[JOE]:
Between writing notes, filing insurance claims, and scheduling of clients, it can be hard to stay organized. That’s why I recommend TherapyNotes. Their easy-to-use platform lets you manage your practice securely and efficiently. Visit therapynotes.com to get two free months of therapy notes today. Just use the promo code JOE when you sign up for a free trial at www.therapynotes.com.

This is the Practice of Practice podcast with Joe Sanok, session number 505.

Well, thank you so much for spending time with me today. I’m here, Joe Sanok, in Practice of the Practice world headquarters, on the road still, with our giant, thirty-seven-foot camper that we pull behind a truck – I never thought I’d be a truck guy. Nothing against truck guys, but just didn’t seem like my vibe. But uh, this campers a lot of fun, and getting to know the family better, and figuring out random things like where I can podcast. It’s really cold outside right now so I’m podcasting in our bedroom. It’s funny, because when I first started the Practice of the Practice podcast, I would go upstairs into a bedroom and I didn’t have this… I have a little wrap-around, it kind of goes around your mic to get a little better sound, but I didn’t have that so I put a blanket over my head. So it feels like a return where I’m in a cramped space and just kind of squeezing in the podcast stuff when I can figure out where it is.

Been getting better at kind of figuring out my time, mostly working Tuesdays as my big kind of consulting and podcasting day and then kind of filling in other things during different times. I turned in my manuscript for my book, Thursday Is the New Friday, to Harper Collins. And so getting feedback on that, that’s a super exciting thing. It’s all about how the four-day workweek boosts creativity and productivity. So that’s really exciting that that’s gonna be coming out in October 2021. You’ll be hearing a whole lot about that, I’m sure, through the podcast, but we are going to be doing – so I just want to kind of plant this in your brain – we are going to be doing all sorts of bonuses for people that buy bundles of books because when we first launch, we’re going to be looking for a lot of partners that can get the word out. So whether it’s giving it to your clients or your friends, we’re gonna be doing bundles where you can get larger amounts of books and get some bonuses as part of that. So I’m super excited about that book. It was such a fun process to walk through, and I have so many other book ideas, I think this is going to be another arm as well of what I do.

Well, today I’m so excited about Cristina. Cristina has the Behind the Bite podcast. And Cristina’s story is just awesome in regards to how she started working on her own eating recovery, and she’s a therapist, and she now has a podcast. She’s part of the Practice of the Practice Podcast Network and we support her through our Done For You podcasting. If you have a podcast inside of you and you’re thinking, I do not have the time to learn WordPress, or show notes, or transcriptions or any of that, let’s chat over at practiceofthepractice.com/apply. We’ll chat about your podcast idea. We’ll talk about whether or not we think we can monetize it and if we can support you in that. The Done For You podcasting is really a great way for professionals that know their value that say, you know, honestly, I’d rather work doing counseling than learning WordPress or SEO or all this other stuff; I’d rather just outsource all that. So it’s a really great thing there if you’re interested in it. So that’s practiceofthepractice.com/apply. So without any further ado, here is Cristina.

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[JOE]:
Well, today on the Practice of the Practice podcast, we have Dr. Cristina Castagnini. I’m so excited to have Cristina on the podcast. She’s one of our Done For You podcasters. She has the Behind the Bite podcast as well as her own practice. Thank you so much for being on the show, Cristina.

[CRISTINA]:
Thank you for having me, Joe. Excited to be here.

[JOE]:
Yeah, you know, I want to start with… Actually, you shared with me a while back about kind of why eating issues, eating disorders, eating recovery is important to you. Do you mind sharing some of your story in regards to why that’s important to you?

[CRISTINA]:
Sure. So actually, I had an eating disorder for a number of years. It started when I was a preteen. And never in a million years would I have thought I’d be sitting here with you today to be honest. I went through my own struggles for years and went through recovery. And I always knew I wanted to be a therapist or in the mental health field. I actually thought I wanted to be a psychiatrist but ended up being a psychologist and, you know, at some point it hit me that I wanted to be the therapist I never had during my recovery. And so I actually specialized in treating eating disorders. So I guess that’s kind of the long and short of how I ended up in the eating disorder field.

[JOE]:
Yeah. Now, I know that you’ve shared a lot on your podcast about who you are as a person and the struggles that happened when you were going through recovery. What were things during recovery that were helpful, maybe moments that people really coached you through that and maybe things that weren’t so helpful? Because I think that as therapists, as counselors, as coaches, it’s good to know, like, what was helpful, but also some of the disasters or red flags that, to you you’re like, man, I hope nobody ever does fill in the blank, like, what were some of those things that were really helpful and other things that weren’t so helpful during that recovery time?

[CRISTINA]:
Yes. So I think what happened was, I went in and out of treatment a number of times because I just felt like people were telling me to do things like eat. And that was very scary. And to me, you know, I would ask, like, well, have you been through this? Because I wanted to know. And people would tell me, no, but this is what we know. And so I felt like people couldn’t relate to me. And so there was a lack of trust, I think, on my part. And I think there was a lack of knowledge way back when. I’m a little bit older, so there was maybe a little bit of a lack of awareness of what to say. So there were a lot of… and I think, maybe still, to this day, a lot of things said about wait, like, oh, you look really healthy. And to say that to somebody with an eating disorder just catapulted me into like, a place where I wanted to restrict more or, you know, there was a lot of kind of looks of disbelief, like, oh, well, maybe you’re eating more than you’re really realizing. Or there was a lot of misunderstanding about, maybe you don’t have to look emaciated to have anorexia. So I just felt like people were questioning what I was saying and so I didn’t feel like I could open up a lot. And so that didn’t feel like a safe place to be a lot of times, in treatment.

But I think what was very helpful eventually, at the end, was finding a really good, knowledgeable nutritionist, dietician who got me past my fears of food and actually broke down what was in the food, and explained to me how all the different parts of like, say pizza, or something, actually helped my body instead of hurt it, or made me… In my mind, it was like, everything was going to make me fat or make me gain weight. But she explained it in a way that was like, hey, actually, if you eat this, it actually makes you healthy. And it helps you versus hurts you. So yeah, and I actually think I was ready too. I had gotten to a point where I had a really big scare where I actually was very scared for my health and so hearing somebody tell me, like, hey, this is gonna actually help you and repair your body and make you healthy, it was just what I needed to hear at the time.

[JOE]:
Yeah, so kind of that low point made it, you were just more open to hear it.

[CRISTINA]:
Absolutely. Right.

[JOE]:
At what point through your undergraduate, graduate, doctoral work, all of that, was it always that you knew you wanted to do eating work, or was it kind of clicked throughout?

[CRISTINA]:
You know what, I really didn’t. I actually was working more with families and children. And so I thought I was going to be doing more work with families and kids and couples. And so I had no idea that I was going to end up being certified to work with eating disorders at all. That hit way later.

[JOE]:
Yeah. What led you to that work?

[CRISTINA]:
Well, so it was actually, I was far enough out of recovery and, you know, there was always like that fear I had, like, people saying, oh, you know, people go into mental health because they’re trying to work out their own problems in the therapy room. And I was always very aware of not wanting to do that. So I actually kind of shied away from eating disorders for that reason because I knew I had had one. But I had an intake once where – I was working in a hospital and you don’t really get a choice in who comes into your room – and this person was just talking about stuff and I just kind of, in the back of my head, going, she sounds like I did when I was struggling with my eating disorder. She didn’t put anything down on her intake paper that indicated eating disorder, but I just started asking her questions, and she started breaking down and I went, oh, my goodness, like, she really is struggling with an eating disorder. And so I just kind of asked her outright, like, hey, are you doing these things, and these things, and these things? And she’s like, oh, my gosh, how did you know? And it was at that point she just kind of had this moment of like, oh my gosh, you get me. And I’ll never forget the look. It was like, okay, like, she doesn’t have to explain anything. And she just felt so relieved. And like, okay, this is the kind of work I have to do because I wish I would have had that moment one time in therapy. So I was like, okay.

[JOE]:
So then, for you as a clinician, in that moment, how did that feel to think I’m being called into this work, but kind of on the other side?

[CRISTINA]:
It actually felt good because I want people to feel like when they come in, like, they don’t have to feel judged, or they don’t have to explain a whole lot, but they feel like it’s safe. And they feel like they’re understood and they’re gonna feel cared for, and that they feel hope. When they come in to see me, I can say directly to their face, hey, you know what, you can get to recovery, it’s possible. Because if they lose that hope, or they don’t have it, it’s really hard to stay in treatment, especially for an eating disorder. It’s tough. And if you don’t have somebody kind of guiding you and continually reminding you, hey, stick with it, it’s tough, but you can get through this, it’s really hard. So that’s really what I want to provide my patients, is that hope.

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[JOE]:
I am so excited to promote one of our Podcast Launch Schoolers. Michelle has launched the Free to Be Me podcast. It’s a weekly podcast geared to helping Christian women discover more about themselves, and who God created them to be, to overcome the things that hold them back and to learn how to successfully take the positive steps necessary to live out their unique purposes in life. From deep conversations and social justice issues, to topics like time management, personal tests, and spiritual growth and goal setting. Together, we’ll think, laugh, and take action to step into the best lives yet. This podcast is hosted by Michelle Kroll, a licensed professional counselor from Pittsburgh, Pennsylvania. Find her on any podcast app, the Free to Be Me podcast.

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[JOE]:
Now, when you started to open your practice, was it right away it was going to be an eating disorder clinic? Was that going to be the focus or did that kind of come throughout the development of the practice?

[CRISTINA]:
So actually, I was at a hospital for the last fifteen years. I just left in October of 2019. And I was the leading eating disorder clinician there. And so my practice was actually just one day a week. And that was where I balanced things out where I just saw families and couples because I couldn’t do that at the hospital. So actually, I slowly built up over time, my practice, so that I could leave the hospital and focus on treating eating disorders solely in my practice.

[JOE]:
Now, I know a ton of our Next Level Practice people, they’re in a full-time job, and they’re moving into kind of part-time practice, or full-time, they want to leave that job. For you, what was really helpful in that transition to leave that hospital system and to jump into the private practice?

[CRISTINA]:
What was helpful? Oh, my gosh, so many things. Well, you, to be honest. But I think it was just feeling like I’d hit the ceiling at the hospital and wanting to really do different kinds of work. I wanted to reach people in different ways, much like doing my podcast is one way where I feel like, maybe I can reach more people and get more information out there. Just sitting behind the same four walls, I felt like, you know, after fifteen years, only reaching a certain population and a certain number of people. So I had more motivation to reach a different level in my career at that point.

[JOE]:
Yeah. And for you, like, when did the podcast start coming in as something that you thought, you know what, not only do I want to do this in my practice, but I also want to have a podcast?

[CRISTINA]:
You know, I had started listening to podcasts myself for a number of different things. And I thought, you know, a lot of people are coming in with a lot of misinformation about eating disorders. And I also hear a lot of people who don’t have them, just not understanding them. And so, hey, you know, let’s try this. What better way to get as much information out there to a number of people as possible. So I’m always up for something new, and I get excited about new things. So I figured this is my opportunity to try something totally different.

[JOE]:
Yeah, and when you were starting the podcast, like, how did you really sort through what your message was and who you wanted to interview and all of that? I know that having helped quite a few podcasters now, there’s different kind of phases people go through. How would you describe that kind of initial, I don’t know, fifteen or so episodes where you’re kind of getting into it and sorting it out? What was easy, what was hard, what kind of mind tricks happened in your brain?

[CRISTINA]:
Well, I’m not gonna lie. I think the first few were very scary and I hesitated because I was going through this thought of, okay, if I’m a listener, what do I want to hear? And thinking okay, they don’t know me. I’m nobody, really. And so they have to have some level of trust, or say, okay, who’s this person? Why do I want to listen? But in order to do that, I have to share my story. And so there’s this line, you know, in my profession, where we don’t really divulge a lot about ourselves. I mean, people I work with know I’ve had an eating disorder, but there’s a lot they don’t know. So it was kind of this, okay, if I’m going to do this, I have to really take a risk and open up a lot about myself. And to be honest, you know, nobody really knows all my story, whether it’s family, friends, or, you know, patients or whomever. So I think I hesitated because I was like, well, I’m gonna put everything out there. But there’s a reason I did that too because nobody really talks about everything and that’s the reason I think there’s such a stigma about eating disorders, and why people stay sick and nobody talks about them. Because nobody talks about it. So that was the hardest part for me. And so I hope my first few episodes don’t sound, you know, really awful. But I was really nervous. So hopefully…

[JOE]:
Well, I go back and listen to my first episodes of the Practice of the Practice podcast, and they’re terrible. But it’s good that they’re up there, you know, and I was so, like, I felt like I had to prove myself, so it was super narcissistic, just because I was so insecure about sounding like a regular person. And I had to be this big professional, and it’s ridiculous. But I leave them up because, you know, how else will you learn how people grow over time? Hopefully. I hope I grew over time. So then, you know, when you think about helping people that are serving those that are dealing with eating disorders, when you think about that whole field, I’d love some tips, just, if someone’s listening, they have a specialty that’s not eating disorders – what are maybe five bullet points that we can go into, that you’d say these are things that they really need to master or get better at in order to really just grow in serving that population?

[CRISTINA]:
So, I guess, another therapist?

[JOE]:
Yeah, I mean, or maybe, I mean, and I know your specialty is more kind of the end listener, so maybe let’s focus more on that. So when people are going through their eating disorders, or they’re listening to your podcast, what are some principles that you really want them to know as they think through eating disorders?

[CRISTINA]:
Well, I think the one thing is to understand it’s not a diet. And so that’s the thing people get confused between oh, it’s a choice, people are choosing this. And it’s not a choice, it’s an illness. So that’s number one. And the other thing is, you can’t look at somebody and know if they have an eating disorder. I think there’s such a thought out there that you can look at somebody and know if they have an eating disorder and know which one. Obviously, people think oh, they must have anorexia only if they’re really emaciated and that’s just not the case. Or they have binge eating disorder if they’re in a larger body, and that’s not the case, either. So there’s a lot of bias and misinformation out there.

[JOE]:
Yeah, what are maybe some common things that is misinformation, that you would say, we really need to undo these things?

[CRISTINA]:
Well, for someone who has one, thinking it’s their fault, they’re a failure. You know, you can’t just treat your own eating disorder, and you do need help to get through it. And I know another thing is, so many people and families and loved ones are well-meaning by things they say to, you know, try to “help” their loved one. You know, well, why don’t you just eat? Or why don’t you just this? There is a lot of “why don’t you just…?”, as if it was that easy, right? And so for people who are living with somebody who has an eating disorder, for them to also get help, or maybe read up on it, or go to therapy with them to get support about how to best support them, so they can learn how to say things that are helpful instead of maybe they might inadvertently be saying things that they think are helpful, but actually they’re not.

[JOE]:
So really thinking about kind of the family system and all that’s around them as well. So, when you think about kind of moving forward in your career, how do you think through what you’re going to work on next? Because I think people will hear someone that worked in a hospital system, started a practice, and quickly started a podcast, they hear all these kind of successful steps. How do you decide what you’re going to work on next?

[CRISTINA]:
To be honest, I think it just comes down to what… I just get this sense of like, hey, that sounds like a good avenue, and so I just kind of look into it a little bit and then I say, you know, that sounds like the next best direction. And actually, working toward doing my practice full-time was actually like a five-year, well-thought-out plan,; it took me a long time to just jump. Leaving a very stable position at a hospital I’d been at for fifteen years was no small jump in my mind. So once I left, I felt like there was so much open to me. So the podcast was just like, yeah, let’s try this. I’m out already.

[JOE]:
Yeah. Right. Awesome. So, the last question I always ask is, if every private practitioner in the world were listening right now, what would you want them to know?

[CRISTINA]:
I want everybody to know that you really need to have a work-life balance, because it can get very isolating out there in private practice. And so make sure that you’re doing work that you find fulfilling, but also make sure you don’t let your private practice take over your entire life because that can be very easy to do. It can be isolating. So make sure you reach out to other practitioners, and make sure you’re doing work that’s exciting. You know, I am very excited about the podcast, it could easily take over, like so much of my life, but I do have to cut it and make sure I focus on family, friends, other things. And so, yeah, private practice is fantastic, but it cannot overrule your entire life.

[JOE]:
No, that’s great advice. And Cristina, you have a free email course that you’ve put together. Tell us a little bit about that, and how people can contact you if they want to hear the podcast or subscribe for the email course.

[CRISTINA]:
Sure. So it’s a nine-week email course; you’ll get one email a week that brings you through some exercises to help you understand eating disorders, or if you actually have one. It doesn’t diagnose you with one, but it’ll help you kind of gain some clarity about your relationship with food. And if you, at the end of the course, feel like you need some further help or therapy, then you’ll have more awareness about that, and hopefully reach out for some help. And that is at behindthebitepodcast.com, and that’s where the course is. So you can sign up for it there and get that emailed to you. And also, that’s where you can listen to the podcast as well. There’s a link for the podcast there.

[JOE]:
Awesome. And it’s also on iTunes, Stitcher, all those other places. Well, Cristina, thank you so much for being on the Practice of the Practice podcast.

[CRISTINA]:
Well, thank you, Joe.

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[JOE]:
So what are your big takeaways? What are you going to do with this? How are you inspired to take the work you do in your sessions and take it to a broader community? We all start somewhere, and you can go beyond just your individual sessions. Even beyond your own group practice if you have one. Recently, I’ve started saying that we help people from the moment that they start a private practice or want to start a private practice until they’re ready to exit it and go into podcasting and doing things that go beyond the private practice. So from start to exit, we are here to help you. We have so many different things. For example, if you haven’t signed up for Group Practice Boss, Whitney and Alison have started a membership community for people that have already hired their first couple people for their group practice. And last I checked, they had I think over seventy different group practice owners in that membership community. So a vibrant community that is supporting each other, that is continuing to grow, Group Practice Boss, you can find out all about that if you just go to practiceofthepractice.com, you’ll see all the different things that we offer.

We try to find things that at every stage of practice can help you, so whether you’re just getting going, super cheap things like a one-year practice plan over at practiceofthepractice.com/plan, all the way up to Done For You podcasting and everything in between. So thank you so much for letting me into your ears and into your brain. TherapyNotes, thank you so much for being a sponsor of this podcast. We couldn’t do it without you. Also, you have an awesome product. You have the best electronic health records for therapists, counselors, psychologists, MFTs that’s out there. Use promo code JOE to get those free months. That’s going to help you but also, it helps them track where referrals are coming from.

As well, I want to make sure if you are a Next Level Practice member, make sure you forward that receipt to me and I’ll get you six months for free. That’s something that you can do as just an extra benefit of being a Next Level Practice member. If you’re not, head on over to practiceofthepractice.com/invite. We’ve got our opening happening right now. By the time this goes live, probably this afternoon, things are closing up for this cohort of Next Level Practice, then it doesn’t open back up until February. So check that out over at practiceofthepractice.com/invite and thank you so much for letting me be a part of your life and a part of your practice. Have a wonderful day. Talk to you soon.

Special thanks to the band Silence is Sexy for your intro music; we really like it. This podcast is designed to provide accurate, authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the publisher, or the guests are rendering legal, accounting, clinical or other professional information. If you want a professional, you should find one.