As clinicians, it’s important that we are aware of how a patient’s life events and stressors might be impacting their functioning, as well as how to help them to navigate through these challenges.
As an eating disorder therapist in private practice in Rockville, Maryland, specializing in helping teens and adults with anorexia, binge eating disorder, bulimia and body image issues, I often find that periods of transition and big life changes can be a time when people’s “eating disorder voices,” get louder.
The following are some tips for helping our patients in eating disorder recovery to cope with change and transitions.
1.Help them to separate out their “eating disorder self” from their “healthy self.”
When treating patients with eating disorders, it’s crucial to help them to start to separate out their “eating disorder self,” from their “healthy self.”
For example, we might start to notice things that the “eating disorder self,” is telling them and then practice responding from their “healthy self.”
Eating Disorder Self: You shouldn’t eat that dessert. Cake is bad for you and it will make you fat.
Healthy Self: You deserve to nourish yourself with food that you enjoy. No food is good or bad and all foods can fit in a healthy diet.
It’s important to help clients to strengthen their “healthy self,” and to take actions that are in alignment with their true values, rather than listening to what their “eating disorder self” is telling them to do.
2.Collaborate with them to create a relapse prevention plan.
Especially during times of stress and transition, clients may feel more triggered to turn to eating disorder behaviors. While recovery from alcoholism is pretty clear cut, often people’s specific warning signs that they are slipping in their recovery may not be as evident to them.
Therefore, when working with patients, I often will help them to create a relapse prevention plan where they identify their “green light,” “yellow light” and “red light” signs.
-Under green light, clients put how they will know that they are strong in their recovery.
-For example, “I don’t spend much time thinking about my body and “I am able to be flexible with food.”
-Under yellow light, patients will put warning signs that they are starting to slip in their recovery.
-For example, “I start to eat out at restaurants less” and “I begin to avoid certain foods.”
-Under red light, clients will put signs that they have relapsed into their eating disorder.
-For instance, “I use eating disorder behavior.”
It can be helpful for clients to share this plan with their support system and treatment team, as well as to determine what steps they will take if they (or a loved one) notice that they are slipping into the “yellow light zone.”
3. Encourage them to practice reaching out to their support system, rather than turning to eating disorder behaviors.
It’s also important to normalize for clients that times of transition and stress can often cause people’s “eating disorder voice” to grow louder. Additionally, they can work to be compassionate with themselves, as they are definitely not alone in what they are experiencing.
Further, it can be helpful to encourage clients to practice turning to their support system (such as friends, family, or their treatment team) in times of stress, rather than using their eating disorder behaviors.
The Bottom Line
Ultimately, it can be beneficial to reframe for patients that times of change and transition are great “learning experiences,” when it comes to practicing using healthy coping strategies and turning to their support network, rather than eating disorder behaviors.
With time and practice, they can learn how to listen to their “healthy self,” even during times of stress and transition.
With access to treatment and support, people with eating disorders can recover and go on to lead meaningful and joyful lives.