Relapse Prevention

Eating Disorder recovery , anorexia recovery ,bulimia recovery ,Binge recovery

What is Recovery?

Recovery is a process, not an endpoint.  In the long-term, your loved one can live a normal life.  For most clients, there will be a point at which their lives will not revolve around food issues and concern over their weight.  Your child will slowly learn how to reconnect with others and renew hobbies and other interests.  However, you must also expect that there will be challenges ahead during this recovery process.  During times of stress or change, your loved one may be tempted to use their eating disorder to cope.  Change does not occur overnight; so it is possible to see progress, as well as an inching back towards the eating disorder.

Relapse Prevention

It is important to identify potential high-risk situations.  This will increase the likelihood that your child will catch themselves before they slip.  The more high-risk situations identified, the better prepared you will be to handle stressful situations.  Some common high-risk situations for slips include:

  • seeing others from treatment not doing well
  • family gatherings
  • going on vacation
  • returning to school or work
  • holidays
  • reconnecting with loved ones
  • spending time alone

Again, it is important to plan for these situations ahead of time.  Your child’s outpatient providers can assist in creating a plan that will fit their unique situation and utilize their positive coping strategies.  For example, if your child would often binge at night, have them plan dinners with friends.  Or, if you anticipate that an upcoming family gathering will be stressful, encourage your child to go for a walk with a relative they feel comfortable spending time with.

Slips and Relapse Prevention

Another useful tool in preventing relapses is to notice the warning signs of a slip.  Some examples include the following:

  • slippery thinking (“I just need to lose two pounds, and then I’ll be fine.”)
  • skipping snacks and/or meals
  • spending more time alone
  • skipping medical appointments
  • avoiding discussions regarding treatment issues
  • making excuses not to have meals with family members or friends
  • food missing in the home (binge eaters)
  • increase in exercising
  • sleeping more than usual

It is helpful to become familiar with the above signs and check in often with your child to see if they are exhibiting any of these behaviors.

How Can Your Child Keep a Slip from Becoming a Relapse?

Help your child in becoming aware of when they may be slipping.  It can be easy for your child to rationalize their unhealthy behaviors.  For example, they might say to you, “I was too busy at school to eat my snack.” and then, “It didn’t really matter that I missed the snack. I am doing fine with just my meals.”

If symptoms do re-emerge during stressful times, try the following steps:

  • identify the stressor and problem-solve
  • inform their treatment team that they are struggling – possibly plan for an increase in visits
  • reach out to let their supports know how they can be supportive
  • ask their nutritionist for assistance in re-starting their meal plan
  • plan days ahead, and include supports; however, don’t schedule too much
  • encourage journaling
  • identify the most difficult meal, and make plans for your child to eat with a friend or family member

What can you do as supports when you notice warning signs of slipping?

Do:

  • Set clear limits.
  • Let them know you are concerned, and ask how you can help.
  • Find someone that you can use for support yourself (spouse, parent, or friend).  It is understandable that you may be scared or angry. Talking this through with someone can be very helpful.

Don’t:

  • Expect your loved one to be perfect.
  • Say things like “I’m so disappointed” or “I’m afraid that you may never get better”.  (These statements may lead to negative emotions, followed by a move to more eating disordered behavior).
  • Try to control everything.  This often leads some individuals back to previous unhealthy behaviors.

Slips are a normal part of the recovery process.

This doesn’t lead to giving your child permission to return to their eating disordered behaviors.  But the reality is that most individuals do slip or even relapse on the way to a full recovery. One can best avoid slips by planning ahead as much as possible.  If your child does have a slip, help them to do the following:

  • Reframe–the episode as a “problem” or  “setback”, not a “failed recovery”.
  • Renew–the commitment to long-term recovery.
  • Return–to the plan of regular eating without restricting or purging.
  • Reinstitute their Relapse Prevention Plan.

 

Valerie Gurney, PhD
Clinical Psychologist

Eating Disorder recovery , anorexia recovery ,bulimia recovery ,Binge recovery

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