Who I Work With | Ashley Mccune Shyver

Who I Work With

Eating Disorders and Body Image

I specialize in working with adults across the eating disorder spectrum, including those struggling with restrictive eating, binge eating, bulimia, chronic dieting, body image distress, and rigid or obsessive patterns around food, weight, and exercise.

Eating disorders do not always look the way people expect them to. You do not need to have a particular body size, meet every criterion for a specific diagnosis, or feel “sick enough” for your relationship with food or your body to deserve attention.

Treatment may focus on:

Restrictive eating and food avoidance
Binge eating and loss-of-control eating
Bulimia and compensatory behaviors
Chronic dieting and food rules
Food anxiety and increasing flexibility around eating
Body image distress and body checking
Perfectionism, shame, and self-criticism
Recovery support and relapse prevention

The Intersection of Eating Disorders and OCD

Eating disorders and OCD can overlap in ways that are difficult to untangle. Food rules, checking, reassurance seeking, intrusive thoughts, rigid routines, avoidance, and the need to feel certain or “just right” may be driven by the eating disorder, by OCD, or by both.

I have particular experience identifying when obsessive-compulsive processes are occurring alongside eating and body image concerns and helping determine what may be driving a particular thought or behavior. Understanding that distinction matters because treatment may look different depending on whether we are addressing an eating disorder behavior, an OCD compulsion, or an interaction between the two.

When OCD symptoms are mild to moderate and can be appropriately addressed within our work, I may incorporate Exposure and Response Prevention (ERP) and other evidence-based strategies into treatment. When OCD is more complex, severe, or would benefit from specialized treatment, I collaborate with or refer to trusted OCD specialists while continuing to address eating disorder concerns when appropriate.

Anxiety & Perfectionism

Anxiety disorders are another primary area of specialization in my practice. I work with adults experiencing persistent worry, overthinking, difficulty tolerating uncertainty, avoidance, reassurance seeking, feeling constantly “on,” or having a hard time slowing down even when you’re exhausted.

Perfectionism often becomes intertwined with anxiety. You may set incredibly high expectations for yourself, struggle with mistakes or uncertainty, overthink decisions, or feel as though what you accomplish is never quite enough.

Treatment focuses on understanding the patterns that keep anxiety and perfectionism going, developing more flexible ways of responding to difficult thoughts and emotions, and learning to tolerate discomfort and uncertainty without allowing them to dictate your choices.

ADHD in Women

ADHD in women is often overlooked, particularly in those who have learned to compensate by working harder, overpreparing, staying highly organized, or holding themselves to impossibly high standards. From the outside, you may appear capable and successful while privately feeling overwhelmed, scattered, exhausted, or frustrated by how much effort it takes to keep everything together.

Many women reach adulthood without recognizing ADHD because their struggles have been attributed to anxiety, perfectionism, procrastination, or simply “not trying hard enough.” For some, increasing demands or major life transitions eventually make the strategies that once worked much harder to maintain.

Therapy can help you better understand how your brain works, reduce shame and self-criticism, develop strategies that actually fit you, and begin separating your sense of worth from how productive, organized, or “together” you are able to be.

Life Transitions & Personal Growth

Not every reason for coming to therapy fits neatly into a diagnosis. Sometimes life changes — or you do — and the ways you have always understood yourself or moved through the world no longer seem to fit.

Major transitions in relationships, family, career, identity, or other roles can bring uncertainty even when the change is wanted or positive. At other times, there may not be one obvious transition at all. You may simply find yourself questioning what you want, reevaluating old patterns or priorities, or realizing that the life you have built no longer feels quite right.

Periods of significant change can also be times when old coping patterns resurface or new ones begin. For individuals with a history of eating or body image concerns, transitions can sometimes trigger a return or intensification of symptoms — even after a long period of feeling relatively well.

Therapy can provide space to understand what is changing, clarify what matters to you now, and make more intentional choices about what you want the next part of your life to look like.

A Note From Ashley

One question I’m asked often is whether you need to have an eating disorder to work with me. You absolutely do not. Eating disorders, body image, and anxiety are significant areas of specialization in my practice, but they are not the only reasons people come to see me.

And if you do come to therapy because of an eating disorder, anxiety, ADHD, or another specific concern, that does not mean it is all we get to talk about. You are a whole person, and therapy should make room for your relationships, family, work, experiences, challenges, and everything else that matters in your life.

Eating disorders also commonly occur alongside other mental health concerns, including anxiety, depression and other mood disorders, obsessive-compulsive symptoms, and trauma or PTSD. After many years of working with eating disorders, I am very accustomed to helping clients navigate these concerns together and understand how they may interact with one another.

You do not need to fit neatly into one category — and neither does our work together.