Ken Huey 0:00

Welcome to The Voice of Hope, where bold leaders and healers share how they're building hope, not just talking about it. I'm Dr. Ken Huey. Let's meet the changemakers transforming lives from the therapy room to the boardroom. Our guest today is Tammy Gangloff, a seasoned behavioral health professional with 15 plus years, specializing in eating disorder treatment, clinical outreach, and education. She serves as National Business Development Lead at Hidden River Eating Disorder Treatment. She's an adjunct professor at Westchester University and the author of Chronic Illness and Eating Disorders. Tammy blends clinical expertise, lived experience, and advocacy to expand access to quality care, empower professionals, and drive innovation in mental health. Her work as a speaker, educator, and clinician continues to shape communities and elevate the field of eating disorder recovery. Tammy, great to have you with us. Thank you.

Tamie Gangloff 0:59

Great to be here. Thank you so much. Thanks for having me.

Ken Huey 1:02

Yeah. So the voice of hope is it's about healing through real stories. What part of your own story kind of most shaped you as a clinician and educated that you are today?

Tamie Gangloff 1:14

Oh my gosh. Well, so many parts of my story. So what led me into the eating disorder field was my own recovery from an eating disorder many years ago. And in those days, back in the 90s, there really wasn't eating disorder treatment like we have now. There were very few. Actually, Montanito, where I trained as an intern therapist, just celebrated 30 years. So if you can imagine back then there wasn't really eating disorder treatments. So my own eating disorder recovery, my own sobriety, and then of course my own personal lived experience with chronic illnesses. So it's kind of all together.

Ken Huey 1:49

All right. You work at an interesting intersection: chronic illness, eating disorders, behavioral health. Where do families most misunderstand what recovery actually requires?

Tamie Gangloff 2:00

Great question. Recovery requires the illness to be part of the eating disorder treatment. So if somebody is in treatment for an eating disorder, and this goes for the treatment teams too, the chronic illness has to be part of the treatment plan, not just that's something that's in their notes, right? Of their history and physical, they have this scoliosis or autoimmune disease. It's part of their actual treatment plan and needs to be assessed separately because it has its own grief and depression and anxiety and on and also mental health symptoms go along with a lot of those illnesses as well. So we have to really fully look at both and then integrate them. So it's a little complicated, but we can do it.

Ken Huey 2:44

Trauma, it shows up in very subtle ways at times. Can you tell me a little bit about signs you might see in eating disorder treatment that are really trauma responses at disguise?

Tamie Gangloff 2:55

All of them? Joking, but not. I think that, you know, very high percentage of clients with eating disorders do have a trauma history. Back in the days where we would say capital T, small T, it doesn't matter what size T it is, it's all trauma. And so I think that most have some type of trauma that we have to tap into and work through because the eating disorder is serving a purpose, and that purpose is to protect from that the harm the trauma caused. And it works until it doesn't, right? And that's what we have to process and treatment.

Ken Huey 3:27

Yeah. Families want to help frequently and don't quite know what to do. They're kind of afraid. What does supportive language sound like when someone's struggling with body image or illness?

Tamie Gangloff 3:39

So there's no right answer when somebody says, Do I look fat? That's a trap. There's no correct answer. You know, I think some of the most supportive things you can do is when somebody would ask me that question is asking how you feel and what do you need right now? Because if I'm asking you if I look a certain way, it means that there's something else going on. Because logically, we know I don't look any different today. Maybe my hair is styled different, but I don't look anything different today than I did yesterday. So if I'm asking you today, like, do I look fat? I don't look okay, what else is going on? So just asking that question, what else is going on? How can I support you? And just starting with the really gentle approach in that way.

Ken Huey 4:19

For sure. Your book blends lived experience with clinical tools. How can storytelling help people feel less broken and more understood?

Tamie Gangloff 4:29

I like how you worded that. I think storytelling is everything. That's how we connect with people, right? We connect with people over stories. So my book has my story as well as lived experiences of a number of other people, because I'm just one of many, many stories. So I think that the storytelling makes you feel less alone. If you can be like, yeah, I know, I know what that feels like. Or I really thought I was crazy when I had this experience with my doctor's appointment. I had that experience last week and I brought it into my talk on Friday. And so when we are in it alone, we can really get in our head and get lost in those thoughts and feel very isolated and alone. And so if I can hear your story or someone else's, it can help me feel connected and not so um it's important.

Ken Huey 5:16

Yeah. Tammy, medical trauma is not something that's understood by probably some in my audience. So I got two questions. Number one, what does it mean when we talk about medical trauma? And how does medical trauma fray the trust of people in the behavioral health care system?

Tamie Gangloff 5:31

Wow. Yeah. So really important question. So medical trauma is it could be a number of things, right? It could be actually being injured by a medical provider, which sadly happens. It could be an accident, it could be a major surgery. It could be kind of what I'm going through right now, right? The series of doctor's appointment and getting another test and so just constant inundation with a lot of medical appointments and diagnoses and things that can be really confusing. So all of that is can be considered medical trauma. Some sources call it medical traumatic stress, the stress that you're going through. So the medical traumatic stress is sometimes what we call that overwhelm of all the medical appointments. And then the medical trauma is, you know, when we might start seeing somebody isolate, cancel doctor's appointments, that fear of entering a medical setting in some way. And so that's where it's really interfering in their actual care. And tell me the second part of your question again.

Ken Huey 6:32

Yeah. And so the second part would be how does that complicate trust in behavioral health care?

Tamie Gangloff 6:38

Absolutely. So ideally in a medical setting, we have that therapeutic alliance with our doctor, with our physical therapist, whoever it is. But when there are those ruptures in trust, it's then gonna now you want me to go to therapy and trust another person after this doctor did the thing or I wasn't seen and heard, because even the best doctor has such a big caseload and they have a really limited amount of time. And so you might not feel seen and heard in that 15 minutes that you have with that doctor. And so then it's, you know, I lose trust in them. And then I might not even want to quote, waste time going to see somebody who's not gonna just another number on their clients that they're seeing for that day. So it's really important to explain that to potential clients. And then I always say, give it three, three appointments first, give it three sessions, see how it goes. You might realize that after your first couple, you'll let your guard down, knowing that this is a really different experience than it might be with a doctor. I always compare everything to dating. So it's kind of like that. Like you've gone on three dates, you either want to get in the relationship or you want to call it off. So give it that time. Unless there's some big red flag, because sometimes there are. So unless there's a big red flag where you feel uncomfortable, give it a try so that you don't count out because we know that mental health plays such a role in our physical health.

Ken Huey 8:03

You train clinicians across the country. Talk to me maybe about a mind shift, any kind of a mindset shift that consistently leads to better outcomes for clients and families.

Tamie Gangloff 8:15

Absolutely. I think just being able to start with reframing whether it's the eating disorder or the chronic illness or both, reframing that in a different way. And so I'll give this example. I started doing this. This is an assignment that came out of my book, and I started doing it in my talks. And it was it's called What's in a name? And so using narrative therapy to kind of reframe the illness. So in the eating disorder world, a lot of times they call it Ed for eating disorder, but for somebody else, it might be coming up with a name for their illness. So we're not saying, I'm so mad at my myself, I failed, you know, all the negative self-talk, we can reframe it. And I was calling mine Rocky, was my beloved cat who's not with me anymore, but Rocky this year, because it's been a Rocky year medically. And so instead of me being angry with my body, I'm just frustrated with Rocky today. It sounded really cheesy when I first started doing it. And as I asked more and more clinicians, they're like, This is actually something that's really helpful to externalize that instead of all that self-blame and shame that we have.

Ken Huey 9:20

Interesting. It reminds me of internal family systems. IFS work just to take it away from me as a person and have it more be about this part of me or this thing then that I'm dealing with. I like that.

Tamie Gangloff 9:31

Yeah, absolutely.

Ken Huey 9:33

All right. Hope can be fragile in long-term recovery. So, what helps people stay engaged when the process feels kind of slow and invisible?

Tamie Gangloff 9:44

You know, I I feel that right now with my medical. So I think one of the most important things to stay engaged in that hope is to have people in our life that can remind us of that when we can't remind ourselves. We often in recovery say that I hold on to hope for you, even if you don't have it yet. And so, as a holder of hope, also I need somebody else to hold it for me too, sometimes. And so to stay engaged in that and stay connected to people that can then remind you that there is hope. I don't know what the end result is going to be, but there's always hope for your recovery, whether your eating disorder, whether it is your illness or substance use, whatever you're dealing with.

Ken Huey 10:26

Yeah. Your behavioral health really kind of treats the individual in isolation in many ways. I'm interested in the larger system. And could you speak to relational healing, particularly in eating disorders? What's the role there?

Tamie Gangloff 10:40

Yeah. So I mean, we heal in relationships with others, right? We know that. So in the eating disorder, if we start at the highest level of care and higher levels of care in residential, or they're kind of forced into those relationships, right? You you form a relationship with your therapist, with your dietitian, with our psychiatrist, and then with the other clients, and it becomes this microcosm for what you might be like in relationships outside of treatment. But for somebody who's not in a higher level of care or stepping down from one, it's really tricky, right? Some people might say, I don't have a network of people, I don't have relationships. How do I then create that? And so in the bigger system, I always say, like, let's start with a group, whether it's 12-step, whether it's an eating disorder, virtual support group. That way, if you don't have people, you don't know how to ask for help, you just show up and you can just sit in there and listen in. You don't even have to say a word. Or you can then maybe feel brave enough to type something in the chat, just these little slow baby steps to them. Then you might feel comfortable enough to then say something in group and get a response. Just these little baby steps to practice engaging in kind of a safer way in this group support setting so that you can then hopefully translate that to the people under life.

Ken Huey 11:58

Tammy, you have an interesting mix of kind of public facing and professional facing. You speak to both groups. What's different about the way that you give your message and still maintain what you're trying to tell and teach?

Tamie Gangloff 12:12

It's interesting because I think Friday's group is an example of that. There were some community members that were those that were struggling with the mental health chronic illness, and then also some providers, and then some both. And so I think the message is useful to either party. I'll go to the book. It's written in the way that I think the language is helpful for someone with an eating disorder, a chronic illness, both, or friends and family, or the clinician. That's what I had in mind. And so when I do these talks, when I did my narrative that what's in a name assignment activity on Friday, it was, you know, some of the community members were able to directly pull from their chronic illness. And then to the clinicians in the room, I asked the same question if you don't have a chronic illness or an eating disorder, because we all have something. So what is something in your life that you need to change the narrative? And let's practice that so that they're practicing the same tools that a client might be practicing.

Ken Huey 13:07

Levels the playing field, so to speak. Yeah. Yeah. Right. So families can become overwhelmed and exhausted. It's a hard thing dealing with these kinds of issues. What do you want them to know about their role in healing?

Tamie Gangloff 13:21

They need to take care of themselves, which is the hardest thing to do when you're a loved one watching someone in your life suffer. And so I think put placing their own self-care, but also in addition to that, if possible, go into their own therapy. For eating disorders, there are support groups for families. So I always recommend that to a family member. Family therapy, of course, is a part of treatment, but really fund your own resources and your own network. So support groups, whether it's for eating disorders for substance or alcohol use disorder, and then really making sure you have some time away from the loved one that's struggling, which is really hard to do, but self-care. Preaching to the choir, but self-care is something that's really, really hard to do. I was talking to a grandparent who's a caretaker, and she was really struggling with coming up with her own self-care that didn't have to do with work.

Ken Huey 14:13

Yeah. You know, if we could do a little detour there, talk to me about self-care. There's a bubble bath, or is that what we're talking about? Or what does self-care look like?

Tamie Gangloff 14:23

I mean, it could be a bubble bath, but I think it's different for everybody. Some people it might be, I'm gonna keep my computer closed for a whole entire day because if I open it, I'm either gonna go on Dr. Google and research things about my illness or my family members' illness, or I'm gonna do some work. So that could be self-care. Self-care could be going out and taking a walk. It could be taking a bubble bath or getting your nails done. It could be something like that. Just something that brings you some sense of calm and sense of joy, right? So that could be coloring in a coloring book, it could be watching silly TV. So just something that's gonna bring you a sense of peace and calm outside of this other part of your world that might feel really chaotic sometimes.

Ken Huey 15:09

So Tammy, we've got somebody listening today who feels kind of stuck. I don't know who, but what's one small hopeful step you believe almost anyone could take?

Tamie Gangloff 15:20

A small, hopeful step is send me an email. No, I think a small, hopeful step is really just being able to say out loud what you're struggling with and knowing that somebody else out there is holding the hope for you. I think some other steps I'll say on the chronic illness side is we can often feel really powerless. I'm powerless to my doctors because they're making the decisions for me. And so I want people to know that they can advocate for themselves and that they do have a say because whether you believe it or not, you know your body better than anyone else does. And so you can use your to give somebody the empowerment to use their own voice. I do have uh some resources. I have a great worksheet I came up with for to bring to your doctor's appointment with. So empowering yourself and knowing that there are other people out there to support. This is Linda Carter. I don't know if you're a pyish that I mean or who Linda Carter is, but that's awesome.

Ken Huey 16:19

That was a great timing.

Tamie Gangloff 16:20

Yes, that's a good cameo.

Ken Huey 16:23

So as we finish, if somebody wants to get a hold of you, Tammy, they want to read your work, they want to find out more about what you're doing, where would they go?

Tamie Gangloff 16:32

My website, or if you're on social media, social media, my website is just my name, TammyGangloff.com, and the email is the same, Tammy at TammyGangloff.com, and then Instagram at author Tammy Gangloff, just to make it nice and simple. But obviously, I do a lot more than just the book things, but a lot of speaking, some case consultation, counseling, and coaching for clients and family. So and I also do a free support group once a month for clinicians that have their own chronic illness. We came up with the name unmasking, so it's just a space where you can take your mask of clinician off and just be with a group of clinicians that also struggle to talk about what is it like to live in the space where we're a helper, but we're also really still struggling with our own medical. So lots of resources on there.

Ken Huey 17:22

All right. Well, Tammy Gangloff, thank you. Thanks for joining us on The Voice of Hope. If you were inspired, share the light. And remember, hope's not just a feeling, it's a force. We'll see you next time.