In this candid conversation, couples and sex therapist Dr. Nicole Van Ness, LMFT joins Dr. Marianne to explore how developmental trauma shapes attachment styles, body image, sexual desire, and day-to-day intimacy. Dr. Nicole explains what developmental trauma is, how it differs from or overlaps with complex PTSD, and why chronic misattunement in childhood can echo through adult relationships, stress responses, and self-regulation. You will hear practical, compassionate strategies to rebuild safety, agency, and connection in your body and with your partner.

Developmental trauma 101: How repeated misattunement and lack of repair in childhood influence trust, safety, and the nervous system in adulthood.

Attachment and sex: How anxious and avoidant patterns can create desire pursuer–withdrawer cycles, sensitivity to rejection, and misaligned invitations for sex.

Body image and pleasure: Why self-loathing, dissociation, and low interoceptive awareness can shift sex from pleasure to performance and how to return to embodied enjoyment.

Masturbation as self-care: Ways self-pleasure can restore agency, support trauma recovery, and improve partnered intimacy through curiosity, consent, and pacing.

Desire discrepancy: How to reframe a declined invitation as information rather than personal rejection and how to stay connected when desire levels differ.

Pelvic and sexual pain: How chronic stress and hypervigilance can contribute to issues like vaginismus and pelvic floor tension and why relaxation and safety matter.

Neurodivergence and RSD: Tools for identifying rejection sensitive dysphoria in the moment and naming it with your partner to reduce spirals and repair faster.

Eroticism and aliveness: Gentle, stepwise practices that rebuild embodiment and pleasure, from sensing music and movement to sharing desire with a partner.

Trauma adaptations are creative survival strategies. They deserve respect while you learn new options that fit your current life.

Pleasure requires enough safety, agency, and self-worth to receive and enjoy it. These ingredients can be rebuilt.

Honest conversations about boundaries, pacing, and permission support intimacy more than duty or performance.

Small, consistent body-based practices help restore interoception, reduce hypervigilance, and widen your window of tolerance during sex and affection.

Name your nervous system state: Am I keyed up, shut down, or settled. Choose regulation first.

Solo exploration with care: Treat self-pleasure like self-nurture. Slow it down. Focus on sensation, comfort, and curiosity.

Low-stakes embodiment: Sway to a favorite song, notice breath, enjoy soft fabrics, or feel grass under your feet. Build from neutral to pleasant sensations.

Clear invitations and exits: Ask for what you want. Offer options. Affirm that no is welcome. Agree on easy ways to pause or change course.

Rejection reframe: A no is information about timing or capacity, not your worth. Validate disappointment and stay connected.

Developmental Model of Couples Therapy by Pete Pearson and Ellyn Bader

Complex PTSD conversations influenced by Bessel van der Kolk

Codependency concepts associated with Pia Mellody

Cultural touchpoints about sexuality education and agency referenced in feminist media history

Dr. Nicole Van Ness, LMFT is a couples and sex therapist who practices virtually in Texas, California, and Florida. She integrates attachment science, nervous system education, differentiation, and sexuality counseling to help clients cultivate secure intimacy and erotic connection. She works affirmatively with diverse relationship structures and identities.

Connect with Dr. Nicole:

connected-couples.com

Apple & Spotify.

If you want trauma-informed, neurodivergent-affirming support for eating concerns, body image, or intimacy challenges, you can work with me in therapy in California, Texas, and Washington, D.C. Learn more and schedule a free consult at drmariannemiller.com.

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Standard eating disorder treatment often assumes that one model will work for everyone. But for neurodivergent people, such as autistic folks, ADHDers, and those with sensory processing differences, this approach can feel like being handed a map that doesn’t match the terrain you’re actually walking. Instead of support, clients often experience shame, retraumatization, or the sense that recovery is out of reach.

In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller explores why one-size-fits-all treatment fails neurodivergent clients and what affirming, individualized care looks like. She discusses how sensory sensitivities shape eating experiences, how ADHD executive functioning challenges complicate meal planning and follow-through, and how trauma and systemic oppression create additional effects that amplify struggles. She also outlines what neurodivergent-affirming eating disorder treatment looks like in practice: sensory-attuned, trauma-informed, flexible, and rooted in autonomy and consent.

In this episode, I discuss eating disorder treatment, recovery challenges, and the effects of trauma. Please listen with care and step away if needed.

If you or someone you love lives with ARFID, selective eating, or eating struggles connected to autism, ADHD, or have other types of neurodivergent traits, know that recovery is possible with the right support.

For deeper guidance, check out Dr. Marianne's ARFID and Selective Eating Course, which offers practical, compassionate strategies that are neurodivergent-affirming, trauma-informed, and sensory-attuned. If you’re located in California, Texas, or Washington, D.C., you can work directly with Dr. Marianne in therapy to create a path to recovery that actually fits your life.

Learn more at drmariannemiller.com.

Recovery is often described as freedom, joy, and relief. But for people who have lived with eating disorders for many years or even decades, the reality is much more complicated. In this episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne explores why recovery can feel unsafe and why ambivalence is such a common part of the process.

You will hear about how eating disorders become entangled with identity, daily routines, and survival, and why letting go can feel destabilizing even when it is necessary for healing. Dr. Marianne explains how trauma, systemic oppression, sensory sensitivities, and executive functioning struggles can all make recovery feel threatening to the nervous system. She also shares how grief and ambivalence show up in long-term recovery and why both deserve compassion instead of shame.

This episode highlights the importance of trauma-informed, neurodivergent-affirming, and fat-affirming care, and it offers practical ways to build a sense of safety through sensory supports, executive functioning tools, and pacing change.

Why recovery often feels unsafe instead of freeing

How ambivalence is a normal and intelligent survival response

The role of trauma in making recovery feel threatening

How intersectionality and systemic oppression shape recovery experiences

Why grief is an important but overlooked part of long-term recovery

Sensory and executive functioning strategies that can support safer eating experiences

If this episode resonates with you and you are ready for support, Dr. Marianne Miller offers eating disorder therapy in California, Texas, and Washington, D.C. Her approach is trauma-informed, sensory-attuned, and affirming of neurodivergent and marginalized identities. Learn more and connect with her at drmariannemiller.com.

Licensed clinical psychologist Dr. Courtney Crisp (@drcourtneycrisp) joins Dr. Marianne to talk about eating disorders during pregnancy and postpartum. We discuss how body changes, medical weight stigma, breastfeeding pressure, and sensory sensitivities can trigger old patterns or spark new struggles. Dr. Courtney shares insights from her work with athletes and perinatal clients, along with lived experience of pregnancy nausea, food aversions, and postpartum adjustment. We also explore how neurodiversity, ADHD, and autistic sensory needs shape care, and why weight-inclusive, consent-based support matters for parents.

How pregnancy, medical monitoring, and rapid body changes can activate perfectionism, control seeking, and body dissatisfaction

The effects of weight stigma in prenatal and postpartum care, and what weight-inclusive providers do differently

Why severe nausea and food aversions can persist after birth, and how to support flexible, adequate nourishment

Breastfeeding, pumping, and formula choices through a nonjudgmental, mental health first lens

Sensory overload in pregnancy and the fourth trimester, including smell sensitivity and tactile overwhelm

Athletes, performance culture, and disordered eating patterns that can resurface in the perinatal period

How to protect recovery when social media pushes “bounce back” messages

Building a trusted, affirming care team that honors intersectionality and neurodiversity

Your body will change during pregnancy and after birth, and that reality deserves compassion, not comparison.

Weight-inclusive prenatal and postpartum care improves outcomes by removing shame and centering consent.

Feeding decisions work best when they support the caregiver’s mental health and the baby’s needs, not a rigid ideal.

Sensory supports reduce distress. Use smell blockers, quieter environments, comfortable fabrics, and predictable routines.

Curate your feeds. Unfollow “get your body back” influencers and follow licensed, values-aligned clinicians.

Recovery helps you show up for your baby and for yourself. Nourishment and rest are part of caring for your family.

00:00 Meet Dr. Courtney Crisp and her background in athletics and psychology

06:40 Why sports culture can model both body awareness and perfectionism

10:45 Pregnancy triggers, medical encounters, and weight stigma

14:40 Severe nausea, limited safe foods, and lingering food aversions

18:55 Postpartum body image, grief, and the pressure to snap back

21:40 Breastfeeding, pumping, formula, and mental health first choices

24:30 Sensory sensitivities in pregnancy and postpartum

26:45 Building a trusted, affirming care team for your unique family

28:20 Neurodiversity, ADHD, and autistic masking in assessment and care

29:30 Where to find Dr. Crisp online

Guest site: drcourtneycrisp.com

Instagram: @drcourtneycrisp

Substack: The Pop Culture Psychologist at drcourtneycrisp.substack.com

Create a simple postpartum nourishment plan with two or three easy options per meal, low lift snacks you tolerate, and a backup shelf-stable choice. Add sensory aids you find regulating. Ask your care team to avoid blind weighing and to discuss numbers only with consent. Invite a partner or friend to support meals, hydration, and rest.

If you want weight-inclusive, neurodivergent-affirming therapy for eating disorders, OCD, and body image concerns in California, Texas, or Washington, D.C., learn more and connect through my website. I also offer specialized support for ARFID, binge-type patterns, and long-term recovery.

Eating in the morning sounds simple, but for many people in eating disorder recovery it feels nearly impossible. Breakfast can bring up anxiety, sensory overwhelm, executive functioning struggles, and old diet culture narratives that equate delaying food with being “good.” In this episode, Dr. Marianne Miller explores why breakfast is so hard, what’s happening in the body and mind during mornings, and how oppression and neurodivergence can amplify these challenges.

Why hunger cues may be blunted in the morning for those healing from anorexia, ARFID, binge eating disorder, bulimia, or atypical anorexia.

How anxiety, sensory sensitivities, and executive functioning difficulties make mornings especially tough.

Why low-lift and “zero spoons” food strategies are key for ADHDers and neurodivergent folks.

How systemic oppression and diet culture messages intensify morning eating struggles.

Practical steps for making mornings less overwhelming and building breakfast into your routine.

This episode discusses eating disorder recovery challenges and mentions binge urges, food avoidance, and systemic oppression. Please take care of yourself as you listen.

Morning eating struggles are not a personal failing. They’re a reflection of body rhythms, trauma, and cultural messages around food and bodies. Understanding the intersection of physiology, psychology, and oppression allows recovery to be rooted in compassion rather than shame. Whether you’re working on ARFID recovery, managing binge urges, or navigating long-term eating disorder challenges, starting the day with nourishment can support stability and healing.

If mornings feel like an impossible hurdle, I created the ARFID & Selective Eating Course to support you. It’s designed for people who struggle with food avoidance, sensory sensitivities, or anxiety around eating, as well as for parents and providers seeking neurodivergent-affirming strategies. The course is self-paced and packed with practical tools to make eating less overwhelming and more possible. Dr. Marianne Miller, an eating disorder therapist based in San Diego, California, as well as serving eating disorder clients in Los Angeles, the San Francisco Bay Area, Texas, and Washington, D.C., unpacks the biology, psychology, and cultural conditioning that make morning eating so difficult. With a neurodivergent-affirming lens, she offers low-lift strategies for ADHD and autistic folks, highlights how systemic oppression and anti-fat bias amplify these struggles, and provides practical tools for building safety and consistency with food in the mornings.

Struggling with eating breakfast is a common challenge in eating disorder recovery, whether you’re healing from anorexia, bulimia, binge eating disorder, ARFID, or atypical anorexia. In this episode, Dr. Marianne Miller, an eating disorder therapist based in San Diego, California, as well as serving eating disorder clients in Los Angeles, the San Francisco Bay Area, Texas, and Washington, D.C., unpacks the biology, psychology, and cultural conditioning that make morning eating so difficult. With a neurodivergent-affirming lens, she offers low-lift strategies for ADHD and autistic folks, highlights how systemic oppression and anti-fat bias amplify these struggles, and provides practical tools for building safety and consistency with food in the mornings.

Avoidant/Restrictive Food Intake Disorder (ARFID) is one of the most misunderstood eating disorders. Although many people assume it is about being a “picky eater,” the truth is far more complex. ARFID can involve overwhelming sensory sensitivities, intense fears of choking or vomiting, and nervous system responses that make eating feel unsafe. For those living with ARFID, every meal can feel like navigating a minefield. Shame, isolation, and years of being dismissed by others often add to the struggle.

In this episode, Dr. Marianne Miller explores what ARFID really feels like from the inside, why it is so often overlooked or misdiagnosed, and how to shift from shame to self-compassion. She discusses the intersectional barriers that people with ARFID face, from fat folks being dismissed by providers, to autistic and ADHD individuals being mislabeled as “quirky eaters,” to cultural stigma in BIPOC communities. By unpacking these misconceptions, Dr. Marianne shines a light on why ARFID deserves serious recognition and care.

Midway through the episode, Dr. Marianne shares details about her self-paced ARFID and Selective Eating Course at drmariannemiller.com/arfid. This resource supports parents, adults, and providers alike with a neurodivergent-affirming, sensory-attuned, and trauma-informed framework. It includes practical tools for creating safety around food, reducing shame, and building flexibility without force.

Listeners will also hear about strategies that actually help people with ARFID: validating experiences instead of minimizing them, using sensory-based bridges to expand safe foods, providing trauma-informed care that honors fear as protective, and integrating low-lift routines that work with executive functioning needs. Dr. Marianne explains how true healing is not about eating everything, but about gaining more freedom, more nourishment, and more autonomy.

ARFID is not a choice, and it is not a phase. It is a real eating disorder that deserves respect, compassion, and effective support. Tune in to learn why understanding ARFID matters, and how shifting the conversation can open new pathways for care.

Author and fat liberation advocate Amanda Martinez Beck @thefatdispatch joins me to share what it’s like to navigate eating disorder treatment while taking a GLP-1 medication for diabetes care. She opens up about her lived experience with atypical anorexia in a larger body, the challenges of muted hunger cues on Ozempic, and how she’s learning to embrace nourishment with compassion. This conversation highlights the nuance of recovery, the complexities of body change, and the importance of choosing curiosity over judgment.

This episode discusses eating disorders, fat stigma, and experiences with GLP-1 medications. Please take care while listening.

How atypical anorexia is often overlooked in larger bodies

Why Ozempic can suppress hunger cues and mimic anorexia symptoms

Building structured meals and snacks when appetite cues are muted

Holding nuance in fat liberation while navigating diabetes care

Practicing curiosity instead of judgment when bodies change

Fat accessibility in professional settings and advocating for support

The creation of Nozempic Mondays as a community resource on Substack

Eating disorder recovery requires intentional nourishment, regardless of body size.

GLP-1 medications are not a “miracle cure” and can complicate eating disorder treatment.

Choosing curiosity over judgment creates space for healing and body acceptance.

Accessibility and advocacy matter in workplaces and communities.

Amanda Martinez Beck is a fat author, disability advocate, and fat liberationist whose work centers on embodiment, faith, and justice. She writes The Fat Dispatch on Substack and is the author of Lovely: How I Learned to Embrace the Body God Gave Me and More of You: The Fat Girl’s Field Guide to the Modern World. She also hosts Nozempic Mondays, a resource for people navigating GLP-1 medications in weight-stigmatizing environments.

Substack: thefatdispatch.com

Instagram: @thefatdispatch

Threads: @thefatdispatch

Dr. Rachel Milner’s comparison of GLP-1 side effects and anorexia symptoms

0:00 Welcome and introduction

“Curiosity instead of judgment has been the most valuable part of my journey. I ask if I am nourished, and I let my body be.” – Amanda Martinez Beck

People navigating eating disorder recovery while on GLP-1s for diabetes

Those in larger bodies seeking validation and support

Clinicians interested in fat-affirming, non diet, and neurodivergent-aware treatment

Families and loved ones supporting someone through recovery

If you’re seeking eating disorder therapy and anorexia treatment that is fat-positive, sensory-attuned, and neurodivergent-affirming, I offer services in California, Texas, and Washington, D.C.

What if your sensory needs around food were not something to fix, but something to honor?

In this solo episode of Dr. Marianne-Land: An Eating Disorder Recovery Podcast, Dr. Marianne Miller explores how taste, texture, and smell can shape food experiences for autistic people, especially those struggling with ARFID or longstanding selective eating. For many neurodivergent folks, eating is not just about hunger or nutrition. It is about navigating an overwhelming sensory world where food can trigger discomfort, distress, or shutdown.

In this episode, Dr. Marianne challenges the idea that “picky eating” (not a fan of this term) is a behavioral issue. She instead centers a neurodivergent-affirming lens. Dr. Marianne explains why certain tastes may be too intense, why some textures are intolerable, and how even the smell of cooking can completely derail someone’s ability to eat. Rather than dismissing these experiences, she offers a framework that respects the wisdom of the sensory system and centers bodily autonomy.

Throughout the episode, Dr. Marianne also highlights how intersecting identities influence whose sensory needs get honored and whose get ignored. Fat autistic people are more likely to be accused of bingeing instead of being screened for ARFID. Autistic people of color may be labeled as oppositional instead of recognized as overwhelmed. Trans and nonbinary folks may feel especially vulnerable to dysphoria or sensory shutdown. When treatment spaces fail to consider these intersections, they increase the risk of harm and deepen eating-related trauma.

Listeners will come away with a greater understanding of what sensory-based food aversions really are and how we can create supportive environments that do not rely on compliance, but rather collaboration, compassion, and choice.

About halfway through the episode, Dr. Marianne discusses common invalidating experiences autistic people have in treatment, including being coerced into eating foods that feel unsafe, ignored by providers, or misdiagnosed because of anti-fat bias or racism. There are no graphic food descriptions, but this part may be activating for folks who have experienced treatment trauma or food-related distress.

If you or someone you care about is navigating ARFID or sensory-based eating struggles, Dr. Marianne’s virtual, self-paced course, ARFID & Selective Eating offers an accessible and affirming starting point. Built on her NIT-AR model (Neurodivergent-Affirming Integrative Therapy for ARFID), this course is ideal for autistic individuals, parents, and providers alike. It offers tools for supporting sensory needs without shame, and helps you rebuild trust with food on your terms.

Learn more at drmariannemiller.com

autistic sensory eating, ARFID sensory sensitivity, taste aversion autism, texture sensitivity eating, food smell sensory autism, selective eating autism, autistic ARFID treatment, neurodivergent eating disorder support, trauma-informed ARFID course, sensory food aversions, autism and feeding challenges, liberation eating disorder therapy, autism sensory tools for eating, affirming ARFID support

What happens when the most painful wounds from childhood were not physical but verbal (or were both)?

In this solo episode, Dr. Marianne Miller explores how childhood verbal abuse shapes our relationship with food, body image, and self-worth. Words like "You're too much," "Are you really going to eat that?" or "You’d be pretty if you lost weight" do not just pass through us. They often take root and become beliefs that fuel restriction, binge eating, ARFID, and body distrust. These early messages are rarely named in traditional eating disorder care, yet they are at the center of how so many people learn to disconnect from their own needs.

This episode also takes a close look at intersectionality and how verbal abuse is often amplified when it lands on marginalized identities. Fat children, neurodivergent kids, BIPOC youth, disabled teens, and queer or trans kids often receive more frequent and more punishing verbal messages about food, emotions, and appearance. These experiences are not isolated. They are shaped by broader systems that devalue certain bodies and behaviors while demanding compliance and control. Dr. Marianne outlines how those messages become internalized and how they show up decades later in eating struggles that are often misunderstood or minimized by standard care.

Rather than framing recovery around food rules or rigid programs, this episode invites you to imagine a different path. One that centers truth, autonomy, compassion, and body liberation. Whether you are navigating ARFID, binge eating, restriction, or an unnameable discomfort with food, this conversation offers validation and a starting point for deeper healing.

The many forms verbal abuse can take in childhood

How shaming language around food and body shapes long-term eating patterns

Why intersectionality matters in recovery

How internalized shame drives disordered eating

Why traditional eating disorder treatment often fails marginalized clients

What a neurodivergent-affirming, sensory-attuned, liberation-focused approach looks like

This episode discusses verbal abuse, body shaming, disordered eating, and childhood trauma. Please care for your nervous system while listening. Take breaks, skip, or pause when needed.

You were criticized or mocked for your body, eating habits, or emotions as a child

You live in a larger body or identify as neurodivergent, BIPOC, disabled, queer, or trans

You experience food restriction, binge eating, or fear-based eating

You are seeking eating disorder recovery that respects your lived experience

You want support that centers your nervous system and autonomy

Dr. Marianne Miller is a Licensed Marriage and Family Therapist (LMFT) who works with teens and adults in California, Texas, and Washington, D.C. She specializes in trauma-informed eating disorder therapy that is sensory-attuned, neurodivergent-affirming, and centered on body liberation. Her clients often come to her after feeling dismissed or harmed by traditional treatment models. Many are working through ARFID, binge eating disorder, bulimia, anorexia, or mixed experiences that do not fit neatly into diagnostic boxes.

Dr. Marianne supports clients in larger bodies, those navigating chronic illness, sensory sensitivities, and those who live at the intersection of multiple marginalized identities. She believes recovery should not be about compliance or perfection. It should be about truth, autonomy, and building a relationship with food and body that is rooted in safety and dignity.

If you are seeking a therapist who will honor your complexity and offer support that aligns with your values, you can schedule a free 15-minute consultation call at:

In this episode, you will hear conversations relevant to anyone searching for a neurodivergent-affirming therapist for eating disorders, trauma-informed ARFID therapy in California, Texas, or Washington D.C., support for binge eating and body shame, or eating disorder therapy for marginalized communities. This episode includes key themes like internalized shame and food, fat liberation in recovery, body trust, verbal abuse and disordered eating, sensory-attuned care, and the role of systemic harm in eating struggles.

What does it mean for men to navigate eating disorders in systems often designed without them in mind? In this conversation, George Mycock, PhD student and founder of MyoMinds, returns to Dr. Marianne-Land for the third time to share the evolution of his research and lived experience.

Together, Dr. Marianne and George unpack what his multi-year studies reveal about barriers men face in seeking help, how treatment systems may unintentionally exclude them, and what can be done to make services more inclusive and effective. From the absence of representation in outreach materials to clinician bias in diagnosing and treating men, George highlights systemic gaps—and the hope that comes from centering men’s own voices in solutions.

Why George has structured his PhD around muscularity-oriented issues such as muscle dysmorphia, exercise addiction, and disordered eating

Findings from his studies on organizational and systemic barriers that prevent men from accessing eating disorder care

How imagery and outreach materials often alienate men, and what services can do differently

The importance of lived experience research and co-designing resources with men themselves

How messages of “it’s okay not to be okay” may fall short, and why men often need purpose-driven, hopeful framing instead

Practical ways providers can support men without pigeonholing their experiences

George reminds us that there is no one “male experience” of eating disorders, and shares why focusing on diversity, autonomy, and agency is essential in both research and treatment.

This episode discusses eating disorders, body image concerns, and systemic barriers to care. Please listen with care.

You can contact and follow George through the following links:

Website: MyoMinds.com

Twitter/X: @myominds

Instagram: @myo_minds