Episode 41 - Recovery is possible even after a lifetime of ED with Chris Sandel

In this episode, we meet Chris Sandel, an incredible nutritionist, coach and expert in the field of eating disorder recovery. Chris has worked with clients for over 15 years (including our very own Florence!), helping them to reach a place of full recovery, where they are no longer impacted by eating disorder thoughts and can get on with what’s truly important in their life.

Access Chris Sandel's FREE mini-course here: the First 5 Steps To Take In Your Eating Disorder Recovery
Or contact him for his group programme or 1:1 coaching via https://seven-health.com/ 

To find support in your HA recovery:
Get the "No Period. Now What?" book at noperiod.info/book.
Get the French version "Je n'ai plus mes regles" book at noperiod.info/livre.
Get the German version "Keine periode - was jetzt?" at noperiod.info/buch.

To join our support groups, please visit noperiod.info/support
for English, noperiod.info/communaute for French, and noperiod.info/community for German.

To make an appointment with Dr Sykes and get individual support to get your period back or improve your fertility, please go to noperiod.info/appointments
To make an appointment with Florence Gillet and get help with the body and mind changes happening in recovery please visit www.beyondbodyimage.com

You can find us on social media:
Instagram:
@noperiodnowwhat in English
@jenaiplusmesregles_livre in French
@keineperiodewasjetzt in German

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Transcript

Full Episode

[00:00:00] Welcome to All In, a straight shooting, science based podcast about periods, fertility, and nurturing health outside of unrealistic beauty expectations. We will mostly, but not exclusively, focus on hypothalamic amenorrhea, HA, a component of relative energy deficiency in sport, formerly known as the female athlete triad.

I'm Dr. Nicola Sykes, scientist and author of the book No Period, Now What? I specialize in helping people understand how their eating, exercise, and lifestyle habits are keeping them from hormonal health and their best life. My work focuses on regaining periods, improving fertility, and breaking free of the rules underlying diet culture.

My name is Florence Gillet. I'm a certified eating psychology coach, a former HA patient, and an [00:01:00] advocate of health at every size and body neutrality. I help people let go of their obsession with size and appearance to regain self confidence, finally appreciate their bodies, and live an overall fuller, more joyful life.

Every two weeks, the All In podcast brings you real recovery stories, expert insights, and new scientific research on HA, hormonal health and fertility, with an unmissable touch of body respect and women's empowerment. Just a reminder that this podcast represents the opinions of the hosts and their guests.

This content should not be taken as medical advice, it's for informational purposes only. And because each person is unique, please consult your primary care practitioner for any medical questions. Music by the Andy Shulman Band, available on Spotify.

Florence Gillet: Hi everyone. Before we start today's interview, I want to say that we recorded it in [00:02:00] March of this year. And since then, Chris Sandel has not only got his program that he talks about, but he's also taking on new one to one clients. So if this is something of interest to you, then go to the show notes and you can connect with him.

Have a good listen!

Nicola Sykes: Hello, everybody. I'm really excited today to bring you Chris Sandel. Chris is a nutritionist and a coach. He attended the College of Naturopathic Medicine and graduated with a diploma in nutritional therapy. He started Seven Health in 2009 and found his calling in supporting people struggling with eating disorders to reach a full recovery. Instead of adopting the traditional and unsuccessful method of dieting, his work solely focuses on a weight neutral non diet approach. As a perpetual student, Chris Sandel is also trained in intuitive eating, health at every size, eating disorder recovery, motivational interviewing, acceptance and commitment therapy, poly vagal theory.

I'd like to learn a little bit more about that one. That's really interesting. Neuro linguistic [00:03:00] programming, trauma, behavioral psychology and habit formation. Definitely a perpetual student. Originally from Sydney, Chris lives in the UK with his wife, Allie and six year old son, Ramsey. So welcome Chris.

We're really excited to talk to you and learn more about the work that you've been doing recently.

Chris Sandel: Thanks for having me on. I think Nicola, I spoke to you probably the first time seven years ago, or might have even been eight years ago when I had you on my podcast. I've had you a couple of times and then Florence, yeah, we also worked together and then I had you on my podcast as well. So this is like a gathering of old friends.

Nicola Sykes: Yes, absolutely.

Florence Gillet: It's so nice to see you again. You really hold a dear place in my heart. You were one of the practitioners that helped me so, so much in my recovery. And you'll be glad to know that some of the practices you had recommended, I still do today. So it's kind of full circle. Because I feel like some of those practices I recommend as a coach to many of my clients as well. So thank you, Chris, for [00:04:00] being here. Can you tell us a bit more about your life story and how did you come to be a nutritionist?

Chris Sandel: I've spent the first 21 years of my life living in Sydney and I really didn't care about food very much at all. I was kind of a picky eater as a kid. And then I just wasn't that interested in food. Food did not play a big role in my life. There were so many other things that I cared about and that were important and food just wasn't a big thing for me. And I then moved to the UK and through some people that I live with got interested in food and started just reading about it and I had moved to the UK because I'd finished a business degree and I had no idea what I wanted to do and thought I would just come over here for a couple of years and then travel around and then move back home and I've now never left and it's been 21 odd years of being here but yeah I became interested in nutrition and then went to College of Naturopathic Medicine to study and did that for three years.

And I would add that a lot of what I learned there, I've now kind of disavowed and I [00:05:00] wouldn't necessarily support or promote. But that was really where I got my start and just found that I really, really enjoyed nutrition and what I became much more interested in wasn't the sort of dry piece of like, oh, you need this amount of protein or you need this amount of zinc or that kind of tri site nutrition.

It was really the messiness of human beings interacting with nutrition and their relationship with food and their relationship with their body. And that was where I kind of really found like, oh, this makes sense to me. And this is interesting to me. And I think if growing up, I had anyone in my life who had been a psychologist, I think I probably would have gone down that path.

And that's probably what I would have ended up, but I just didn't have that in my life. And so I kind of found it later on and I'm kind of glad that I found it in the order that I did, because having the nutrition background is so important for me because I understand physiology. I understand the body.

I learned so much [00:06:00] about the human body that is so important for eating disorder recovery, that if I just study psychology, wouldn't have necessarily been there. And so for me, I feel like I never promote myself as a therapist. I never say I'm a psychologist or anything along those lines, but a lot of the practices that I use within those modalities, so things like acceptance and commitment therapy are things that I will then use in my practice. So yeah, really, I got into nutrition. And then it just sort of morphed over time in the direction of helping people with eating disorders.

Nicola Sykes: Okay. Lovely. So, it seems like your practice has evolved quite a bit over the last 15 years. So we first connected shortly after I'd published No Period, Now What? and I just remember being so thrilled when you picked that as one of your books of the year. So thank you for that. And at the time it seemed that you were mostly working with sort of people in that space, like chronic dieters, people that had HA. Is that still your main focus or how has sort of your patient focus changed over the [00:07:00] years? 

Chris Sandel: If I look at my trajectory, maybe over the last 10, 12 years, something along those lines, I would say that it was very much the dieters who were wanting to quit dieting. And then it got a little more into the disordered eating. And that was where I was doing more of the HA work.

And then it got much more into eating disorders. And then now I'm at the stage where it's much more chronic eating disorders. So people who've been living with this for 10 years, 20 years, 30 years. And it's not like if someone's only had one for two years, I'll say, Hey, no, it's not going to work.

It's just the people that find me now and the people that want to work with me now. And the way that I talk about eating disorders is very much at that level and those kinds of people. Cause I think it's, one, something that is, is going on a lot more than people really think about. I think there's this misunderstanding that someone has an eating disorder and then give it five or seven years and they get better or something that goes on in their teenage years and then they just grow out of it.

And that's just [00:08:00] not the case. And so there are many, many people where this thing did develop in their teenage years. And yet here we are in their forties and it's still around. So I think it's a very underserved market. And I also think that there is not a lot of hope that is being given to those kinds of people.

And there's a lot of, well, look, this has just been going on for so long, you're never gonna recover. This is terminal. This is as good as life is gonna get. And you just need to learn to suck it up and, and deal with this. And I'm just like vehemently against that as a narrative.

And I truly believe that everyone can reach a point of full recovery. It's not a, maybe it'll happen. I'm like, it will definitely happen . There are things that you're gonna need to do that are uncomfortable or challenging, or you have huge amounts of fear connected to them. But if you do them, you will reach a point of full recovery.

And I don't see that message being delivered to many people at all. And I also don't see many people then backing that up and able to do the thing and spending the time that [00:09:00] needs to be taken to make that happen.

Florence Gillet: That's so interesting. And I'm just curious to know what led you to that point actually, because it's interesting, you kind of came at it from a maybe lighter and then got more into disordered and then more eating disorders and now people that have been really stuck in that mindset. And I really love what you said. I think it is totally a spectrum. And you can really move from one side to the other of the spectrum over time if you've been in it a long time, it doesn't mean you've been in it always as a really hard case of eating disorders, but if you've never really been off the roller coaster, I feel like it's really difficult to maybe do something about it.

So I guess my question is like, what got you to look at that population more specifically? And, what do you think maybe the field needs that you can bring that you haven't seen happen?

Chris Sandel: It was very unintentional is the [00:10:00] first answer to that. Like it just started to happen more and more organically. I've got a long sounding podcast, I've got a blog that I've written for a really long time. And it just, I started to write more about this. I started to talk more about this.

And then I just looked at the population I was seeing and okay, initially it was, I've had an eating disorder for five years and then the average became 10. And then it just kind of caught more and more along there. I think probably I've got older. And so the people that I'm seeing have also got a little older.

And so now my average age, I would say, is someone in their 40s or early 50s. And previously, it was much more people who are in their late 20s or early 30s. I'm working with people who've been alive for longer. So it gives the eating disorder a chance to be there for a longer amount of time.

And when I think about eating disorders, if I think more just generally about humans, we are perpetually in a state. We are in a state that is being impacted upon by our physiology. And so like in very simple terms, [00:11:00] if you've only got two hours sleep, the night before the kind of thoughts that naturally arise to you, or the kind of emotions that you naturally experience, or the kinds of perceptions that you have about your day to day is impacted upon by that experience of the fact that you got less sleep and so when you do this with an eating disorder and you stack on days and days and years and years where there's been insufficient energy coming in, there's been doing exercise that is then driving someone even further into energy debt, it makes sense that someone then, if they have the genetics and the capacity to develop an eating disorder, it makes sense that there's going to be these kinds of thoughts and feelings that naturally arise.

And so when someone's like, oh, they're never going to get out, it's like, no, they can definitely get out of it. We just need to change someone's physiology. And not just their physiology, we need to look at like their ability to emotionally regulate. We need to look at their psychology.

There's all of these different things, but the foundational thing that is driving all of that is [00:12:00] the physical state that the body is in. And so that's why I'm very much of the perspective of like, there is always hope because we can, we can always change someone's physiology. There's nothing to be able to stop that occurring.

I mean, yes, someone can choose to not do that, but there's nothing that is like, Oh, you've now crossed some line that prevents this from happening. And I've had many clients that I work with, like one is coming to mind right now, she developed anorexia in her teenage years and I helped her recover in her fifties.

And so she was dealing with this for 36 years and yet she was still able to make a full recovery. And so that's why I'm of the opinion of like, never say never.

Nicola Sykes: I really appreciate that. I think that that's something that we come across with clients as well is other medical professionals having said things like, Oh, you know, your hypothalamus is never going to recover, you know, just go on birth control pills or hormone replacement therapy. And, you know, there's nothing you can really do about this.

And that always drives me up a [00:13:00] wall. But I hadn't really thought about it in terms of people being told the same thing with longer term eating disorders. Oh, you can never recover. I agree with you. I think that the message of hope and change is really important because, you know, certainly with people with HA. There are, occasional cases where there's something else that's preventing full recovery, like a brain injury or empty sella syndrome or like other really bizarre things that, you know, our bodies are just incredible. But the, vast, vast, vast majority of people can recover and I really appreciate hearing the same thing about eating disorders because I think that there is that messaging out there that you're sort of out of luck basically. 

Chris Sandel: Just going to add, like, when I was doing that, where it was much more just the HA that I was working on, and obviously there was disordered eating and disordered relationship with food, but I would have situations where people are going to doctors and they're being tested and their hormones are all really low.

They've been tested for osteopenia and they've got osteopenia and they're in their thirties and [00:14:00] then the doctor's like, we don't know what's going on, but I really want you to keep up doing all the exercise you're doing because that's clearly really healthy for you and you're just like, can you not see the disconnect here between encouraging someone to exercise? Or like, Oh, we chatted about their diet and they're just so healthy in what they're eating.

And it's just like, there is this very obvious thing that is driving this. And yet you're being encouraged to keep up those behaviors.

Nicola Sykes: Yes. 

Florence Gillet: I find it interesting also in a world where we're inundated with all that information. And it seems like it applies to anybody, which I just literally came off a call with a client where I was like, I don't think all that advice really applies to someone like you, who's really struggled with anorexia for a long time.

You know, we need to really look at it from a personal point of view, but also the fact that many of these patients I find when they come to you, they may have spent [00:15:00] 36 years in an eating disorder also, because there is no good available treatment around them . I mean, we know that access to treatment is terribly, terribly bad. 

So I find it interesting also that sometimes they will go and seek treatment and maybe this is not the treatment that they need, or maybe they're not in the right phase of their lives. There's so many factors to take into consideration, but then for a practitioner to say: we tried. Tough luck!

It's not going to work. I agree with you. I think it's also complicated for the practitioner, obviously, to recognize that they haven't been able to help that person, which doesn't mean that another person could not help them. You know what I mean?

So I love what you said.

I think it's very, very encouraging. And I know we have some people listening to our podcast that are in that situation where they're like, I feel like I've done better and then I've gone backwards again and I'm not sure if I'm going to be able to find full freedom. And what you're saying is, yes, [00:16:00] you can.

Chris Sandel: Yeah, definitely. And I think the longer it goes on, the longer there is that feeling of I'm just not going to escape. And I think also, there's a lot of things that people are doing that make that more likely to occur where people do really get stuck in this sort of quasi recovery where they think, I mean, I've done so much, I've done enough, or there is all the health type stuff where it's like, well, but it's healthy to exercise or it's healthy to eat these foods. And so that then becomes a block to someone doing the things that are truly going to help them recover.

And the thing I'm always looking at is health in the context of someone's life, but you can have two people who are doing the same thing and for one person is very healthy. And for someone else, it's the complete opposite thing that they need to be doing. And so I'm always wanting to look at that of like, okay, in the context of your life and what you truly need at this point, let's then answer the question: is this thing a really healthy thing for you? Cause it's not black and white. It's not that things are always [00:17:00] healthy or they're unhealthy. It depends.

Nicola Sykes: Yeah, absolutely. You're a bit of an exception as a male practitioner working with mostly female clients. Do you see male clients at all? Do you find that gender plays a role in any of this?

Do you think it's more or less helpful for someone to work with you versus a female practitioner or, am just interested in what you see as the positives and maybe challenges that you face there.

Chris Sandel: Yeah, so I've mostly worked with women and I have definitely worked with men and I've had men who've had longstanding eating disorders and we've worked together and helped, but I think it probably came about because of the progression I've taken in terms of my practice. And so for a long while, I was talking about and writing about HA, and so that is then going to be attracting more women. I think a lot of how I've got clients is dependent on the content I've put out and a lot more of what I put out has been women focused. The feedback from clients of what I've heard is for a lot of women, they feel more [00:18:00] comfortable talking to a man about this stuff than they do talking to another woman.

There isn't the same competitiveness that can necessarily come up because I'm not a woman like them. And so that can then be helpful. The other piece which I know can be both a pro and a con is that I've never had an eating disorder. So I don't have any lived experience with this. And so the drawback of that is like, I have not walked a mile in your shoes.

I don't know what it's truly like to have to go through the different things that you're going through as part of recovery. I've got lots of my own experiences of things that I've had deep shame about, or I've had struggled with and that I've had to overcome. And so I can draw on those things, but I can't categorically know exactly what it's like.

And the upside of that is that clients are not having to worry about, am I fully recovered? Did I really get there? Or am I someone who's still quasi recovered? I also think the problem often with people who have [00:19:00] recovered is that everything they do is then a reflection of their recovery journey. And so it's like, Oh, this thing worked for me. So this is what should work for everyone else. Or that thing wasn't relevant for me. And so it shouldn't be relevant for someone else. Because I don't have that lived experience. I'm like, let's have a look at all of that. And let me just then go with the things that truly work as opposed to me being biased by my lived experience.

And it's not that I don't have biases. We all do. But at least I don't have that impact on me saying, Oh no, you don't need to work on your emotions or we don't need to do body image work because I didn't have to do it as part of my recovery.

Florence Gillet: In your work with people that have had long term eating disorders, can you tell us a bit more about what's the framework that you developed and how it differs maybe from the work you had done before or the work you see out there in the field? Mm

Chris Sandel: So this has definitely been [00:20:00] something that has evolved and I did some reflection a couple of years ago, and in a sense, there was already a framework there, even though I wouldn't have necessarily talked about it in in those terms, and there's two real standout pieces that helped to really crystallize this framework.

 One was working with a client and she sent me a YouTube presentation, a video with Dr. Sasha Goral. And the presentation was called, I always love these presentations because the first part of it is, Is anorexia nervosa an anxiety disorder? Which I is a very standard, straightforward title.

And then the second sentence is leveraging multimodal exploration of eating disorder pathology to delineate potential mechanistic intervention targets. So I always just have a bit of a chuckle that like the first part is like really obvious. And then the second part just loses everyone. And so this was a presentation, she's at the university of San Francisco, and this was a presentation [00:21:00] really looking at that area of, is anorexia an anxiety disorder and not just while it says anorexia in the title, it actually looked at all different eating disorders. And she put forth a really good case for the fact that this is an anxiety disorder. And one of the things that really stood out for me was she talked about the fact that there are three commonalities with all eating disorders.

And so the first commonality that they all share is the fear or the consequences of the outcome of eating. . And so if we're looking at something like anorexia, and I'm talking about this in very stereotypical terms, because it's not quite this stereotypical, but fear of anorexia is putting on weight. The fear of orthorexia is the unhealthiness of food. The fear of ARFID could be, I'm going to choke, but whatever it is, like, there is some consequence that I fear. 

The second commonality is that there is weight suppression. And that the weight became suppressed through some dieting, or some changes to eating, or changes to exercise.

And that if we're looking at this from a genetic [00:22:00] component, or a capacity to develop an eating disorder, it's really that the weight coming down was the thing that really turned it on. And so even if someone is now above that way that they haven't been able to turn the eating disorder off at this point.

And then the third component is that there are behaviors and actions that continue to perpetuate the eating disorder and that those things are keeping that eating disorder alive. So I have to follow these rules around of having a fasting window or I'm only allowed this many calories or whatever it may be.

But this is then continuing to keep the eating disorder going. And so those are true with all eating disorders. And if we then look at anxiety disorders, so if we broaden out, so it's not just eating disorder , the gold standard for anxiety disorders is exposure therapy.

And what exposure therapy really means is taking action. And taking action to do the things that are fearful or that create fear for you.

And in terms of something like an eating [00:23:00] disorder, you're doing actions that not only scare you, but then allow you to start to have that nutritional rehabilitation and get out of the energy debt that you're in.

And so really hearing her talk about that just very much crystallized. This is how I think about eating disorders. And one of the things she talked about as well connected to it is that for most people the anxiety predates the eating disorder. And that actually when they get better, yeah, the eating, the anxiety may come down, but it won't necessarily come down to nothing.

And that often people who have the capacity to develop eating disorders, have higher levels of anxiety than the average person. And so the goal then is how do we develop different skills and ways to manage that anxiety? And for me, I've used things like polyvagal theory or acceptance and commitment therapy as ways of learning those tools.

So that was really the first piece. The second piece was reading a book by Sheryl Sandberg, that I'm now [00:24:00] wonderfully blanking on the title of right now, but it was, so she works at Facebook, she did, and then, out of the blue, her husband dropped dead. 

So basically, the whole book is about the grief that she went through as part of dealing with that. It was written with Adam Grant, and what she talked about a lot with that book was resilience and developing resilience and how important resilience is. And as I was reading it, there was this realization of like, this sounds a lot like what I'm working on with clients.

Like, let me look into the research around resilience and the importance of resilience and just kind of went down this rabbit hole with that stuff and just recognize like how important resilience is for recovery and actually looking at some of the research, someone's level of resilience is actually a predictor of whether they will develop an eating disorder in the first place.

And then someone's level of developing resilience then is a predictor of how they will recover. And the good news is with resilience is that it is a [00:25:00] learned skill. It's not something you either have or you don't, it's something that you can cultivate, you can learn how to do. And really, if I'm thinking about recovery. That is what recovery is about , it's developing resilience. And so part of the framework I talk about that there are different types of resilience. So there's physical resilience, there's psychological resilience, there's emotional resilience, and then there's connection resilience.

And I go through what each of those mean and what it takes to develop them and like going from having very little of that and the journey to then reaching a place where that's truly, truly there and then looking at, okay, what's important at different points and physical resilience is the foundational key of all of that.

Because, as I said earlier on, if you're in this energy depleted state, the kinds of thoughts and feelings and perceptions and all of that that will naturally occur to you are very different than when you're well rested and well nourished. And so very much starting there and then working on all the other forms of resilience.

And that's [00:26:00] truly how you reach a place of full recovery.

Nicola Sykes: I really like that framing. That makes a lot of sense to me also. And I really appreciate you're articulating it so clearly. I think that's really helpful. You mentioned polyvagal theory again. I don't know what that is. Can you tell us a little bit about that?

Chris Sandel: Yeah. So polyvagal theory is a study of looking at your nervous system and your autonomic nervous system. And despite having the word theory there, it's not really up for debate. It's like, this is what actually happened. And it was developed by a guy called Steven Porges probably like 20 or 30 years ago.

So it's been going on a really long time and he's still doing lots of research connected to it. And there's a person that he's very closely aligned with called Deb Dana. And Deb Dana has then done a lot of writing around polyvagal theory, looking at how do we then use this in a really helpful way and getting it out into the clinician world so that other therapists and practitioners [00:27:00] can then take this really important research that can be very nerdy and very kind of physiologically driven to how can we actually relate this to people.

And so in very simple terms, it's looking at within your autonomic nervous system. So your autonomic nervous system is the nervous system within your body or the part of the nervous system that is on sort of autopilot. And so it includes lots of different things. So it can include your breathing. It can include your perspiration, your pupil dilation, all of these different areas.

And obviously it's not just automatic, like you have some level of control over it. Like I can notice my breathing. And so I can choose to breathe more deeply but it's mostly running in the background and within the autonomic nervous system, there are different states that you can be in and so like in very simple terms, you can be in, they talk about being safe and social. They talk about the vagus nerve or the vagal [00:28:00] nerve as being the driver with this. So there's kind of more complicated names, but let me just keep with the run of the mill, easy names to remember.

So within safe and social, that is where your nervous system is more likely to be on the lookout for cues of safety. This is where you're going to be much more likely to be engaging with other people. You're more smiling. It has an impact on your facial expression, on your heart rate, all of these things.

From there, something happens that then brings you down. And within the parlance of polyvagal, they talk about coming down the ladder. And so something happens that then brings you down the ladder. And the example I'll often use is, has it ever happened that you're out for a walk and then suddenly you jump back because your nervous system has seen something on the ground.

That before your conscious brain has come online. It's now jolted you back because it has detected something. And it could be that you look down and then you see that's a snake and you're like, fantastic, I'm really glad my body jumped back there. Or it could be that you look down and you're like, Oh, it was just a stick.[00:29:00] 

But irrespective of what it turns out to be there has been this reaction within your nervous system, and it's referred to as neuroception. And so your nervous system has neurocepted something in your environment. And so we can have experiences where there's something in the environment that gives us this cue of danger.

And so we then come down to fight or flight and within fight or flight, there are certain things that start to change in terms of your breathing, your heart rate, again, the kinds of thoughts and feelings that naturally arise for you. And then again, you can come further down the ladder. Like if your body feels like, okay, fleeing from this thing is not an option and fighting this thing is now not an option, we can then come down to shutdown.

Which is kind of the lowest place down the ladder. And that is where, okay, my best option here is just to, in a sense, plate it. And when I've given those examples, like, okay, there can be [00:30:00] these situations where you are face to face with a lion and I need to actually run or fight or whatever, but this happens in your every day to day.

And so you can have a situation where someone sends you an email and you come down into fight or flight, or you have this thing happened with a co worker and you come down into shut down.

And so what polyvagal theory is really looking at is what, at least from my perspective and why I find it so helpful is that it helps people to start to identify the state that they are in.

So people can start to notice, okay, the kinds of thoughts that I'm having, or the kinds of feelings I'm having, I very much associate with being in shutdown, or I associate with being in fight or flight, or there are other mixed states, so you can be in play, or you can be in free, so there's more than just what I've said, but why I think it's so useful is you can start to identify, I am in a particular state, and then when I'm in that particular state, rather than thinking, oh, I need to talk myself out of this day, or I need to tell myself all the [00:31:00] reasons why what my brain is telling me is not true, is No, I don't need to do these things.

What I need to do is I need to do things that support my nervous system that automatically then moves me to a different state. So I'm then able to have different thoughts and feelings and perceptions rise. So it could be that I need to go and hug a friend. I need to go and pat a dog. I need to put on some music.

There's all these different things that you can start to discover, help your nervous system. And so that is a very short explanation of what polyvagal theory is.

Nicola Sykes: Thank you. I really appreciate that. That sounds really interesting. And like, having a cat on my lap might be nice for me. Mm

Chris Sandel: Yeah, getting animals as a way of regulating yourself. Like that's why we have support pets because they regulate our nervous system.

Florence Gillet: And one of the things that I notice working with clients is that I tell them also, it's not just waiting for your nervous system to be activated for you to [00:32:00] respond. There's also this sense, because I think that ties up to the anxiety that you were talking about precedes the eating disorder.

Even if you recover, the anxiety is most likely still there, even if you don't use a eating disorder as a coping mechanism. So what I do tell a lot of my clients is you do need to care for your nervous system on a daily basis, almost on an hourly basis, right? So taking a deep breath, having time to do things you love or speaking to someone that supports you. This is not something that you wait to be in the stage where you're like, Oh my God, all my thoughts are completely jumbled, but you actually keep doing those things to maintain a kind of as calm as possible state.

Is that something that you recognize as well?

Chris Sandel: Totally. And that's the thing. As you say, often people wait till everything gets horrendous. And they're like, Oh, what are the techniques I need to use now? And it's like, that typically doesn't work very well because it, yes, it's too [00:33:00] late. And also if the only time you're practicing a breathing exercise is like when the room is on fire, like it's not a great time to practice it.

And so being able to make this part of your day to day is really important. One, because it means you spend more time up the ladder. It's kind of giving you more of a protection, but two, when things are not going so well, you've got practice at being able to, there was someone, I can't remember where I'm getting this wrong, but someone had made some comment of like, I go to group on my good days.

So I know how to turn up to group on my bad days. And I think that's a really important thing to remember that. It shouldn't be like, Oh, I don't need to do the breathing today cause everything feels fantastic. It's like, no, you want to keep doing these things. So they become embedded in the way that you are.

Florence Gillet: absolutely. I love this. 

Nicola Sykes: I'm actually interested to hear a little bit more from you about, resilience . How you would sort of introduce that to clients [00:34:00] and what you might suggest as a starting place for developing more resilience.

Chris Sandel: So it will depend because as I said, there are these different pillars or different types of resilience. So if I'm thinking about it from a physical resilience day and the people that I'm working with, the thing that is most impacting on their physical resilience is the fact that their energy balance is completely off. The amount of energy that is being expended versus the amount of energy that is then coming in is mismatched.

And because that's been going on for so long, there's all of this debt that is accrued because of that. So they're in essence, a million, half a million, whatever it is in debt. And so when they're looking at what energy do I need today? It's not just, what do I need today? It's what I need today, plus all the interest I'm paying and plus to start getting out of that place.

And so if I'm looking at the resilience piece, it's like, okay, cool, we need to then work on things that are going to start shifting that. And so that could be having more food [00:35:00] come in. It could be having your exercise ceasing. And so looking at it from that perspective, if I'm looking at something, one of the other forms of resilience. And when I think about recovery, I tend to think of things happening in different phases and depending on the phase that someone's in, that certain things are more important than others. So if I'm thinking about like phase one, someone's very much at that beginning phase, the most important thing is getting in more energy, like calories trumps everything else. And so all of the other points of resilience at that point are, you're not going to be able to do the deep work to actually cultivate those resilience. So the little bits of work that you are able to do is more just, in support of helping you to be able to get that extra food in that you need or taking that break off from exercise.

It's really just helping you to make those initial changes so that if you do that long enough, then we can start getting into more of the deeper work connected to that. [00:36:00] But if we're still at that stage, if I'm then thinking about something like psychological resilience, a lot of what I think about in this area is looking at how we can recognize that our thoughts are just thoughts.

So one of the things that I will constantly tell people is we don't think our thoughts. Our thoughts naturally think themselves. They are entering into our consciousness and then you become aware of those thoughts. And that's not necessarily how the experience feels to us, but it is actually true of what is going on.

And again, if we come back to the state they're in, they're going to have an impact on those kind of thoughts. And so the exercise I'll often do with this, just as a way of people getting their head around this idea of, like, you don't think your thoughts is think of a capital city of any country of the world. You can pick any capital city that you want to pick, just pick one. And so think of that city. And I don't know what that city is, but my question is like, why did you [00:37:00] not pick Paris? Or if you did pick Paris, why did you pick Paris? What is your reason for picking that? Like, you obviously know of Sydney, or you know of London, or you know of New York.

Why did that come to mind? And we can come up with explanations of like, Oh, I was looking up a holiday to go to Paris, or whatever it is. But really, there is no real explanation for why that thought came to you. It's just, that's what your mind does. And that's what it does constantly. And so what we're trying to work on at this early stage is getting people to really remember that this is true.

Cause what happens is I have this thought. I believe that that thought is true. I believe it's my thought. I believe that I value it. I believe it's telling me something that I must do. And that's then the path that someone goes down as opposed to: this was just a thought. And so in terms of different tools you can use, again, I like acceptance and commitment therapy.

And one of the things that they talk about in [00:38:00] there, or one of the ways that they deal with it is a thing called diffusion. And so diffusion is getting distance between yourself and your thoughts. And so they have a thing where, I'm noticing my mind is generating the thought. So if I have some thought of, I can't possibly have this much for breakfast, cause that would be too much, you insert the sentence, I'm noticing my mind is generating the thought, and then fill in the blank of whatever was said.

And the goal with this isn't that I'm now having the thought disappear, and I don't have this thought anymore. It's just, I'm trying to remind myself that just because I had a thought doesn't mean that it's true, doesn't mean that there's a value of mine, doesn't mean anything apart from I had a thought, and it also can help people move away from 

is this true? Because something can be true and it can be also very unhelpful.

And so this is also connected to is this actually a helpful thought for you? And if it is a helpful thought, great, get hooked by it, lean into it, have that support you. And if it's not a helpful [00:39:00] thought, cool, let's use one of the many different ways to diffuse from that thought. And so that would be an example.

And then there's other examples in terms of how to do it with emotional resilience, other examples in terms of connection resilience. And when I say connection resilience, there's two parts to it. There's connection with other people, but there's also a connection with ourselves because that's what really the eating sort of gets in the way of is this connection with ourselves.

Nicola Sykes: In terms of connection with ourself, I sort of imagine that that means that when you have an eating disorder, it almost feels to me like there's sort of this layer that's in between you and your actual self. All the rules that you've put in place. Is that kind of the right way to think about it or?

Chris Sandel: It is. And so when I'm looking at this connection piece, with the connection with ourselves, there's a lot of work we'll do around values and the difference between lived values and aspirational values, because when we start to dig into it, we can look at, okay, well, what are your values?

And a lot of [00:40:00] people are like, I don't know. I've been living with this for so long, don't really have any values, or I don't know what my values are. But when we can start to do a lot more work and look into it, people are able to start to come up with what their values are and what they think is really important and then we can start to explore like okay Well, how is the eating disorder helping you to live those values and that the response is always well Actually, it's not. It kind of gets in the way of that.

And so it's like okay cool now that we know that these are your values. How can we start to be making choices that if I'm following you with a video camera for a week, I would start to get a sense that these are truly your values. I mean, there's lots of other pieces to it, but that's one of the parts.

Florence Gillet: I am interested to know, like, how do you define recovery?

Chris Sandel: So in terms of full recovery, I think part of this is everyone has to define it for themselves. And I say that with a caveat because I say that where I want you to truly be defining yourself, not having the eating disorder say, Hey, I think this is as good as it's [00:41:00] going to get. This is what full recovery should be, and meaning you don't really get to that place.

And years ago, I discovered the definition that Carolyn Costin had come up with in terms of full recovery. And I kind of used that a little bit as a starting place. So her definition, I'll quote her here. She said, full recovery is when you can accept your natural body size and shape and no longer have a self destructive or unnatural relationship with food and exercise. Food and weight take a proper perspective in your life. And what you weigh is not more important than who you are. In fact, actual numbers are of little or no importance at all. You will not compromise your health or betray your soul to look a certain way, wear a certain size or reach a certain number on a scale.

And so I like that. As a definition for full recovery, if we think about eating disorders in a very narrow band, and we're like, okay, eating disorders are just about what you weigh. And that kind of thing. But actually the more I've done this, the more I see that that is a very [00:42:00] incomplete definition of full recovery because eating disorders touch way more than just this stuff.

And for a lot of people who I've worked with, even if they're getting diagnosed with anorexia and it feels like, oh, this must be about body size and shape and all that. It's actually not. And so there's been a lot of work that I've done over the last few years, looking a lot into neurodivergence, because I think that's a really big thing that's being missed in terms of how much there is this overlap between neurodivergence or even just high sensitivity and eating disorders.

And so for so many people, it's like, well, that definition that you've given me there doesn't really speak to actually what was going on or why this has been going on. There's a lot more to it than just this. Like, this seems like what my treatment team thinks this is about, but it's actually not what it's really about.

And so , it's not that I disagree with any of those pieces, but I think it then needs another layer added on top or many layers added on. And so [00:43:00] for me, what I would add is that full recovery is when the eating disorder is no longer showing up in your life in any form, because for a lot of people, they can get over the food side of it and then, okay, you know, I'm doing some pretty weird stuff in terms of my workaholism, or I'm doing stuff connected to sex, or no sex, or to do with my relationships, or to do with my parenting.

Florence Gillet: Yeah.

Chris Sandel: It's showing up in lots of different ways.

And so it's not just about the dress size and using the scales. It's like that this is no longer a part of your life in any form. I talk about full recovery is prioritizing action, taking over avoidance and doing this consistently, even when it's uncomfortable. And again, this isn't just about food.

This can be, it feels really uncomfortable to have this conversation with my partner or with my mom, or to send this email at work and be like, well, that's actually what recovery is about. It's being able to have those difficult experiences and really show up for them. I mean, if I think [00:44:00] about eating disorders, they're about scarcity and restriction and really playing small and this illusion of safety.

And so full recovery is really the opposite of this. So it's about abundance and expansion and playing big and full recovery is about showing up as your true authentic self and not changing yourself because of the opinion of others. And I know the word authentic gets like thrown around a lot and I'm not using it in that way.

I'm meaning like yeah, there can be things about you that are odd or weird. And that's true of all humans, but it can be especially true if someone is neurodivergent and the eating disorder has been their way of masking or coping with that. And so it's then about, yeah, showing off of like, this is who I am and I'm going to do this as unapologetically as humanly possible.

And I'm not going to change myself for the opinions of others. And I think in Carolyn's definition, that's very much about how do I look on the scale? But again, I want to expand this out of like, this is how I show [00:45:00] up at a dinner party. This is how I show up in text messages, how I show up in a relationship.

And so that's how I would really define full recovery. It's kind of very much broadening things out.

Nicola Sykes: I completely agree. I think that it's so much more than just the food eating body size part. And that's why we talk about being all in is more than just what you're eating and what your exercise is, but really sort of going all in on your life.

Chris Sandel: Yeah,

Florence Gillet: I think we're definitely aligned with what you just said on that and this is a great segue I think to a traditional question we ask all of our guests is how are they all in right now? So not in the sense of eating more and moving less and recovering your periods which would not apply to you Chris, but Really all in with your life, what you just said: the freedom, the abundance, the ability to show up as your authentic self , how does this look for [00:46:00] you in your life at this stage?

Chris Sandel: So 14, 15 months ago, I moved from England to Scotland. So I was living sort of an hour south of London in the English countryside. And I've moved up to Aberdeenshire, so about 40 minutes from Aberdeen going inland near the Cairngorms National Park.

And it's like beautiful up here, but very rugged. The population density is a lot lower than what it used to be. But we made this decision because like, this is the life that we want to have, we love being up here. My wife is originally from Scotland. And so, yeah, I'm really making that commitment to like, this is how we want our life to be.

And so, moving up here is definitely one of the things that is all in. The other one that comes up, and I gotta be honest, I haven't been practicing as much in the last little while, because I've been creating a new online program and doing group coaching and kind of making this transition after seeing one on one clients for [00:47:00] 15 years, and that being my sort of everything with my business to then transitioning into this other thing.

But prior to that transition, I dropped down to working four days a week and really prioritizing the fact that, yeah, I want to work and I really care about what I do. And there's a lot of meaning and purpose here. And I also know that we have a finite amount of time on this planet and I have a six year old son we home educate because of his needs and what is most appropriate for him at this point.

And so, there are other things that I want to be able to focus on. I read oliver Berkman's 4, 000 weeks a number of years ago, and it had a really big transformation on me just in terms of the way I think about time and the finite nature of it. And so that was the thing that got me to change over to four days a week.

And then wanting to be creating more and more of that space so that there is stuff outside of work that I can be prioritizing and getting joy and all of those lovely emotions [00:48:00] from.

Nicola Sykes: That's fantastic. Yeah. Totally on the same page there too. Tell us a little bit more about how people can find you and I'd love to hear a little bit more about your group coaching and what you're doing there because I think that there are a lot of our listeners that might be relevant for. 

Chris Sandel: Cool. So in terms of finding me, I've got a website, 7-health.Com, and that's been there for a long time. There's a lot of content that you can find on that site. I have a podcast that I've been doing for eight years or so, and it's called Real Health Radio. And so if you Google that, you'll be able to find it.

So those are the two places I would most suggest that people go. In terms of the program, the program is called the fundamentals of full recovery. And as part of it, there are core modules. And so there's lots of information about all the different types of resilience that we've talked about.

As I said, I've been doing this for 15 years. I understand how to take people through recovery. And so there's been a lot of thought put into the structuring of [00:49:00] it. And so there is the core modules, but then there is a community support area where people can be asking questions and supporting one another.

And this for me is like the best part of the program. It's been such a joy to see how amazing everyone has been. And I really wanted to create this culture of full recovery and this culture of supporting one another and helping others to take pro recovery steps. And so, yeah, we've done a lot to create that.

And it's so lovely to see that someone posts and then rather than waiting for me or one of the other coaches to come in and respond, other people are there and and are supporting. And so it's this really lovely, lovely community. And then we do live calls. And so there's live calls that I run in terms of live coaching calls where I can be delivering content and also giving opportunities for people to do hot seats or get questions answered and then we also have meal support calls so people can come to the call and they can eat with other members of the group as well as a coach who is facilitating that and [00:50:00] we have cooking calls.

So there's someone who's a dietician, they cook meals and you can then cook along with them or you can be watching the replays. And so, yeah, there's just all of these things that are there, that are helping people to reach that place of full recovery. Because as much as I totally believe in full recovery, I also am a big believer that this is no quick win.

This is not something easy that you kind of just, you know, wake up one day and you're like, Oh, fully recovered. Don't know how that happened. Like. There is so much that has to happen to make that occur and I want to make it as easy as it can be by having all of these different touch points and level of support, as part of it.

And so, the goal with the program is to continue to expand it, to have more people come in, to have more coaches and people facilitating it so that it's much bigger than just me. It becomes this whole thing in and of itself.

Florence Gillet: And can people just join anytime or you have specific entry [00:51:00] periods? 

Chris Sandel: Yeah, I have specific entry periods into it. And I've got a free, online program that people can do, it's called the five steps of full recovery and all the first five steps, and so it's like a mini course that people can go through.

And that would be the thing that I would suggest that people can sign up to you will then be able to get a sense from this interview of who I am. You'll get a sense from the course of what I'm about and what I recommend. And if is then of interest to you, the fundamentals is very much of the same model.

And so if you like the free program, you're going to very much like the paid program.

Florence Gillet: That's awesome. I think it's great. And I love what you said about a community because I think it's also something, you know, Nicola and I definitely spend a bit more time and effort on, we now have specific support groups in different languages. And the goal is to also, you know, feed them with more than just, okay, you have the book and then you exchange on what do you do, but it's [00:52:00] also like doing live calls and talking about specific topics that will definitely apply to everybody. And I find that it's such a relief to these people when they say like, Oh my God, I thought I was the only one.

I thought it was just me, but we all think the same. We all feel the same. And I think there's this sense of, they also find themselves a lot more motivated to do work with other people that they may not know from their everyday lives, but that are still encountering the same challenges, the same difficulties.

And I find that people are so kind and compassionate in our groups. And honestly, we don't really have to filter much there. We establish rules to start with, obviously, but I mean, it's been a while now and I'm always amazed at how kind and compassionate people are.

And there were there to support each other. [00:53:00] So, I would have loved to do your program when I was in my eating disorder for sure.

Chris Sandel: That was one of the things that was just missing when I was doing just one on one is that I think there is a huge amount of recovery that happens in community and connection. And look, it doesn't happen that just you create a community and it will instantly happen. My block for doing this for so long was like, you put 15 people in a room with eating disorders, like the competitive nature with that is going to make him the last star.

And I had that belief and I don't think it is necessarily true. When you create the right kind of culture and you have the people coming in with the right mentality that It's actually can be very, very, very supportive. And it was interesting, I actually had a client who sent me a Reddit forum about eating disorder recovery.

And I spend no time on Reddit and what little I know about Reddit is not very positive, but it was an amazing forum. And like, really what I would never have expected from Reddit and really, really positive. I don't know what it's like [00:54:00] now. It's been a number of years, but there was the experience then of like, wow, okay, if I'm going to recreate something, this is what I want it to be.

I want it to be super supportive and pro recovery and where people aren't censored.

I don't want this to be a place where you feel like I have to make sure that I can never, ever say the wrong thing that I have to just neuter myself to the point where this post barely makes any sense because I'm so worried I'm going to say the wrong thing.

I'm just like, look, if you don't need to be including numbers, don't include numbers. Like we can have some minimums in here of like, unless it is fundamental to your posts, just don't include it in there. But apart from that, like we will deal with that. And so yeah, I'm a huge advocate of the community aspect.

Nicola Sykes: Yeah, absolutely.

Florence Gillet: Thank you so much for your time, Chris. 

Nicola Sykes: It's been really lovely to chat with you again 

Chris Sandel: Thank you for having me. 

Florence Gillet: You're such well rounded practitioner. This is really something that I've experienced when working with you. We recommend your podcast a lot. Your blog is [00:55:00] full of amazing information and you have this ability to really make it simple to understand. And, we're very grateful you came on the podcast today. 

Nicola Sykes: , Yes, thank you so much. time has flown by 

Florence Gillet: Take good care of yourself, Chris.

Nicola Sykes: Bye.

Chris Sandel: Same to you.

Florence Gillet: Bye

One thing that always strikes me is how different each person's all in journey is. As I often say, there are many paths to HA and many paths out of it. Your journey is unique. That is so true. If you need more support on your journey, you should definitely start with NoPeriodNowWhat, which you can get at noperiod.info/book And Florence and I both work with people on different aspects of period recovery and so much more. If you'd like more personalized advice and attention, you can go to noperiod.info/appointments to schedule a time to speak with me on fixing issues underlying missing [00:56:00] periods, blood work, diagnosis, and lots more.

or beyondbodyimage.com to work with me on the fear of weight gain and making peace with food, exercise and your body. I also take care of the new French version of No Period Now What through the Instagram account jenaiplusmesregles_livre. We also have joined clients and online support groups so you can access both our domains of expertise and get the physical and mental help you deserve to put an end to disordered eating once and for all.

If you enjoyed this podcast and found it helpful, please subscribe and drop us a review to help more people find it. Also, join our online recovery community at noperiod.info/support in English and noperiod.info/communaute in French and let us know how All In is going for you. All In is not just about period recovery, it's about getting your life back.

See you in two [00:57:00] weeks!