#93 - Neurodivergence & Eating Disorder Recovery with Dr. Marianne Miller
Jun 26, 2024
Naomi Katz & Sadie Simpson
This week we are talking all things neurodivergence & eating disorder recovery with Dr. Marianne Miller.
Dr. Marianne has been in the mental health field for 27 years and has specialized in eating disorders for the last 12 years. She was a full-time academic for 12 years and had a part-time eating disorder practice for much of that time until she left the university and went into private practice full-time in 2018. Dr. Marianne loves working with eating disorders as a therapist and a coach. She takes a non-diet, feminist approach that helps people of all genders live empowered, authentic lives. She embraces the Health at Every Size model, and is neurodivergent and LGBTQIA+ affirming.
We talked to Dr. Marianne about:
How eating disorders & disordered eating behavior can be a coping mechanism for neurodivergent folks who struggle with feeling out of place in a society that emphasizes conformity and suppresses emotional expression.
The complexities of eating disorder treatment for neurodivergent individuals & the limitations of standardized treatments, like cognitive behavioral therapy.
What neurodivergent-affirming care looks like & how we can create more inclusive and effective therapeutic environments.
This week we are talking all things neurodivergence & eating disorder recovery with Dr. Marianne Miller.
Dr. Marianne has been in the mental health field for 27 years and has specialized in eating disorders for the last 12 years. She was a full-time academic for 12 years and had a part-time eating disorder practice for much of that time until she left the university and went into private practice full-time in 2018. Dr. Marianne loves working with eating disorders as a therapist and a coach. She takes a non-diet, feminist approach that helps people of all genders live empowered, authentic lives. She embraces the Health at Every Size model, and is neurodivergent and LGBTQIA+ affirming.
We talked to Dr. Marianne about:
How eating disorders & disordered eating behavior can be a coping mechanism for neurodivergent folks who struggle with feeling out of place in a society that emphasizes conformity and suppresses emotional expression.
The complexities of eating disorder treatment for neurodivergent individuals & the limitations of standardized treatments, like cognitive behavioral therapy.
What neurodivergent-affirming care looks like & how we can create more inclusive and effective therapeutic environments.
Welcome to Satisfaction Factor, the podcast where we explore how ditching diet culture makes our whole lives more satisfying. Welcome back to Satisfaction Factor. I'm Naomi Katz, an intuitive eating and body image coach.
Sadie Simpson:
I'm Sadie Simpson, a group fitness instructor and personal trainer.
Naomi Katz:
So we've got a great guest this week that we think you're really going to love. But before we dive in, just a quick reminder about the Satisfaction Space, our online podcast community. We know it can be hard to find anti-diet community that's aligned with your values, especially if you're the first in your family or friend group to make moves towards ditching diet culture, and that's why we created the Satisfaction Space. If you've ever found yourself listening to the podcast and wanting to add something to the conversation or ask a question, this space was created for you. The Satisfaction Space is our online membership community that includes a private virtual community of folks outside of Facebook, bonus content during the podcast, off weeks, monthly live virtual hangouts with us and a community feed where you can post your comments or questions and get feedback from us as well as from your fellow community members. Membership to the Satisfaction Space is just $10 a month and can be canceled at any time, and you can enroll at thesatisfactionspacemnco, and that link always lives in our show notes.
Sadie Simpson:
We also have merch. We have a handful of designs on TeePublic that can be printed as stickers, t-shirts, sweatshirts, mugs, tote bags and whatever else you like. T-shirts and sweatshirts come in sizes up to 5X and you can check that out at the link in our show notes.
Naomi Katz:
So today we are talking to Dr Marianne Miller about the intersection of neurodivergence and eating disorders. Dr Marianne has been in the mental health field for 27 years and has specialized in eating disorders for the last 12 years. She was a full-time academic for 12 years and had a part-time eating disorder practice for much of that time, until she left the university and went into private practice full-time in 2018. Dr Marianne loves working with eating disorders as a therapist and a coach. She takes a non-diet, feminist approach that helps people of all genders live empowered, authentic lives. She embraces the health at every size model and is neurodivergent and LGBTQIA plus affirming.
Naomi Katz:
So, without further ado, let's talk to Marianne. Marianne welcome. Thank you so much for being here with us today. Thanks for having me. We are very excited to talk to you all about neurodivergence and eating disorders. We think that's a topic that our listeners are really going to be interested in and be able to learn a lot from you about. Can you tell us a little bit about your experience with diet culture and maybe how that's led you to the work that you do today, and maybe how?
Dr. Marianne Miller:
that's led you to the work that you do today. Sure, I grew up in a family of origin with a lot of diet culture messages. It was a very restrictive family that sent a lot of restrictive messages about food and it really prioritized fitness, prioritized appearance and really idealized the thin body. And I also grew up in an era, you know grew up in the late 70s, 80s when people just didn't really know about eating disorders. We knew a little bit about anorexia and bulimia, but it was very, very little. It was kind of seen as just extreme, outlier cases and people didn't really know about it. And so so any sort of dieting or obsession about food, eating and body image was in, at least in my family of origin, seen as the norm. And so I began dieting when I was in elementary school and that was very much supported by my family when I lost weight in elementary school and that was very validated not only by my family but by, like teachers and, you know, parents of other kids that I knew and that kind of thing and so. And then I got into like teen magazines, because of course back then we didn't have social media, but it was all about like the teen magazines. Uh, cause, of course, back then we didn't have social media but it was all about, like the teen magazines, and so they really promoted dieting and and being, you know, really um, lifted up the thin white ideal and um, and that was just really pressured and emphasized. And there was also, I think you know, my parents also had like really weird patterns around food. That was was like restrict, restrict, restrict. And then with the occasional like indulgence night and and how that was seen as, that was seen as like normal, of kind of this all or nothing way to look at food. There was no gray, there was no, you know, a food abundance. It was really about food scarcity. Now we didn't have food insecurity I did have, you know, I grew up privileged enough to not have to have food insecurity and there was food scarcity in that it was kind of an ingredient only household, and so that was. It was very, very difficult.
Dr. Marianne Miller:
And then when I was in middle school I developed like, looking back, I developed anorexia and what would many would call atypical anorexia. And so because, like, on the outside I wasn't severely underweight and I did drop weight but I was restricting a lot of calories and I basically, for two years was was restricting calories to the point at which, like, my period stopped and I thought that that was just normal. Like nobody like not my pediatrician, definitely not my parents Like nobody even really thought that that was normal. It's just like, oh yay, she lost weight, she's healthier quote. You know that thing. And then it really wasn't until a couple of years ago.
Dr. Marianne Miller:
When I look back okay, let me look at all the criteria boom, boom, boom. Okay, yeah, I had anorexia, right and yeah, and then in high school, um, it was anorexic behaviors, um, that, uh, when that shifted, when I got my driver's license, because then then I had access to food, and so then it turned into, I would say, like a binge eating disorder where I was binging and restricting Because if there's binge eating, there's always restricting going on with a binge eating disorder. And then you know again, diet culture was incredibly prevalent. I'm neurodivergent and so my particular flavor of neurodiversity is sensory processing sensitivity, and so what that means is that if you look at people as bugs and everyone has, like the neurotypical people have two to four antenna that they're getting in information from the world around them, and I have like a hundred antenna. So people with sensory processing sensitivity, have very heightened senses. You know, you think, sights, hearing, smell, taste.
Naomi Katz:
I love this analogy of the bugs.
Dr. Marianne Miller:
Yeah, thank you. Yeah, and so, and so I like from an early age I never really felt like I fit in. You know emotions my family is very emotionally constipated, my dad is British, my mom is from the South, um, uh, she's, and it really kind of there was this message of like you put on you know the stiff upper lip, like everything's fine, we don't talk about our emotions. Plus, we, we are really focused on what other people think about us and, um, especially as girls, um and women, you have to be quiet and silent, and that part of some um I was.
Dr. Marianne Miller:
I grew up in a evangelical Christian faith and our particular religious group, um, was very sexist and misogynistic and so it really, you know, silenced girls voices and you know I never really felt like I connected well with, especially in groups, because groups were just really overwhelming for me. And yet I was criticized by family members because like why are you sitting at the back? Like you need to be in the front where the popular girls are, and that kind of thing, and so I just never really felt accepted for who I was and so I kind of turned all of those things inward, and dieting and changing my body and focusing on food was a way for me to survive that situation. It was really a survival, survival mechanism, sure. And so, whether it was restricting food or whether it was, um using food to using food to like, um, soothe myself through binge eating, um, when I I did have money, like allowance and stuff, I would, I would spend it. I would go down to Kmart and get snacks, and snacks the type of snacks that weren't allowed in my household, and so I'd have to hide them. And then, if I had them, I had to eat them quickly because I was afraid that my parents would find them.
Dr. Marianne Miller:
So, just a really like warped, like very like psychologically dysfunctional relationship with food, coupled with being neurodivergent, progressive, I would say it's very misogynistic and it's ableist. In diet culture. It is misogynistic, it's ableist, it's a lot of ists racist, I mean, it's just. I think it was definitely a perfect storm. Plus, biologically, I had the predisposition to develop an eating disorder. Um, because they run rampant in family, extended family, those kinds of. So so what I really struggled with, I think, was just like feeling like I was okay, sure.
Dr. Marianne Miller:
Because, I like from a young age I just felt like something was really inherently wrong or broken in myself and I think a lot of that was was because of, like, maybe some attachment, insecure attachment issues growing up, but a lot of it was just being neurodivergent in a way that people like had no idea, like people knew nothing, you know.
Naomi Katz:
Yeah, that's definitely something we haven't really. I mean, I feel like we're still only scraping the surface of it.
Dr. Marianne Miller:
Oh, barely, yeah, barely, and I was very, you know, I think also there's some other like traits that I have of some other flavors of neurodiversity, but sensory processing sensitivity is definitely the one that I identify with heartily.
Sadie Simpson:
So, yeah.
Dr. Marianne Miller:
So, and because I'm such a deep feeler and thinkers things going on the outside, you know I would internalize it, and so diet culture definitely became part of my internal you know makeup and internal life. And it really wasn't until I got the right help for my eating disorder recovery in my 30s I'm 51. And it wasn't until that when I started like reading it was very, it was a really, really um, it was very helpful for me to just hear from other people, uh, that took a stance that was different from anti-fat bias and weight discrimination and fat phobic, and so that was incredibly helpful for me. And then eventually that became more mainstream. Not no, it's still not mainstream. I mean to be very clear it's still not mainstream, but more there's more awareness. When social media started coming out and then people began talking about it, you know, like Gen Z, right now they know what fat phobia is Right and like, so, so that that is very helpful.
Naomi Katz:
So that is very helpful, so definitely for sure. So you know it kind of it sounds like you know we talk about eating disorders as like a biopsychosocial issue and like it sounds like your story, like you can really hear how all of those elements really came together to create this kind of perfect storm for you. And it's just, I think. I think that's something that people that's really important for people to understand about eating disorders is that like it's not just the diet culture, like it's not just the genetic predisposition, it's not just anything, it's like this combination of factors that come together like that. And yeah, it's just like and we can really hear that in your story.
Dr. Marianne Miller:
Yeah, yeah. And I would add it's biopsychosocial, spiritual, because there was a lot of like spiritual, religious repression and oppression and I had a very rich spiritual inner life. That was not. That was very, very repressed because of the type of doctrine I was being taught and so and so. And it doesn't matter how people define spirituality, even if it's just like a connection with the world around you or with the universe or nature or whatever, or a God or, you know, higher power, whatever you want to call it, I do think that there's like a spiritual element to it.
Dr. Marianne Miller:
And then the other thing I was going to mention in response to your statement is that I, um, yes, you know, diet culture involves a lot of different things, and to grow up and develop an eating disorder, it's a multifaceted, very complex thing, and that's why it's so important to find treatments by people who are really experienced and trained in eating disorders, not just from therapists who like, oh, you know, I have a few clients with eating disorders, Like I I'm an eating disorder therapist and 98% of my clients have eating disorders Like that's what I do and so cause I had to get a ton of specialized training, specialized supervision, is it's not taught in graduate school, and so so it, because it's a very complex issue.
Dr. Marianne Miller:
That said, the way that I see it is, people are born with a biological predisposition and then environmental factors, and that includes diet. Culture really flips the switch, you know, and sometimes it can be trauma. Sometimes it can be, you know, you know very different, different kinds of trauma. Trauma whether it's like a one event or a chronic trauma. It could be diet culture, it could be family of origin issues or being neurodivergent in a neurotypical world. It's like, you know, all of those things combined, yeah absolutely so.
Naomi Katz:
I want to get more into kind of how neurodivergence intersects with eating disorders and how it reflects some of these things that we're talking about. But before we do that, just kind of as background, how would you define neurodivergence and like what kind of things would you say fall under that umbrella term?
Dr. Marianne Miller:
Okay, so initially in 1998, an Australian woman and her name escapes me right now started the term neurodivergent or neurodiversity um to apply only to people on the autism spectrum, because they really wanted to um, kind of the movement that that came out of really wanted to de-pathologize um autism and and so it's moving from saying, okay, people on the autism spectrum they're not bad, they're not, they don't have, it's not a moral failing, it's not anything, they just have different brains that just work differently.
Dr. Marianne Miller:
So the neurodivergent versus neurotypical.
Dr. Marianne Miller:
So I would say what's happened recently, especially in the last five years, neurodiversity has the umbrella has broadened to include other types of different kinds of brains, including sensory processing sensitivity, like me, which is also known as the highly sensitive person, and that term was coined in the nineties.
Dr. Marianne Miller:
It includes and these things can overlap Like a lot of people on the spectrum have sensory issues, and then they there are. It also can include people with ADHD. I think after being on the spectrum that was like the next thing they added was ADHD and then and then they started thinking about other things like OCD, and some people even include, like people who have generalized anxiety disorder or major depressive disorder, and the way it's involved, evolved now is that people are just saying you can define it. You know, if you feel like your brain works differently, you know and you don't want to like use any sort of label or category and this, being neurodivergent, seems to fit for you, then you can claim that as your own and it's really not up to anyone else to define that for you. It's you to define that. It's your. You know your privilege, I guess, or your your choice to define it for yourself.
Naomi Katz:
I really love that, because we know there's often a ton of obstacles to like actually getting a diagnosis of any of these things like obviously the cost, the access, any of these things like obviously the cost, the access, all of that stuff. Um, and then not to mention the fact that, like gender impacts the way people are diagnosed, like so many women are diagnosed much later in life, if they're diagnosed at all, because most of the studies and the diagnostic criteria are based on men, and like all of this stuff. Yeah right.
Naomi Katz:
Exactly White boys white boys in particular. Yes, and so you know it's like being able to go off your own lived experience and understanding of your own brain. I think is really important for these conversations. I mean, it's similar to like getting an eating disorder diagnosis is really difficult for a lot of people, and so, like you can, like you might have a valid eating disorder story even if you've never gotten an actual diagnosis for it, and these are things that are really important for us to start to recognize in this field, and so hearing you define neurodivergence that way, like it makes a lot of sense and it really focuses on neurodiversity in women.
Dr. Marianne Miller:
And I forgot the author. Maybe you could look it up and put it in the show notes or something like that. But it's written by a journalist who realized that she had a lot of flavors of neurodiversity and so she kind of explains her journey and then she defines, like, all the different types, and it's it's, it's especially good for adult women to read that and it's very, very validating.
Naomi Katz:
Yeah, yeah, absolutely so. One of the things that you mentioned was that, you know, sort of an eating disorder can function as almost like a protection or coping mechanism as, like you know, possibly be due to trying to function with a neurodivergent brain in a neurotypical world, and so maybe can you expand a little bit on that. Like, does that make neurodivergent folks more susceptible to things like eating disorders? How does it change their experience with eating disorders?
Dr. Marianne Miller:
I'm creating this ARFID course, an self-paced online course that I'm going to launch sometime, probably mid to late July, and I was doing some research on it or for it prior to this recording. And one thing that some researchers are just beginning to look at barely is, you know, the co-occurrence of autism spectrum disorders and ARFID, which is avoidant, restrictive food intake disorder, and so you know that again, barely, and that's not including you know they're not looking at ADHD, they're not looking at SPS, they're not looking at those kinds of things. And so I mean it's difficult as someone who was a former researcher because I was a professor for so many years and for my dissertation it would be very difficult to use the overarching variable of neurodiversity You'd have to really focus on, really have to focus on one of those like diagnosis things, and I think there is a way for you to do some type of qualitative research where people are self-identified as neurodivergent, and so it's kind of a different way of interpreting the data that it would be difficult to look at any sort of correlations between neurodiversity and eating disorders. That said, there is some research on ADHD and eating disorders that among people who have ADHD there's a higher prevalence of eating disorders, which kind of makes sense given the impulsivity factors of ADHD and I would say the rejection sensitive dysphoria that's also comes as a result of ADHD. I have not seen any research on sensory processing sensitivity, which it is a very under-researched area anyway. It's mostly like autism and ADHD, that's it so well, and OCD and major depression anxiety, but they don't really researchers really don't consider that as part of neurodiversity.
Dr. Marianne Miller:
Right now, again, this is all emerging, everything is changing.
Dr. Marianne Miller:
We're in a very fluid time where our understandings of it is emerging and I think that's important to take that into consideration.
Dr. Marianne Miller:
I do think that someday down years it'll probably be at least a decade or two that there will be um, more research on different neurotypes and um and the prevalence of different eating disorders and various neurotypes and so um, and it'll be interesting to see how neurotypes are mapped out and and what that ends up being um. My worry with that is that that might turn out to be exclusionary, because that's the thing is, anytime you reduce things down to a measurable variable that you can research, you're you're being exclusionary. So anytime you say you have to meet all these criteria for a particular, you know diagnosis, you're being exclusionary. So that's why it's important to both have quantitative research where you're looking at like percentages and numbers and statistics, and qualitative research where you're looking at the lived experience. And that's where I think the field of neurodiversity and intersecting eating disorders I think can benefit is just really to lean into what do we know about lived experience? And let's talk about that and gather our data that way for qualitatively versus quantitatively, yeah, or in addition to quantitatively, I would say.
Naomi Katz:
Sure, Like, let's look at the whole picture. Let's look at the whole picture. Yeah, yeah, that absolutely makes sense. So once you know, okay, so you're, you're, you are a neurodivergent person. You have, you've gotten a diagnosis of an eating disorder perhaps, or you're experiencing an eating disorder. How does the experience of being neurodivergent impact recovery? You know the way we interact with different treatment methods and things like that. Like, does does the experience of the eating disorder, does the experience of recovery look different for somebody who's neurodivergent?
Dr. Marianne Miller:
Yes, and unfortunately the vast majority of treatment protocols don't take that into consideration. Don't take that into consideration. So, for example, like straightforward cognitive behavioral therapy that is used, that's kind of the tried and true eating disorder recovery approach. It's CBTE, that's what it's called, and not all of the things that you do in CBT-E would work for people who are neurodivergent. It certainly did not work with me, you know, and thankfully I had a therapist who did some CBT stuff but she did not like go all in CBT because my brain just would have been like nope and it would have been too painful. So she, she leaned heavily into like object relations theory and family systems theory, in addition to some CBT and then acceptance, commitment therapy, that kind of thing. So that combination worked very well with me and I think it's very important that to tailor, tailor treatment to individuals particular needs. And unfortunately, because there's this very homogenized approach to eating disorder treatment, partially because you've got like University of California, san Diego, that has, you know, a very like world renowned eating disorder treatment center. Stanford does as well. There's some on the East Coast based in universities. I think Duke has one and another one on the East Coast and in order to test, quote these methods.
Dr. Marianne Miller:
You have to have a very scripted, you know, homogenized way of doing things and in order to measure whether it's effective, and I get it and it's not helpful for people who are neurodivergent, and so so they might get some benefit from it, but not in a way that really tailors to their unique needs. And actually what I found is sometimes they can be pathologized and seen as treatment resistant, and that's just really brutal. And and then for me, you know, I I never went into a treatment program, but oh my gosh, if I would have have, that would have been so awful for me. Um, I mean, I really needed to get to a place where I was just seeing one therapist. I did find a group that I went for a while, but then after a while, like it was, it got to be too much and too overstimulating for me and and I had to just like do my my own work by my own research, in addition to individual therapy.
Naomi Katz:
Yeah, you know I don't.
Naomi Katz:
I don't work with people with eating disorders, but I certainly work with folks who are dealing with a recovery from, like, disordered eating patterns, and a number of my clients are neurodivergent and I have seen so many times things that come up with like sensory overwhelm and like either with foods that they're trying to introduce or like, or just the process itself or, like I know, sometimes even like the feeling, like feeling hunger and fullness cues can like add to sensory overwhelm and like there's just a lot of stuff that like I feel like would be really important to address in eating disorder treatment and recovery, but in a standardized treatment setting isn't really going to be addressed.
Naomi Katz:
And then it's so easy for people who are struggling with that to look like they're non-compliant, which is like a beyond horrible thing to say about a patient in any context. But like, especially what's what's really hard is within eating disorder treatment, like especially residential programs will kick people out if they, if they think that they're being non-compliant and so it like literally prevents you from getting the treatment that you need because you can't, because the treatment's not made for you because you can't, because the treatment's not made for you, correct.
Dr. Marianne Miller:
And I to add to that, a lot of that is driven by insurance and whether an insurance will pay and how much. You know, compliance is needed and recovery is needed to be seen in order for the insurance company to keep paying for it. And so it all boils down to numbers and measurements. That doesn't fit, you know, numbers don't fit folks who are neurodivergent. And so I mean it's tough because there's a lot of people who need a higher level of care. Because there's a lot of people who need a higher level of care, and sometimes I think it it can be detrimental, you know, for people who are neurodivergent.
Dr. Marianne Miller:
I mean sometimes it's better to get an outpatient team set up with a therapist and a dietitian and a medical provider, but only if the person is medically stable. You know enough to have that. But if they're not medically stable enough, you kind of just have to grit your teeth and refer them to, you know, the higher level of care or the hospital or whatever. It's just it's just really unfortunate that it's that way. I think educating the individual, if it's an adult, or the families, if it's a minor, I think is really important. Just saying this is not going to solve the address the entire puzzle and just be aware that your kid is neuro, neuro spicy and and so the neuro spicy piece is something that you'll have to manage on on your end and just know. You know I think it's important for when you are ready for outpatient work that you work with a neurodivergent affirming you know therapist, or even a therapist who is neurodivergent themselves, that really get that piece.
Naomi Katz:
Yeah, who are able to like understand what they're looking at and like like, not just assume that you're not following the rules or you're being difficult and, like you know, I think there's a lot of when it comes to neurodivergence, trying to fit a like square, a round peg, in a square hole or vice versa, and it's it's like why won't you do the thing? And it's like you literally can't do the thing. And so, seeing a provider who's able to be like okay, how can we change the thing? Like how can we, how can we have the thing, meet you instead of trying to force you into the thing.
Dr. Marianne Miller:
Exactly, and I think one great workbook is the the neurodivergent friendly DBT skills workbook friendly dbt skills workbook um, so it's a dialectical behavior therapy workbook and um, a lot of people with lived experience who are neurodivergent find um many of the dialectical behavior therapy skills to be not um as helpful or just it, just a pure dT just doesn't work for people Like if I have someone who really needs DBT and they have ADHD, that's totally not going to work. Because with purest DBT you have to like fill out all these cards and you know, and do the skills and do the chart, you know all that kind of stuff, and you have someone whose brain is like ping ponging everywhere. That's just not going to work. So and and even if I have the workbook, like and I say, oh, do this, you know, do two pages of the workbook in the next week, yeah, that's not going to happen. So what do I do? I go through the workbook with them in session and then we talk about it and just take a little bit at a time. And that workbook is excellent.
Dr. Marianne Miller:
If you could put that in the show notes as well. It's by Sunny. Oh, I always forget their name. That person is neurodivergent as well. It's not specific to eating disorders and I use it with people with who are neurodivergent and have eating disorders, because it helps offset any kind of like incongruence that might come up when just using purist DBT skills or CBT skills.
Naomi Katz:
We will definitely put that in the show notes and I am also going to make myself a note to go get that book.
Dr. Marianne Miller:
It is amazing it's on Amazon. It is so good.
Naomi Katz:
Fantastic, yeah. So in general, what do you think that folks should look for in a treatment provider or a treatment plan when they are approaching eating disorder recovery with neurodivergence? Is there anything they should watch out for, anything that they should look for specifically?
Dr. Marianne Miller:
Well, I would ask them what their experience is like with eating disorders and I and how much work they've done with eating disorders. And I wouldn't take anything less than five years with eating disorders because of just the complexity and I get it. You know, people who are just starting out are probably like, ah Marianne, why are you saying that? And I'm like like I get it.
Dr. Marianne Miller:
I started out too and I was going through supervision on my own. I had been a therapist for like many, many years prior to that and then I was getting an additional supervision and training so I already had like the therapeutic foundation and then I was being supervised so I could talk about the cases as I was starting out my eating disorder practice, um, which began 12 years ago, so, um, so I would say at least five years and then at least 70% of their um caseload to be eating disorders. You just need someone that that's their lens and then ask whether they're neurodivergent, friendly, um, you know how, how many of their clients like what is a rough percentage of their clients that are neurodivergent? I would say for me it's probably like 70 percent.
Naomi Katz:
uh are neurodivergent of my clients 65 to 70, and then um, and then like 98 well, those are really great tips for like questions to ask as people are trying to find treatment, because I think sometimes it's so hard to know like what questions to ask. Because you can say like oh, are you neurodivergent friendly? And people can say yes, because in their minds they don't like discriminate or they don't you know, but like no, like I need to know that you have experienced like not just that you're like fine with neurodivergent people, but like that you actually know how to work with neurodivergent people.
Dr. Marianne Miller:
Yeah, and I would say to add to that, having I would. I would just say, hey, how, what kind of? In what ways do you modify your, your approach to therapy with people who are neurodivergent, Like, and if they can't answer that question, that's a big, that's like a red flag.
Naomi Katz:
Yeah, that is a. That's a great question also.
Dr. Marianne Miller:
So, speaking of finding providers, Speaking of finding providers, how do people find you and work with you? So they can go to my website at drmarianemillercom, and my name is spelled the French way, which is M-A-R-I-A-N-N-E, so drmarianemillercom. They can also follow me on Instagram, which is at Dr Marianne Miller, and I have a podcast which is Dr Marianne land and eating disorder recovery podcast. That's, we talk about all things neurodiversity and eating disorders and all of the things. So you know, it can be a very helpful resource for people who are struggling with eating disorders and who may identify as being neurodivergent.
Naomi Katz:
That's fantastic, and we will absolutely put links to all of those things in our show notes as well, so people can find you. So, before we wrap up, we always ask one final question of all of our guests, and that is what is satisfying for you right now.
Dr. Marianne Miller:
Satisfying. Okay, I have two answers. The first thing that came up was I make my own trail mix and I'm going to eat some right after I'm looking at it right now. And then also one of my special like I said, actually my main special interest is Star Wars, and there's a new Star Wars show that's on right now called the Acolyte, so that is incredibly satisfying to watch a new Star Wars content. That is awesome, I. So that is incredibly satisfying to watch new star wars content that is awesome.
Naomi Katz:
I love that. I have to ask a follow-up question what is in your trail mix?
Dr. Marianne Miller:
oh, okay, uh, uh, almonds um pumpkin seeds, walnuts, raisins and m? Oh.
Sadie Simpson:
I was waiting for what like chocolatey type thing.
Naomi Katz:
That does sound like a truly satisfying trail mix. Well, marianne, thank you so so much for talking this through with us today and giving us just so much good information. Again, I know our listeners are going to benefit from this so much. I benefited from this a ton I'm sure Sadie did too. So thank you so much for your time and for being here with us today. We really appreciate you.
Dr. Marianne Miller:
I'm honored to have been a guest.
Sadie Simpson:
A big thank you again to Marianne for coming to talk to us and if you enjoyed this episode, consider leaving us a rating or review in Apple Podcasts or Spotify. Those ratings and reviews help us reach more people, which means more people get to hear the anti-diet message, and you can always find us on Instagram at satisfactionfactorpod. That's it for us this week. We'll see you next time. Bye.