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Psychotherapist Asher Pandjiris joins us to discuss their experience with chronic illness and “autoimmune diets,” why they were attracted to naturopaths and other alternative-medicine providers, the role of values in people’s attraction to wellness culture, cultural healing traditions vs. cultural appropriation, their approach to working with orthorexia, and lots more.
Asher Pandjiris is a psychotherapist, Ketamine Assisted Psychotherapy Provider, Disordered Eating Consultant and Co-Director of The Kintsugi Therapist Collective. They come to their work as a scholar of critical, psychoanalytic, and mindfulness-based theories. Asher has 14 years of experience working with issues related to trauma and its impact on the body and has published on the topics of intergenerational trauma transmission, the treatment of eating disorders, the wellness industrial complex, gender dysphoria, and clinician burnout. Find them at asherpandjiris.com and kintsugitherapistcollective.com.
Resources and References
Christy’s second book, The Wellness Trap: Break Free from Diet Culture, Disinformation, and Dubious Diagnoses and Find Your True Well-Being
Subscribe on Substack for extended interviews and more
Two-eyed seeing in healthcare
Indigenous MD Lewis Mehl-Madrona on two-eyed seeing approaches to HIV/AIDS
Transcript
Disclaimer: The below transcription is primarily rendered by AI, so errors may have occurred. The original audio file is available above.
Christy Harrison: So Asher, welcome to Rethinking Wellness. I'm so excited to talk with you.
Asher Pandjiris: Thank you.
Christy Harrison: It's great to connect again as always. We first met years ago when I had you on my other podcast, Food Psych, and then later I interviewed you for my book The Wellness Trap. And those were both such great conversations, so I definitely recommend people check them out if they haven't. But for those who haven't listened to them or read them, I'd love to start off by just having you tell us a little bit about your history with diet and wellness culture and how you came to do the work you do today.
Asher Pandjiris: Sure, our conversations were really helpful in kind of coalescing my story around wellness influences in my life and the why and what of all of that. I was diagnosed with Crohn's disease when I was 14 and subsequently have been diagnosed with a couple of autoimmune conditions, all of which are sort of understood and sort of not by the medical world.
Crohn's disease is probably understood the most, and even that is there's still a lot of questions around the origins of the disease and how it functions. Being diagnosed at such an early age, I guess I had to live with a lot of questions about how my life might play out, what was possible for me, and when I would come up against, you know, a flare or a period of difficulty that couldn't be totally managed by medication, Western medication. I find that newer medications are helping me much more. But there was, you know, a period of time when every couple of years, I would really have a significant flare in symptoms. And I found myself turning to a lot of alternative practitioners or being introduced to wellness practitioners by other people or being told that the medical world was not going to be able to cure me or heal me of my disease. But there were people who could and who could make me symptom free or there were diets that could do that. Mostly diets, mostly food-related interventions.
And you know, over the years I've tried countless wellness related diets. I live with relative thin privilege, so I have never been as susceptible to weight loss based dieting. So really this has been more along the lines of kind of like purifying myself of anything. Gluten, dairy, FODMAPS, fructans. I can't even think of all of the things, many, many more. Nightshades, you know, all of that. I've had a lot of experience both with unsolicited advice and also with soliciting the perspective of many alternative medicine practitioners or wellness gurus. And a lot of that in the spirit of kind of taking control of my own health, quote, unquote. And a lot of that has been in the face of medical professionals who maybe don't have the best bedside manner, maybe don't listen to my experience very well. A lot of my orientation around the western medical world, you know, occurred when I, as a result of being young when I was diagnosed and really seeing these doctors as authority figures who could tell me what my life was and what was possible and what wasn't, and feeling really frustrated with some of those realities.
So there's a lot of influences that have had bearing on my life in terms of the work that you do. And I also, you know, probably as a result of some of these things ended up working as a psychotherapist in the field of disordered eating. And so as a clinician, I've really been interested in the way that trauma or intergenerational trauma is stored in the body and how that plays out in either food restriction or other disordered eating behaviors. And as a result, many of the same influences that it had bearing on me in terms of the wellness world. I tend to work with a lot of people who have been deeply influenced by alternative medicine practices or purification diets. A lot of orthorexia is a presentation of what I see in my work. I've kind of been in that world for quite some time, both personally and professionally.
Christy Harrison: Thanks for sharing that. And it really is interesting how those things intertwine for so many of us. I think for me, too, I was drawn to the world of nutrition and then eventually to specialize in eating disorders because of my own experience. And initially it was driven by wanting to perfect and, you know, attain that ever elusive goal of dietary perfection. But then it sort of morphed into something else of more deeply understanding my own relationship with food and wellness and, or un-wellness, as the case may be, and, you know, starting to unravel the grip of disordered eating in my life. I'm curious for you, like, what was your experience with alternative medicine and all the supposed autoimmune diets that you tried and the other practices that maybe were recommended to you?
Asher Pandjiris: I'll say this about myself, I'm a very motivated patient, I guess you could say. And so when I am presented with a suggestion that holds the promise of maybe reducing significantly or eliminating some really painful symptoms in my life, I go for it. I think that both has been a problem in a lot of ways, but also has led me to kind of see things through.
So, for instance, you know, there's a lot of questions, of course, around gluten and dairy when it comes to digestive disorders, but also anything related to autoimmune processes. And I think a big thing about having autoimmune disease is that there is a general sentiment amongst many doctors that sort of communicates that what is happening with my immune system and, you know, inflammation is kind of bewildering. All that is known is that it is abnormal, right? My immune system operates abnormally. And so it leaves a lot of room, I think, for people who have a specific diet in mind or a specific approach to kind of come in and fill that space. And to say, yeah, we get that you have this kind of autoimmune dysfunction, let's just say, but this is just inflammation in the body, and so let's eliminate the inflammation. And the way to eliminate inflammation is: fill in the blank.
So one of the things that I've done, and it's been called many different things, is, you know, eliminating gluten or eliminating dairy and taking a lot of supplements in various forms. I've worked with naturopathic medicine. I've worked with homeopathy, which is not dietary in nature. I've worked with acupuncturists. I mean, I will say, and I've said this to you before, but I have had some positive experiences working with acupuncturists. And we probably will get to this later in the conversation, but I think a big part of that work has been pain related. So some pain relief. But there is also the kind of holistic intake process that I think can really appeal to a lot of people in the sense that all sorts of questions are asked about your body, its processes, you know, things that seem unrelated, that are kind of connected. Like my sleep to my digestion, to my mood, to what my tongue looks like to what my bowel movements are doing. You know, like all of these different things are sort of connected. And when someone says all you have to do - this is separate from acupuncture - but when someone says all you have to do is take out gluten and you will see all of those different areas of your body will benefit and the inflammation will decrease, that is really appealing. And why not, you know, why not try it?
You know, I can say this after years. I don't think that I could say this, you know, initially. You don't really know how to trust whether or not something is working or not. And I think that's another real issue is it's hard to demarcate your symptoms. And what is placebo and what is, you know, all of these things that you dive deeply into. But for instance, you know, removing gluten from my diet has, on the whole, done absolutely nothing in terms of my symptoms. And basically no elimination diet has really impacted my symptoms at all. And I can say that now it's been 30 years or something of trying this, but I think I couldn't confidently say that. Maybe even 15, 10 years ago.
Christy Harrison: Yeah. So you really had to go for it and try everything and see what was going to work or if anything possibly could work.
Asher Pandjiris: Yeah, and this goes to a little bit of my personality, you know, of like saying, 'okay, I'm going to try it and go for it.' I think I really at an early age, because of being diagnosed with such a potentially pretty severe and definitely a debilitating disease, is that self-optimization or self-improvement started really early on in terms of my holistic health. I really felt motivated to essentially not be sick. There is so much internalized ableism that I live with and you know, thankfully, I don't live with as much of anymore. But I really wanted to eliminate any trace of my illness from my daily life. I went for all of these different diets and approaches in part because I didn't know how to be with the inevitability of the flare-ups and the pain that I was experiencing because I was determined not to be marked as someone who was different or sick. And that was a really hugely motivating factor for me for quite some time.
Christy Harrison: And that's such a promise that's held out in a lot of alternative medicine spaces, right, or just wellness spaces in general, that you can put your disease into remission, that it is possible to not be sick at all and to like get off on medication. I know you said in one of our interviews that that was a big theme that kept coming up too, was like, get off Western meds.
Asher Pandjiris: Yes. Getting off Western meds felt like, you know, there's a narrative around being kind of strong and sturdy enough to not need Western medication. That somehow like the natural healing potential in my body was not really being activated because I was dependent on Western medications. And so getting off of them seemed like what would be a good solution to kind of reveal my inherent stamina.
And that promise was really compelling. And it also is pretty demoralizing when you do try to see these things through and you find yourself similarly symptomatic. The increasing simplicity of - I'm thinking about primarily like the celery craze. There was something about that that really stuck with me, because I did try it. I tried it a little bit with a tremendous amount of skepticism. I didn't think, 'okay, I'm going to drink celery juice and like my symptoms are going to go away.' But I was so struck with the seductive simplicity of that. Right? All you need to do is use this one vegetable and then, you know, you find yourself buying extra celery at the store and thinking, 'what am I actually doing? You know, like really, what am I doing?' So I've been there. I mean, I say all this from the perspective of someone who's been there.
Christy Harrison: You really did it. You really gave it a shot, as you said. And I think it was our interview for The Wellness Trap. You, like, really can do things to the letter if you try and like that you were going back to these practitioners and saying, 'I don't think it's helping. I don't think anything is different.' And then they would be like, 'are you sure you didn't slip up and have some cheese or have some alcohol or whatever?' And you're like, 'no, seriously, I did this to the letter.' Like, this is. 'I did your diet. I don't know what you want from me.' You know?
Asher Pandjiris: Yes, that is the good, like, obedient Catholic Virgo in me. I can definitely follow things, which makes me a good research subject in a way. Right?
Christy Harrison: Yeah. Like your own self-experimentation. You can really sort of say, okay, I gave this my all and it didn't actually work.
Asher Pandjiris: Yep, that's so true.
Christy Harrison: That's a helpful quality in some ways, I'm sure a difficult quality in others in terms of the orthorexia type of stuff, because that makes it easy to slip into this sort of obsessive following these rules to purify yourself or whatever. And then that's its own whole other ball of wax.
That conversation that we had for The Wellness Trap really stuck with me over the years. This was back in 2021, I think, that we talked for The Wellness Trap, but I've been thinking about different aspects of it for years now. And one especially, I think, is that you shared - and it was kind of a small part of the conversation, but it's something I want to, like, dive deeper into today - is the part where you shared why you found alternative medicine spaces more welcoming and in alignment with who you were. Can you talk a little bit about that? I mean, I guess wrapped up in feeling like Western medicine was failing you or not giving you what you needed. There was this other piece that you talked about then of your identities and sort of how alternative spaces felt more open to that.
Asher Pandjiris: Yeah, absolutely. I've also been thinking about that question. When you reached out to me, I think one thing I remember in my history is that I attended small liberal arts college and was what they called at the time, a women's and gender studies major. And I was also doing a lot of pretty radical activism around environmental causes. And I was working with a lot of people and drawn to a lot of movements around challenging systems of oppression. And that meant really looking at the impact of power structures and like the hegemony - that was a big phrase, you know, like a big thing that we talked about, ike the hegemony. But that resonated for me personally and it still does in a lot of ways.
I think there are obviously deeply disturbing structures of oppression that are within us and external to us, that are important to think about. But there was a kind of movement around not trusting authority figures, not trusting these structures. And also at the same time, you know, in my early adulthood, I was coming out as queer and eventually coming out as non-binary, but always feeling, you know, increasingly like I had several aspects of my identity that put me into conversation with Western doctors in a way that felt uncomfortable. You know, I would, I would see doctors and a lot of specialists. I don't want to say all, but many, many specialists I think are quite curt. They're very siloed. And so I would say that if I was having some symptoms external to the organ systems that this particular specialist was interested in, that was none of their concern. And additionally, so then I was quieted or silenced around that.
And then additionally, the more visible my queerness and my gender identity became, the more uncomfortable or strange I felt in these doctor's presence. And I think that did have a lot of bearing on how my questions were related to or how I was treated. I became almost like more of a mystery to certain Western medical doctors. You know, I already had this like autoimmune condition that felt like, well, we don't know what we can do for you. And also I became kind of more visibly out of place, I guess. So all of those factors kind of came together, I think over the years to cause me to question what the intentions were for the medical doctors, you know, where was their care, supposed care, coming from? What were they interested in addressing and why were they leaving so much of my experience out of the picture?
And I think that is primarily what led me to - I just mentioned earlier acupuncture, but, you know, led me to working with some alternative medicine practitioners because many of them, you know, you sit down and they take a very complete history of your whole body, sort of the totality of your experience. And you know, as a psychotherapist, I think about the kind of intakes that I do and I'm really interested in many, many dimensions of a person's life and internal world. And there are some therapists who, you know, have a form that they fill out, and they're filling it out while they're talking to you. And that has a lot to do with managed care. It's not a criticism of the therapist. But I think there is a huge difference in terms of trust and comfortability when you feel listened to and heard. So that's a little bit of what I associate with that kind of period of my life.
Christy Harrison: You said also in that interview there was something about the fact that alternative providers don't treat queer and trans bodies as like messed up or weird. And because they're like, we're weird, we're weird over here. Right? We're different, we're all weird and it's okay, you know, and there's like a shared sense of difference and being outside the mainstream. And I wonder how much that played a role. You know, you've mentioned that that was part of it for you and maybe a part of it for other people you're in community with. That's part of the appeal and the attraction is there's this alternative space where you don't feel like you stick out as much. You feel like you actually are accepted for who you are.
Asher Pandjiris: Oh, absolutely, yeah. I'm glad you brought that up. Yeah, I mean, 100%. I think, you know, I can't speak for like my community broadly, but I can say that still today I would say many, most maybe, of the people that I consider to be in community with would prefer at any turn to be treated in an alternative medicine space rather than in conventional medical settings. And I think part of that does have to do with how queer, trans people of color, disabled people are treated in the Western medical world. And this isn't just a theory. I mean, it is true that many alternative medicine practitioners are, I mean, this is very broad statement, but of the ones that I've interacted with, that dimension of my identity isn't seen. It isn't really of note.
I would say that more of myself is welcomed in and I think a lot of people experience that. And you know, this goes to. I'm going to speak as a therapist again, but when we have - we meaning people who live in non-normative bodies, whatever that means - we have had historically many experiences either within our family systems or, you know, outside of our family systems of kind of being denied care and affection or support pretty systematically as a result of our difference. And I think that it can be very uncomfortable. It can be very triggering to be in environments where you are a vulnerable body, you're sick, you need soothing and help and attunement, attuned care, and you're already coming in with sort of a lot of wounding around being cared for. And so it can be extremely comforting, I think, for people to not only in these kind of aberrant bodies, to come into an alternative space and to not only be told, you know, 'I want to listen to your whole story.' But also to be told, 'there's something that we can do to, you know, ease your suffering. Like, there are answers here. You make sense.'
You know, I think that was a big thing with acupuncture. We can talk a little bit about a complication in what I'm saying, but I think a big part of acupuncture was that if I said, my back hurts and I'm having this other pain, oftentimes the conceptualization of what was happening for me was, oh, that makes sense. Those things are related. They're linked. And that felt good, for sure.
Christy Harrison: It feels good to have somebody say that, like, you make sense and probably too, feeling like your body makes sense in all the ways in that space, versus, like you said, being in Western spaces, feeling like you were a bit of a mystery already with your symptoms that sort of went beyond what the specialist might be able to address, and then also presenting in a different way than they are expecting or than a lot of patients or whatever, that it sort of adds to this sense of like, well, we just have no idea what to do with you.
Asher Pandjiris: Yeah, exactly. That's it. Yes.
Christy Harrison: What do you think is the complication of that, too?
Asher Pandjiris: I mean, I guess there's a part of me that feels complicated about sort of creating too much of a dichotomy around Western and then alternative. Because I think within the context of some alternative wellness spaces, we're talking about healing traditions that are indigenous traditions. You know, they're really powerful cultural practices that I have a deep and rich history. And so, you know, I think we talked a little bit about this before when we talked about doing this interview, but I guess it would be interesting just to hear from your perspective what you are interested in making a differentiation about in terms of those practices. Because for me, I think, yes, it felt good to be told, yes, your body makes sense. And also I think that, for instance, acupuncture is a tradition that has lasted for, I don't even know how long. Centuries? Yeah, I don't know. I guess I'm interested in having part of that conversation.
Christy Harrison: Yeah, totally. And I think that's something that I grappled with a lot in my book, The Wellness Trap, and then sort of haven't really brought in as much the conversations here, because I've been focused on sort of more specific questions of does this thing work, does that thing work? Or like, you know. But now I'm starting to think about this broader notion of values. I mean, that is ultimately sort of why I wanted to have this conversation with you, is that I'm thinking through how values seem to play a big role in people's adoption of alternative medicine and also in people's susceptibility to misinformation. And there is so much misinformation within alternative medicine, and a lot of it is unfounded scientifically. But then there's also these rich healing traditions, like you said, that are their own thing.
And what I sort of arrived at in the book and interviewing people, including a number of people, for a section that I ended up not being able to use, but that really did sort of help inform some of my thinking, was this idea of, you know, I think a lot of wellness culture really strips healing traditions down for parts and takes the parts that it wants and leaves the rest, you know. And like Susanna Barkataki, who I interviewed for the book, talked about how yoga is so much more than just the physical postures, the asanas. There's like, I think it's eight limbs of yoga, and asana is only one of them. And, you know, it's a whole system that's sort of geared towards collective liberation ultimately, and has a real spiritual component and all of these rich aspects to it that just get pretty much lopped off when it gets sort of imported into your everyday kind of like neighborhood yoga studio, you know. And that is, you know, her point.
And I think the point of many people thinking about these issues is that that is a problem, right? That's cultural appropriation. And it's not really doing a service to the culture being appropriated from or the people that are engaging with the appropriated culture necessarily. You know, like when you go to a yoga studio that sells tshirts that are like "Om Shanti" or whatever, you know, whatever sort of appropriated phrase or like even, you know, worse like "Spiritual G" and things like that, you know, it's just divorced from the roots of the tradition that are ultimately about so much more.
And I think when you get into some other alternative practices, you know, especially like indigenous healing traditions, I think it becomes even more stark, like ayahuasca for example, you know, I really was interested in sort of the discourse around ayahuasca in Western culture and the sort of excitement about it and wellness spaces as compared to what some of the indigenous healers who have these huge, long traditions behind them and have been developing, you know, there are governing bodies of indigenous healers in various cultures that will make statements and talk about what the tradition is and isn't and who they want it to be used for. And, you know, this particular group in the Amazon where ayahuasca is from was talking about, like, how you really can't take it out of its place and that it is rooted to this place. And, you know, we don't want people taking it abroad and using it in these ways that are divorced from the traditions here, you know, and divorced from this place. And that just, I think, has really shaped my thinking about this stuff.
You know, I'm certainly no expert on this, but I've tried to listen to a variety of people who do know a lot more about this than I do. And what I've come to think is cultural healing traditions that have value for a certain place, a certain culture, a certain group of people, I think are very valuable and have their own value and their own logic to them. You know, they have their own meaning in those cultures and can be very powerful for people who have an actual connection to them, you know, for people of that culture, for people maybe who are, if they're indigenous folks living in the west but want to reconnect with their culture, like that kind of thing is, I think, of great value. And I think when it's like someone like me, sort of your average American white person, who's, like, stumbling around trying to find something to help us with chronic conditions, and we all need support and healing in so many ways. And I think there's so much the Western medical system leaves out. And so it's understandable, I think, that people who don't have any connection to these cultures are attracted to them and find them appealing because of maybe a more holistic attitude towards the body and towards healing and all of that.
And I think it's ultimately pretty problematic to be a cultural tourist in somebody else's healing tradition, and especially when it's being commodified for the benefit of Western audiences, where it's being stripped down for parts and these traditions or aspects of things are taken out of their system and just sold as is, you know, as a commodity for Western audiences. I mean, that said, I practice yoga. I practice meditation. I don't necessarily practice in a way that is, you know, fully rooted in those cultures that these practices came from. And I grapple with that certainly. And I think, you know, yoga and meditation also happen to be a couple of evidence-based mind body practices that do have good scientific research around them versus some other things that don't. And so it's all super complicated, and I don't have all the answers. But I think there is some distinction to be made, I guess, around something that is a whole system of healing and a whole tradition that belongs in a particular culture or place versus the stuff that doesn't or that's been cherry-picked.
And then I think in addition to, or maybe Venn diagramming with that, is these alternative medicine practices that don't have any roots in any sort of healing tradition that are sort of just like made up out of whole cloth or that are descended from practices that were going on in Europe in the 1800s that are not evident, you know, really unfounded. Like homeopathy, I think is one of those, you know, there's no evidence to support it really. It's something that has not been shown to work. And yet, you know, there's so many devotees of it and people that really swear by it. There's lots of reasons for that. But I think there's a big industry built up around some of these things, right. And there's, you know, they're commodified and they're part of a system that, you know, the alternative medicine system that kind of holds itself up as the alternative and the better thing to Western medicine without any real rootedness. And they're not actually ancient traditions, even if they might purport to be. And they don't actually have a real cultural significance or value system attached to them. You know, they're just like, as Robin Wall Kimmerer would say, knowledge without values. You know, it's like something that is really sort of divorced from any sort of value system. So, yeah, I don't know. I don't know if that is helpful or makes sense. Those are just some of my thoughts on that.
Asher Pandjiris: Yeah, it's great to hear your thoughts on it. I mean, I think you've clearly investigated a lot of these things already, and it's just really helpful to hear your perspective. And I think in terms of values, I do think at this point many alternative, quote unquote, alternative practices are actually appealing, actively appealing, especially the ones that, as you said, you know, some of these diets that are being proposed that don't have really any empirical evidence to support them, that they are actively recruiting, in some ways, people who have, quote, unquote, alternative values in other ways. I mean, the idea of, I think, more politicized, and by that, I mean, you know, more progressive political folks who really don't trust Western medicine because they've had some bad experiences interpersonally or traumatic experiences with medical providers that are very real, as you have reported out many times. But those people, us, I would include myself as one of them, you know, are also connected through this world to, you know, radical Christian extremists or, like, people who don't trust the government and are only feeding their children, I don't know, a macrobiotic diet or, you know, maybe macrobiotic is the wrong word.
Christy Harrison: Maybe feeding, like whole, minimally processed, whatever. Yeah.
Asher Pandjiris: That is an interesting confrontation, at least for me to think about and to notice as I've been exposed to some of these things to kind of be lumped in together.
Christy Harrison: Yeah. It sort of forces you to question what is actually driving the decisions and how much motivation do you share with people that you might not want to align with otherwise.
Asher Pandjiris: Yeah, totally.
Christy Harrison: And, yeah, I mean, this question of values, I think, has been super interesting because as I alluded to, values have been shown to play a role in people's attraction to wellness culture in some way. I'm working on a piece about this now that I shared a rough draft of with you, and it's still very rough, but it's interesting that there are several studies I've come across over the years showing that values are actually a stronger predictor of whether a person adopts alternative medicine than dissatisfaction with conventional healthcare, which, of course, is another big reason why many of us adopt it. You know, it's not definitive research. I think a lot of that research was being done and then it sort of stopped or morphed in a different direction because there was a lot of research or some research around postmodern values and alternative medicine and sort of how postmodern values make people more likely to adopt alternative medicine. And I think in a way that aligns with what you shared about alternative spaces feeling more welcoming and feeling more aligned with people who are progressive and don't trust conventional authority and stuff like that. It's like alternative medicine feels more aligned with those values, even if it's not especially now, ultimately is being used for very different ends and sort of embraced by very different communities.
Asher Pandjiris: Yeah. One thing that just came to my mind while you were saying that is
