Want to hear a secret? In this episode, Opal Co-Founders Julie Church, RDN, and Lexi Giblin, PhD, reveal Opal’s unique approach to therapeutic meal support. Tune in to learn how the Opal team stepped beyond traditional meal support methods and embraced radically open dialectical behavior therapy (RODBT) to guide their work. This innovative approach has helped create a supportive community where eating becomes an experience of connection, curiosity, and courage—less about rigid rules and more about trust, play, and the belief that recovery is possible.
To learn more about RODBT go here.
or listen to some of our self-inquiry series podcasts, like:
The Appetite episode 134 or The Appetite episode 124
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Thank you to our team…
Editing by David Bazzi
Music by Aaron Davidson: https://soundcloud.com/diet75/
Sound engineering by Ayesha Ubayatilaka at Jack Straw Studios
Transcription brought to you by Rev.com
Julie Church (00:07):
Welcome to the Appetite, a podcast brought to you by Opal Food and Body Wisdom, an eating disorder treatment clinic in Seattle, Washington. We talk about all things food, body movement, and mental health on this podcast. And I am Julie Church, the nutrition director and co-founder of al. And I am here with Dr. Lexi Giblin, psychologist and executive director. And today we are talking about RO-DBT. So radically open dialectical behavioral therapy and how that informs effective meal support for folks in eating disorder treatment.
Lexi Giblin (00:46):
Yeah, we’re letting you in on one of our best kept secrets, I think at Opal, which is how we do meal support. So we think we’ve kept it quiet long enough, and hopefully listeners will benefit from maybe understanding our approach and that can help other treatment centers or folks who are coming into treatment might better understand where we’re coming from in our approach to be prepared for the conversations we might be having that are based in this theoretical orientation.
Julie Church (01:22):
And as we kind of have teamed together over the years, obviously as co-founders of Opal as Lexi got really passionate about RO-DBT and we switched to that as our basis of our therapeutic approach. And then myself as a nutrition director, we kind of melded the two without really any formal guidance and there certainly isn’t any research that we’re going to be able to share. We don’t even know of another place that does it this way. And that’s why I think it’s exciting hopefully to give this as a launching pad for whoever out there.
Lexi Giblin (01:59):
Okay. But before we get into it, let me give you just a few ideas to ground our conversation. We’re going to be talking about RO-DBT radically open Dialectical Behavioral Therapy, which is an evidence-based treatment for disorders of over control. And it was founded by Dr. Thomas Lynch. And in this treatment we are addressing the temperament that often underlies eating disorders, chronic depression, treatment resistant anxiety, autism spectrum disorders, and a few others. And so we’re really working with changing, encouraging the personality that tends to make one vulnerable for these conditions. We’re working on finding more flexibility and importantly connectedness. So our big mission in RO-DBT is to decrease loneliness. So all the efforts that we go through and RO really are about connectedness and in that flexibility,
Julie Church (03:04):
And that is why you can hopefully hear, Ooh, food connection. Yes, eating is such a key part of our lives that brings us closer to others. And so how we have been able to see RO bring that, you’re going to hear that through
Lexi Giblin (03:19):
This. Julie, would you take us back to what issues maybe we were dealing with before we started this RO approach to a meal support at Opal?
Julie Church (03:32):
Yes. So I think most people listening probably know this, but as a higher level of care eating disorder treatment center, we are feeding clients in the midst of their treatment day. So most of them are having two to three meals a day with us. And what we were running into was that folks would be served solid food and they would refuse to eat it. We would pour them a supplemental beverage that about equates what solid food they weren’t able to eat and they would attempt to eat it or drink that and come up short for whatever reasons. They would have a hard time finishing that supplemental beverage. And we would put it in the refrigerator and they would go off to the next group. By the end of the day, we would have cups and cups of supplement proving and showing to us, oh, these folks are here in treatment and aren’t actually being fully fed. They’re not fully getting the treatment, the medicine, however you want to say it, but they’re not actually nutritionally getting the part of treatment that they need to.
Lexi Giblin (04:38):
And it’s a head scratcher because our clients are over controlled clients, their temperaments tend to be gritty. They can do really difficult things and tolerate a lot of discomfort. They are masters at, they have superior inhibitory control, they have high distress tolerance. They are naturally gifted at doing hard things. And so the fact that they weren’t completing their supplement is interesting based on what we know their temperament supports them to do. So we saw this and said, oh gosh, there’s something about how we are approaching meal support that is not taking advantage of the natural temperament at hand for their advantage because everybody is coming to recover from an eating disorder with us. So they are choosing to receive the medicine for recovery. So they’re making that decision.
Julie Church (05:50):
And I’ve always thought most of individuals that struggle with an eating disorder, they have these temperamental aspects that even allow them to have an eating disorder. I mean, feeding ourselves and nourishing our bodies is such a core human need that for somebody to struggle with an eating disorder, there’s some sort of conflict there that pulls them away from meeting their basic basic needs. So yes, that inhibitory control piece, they are using that to succeed at the eating disorder and to follow the rules of their eating disorder. And when we think about this character trait, we want that to be applied to their recovery and to be applied to getting back on track to feed themselves and meet their nutritional needs.
Lexi Giblin (06:36):
I love that so much. Just taking advantage of that natural temperament for their own benefit.
Julie Church (06:43):
Yes. And before I even was introduced to ro, I remember just in my nutrition sessions trying to pull that, you see how disciplined you are or you see how focused you are. We just need that to be reoriented towards what you want in life in terms of recovery. So RO has given us a framework to really highlight that and have folks understand that part of themselves to use it for their betterment.
Lexi Giblin (07:13):
Well, let’s talk about some of the basic assumptions that RO makes that we use in our meal support at Opal. One of the key ideas is that emotion emotions are to be expected and are part of being alive. And emotions are what connects us with one another. So in ro, we’re not interested in regulating emotions necessarily. Our clients are really good, our OVERCONTROLLED clients are really good at regulating emotions, so much so that it’s often getting them in trouble with connectedness. So the last thing RO wants to do is stymie emotional expression when it would be effective to share. So we’ve taken this basic assumption of RO and applied it to meal support and said, eating with emotional discomfort is okay and expected. So we’re going into meals with the assumption that there is a lot of emotion that will come up related to eating or will often come up related to eating. And that emotion is helpful. It is uncomfortable and painful at times, and it’s also helpful in the person learning and growing and connecting with others.
Julie Church (08:38):
Yes, in the midst of a meal, a community meal within treatment environment, we have our milieu therapist team, we have a dietician, we have folks around to help support. And in the time prior to this application of ODBT and meal support, I think our emotional support was, I want to say more warm and fuzzy or it led to a lot of longer conversations of checking in about people’s emotions and trying to help get those emotions to almost be kind of taken out of the dining room. We actually physically would get up and get out of the dining room, talk about it, and then get them to more of a regulated state and then move them back in. And I think with this shift, it’s been more of this community understanding that there’s going to be emotion, okay. And eating through that is exactly the magic and that the community connection and being known is going to be stronger and outweighs the risk that it is to show yourself.
Lexi Giblin (09:47):
We used to do a mindfulness practice at the beginning of each meal as a way to try to decrease anxiety prior to eating. And we’ve thought back about that and have wondered if we weren’t social signaling kind of communicating that something really difficult is about to happen and you must prepare yourself with mindfulness because this is going to be very difficult. And we realized that that social signaling may have been inadvertently actually increasing anxiety, increasing trepidation about what’s about to happen and increasing just this spirit of the unknown is a about to happen and I don’t know where this is going to take me emotionally. So we stopped doing the mindfulness practice at the beginning of the meals for the same reason of that. Emotions are welcome. We want you to take care of yourself, and it’s okay to be anxious. It’s normal to be anxious, and we welcome that in the dining room.
Julie Church (10:50):
And maybe I’m jumping ahead here, but I also would say that part of that is by loosening the seriousness, it moves towards more levity and playfulness, which is another aspect of RDBT. So maybe I’ll pause that, but that’s kind of the setting the stage for the eating and feeding as a part of life as a good thing, not a scary thing.
Lexi Giblin (11:18):
Folks tend to take life very seriously, and so we are trying to make meals light and playful and connective and provide space for folks to have more open expression, which would lead to trust, which will lead to more connection. And what better place to do that than during a mealtime. That’s where a lot of connection happens for human beings. And we wanted to try to replicate that kind of fun yet hard because a lot of times we’re working with a dialectic in meals and in life where there’s, at a given meal, there can often be some serious matters at hand for folks around the table. They’re dealing with difficult life problems. There’s a gravity to what’s happening. And there’s often this playfulness, right? There’s a lightness that you move between the heaviness of life to more of a playful, light spirited kind of orientation, and you move back and forth between those throughout a meal often. So that is the spirit we bring in just holding that dialectic of play and compassionate gravity all at the same time.
Julie Church (12:39):
Yeah, something that also got in the way of that prior to our R-O-D-B-T alignment was that we had a lot of rules around what you could or couldn’t talk about in the mealtime. And so that meant that we weren’t allowing in our mealtimes in the dining room to be able to replicate some of that normalcy that happens in social settings when we’re eating together. And instead, we were asking the clients to follow a bunch of rules about what to talk about and not to talk about. And it’s easy to say kind of sex drugs and rock and roll, no politics, no religion, no fun, and definitely don’t talk about the food because this is eating disorder treatment. You can’t do that. And what we pulled back on and we said, Nope, you can talk about stuff. You can talk about all those things going on in your life.
(13:35):
You can talk about food even. We do have the caveat that we do not allow people to talk about food in relation to numbers, weight, exercise and no numbers related to those things, but we do allow them to talk about food. We do want people to say, oh, this is interesting, or Oh, this reminds me of this meal that so-and-so used to make for me, or What do you think is in this? To be able to bring some of that interaction with the food, hopefully to be a bit more embodied and the connection that brings, if somebody shares this is like my aunt’s recipe or something, wow, I just learned something really special. And to Lexi’s point, some of the gravity of life is brought. People are, yeah, it’s not a therapy session for sure, the mealtime, but people are bringing real content and we have our staff in there to help guide that if needed.
(14:29):
But we also really feel like that kind of creates the right environment for folks to be able to be practicing truly what they need to be able to build the skills to do outside of, and I would say I definitely have done it both ways, and there is more of a, people can breathe in there and folks with more of an over controlled temperament. They’re always very hypervigilant around following the rules. And so here we gave them, they have all their eating disorder rules in their mind. Then they have all of our rules around what to talk about and not talk about. And by releasing that, at least now they can just be trying to manage the eating disorder rules still and hopefully releasing those. But I think they don’t have to have all these other layers of rules and stressors.
Lexi Giblin (15:22):
Yeah, I love that. Then that space allows others to say, can we not talk about this right now and learn this boundary setting this communicating what your needs are. So we want that to be in the hands of the people experiencing the treatment rather than us coming in from top down saying, what should or shouldn’t be spoken about. That is for the controlled temperament. That’s tough because there’s ambiguity there, there’s unknowns there. You don’t kind of know where the boundaries are. From an RO perspective, we’re okay with conflict. Conflict may happen there. Maybe you hurt someone’s feelings or maybe you said something that was difficult for someone else. And we think of conflict as potentially intimacy enhancing. And so again, we’re just getting back to that connection. We’re wanting to create connectedness and kind of reconnect with our authenticity with one another.
Julie Church (16:26):
And I know as a staff person in those meals, sometimes it is really hard to gauge and just thinking about as humans, if we’re around a table and somebody brings up that one topic and then you’re going, oh, no, I know my other friend at the table is going to have some feelings about that, but what do we do? I mean, you could try to redirect, you could try to get it off the subject, but you also could allow for your other friend to speak up and speak for themselves. And so I do think it again, builds that skill to do that. And in the big picture, we also need to be nourishing ourselves through those times in our lives when things are uncomfortable and unknown and uncertain.
Lexi Giblin (17:03):
Another key idea in our RO approach for meal support is surrounding the fact that the client has directly asked for eating disorder treatment from us. They’ve literally signed on the dotted line saying, I agree to this treatment. They’re given full informed consent about what that means, and they’re choosing to receive the treatment. So we see this as a direct communication from them that they want the treatment. Now, we of course know that when the rubber hits the road and the meals in front of them, feelings can change. That anxiety can cause someone to maybe back away from the goal that they had when they first started. But as providers in the meal, our work is to hold our frame, hold the frame of giving the client what they have chosen to receive. And so our responsibility is to follow through with their direct ask and give the full dose of treatment, which in this case is the full meal plan.
(18:11):
So from an RO perspective, we would think of this as sort of lowering standards. So if someone said, no, I only want to eat this, but I don’t want to eat that, we would say, we would hold our frame and say that this is your full meal plan. Of course you can choose to leave for the day if you do not fill up for eating this. But we as a treatment center wouldn’t change our position on what the medicine is that is needed to recover. So as a medical metaphors, we wouldn’t, if someone needed a quadruple bypass surgery on their heart, wouldn’t the doctor, the cardiologist wouldn’t say single bypass is okay that you can see the absurdity of that. And we work to think that way about it. At Opal with food, we’re not going to give you only a portion of the treatment that we know will help you to live the best life that you want to live. And the treatment that you asked for.
Julie Church (19:25):
Yeah. Yes, exactly. And what this shift led to, if it isn’t obvious to the listener, we now have clients that are eating their full meal plan and aren’t going unfed during their treatment day with Opal, and we don’t have cups and cups of supplement that we’re pouring at every meal. So the reality is that this has led to our community being really an eating community, and it was an amazing shift to see how if you hold to this standard and you give some of this kinds of support that people know, yeah, that’s right. I signed up for this and I’m consenting to this and I will do it. Yes, of course there are times where that is not happening for clients, but then it’s an information, it’s clinical information for us, it’s a piece of an observation to say, okay, what about Opal and our treatment isn’t working?
(20:23):
What could shift or change here? Or is there a different level of care needed? Or as dieticians in the mix, creating meal plans is an art and a science. And so of course we are flexible. So if we have a meal plan and it is consistently not working for somebody to be able to succeed and complete and progress in their treatment with us, of course, we’re looking to make sure that this meal plan is not the thing that needs to change. And also we hold a strong non-diet. Food is good and safe and let, yes, your body needs it attitude here at Opal. So then we also are not afraid to feed our clients and have them get adequate nourishment. And so I think the reality is that we see clients with the balance of the nutrition approach and this RO balance. Clients are actually being able to complete their meals and find that it helps to move them in the progress they need in their eating disorder treatment and recovery, meaning getting their metabolism back online and having all the systems in their body back alive and well, and metabolically get them to a place where then their appetite cues come back.
(21:43):
I am going on and on, but I am as a nutrition director. That’s ultimately what we need is for folks to end up seeing that their own food and body wisdom and works again that they can tap back into that. So all of this is, we are seen that as clients, our whole community are actually eating and being fed and getting enough food. Then they get to see the hope of what’s on the other side of controlling their body and controlling their food back to actually feeling like they can eat attuned and listen to their body. So ultimately, I get very excited about the fact that, and proud, I guess, that we are, we’re an eating community and that clients aren’t sitting in therapy groups knowing that that person across the room didn’t eat enough while they did, and that’s not fair. Or vice versa.
Lexi Giblin (22:33):
Yeah, it’s really amazing to see how it’s changed. And we really are an eating community. No one is there that’s not eating right.
(22:41):
So we do have folks who some days are choosing to step away from the treatment day because they’re not up for eating a meal. And we see that as a choice that the person is always has choice. No one has to be, we’re not a involuntary treatment center. This is voluntary. You can always leave. So we lean into the choice part that the person is chosen to come in for that day, and we don’t see eating as necessarily a capability problem. So it’s a choice, not a capability problem, and lean into decision-making rather than to the emotions that are at hand because we do expect the emotions to be there, but we’re talking about a decision rather than decreasing emotions prior to eating.
(23:36):
I think the other piece, Julie, that I would say is the level six validation in an RO is the, I believe in you level of validation. And I think we’re using this, and I think this is one of the reasons it has been so powerful of a transformation at Opal, is that I think our clients can feel that. We can see their strength at maybe at times when they can’t. We can see that they have potential that they maybe don’t have access yet to, and we are speaking with that potential. We are seeing what could be, we’re holding the hope and we’re communicating. We’re offering suggestions based on what we can see, what we can know that they could be as an eater rather than where they are currently. We’re thinking about, can you imagine this person, and this is where, so I’m going to call up the person into that place even when they’re not feeling it. So we see if we did lower standards, we may signal that we don’t believe in our client’s strength, and that’s the last thing we would want to do. We want to find their areas of strength and speak directly to that side of them, even when it’s not yet apparent. You can see glimmers and you can see that they have this temperament that they can use for their benefit if they choose to.
Julie Church (25:10):
And maybe having the little devil’s advocate voice coming forward right now for somebody that is hearing this for the first time and has seen a very different model around meal support in treatment, they might be saying, yeah, but these are folks that have an eating disorder. Lexi and Julie eating is the core problem, so why are No, they can’t do it. This is the whole point. It’s an eating disorder. So I’m curious kind of how you respond to that. I think from my standpoint, I lean heavily into how it is that the emotions might come up. It is okay that the food and eating is still scary. It is okay that you might have some gastrointestinal distress that comes as one is eating prior, during, after, but those things don’t have to keep you from moving through the recovery process and eating enough food. Again, coming back to, I believe you can handle those emotions. I believe that your body can heal, but I’m wondering because I think sometimes it can feel there’s this approach sometimes can feel dismissive of going, wait, why are you saying that you can just do it? This is an eating disorder.
Lexi Giblin (26:36):
Totally. Yes. And I don’t mean it all because to say that this work of eating for a person with an eating disorder is easy breezy because Oh, contraire,
Julie Church (26:48):
Yes.
Lexi Giblin (26:49):
I have such respect for what our clients are doing on a daily basis, coming in and facing their fears at every meal, at every snack and staying in it. It’s amazing. I think what we’re saying with this approach is that it’s both incredibly hard and they’re able to do it and good therapy hurts, and if there’s more support needed, if we need more encouragement, if we need whatever the person needs, we try to rally around them to give that to them. But it’s not to say that this is a dismissive easy thing because it is absolutely not for many clients. It’s the most difficult work they’ve ever had to do in their lives, and we have a lot of honor and respect for that hard work. And the person’s choosing, again, is choosing to come in and wants to recover. And so we are standing beside them, and when the anxiety comes on, it can be easy to back away and we’re going to hold the frame of what they wanted when they weren’t facing the food.
Julie Church (28:09):
Yeah, yeah. And I think we want them to truly know that they too can be human, which means that they too will need to nourish themselves and that they have a place in this world and all the capabilities and their gifts and what they have to offer, it will come alongside eating and nourishing themselves. And so to me, it does that validation and that belief is no, you have something to give this world and you can’t do it without nutrition. You cannot do it without feeding yourself. So we’re going to help you create this practice, this muscle memory so that then the best of you can be fully out there in the world.
Lexi Giblin (28:53):
And something we talk a lot about in RO at Opal is the fuck around and find out. So a lot of this is we’re talking about, let’s just see what happens if you do eat this meal or eat this full meal plan for the next couple weeks, let’s just see. And you can always go back to your eating disorder if that’s what you choose, but here we have an opportunity to really support you around this and see what it feels like to get some nourishment and see how you may be orient to the world into life a little differently.
Julie Church (29:28):
Yeah. Yep. That experimental approach, that’s one of the things when I think about creating a bull, we just didn’t really have that option for our clients, and I was so excited, oh, they could just toe dip, do it for a month, and then even if you go back to your eating disorder, you can know at least what that was like to at least be fed or be presented with what is a normal sized meal. And I remember one client just that’s how much peanut butter is supposed to be in a peanut butter sandwich. Just some of those things. So I think that the opportunity to try that out and then see, right.
Lexi Giblin (30:08):
Yeah. It’s cool to see how the opal, when someone’s been at Opal, it becomes a reference throughout their life. Like you’re saying, I’ve had outpatient clients where I’m wanting to just check in on how they’re eating to make sure they’re not slipping back into their eating disorder. And I’ll say, okay, so are we talking an opal meal? Are we talking a opal snack for this meal? And they know what an opal meal can look like. And so that’s just a cool reference for them for the rest of their lives,
Julie Church (30:39):
For sure.
Lexi Giblin (30:40):
Okay. Another idea from RO that is very much so used is this idea of interpersonal integrity and this work around direct communication. So we are aware that sometimes eating behaviors or restriction can be a way of indirectly communicating with others. And from ROS perspective, we’re interested in taking, working against indirect communication. So the idea is to respond to the direct communication and try to put the indirect communication out of business. It’s often not effective for a lifelong approach to an interpersonal communication. So at the meal times, we will usually ignore indirect communication as best we can. Julie, you can speak to this a lot more.
Julie Church (31:42):
It’s tricky. Gets tricky,
Lexi Giblin (31:43):
Gets real tricky. We are in a group setting, so when it starts to impact the community, others are seeing eating behaviors that seem to be more of a communication. It’s hard to not, we want to protect the community above all, but maybe you could speak more to that.
Julie Church (32:02):
Well, I think that this principle from RO is really important as a big umbrella of going, yes, we are not going to allow you to walk around in the world and only use your eating disorder to communicate your value, your worth, your pain, just that bigger messaging. And yeah, we are not going to allow for that to be the case. So the whole picture of getting them well fed and not having any eating disorder then removes that from the picture, as you were saying. And yes, in the actual mealtime when somebody is playing with their food, let’s say, right, moving it around, maybe not taking bites frequently, is there a feeling of there’s something that somebody is wanting to say or some support that they’re needing and they’re not willing to turn to the staff person and say, I’m struggling right now. Or, Hey, could I talk through something about what’s on my plate or what’s in my head?
(33:06):
That’s what we want the clients to be doing. So yes, our staff might wait a little bit before they say, Hey, you need to pick up your fork and start eating again, or I see that you’re moving around the food, can you please take a bite soon? Because we don’t want to say, oh, I saw that. Oh, I see you playing with your food and I’m seeing that you need support. So it’s tricky. But yes, if everybody’s not doing the active of eating while in meal times at opo, we’re going to have to address that. So unfortunately, we do have to address some of the indirect communication and we do our best to try to, well, the RO principles help give us some language to tell the clients talk directly, ask directly, what are your needs right now? What’s on your mind? So it’s both and right. I think doing just not reinforcing that it’s really effective is important,
Lexi Giblin (34:07):
Right? We’re tending to both the individual and the community at the same time, and that gets very tricky and artful.
(34:17):
Maybe this has already come through in our conversation, but just to say a little bit about the basic clinical stance for RO mill support is as a clinician, the idea would be that you’re coming in with a light, playful, direct communication style, more matter of fact. So you’re not doing a lot of oozing with emotion and empathy. You’re just more light and direct, this is what we’re doing today, and you’re not, there’s no negotiation. Your full meal plan is the expectation, and you’re having a strong, unwavering belief in the strength and capability of others of the clients. So you’re caring, but your tough as nails, you’re softy, but you’re at the same time, gritty and willing to stand up against the eating disorder, and you’re creating a mealtime that is light and connective while in the midst of some of the most difficult moments for clients. So it can be both and somehow. Totally.
Julie Church (35:28):
Totally.
Lexi Giblin (35:28):
Yeah.
Julie Church (35:29):
Yep. I think that captures that clinical approach or just the general stance that we try to bring in to the meals.
Lexi Giblin (35:43):
Sometimes clients will benefit from a check-in outside of the meal, the dining hall. And I’m wondering, what are some of your favorite ways of talking with clients that are coming from this RO perspective to help support them?
Julie Church (36:02):
My stance tends to be playful and direct, really respectful, really calling them up that piece of, Hey, I know that you can do this, or I’ve seen you do this before and now’s the time again, I also would say that we’re trying in that moment to address the matter at hand. And again, back 10 years ago, it would’ve been what’s going on for you? But that’s not going to be the tone. It’s going to be, Hey, you’ve got five minutes left. I see that you have this on your plate. What do you think is going to be helpful to get you there? What’s the next step?
Lexi Giblin (36:51):
Yeah, I love that as contrasting approaches, right? You prompt a different response with what’s going on for you with the softness, it just will elicit more of that soft side, the vulnerable side, and the other one really elicits that strength side of the person.
Julie Church (37:14):
Yeah. And I think that softness comes through in so many other ways throughout the treatment environment, and I just think that the clients do feel when we are being direct and helping them to achieve the goal, the thing they’ve set out to do is helpful. Yes, their eating disorder or all the things might be kind of trying to get them to make this even more complicated or have the food get real mixed in to the other things going on in their head in mind. But in that moment, it’s game time. This is mealtime and we’re going to stay focused on the food aspect. And guess what? There’s process group after this. You have therapy next, you have all these other places. And it’s something to kind of, I would just sort of transition what’s on their mind that might be distracting them to put that in a place to say, you’re going to get to come back to that, but you’ve got to eat through the emotion of this. I’ve seen so many of clients being able to do that. It is really, like you said earlier, it’s really remarkable. It’s inspiring. It
Lexi Giblin (38:20):
Is. I think also when a client is choosing to sign out for the day, not willing to eat the meal plan or the supplement, I know our spirit is one of, we’ll see you tomorrow. We’ll welcome you back tomorrow. And so we hope that clients can feel if they are signing out, that we don’t expect perfection. Some days are harder than others, and it’s not intended to be a punitive sort of response to their difficult day. It’s more of a, yep, this is a tough day and we’ll see you tomorrow. You’ve got this, you can come back tomorrow.
Julie Church (39:05):
Yeah, absolutely. And that too, for those of you that are listening and liking the specifics, yes, we do still pour the supplemental beverage for the solid food they’re not able to complete, and then they’re given time to complete that. So the sort of idea of not completing the food or not meeting their meal plan can be, again, they’re either not eating the solid food or not eating or drinking the supplement. And we’re super creative around supplement around here too. It can be candy from Candy Island, it can be the liquid supplement. It can be some bars that we’ve devised are the right thing for that person. So it isn’t a one size fits in that way. And the ultimate goal is we need nourishment. Your body needs to know that you have access to food, you’re going to feed it regularly and adequately and that you’re getting that full treatment,
Lexi Giblin (39:56):
Which I love. That’s very ro this having a lot of flexibility on our part as long as the goal end goal is met, doing what’s effective versus doing it in a particular way. Yeah. Well, there’s a question that I love from RO that is sort of a consistent question and maybe one that I would ask a client if I was having a conversation with them about making a difficult decision about whether to pursue recovery or not. This is a question I often pose, and it is right now in this moment, you’re going to have pain if you eat or fill in the blank, whatever it is that you’re doing. You’re going to have pain if you go in this direction. And you’re also going to have pain if you don’t go in that direction. So you’re going to have pain if you recover and you’re going to have pain if you don’t recover. So perhaps the better question is, which pain gets you closer to the life you want to live and share?
Julie Church (41:03):
I love that.
Lexi Giblin (41:04):
Yes.
Julie Church (41:05):
And it is in the moment. That can be the micro moment, but also the meta big moment, right? Because I do think that many people will be experiencing some pain during a mealtime or will just be flooded by all of the critical voices from their eating disorder. If they do eat this food, they will then experience the pain that comes from their eating disorder voice. And if they don’t, they will experience the pain
Lexi Giblin (41:31):
Of leaving and what they’ll feel about that of signing out for the day and not getting the support for the rest of the day
Julie Church (41:40):
And the future of thinking, gosh, the seeding disorder is going to be my life. So yeah, I think I love that analogy in the micro and the macro. Well, I do hope that this gives therapists, dieticians, clients, individuals struggling with eating disorders, family loved ones, at least a picture of how R-O-D-B-T can help inform meal support. Obviously, we really honed in on what it looks like within the higher level of care eating disorder treatment center, and I think there’s a lot of hope and potential to this kind of approach in eating disorder recovery broadly. We’ll put a link to books, maybe some articles that might be relevant to those of you that would like to learn more about R-O-D-B-T. But again, there isn’t much out there about this specific conversation, but we will give you some about RO broadly if you would like to read that. And today we want to thank Jack Straw Cultural Center for Sound Engineering, thanks to Aaron Davidson for the Appetites original music, and to David Bozi for editing. If you want to learn more about opal’s programming, you can visit us at opal food and body.com, follow us on social media, on Opal Food and Body, or Opal movement on Instagram. And until next time, thanks for being here. Thanks.
