189. What To Do When Treatment Feels Stuck (For Clinicians) with Jack Heinemann, LCSW-R, BCD

If you've ever found yourself stuck between needing people and wanting to prove you don't, between wanting things and immediately judging yourself for it, or between wanting to be seen and wanting to disappear entirely… this episode might feel a little too familiar. In this episode of Understanding Disordered Eating, I'm stepping away from behaviors, diagnoses, and symptom checklists, and talking about what's actually happening underneath the eating disorder. Not pathology. Not "what's wrong with you." But the very human, very uncomfortable internal conflicts that most of us are trying to manage just to get through our lives. Tweetable Quotes "Underneath behaviors, there are psychological… I'm going to say problems, but then it's not exactly problems that the person is trying to solve." - Rachelle Heinemann "When we have this kind of conflict where one is louder than the other, the eating disorder tries to come in as almost a negotiator or a moderator of the conflict. Conflict is way too intolerable to experience in our bodies. And that's how food or body control might become almost proof of independence." - Rachelle Heinemann "Desire ultimately feels to some people like a loss of control or a moral failure." - Rachelle Heinemann " Visibility is so fraught. It's not just, I wanna be seen or I don't wanna be seen. It's this real negotiation happening internally and there's so much attached to it." - Rachelle Heinemann "The symptoms aren't random, they're very structured responses to conflicts." - Rachelle Heinemann Resources Grab my Journal Prompts Here!  Looking for a speaker for an upcoming event? Let's chat! Now accepting new clients! Find out if we're a good fit!    LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at [email protected]   *Note: The podcast will be off for a couple weeks. We will be back April 14th with an all new episode!*

If you've ever done all the "right" body image work, challenged the thoughts, said the affirmations, stared into the mirror like you were told to, and still felt exactly the same… this episode is for you. And honestly? You're not broken. You're probably just being asked to do body image work that was never deep enough to begin with. Today's conversation comes from a place of deep respect for clients, for clinicians, and for how hard this work actually is. Because let's be real: showing up to talk about body image at all already means you're doing something incredibly brave. This episode isn't a takedown. It's more of a gentle (okay, sometimes pointed) "hey, let's zoom out for a second." Tweetable Quotes "Any clinician or client that comes to the room with any sort of body image concerns, you're already doing a really, really important thing." - Rachelle Heinemann "Body image is rarely just about appearance or what happens in the mirror. It's something that organizes our entire internal experience." - Rachelle Heinemann "Exposure without increased tolerance actually increases the person's sense of threat." - Rachelle Heinemann "Ambivalence is not resistance. That's not an annoyance we have to get through — that is the work." - Rachelle Heinemann "When we isolate body image from psychological context, we miss almost everything." - Rachelle Heinemann "Body image work is very central to eating disorder treatment. Body image work isn't effective enough when we treat body image as the problem, rather than the communication." - Rachelle Heinemann Resources Join my FREE webinar happening March 18th: Brave on Purpose! Grab my Journal Prompts Here!  Looking for a speaker for an upcoming event? Let's chat! Now accepting new clients! Find out if we're a good fit!    LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at [email protected]

"Eating disorders are about control." It's one of those phrases that gets repeated so often it starts to sound like an unquestionable truth. But when you sit with it for more than a few seconds, it gets messy fast. Because if eating disorders are "about control," then recovery is often framed as the opposite: letting go of control. And that's where a lot of people understandably get stuck. That advice is usually offered in a vague, almost dismissive way, as if the problem is that you're gripping too tightly, overthinking everything, or refusing to loosen your hold. The implication is that if you could just relax, stop trying so hard, and surrender a bit, recovery would naturally fall into place. Which, let's be honest, is not how this works. Tweetable Quotes "People love to use the phrase 'Eating disorders are about control', but it's really vague. Like being "in control" is good, and being "out of control" is bad. - Rachelle Heinemann "When we say release control, we mean loosening rigidity… but we're not asking to lose structure." - Rachelle Heinemann "When we talk about control and loosening control, we do not mean to enter into chaos." - Rachelle Heinemann "What we're asking people to do when we ask for increased flexibility is to take away the protection against anxiety. So we have to understand this is not just a matter of asking your clients to just loosen the reins a bit. It's something that is going to feel internally, very, very uncomfortable." - Rachelle Heinemann "Ultimately, when we use the term control… it's only problematic when it really constricts your life." - Rachelle Heinemann "Recovery… is about widening that bandwidth." - Rachelle Heinemann "We are increasing your capacity to experience whatever it might be… without flooding, without impulsivity." - Rachelle Heinemann Resources Join my FREE webinar happening on March 18th: Brave on Purpose! Grab my Journal Prompts Here! Looking for a speaker for an upcoming event? Let's chat! Now accepting new clients! Find out if we're a good fit!    LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at [email protected]

Let's be honest: if eating disorder recovery were just about wanting it enough, none of us would be here. You'd read one book, listen to one podcast, have one "aha" moment… and boom, cured. But that's not how this works, and if you've tried to shortcut your way through recovery before, this episode is probably going to feel a little too familiar. Tweetable Quotes "If we're working toward feeling safe, toward recovery, or toward mental wellness, you cannot ever do that with a starved mind or body. It just doesn't happen." - Rachelle Heinemann "Everybody's recovery is gonna look different." - Rachelle Heinemann "If willpower worked, then you wouldn't need recovery." - Rachelle Heinemann "Insight is great, but the insight without changing the behavior is just having a very nice intellectual conversation, which really does absolutely nothing or very little to change eating disorder behaviors." - Rachelle Heinemann "Healing is not linear." - Rachelle Heinemann Resources Grab my Journal Prompts Here! Looking for a speaker for an upcoming event? Let's chat! Now accepting new clients! Find out if we're a good fit!    LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at [email protected]

Have you ever hit that point where you're doing recovery "right" and instead of relief, you feel like absolute garbage? Like… you gave up the behaviors, you're eating regularly, you're showing up to sessions, and somehow everything inside you feels louder, messier, and harder to deal with than before. This episode is about that part. The part no one really warns you about. The phase where recovery doesn't feel freeing, it feels destabilizing. Where you might quietly wonder if you made a mistake, or if maybe the eating disorder actually worked better than this. Tweetable Quotes "Feeling worse does not mean that you're failing. It means everything is changing." - Rachelle Heinemann "Part of what the initial stages of recovery does, is that it removes your capacity to cope before it builds your capacity to cope better." - Rachelle Heinemann "You're not worse. You're just less dissociated, which is a sign that things are actually headed in the right direction." - Rachelle Heinemann "If you're willing to stay where it's uncomfortable, I guarantee you will find a lot more on the other side." - Rachelle Heinemann Resources Grab my Journal Prompts Here! Looking for a speaker for an upcoming event? Let's chat! Now accepting new clients! Find out if we're a good fit!    LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at [email protected]  

If you've ever been told that you need to "heal the root" of your eating disorder, but no one ever really explained what that actually means, this episode is for you. Maybe you've done the meal plans. The behavior tracking. The symptom management. And yet… something still feels unresolved. Fragile. Like the eating disorder quiets down for a while, only to resurface later in a different form. In this episode, we slow the conversation way down and talk honestly about unmet childhood needs. Not as a way to blame parents, caregivers, or anyone else, but as a way to finally understand why your eating disorder made sense in the first place. Tweetable Quotes "Relapse isn't the end of recovery. It's a moment inside of it." - Rachelle Heinemann "Eating disorders don't just happen. They happen within the context of the rest of your life." - Rachelle Heinemann "When emotional needs aren't consistently met, we still develop strategies internally to help us survive." - Rachelle Heinemann "You can stop the behaviors temporarily, but if the underlying emotional needs remain unmet, something else will pop up." - Rachelle Heinemann "Healing means giving yourself now what you didn't get then." - Rachelle Heinemann "Part of the process in therapy is creating a pause between the urge and the behavior." - Rachelle Heinemann "Your behaviors make sense in the context that you grew up in." - Rachelle Heinemann Resources Group Training for Clinicians, led by Jack Heinemann. Details:  • 6 weekly sessions (75 minutes each) • Thursdays at 12pm EST • Begins 2/12 • $85 per session • Limited spots Looking for more information? Email [email protected] or [email protected]  Grab my Journal Prompts Here! Looking for a speaker for an upcoming event? Let's chat! Now accepting new clients! Find out if we're a good fit!    LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at [email protected]

In this episode of Understanding Disordered Eating, I'm joined by Jack Heinemann for a live, supervision-style conversation that explores what's often happening beneath the surface when therapists feel stuck. Rather than focusing on what to say or do next, we slow the work down and examine how unconscious relational patterns quietly organize the therapy relationship itself, shaping both the client's experience and the clinician's emotional response, often without either person realizing it. This episode isn't about quick techniques or the perfect intervention. It's about learning how to think differently. Resources Group Training for Clinicians, led by Jack Heinemann. Details:  • 6 weekly sessions (75 minutes each) • Thursdays at 12pm EST • Begins 2/12 • $85 per session • Limited spots Looking for more information? Email [email protected] or [email protected]    Grab my Journal Prompts Here! Looking for a speaker for an upcoming event? Let's chat! Now accepting new clients! Find out if we're a good fit!      LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at [email protected]

Have you ever felt like you're living in a completely different reality than everyone around you? Like you're doing the hard, slow work of healing your relationship with food while the rest of the world seems to be shrinking overnight and talking about it nonstop? Feeling angry, jealous or left out is common, and you aren't alone if you're feeling this way too. Right now, weight loss medications and GLP conversations are everywhere. They show up at dinner parties, in group chats, on social media, and even in casual neighborhood conversations. And if you're in eating disorder recovery or trying to practice intuitive eating, those moments can feel deeply uncomfortable, and even unfair. Tweetable Quotes "It can just feel really unfair, like, 'why do these people just get to go on this easy shot and have this quick fix and not me?'" - Rachelle Heinemann "This idea of the eating disorder fixing our body image issues is the oldest in the book." - Rachelle Heinemann "I think something that we have to understand is that weight loss doesn't necessarily equal happiness." - Rachelle Heinemann "Their body is not a cue for me to abandon mine." - Rachelle Heinemann "I'm allowed to want stability more than thinness." - Rachelle Heinemann Resources Grab my Journal Prompts Here! Looking for a speaker for an upcoming event? Let's chat! Now accepting new clients! Find out if we're a good fit!    LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at [email protected]

You know when someone says, "Oh, that's normal", but something in your body clearly doesn't feel right? Maybe you've lost your period and brushed it off because you exercise a lot. Maybe a doctor waved it away. Maybe you've been praised for your discipline, your control, your "healthy" lifestyle, even while your body has been quietly asking for more. In this episode, we're having an honest, deeply human conversation about hypothalamic amenorrhea (HA), disordered eating, and the ways diet culture disguises itself as wellness, especially in athletic, high-achieving bodies. Tweetable Quotes "It is not normal to not have a period." - Dr. Nicola Rinaldi "I had prided myself on my body because I thought I was very healthy. What I came to realize was that I was not, and I was abusing my body in a lot of ways." - Gemma Lewis "I told countless people in my life that I didn't have my period, and nobody had ever said that. Nobody had ever asked me, 'Are you not concerned about the long-term implications of this and what you're doing to your body?'" - Gemma Lewis "Our society really encourages that. Our society encourages exercise more, eat less." - Dr. Nicola Rinaldi "I Googled 'how can I get my period back without gaining weight'. There is no good answer out there." - Gemma Lewis "HA can happen to anyone in any body size." - Dr. Nicola Rinaldi "You are more than your body." - Dr. Nicola Rinaldi  Resources Looking for a speaker for an upcoming event? Let's chat!  Now accepting new clients! Find out if we're a good fit!  Dr. Nicola Sykes website Connect with Dr. Nicola Sykes on Instagram No Period, Now What? Period Recovery Community  REVEAL Study Grab my Journal Prompts Here!   LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at [email protected]

January has a way of making everything feel louder. The pressure to start over, "fix yourself", and come back "better" than before. If you've ever felt that quiet panic underneath all the New Year motivation, this episode is for you. Instead of making a New Year's Resolution, we're making an anti-resolution.  Tweetable Quotes "When we're under pressure, it's kind of impossible to make deliberate decisions and to really feel calm about it." - Rachelle Heinemann "You don't need a dramatic reinvention to be worthy of the start of the year or even a 'fresh start'." - Rachelle Heinemann "A lot of food-related resolutions or like body-related resolutions are rooted very much in shame, guilt, comparison, anxiety, fear of not being in control." - Rachelle Heinemann "If you're thinking 'I need to change because there is something terribly wrong about me as a person'… even if it is the best resolution in the world, that is never gonna hold up." - Rachelle Heinemann Resources Grab my Journal Prompts Here! Looking for a speaker for an upcoming event? Let's chat! Now accepting new clients! Find out if we're a good fit!    LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at [email protected]