Podcast 259 TEAM-CBT for Eating Disorders, featuring Donna Fish In today’s podcast, Rhonda and David are delighted to welcome Donna Fish, LCSW, a New York mental health professional who’s doing pioneering work applying TEAM-CBT to eating disorders such as overeating / obesity, binging and vomiting (bulimia), and anorexia nervosa (starving oneself in combination with excessive exercising). These problems appear to be more prevalent in modern society, perhaps because of the emphasis on physical beauty as well as the availability of fattening foods and the financial resources to purchase them. Donna is an LCSW and Level 4 TEAM-CBT therapist. She is a guest lecturer on eating disorders at Columbia University and Harvard University, and author of Take the Fight Out of Food. She has been a popular guest on many radio and television shows, writes for Psychology Today magazine, and more. Donna began the interview on a personal note, reflecting on one of Dr. Burns’ workshops in 2014. She volunteered for a role-play with David illustrating the Externalization of Voices, a powerful cognitive therapy technique David developed during the mid-1970s. That experience pointed Donna in the direction of learning more TEAM-CBT. Here’s how she described her experience at the workshop: It blew my mind! I don’t easily follow any one particular ‘school of therapy, but I joined a TEAM-CBT training group that Dr. Taylor Chesney had just begun in NYC and then continued my online training until this day! I am thrilled to combine my eating disorder training and experience with the TEAM approach, and have been training therapists at Elise Munoz’s Feeling Good Center in NYC, so that they can use TEAM with the common problem of Binge/Restricting. Donna started her career as a professional dancer, and struggled with her own eating and body image issues. She saw these problems in her many peers and colleagues working as performers as well. She said: I was always on a diet, and saw foods as “good” or “bad.” I would restrict (fasting) during the week and then binge on all the “bad” foods on weekends. My life was a yo-yo of binging and restricting. Later, I taught myself how to eat in a healthy way, and how to say, “Yes, I can have that food and I can have it right now if I want it (which I do). But do I really need it right now?” This simple change in how I talked to myself freed me and cured me! When I became more accepting and less rigid in my “eating rules,” I paradoxically began to feel happier and more in control. I saw so many actors and dancers who used up tremendous amounts of emotional energy struggling with body image issues and problems with eating. That’s why I did a 3-year training program in working with eating disorders. When some of my patients who had recovered became pregnant, they worried about giving their own children an eating disorder. That’s why I wrote my book incorporating the methods that had been so helpful to them. This included a 4 Step Program to help them to give their kids a healthier relationship for life. These are the four steps: Step One: Talk To Your Kids About Nutrition Step Two: Reboot the Connection Between the Belly and the Head Step Three: Separate Hunger and Fullness from Other Feelings Step Four: Teach Your Child Skills and Develop Confidence in Decision Making I incorporated many of the ideas and techniques in TEAM-CBT, including Dr. Burns’ Decision-Making Tool, as well as his “Addiction and Habit Log.” (link to the free chapters on these tools available on the home page of my website). Donna emphasized the role of restricting in the maintenance of eating disorders. She explained that restricting and fasting actually cause and perpetuate the problem because the cognitions become ‘Tempting Thoughts’ to binge such as: “I will definitely re start my diet tomorrow, and I won’t eat that cake that I shouldn’t have had, so I may as well eat more now since I’ve already blown it.” She explained: If you commit to having a pie