

And in terms of what full recovery looks like, there are the early stages of what this looks like and then there’s exploring what this looks like bigger picture, because I do believe that eating disorders aren’t just about food. You can get over an eating disorder from a food perspective, where you’re not doing things with food as a way of getting that sense of control or using it as a coping mechanism or whatever it may be – and then you start becoming a workaholic or you start doing things with online shopping or you start using alcohol in a certain way. So it’s starting to look at how an eating disorder can show up in other ways outside of food, and how to approach this so that you do truly reach a place of full recovery.

And then Week 12 is a live Q&A. This will be answering any final questions that are coming up based on everything that we’ve covered. There’s obviously a lot that we’ll have covered by that stage, but it gives everyone a final chance to ask their questions and to really know how to keep moving forward with it. While the programme is called The Fundamentals of Full Recovery, over 12 weeks, no-one is going to be fully recovered. Full recovery takes much longer than that. The point of the programme is teaching you the things that are most important for recovery, and if you then do those things and keep it up, you will reach that place of full recovery. But it’s not going to happen over those 12 weeks, so this Q&A can allow you to ask questions about moving forward and how to continue to do that.

00:26:57

Timeline + structure of the course

With the calls each week, they’re going to be starting on Tuesday, the 23rd of May. From when this goes out, it’ll be next Tuesday. There will be live calls for 90 minutes, and the live calls will be done via Zoom. All of the calls will be on Tuesday. the first one, as I said, start the 23rd of May, and they’ll be at 7 p.m. UK time, so British Summer Time – I think it’s BST instead of GMT. There’ll be one week, which is Week 3, where it won’t be on a Tuesday, it’ll be on a Thursday. That’s Thursday, the 8th of June. But all the rest are on a Tuesday night.

The calls are recorded, so if you can’t make the live recording, there will be recordings of them. Or if you want to make the live and then listen to them again, you can also do that. You can also submit questions in advance as well, so if you’re not going to be on the call but you want to get a question answered, I can answer it as part of the Q&A of the call.

With the live calls, they will include me sharing live content. I’ve just gone through a lot of what the live content will be; there’s a lot more than just that, but that’s an overview for each of the weeks. I’ll be doing live coaching as well, so there’ll be times where I’m going to be working with someone one on one there and everyone will get to see that happen. I’ll be also answering questions. As I said, there’ll be questions & answers at the end of each of these.

Between calls, there will be homework. This can include journalling exercises, it can include questionnaires, it can include practical exercises that you’re doing. And throughout, you’re going to be setting goals and working towards these during our time together.

00:29:00

Who this is for + who it’s not for

I now want to go through who this is for and who this is not for. The Fundamentals of Full Recovery is a good fit for you if you are ready to recover and you want the guidance and the support you need to make this a reality. It’s a good fit if you’ve been trying to do recovery on your own by watching YouTube videos or listening to podcasts or reading blog posts or reading recovery books, so translating that by consuming more and more information into “How do I make this actionable?”

It’s for you if you’ve been focussing solely on going all-in, and this has really been your only recovery plan. I do believe that more food and nutritional rehabilitation is hugely important as part of recovery, and I also believe it’s not the only thing that is important for recovery, and that there are many other aspects that are important, both in terms of helping you be able to recover and deal with the uncomfortable thoughts and feelings and sensations that arise, and also lots of tools and practices and techniques that are needed and useful after nutritional rehabilitation has been done, and how to then get to a place where you are at full recovery and the thing is not coming back.

It’s a good fit for you if you’ve been focussing more on the psychology or the therapy part, but you’ve then been staying much more in the realm of theory rather than action-taking. I see that this is also really common. For some people, it’s all about eating the food and going all-in and that’s kind of it, and for other people it’s about exploring childhood stuff or relationship with parents or this thing that happened in high school or whatever it may be, and it’s still a lot of talking and not doing the things that are important in terms of recovery. This is good if that’s where you’ve been stuck.

Or if you’ve been trying to recover but doing this in a really eating disorder approved ways – so eating a little bit more, or reducing your exercise by a small amount, or allowing recovery but only if there’s no weight gain. If you’ve been trying to do recovery in that very eating disorder approved way or that really safe way and you’re recognising it’s not getting you where you want to get to, then this is going to help for that.

Who this is not for? This is not for you if you aren’t ready to recover yet or you’re wanting to be convinced for why you should do it. Whenever I have my initial discovery call, recovery strategy calls for a one-on-one client, I am always saying, I am not in the convincing game. If I’m trying to convince you about why you should recover, it just doesn’t work. And especially it doesn’t work when I’m not an inpatient facility, I’m not there 24 hours a day, I’m not forcing you to eat, I’m not there doing all of those things that inpatient can do for someone. And I still believe that inpatient is going to be ineffective if someone doesn’t want to recover.

So if you’re at that stage where you’re like “I still don’t think I need to recover, I don’t think this is a problem” or “I kind of want to recover but someone needs to convince me why this is really important”, then this is not for you because I can’t be convincing you, and I don’t think it really ever works because the more I try and convince, the more all the reasons why this is not the right thing to do then get generated in yourself, and it becomes more of a debate or an argument and that’s just not what this is about. This is for people who are ready and wanting to recover.

And when I say ‘ready’, there can be ambivalence. It’s not that you’re 100% ready. It can be like, “I want to do this thing and I’m also scared, and I think it would be the right thing to do but I can also see all these reasons why it’s not.” That’s completely normal. But if it’s “I’m really not interested in recovery and I need to be convinced why I should be”, this is not for you.

If you’re simply looking for more information but don’t want to take any action, then this is also not for you. There are a lot of podcasts that I’ve put out, there are a lot of blog posts I’ve put out, there’s a lot of content around there; if you’re just wanting to build more information, don’t waste your money participating in this. You should just use all the free resources you’ve got to gather more information. This really is about taking action and how to take action and the ways of doing that. If you’re not ready or willing to take action, then this is not for you.

It’s not for you if you need lots of hand-holding or if you struggle if someone isn’t telling you exactly what to do every step of the way. With the programme, we’re having the 90-minute calls each week, and then outside of that it’s up to you to be implementing that. There’s not email support outside of the programme, the way that I do with one-on-one clients. It really is you taking the content from the programme and going forward with that. And even with one-on-one clients, it’s a very collaborative approach, but they’re still the ones that have to take the action. As I said earlier, I’m not an inpatient facility. This is people who are like, “Tell me how to do some of the things or let’s figure out together what I need to do, and then I’m going to go and do it.” So if you’re someone who is unable to do that, you need a ton of hand-holding, or you’re someone who needs every single step completely outlined for them, then this is not the right programme for you.

If you want one-on-one work and you don’t want to be in a group setting, this is obviously not for you. This is a group programme, and there’s going to be group participation, or at least it’s going to be delivered with people on a call in a group setting. So if you just want one-on-one support, then I’m happy to do that, but that’s not in this format. That’s something separate to this. This programme is not for one on one.

00:36:03

Payment options

In terms of the offer details, there are two payment options with this. You can do one payment of £897, or you can do three payments of £347 per month. This price is significantly reduced to what I think I’m going to charge when I do the full programme. As I said, this is the beta version of the programme, so we’re doing all the calls live; there is no prerecorded content. This is why I’m doing it at this significantly reduced price. It’s likely that it will be double this when I do the full programme.

Because of that reason, there are no refunds as part of this beta. But for those who participate in the beta, you’ll also have lifetime access to the programme, and then you can also participate in future rounds of the programme at no extra cost. I’m planning on running this again; it’ll be starting around late September time, so if you’re part of the beta, when I run it again in the September time, you can participate in the calls and participate in the programme then.

Really, if you want a chance to work with me at the lowest price possible, this is it. And this opportunity isn’t lasting very long. Your chance to sign up for this ends on Wednesday, the 17th of May, so a couple of days from when this is going to be released, and then after that you’ll have to wait until September time, late September this year, to do the programme then. And as I said, it will be a significantly higher price point.

If you do want to join, you can email info@seven-health.com with the subject line of ‘Group programme’ and you can then grab your spot by doing it that way. You’ve got until midnight of Wednesday, the 17th of May to do that.

That is it for this week’s episode of the podcast. I wanted to outline this. As I said, I’ve done a webinar on this recently, and I just know that there’s lots of people who won’t have watched the webinar but will listen to the podcast. Those are all the details. I am really excited about this. As I said at the beginning, this is really long overdue; this is where I see more of my work heading, because I really want to be able to help more people than just the one-on-one work. And I also want to be able to harness the positive community aspect of a group programme – having the support of other people, getting to see what it’s like for other people going through recovery, and you’re getting that support of those who are doing something incredibly difficult alongside you.

So that is it. If you’re interested, as I said, email info@seven-health.com and the subject line of ‘Group programme’. I will be back shortly with a new episode, but until then, take care of yourself and I will catch you soon.

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