Fear subtype: trauma and avoidance

In this episode, Child & Adolescent Psychiatrist Dr Josephine Neale - Clinical Director for Child and Adolescent Mental Health Services at the Priory and founder of Neale Health, the UK’s first fully online child and adolescent psychiatry service - joins Ben to unpack ARFID (Avoidant Restrictive Food Intake Disorder), a condition many people have never heard of but is increasingly recognised in autistic and ADHD individuals.

Josephine explains that ARFID isn’t about weight or body image, but driven by four key subtypes: sensory discomfort, fear and anxiety (often around choking or vomiting), low appetite, or a combination of these.

Drawing on her specialist work across autism, ADHD, and eating disorders, she breaks down why ND people experience food so differently, why ARFID is still often missed, and how eating difficulties can quietly build long before families know what’s happening.

This conversation offers clarity, compassion, and practical tools - whether you’re navigating ARFID yourself, supporting a young person, or simply trying to better understand ND eating differences.

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Host: Ben Branson

Production Manager: Phoebe De Leiburné

Video Editor: James Scriven

Social Media Manager: Charlie Young

Music: Jackson Greenberg

Head of Marketing: Kristen Fuller

00:00 Introduction

00:48 Dr Josephine Neale: Her Background in Eating Disorders, Autism & ADHD

7:20 Why Mind & Body Are Often Seen As Separate in Eating Disorders: & Why That Can Be Problematic 

11:26 What Is ARFID? (Avoidant Restrictive Food Intake Disorder Explained)

15:01 How Clinicians Assess ARFID 

23:35 ARFID in Neurodivergent People: Autism, ADHD & Sensory Profiles

25:29 The Four ARFID Subtypes: Fear, Sensory, Low Appetite & Combined

29:40 What Causes ARFID? Understanding Roots, Triggers & Early Signs

31:13 ARFID Fear Subtype: Anxiety, Choking Fears & Avoidance

32:44 ARFID Low Appetite Subtype: Interoception & Reduced Hunger

34:38 ARFID Sensory Subtype: Texture, Smell, Taste & Food Aversions

48:23 Can ARFID Come and Go? Understanding Episodic Presentations

50:30 Did ARFID Exist Historically? Why Modern Life May Be Increasing Cases

55:36 Christmas & ARFID: How to Support People with Eating Difficulties

1:01:08 ARFID at Someone Else’s House: How Families Can Navigate Christmas Day

1:05:59 Dr Josephine’s Green Dot Badge

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Dr Josephine Neale @drjosephineneale www.nealehealth.com

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