Post-holiday time can be filled with mixed emotions.  Some people experience RELIEF that it wasn’t as difficult as they had predicted, others struggle with post-holiday  FRUSTRATION or GUILT related to eating disorder behaviors or holiday meal challenges.  Still others head out of the holiday week EXCITED to return to the familiar structure and schedule of school or work. There may have been HAPPY times or SAD emotions woven throughout your Thanksgiving holiday as relationships and expectations for the holiday were tested. Maybe you tried some of the tips we suggested in Part I and Part II of our holiday blog series with a lot of success…or perhaps with a lot of struggle.  No matter how things went or how you’re feeling now its important to honor your emotions and continue on from this point in a recovery-focused way. Here are some tips that can help you make the most of your week-after-Thanksgiving (and beyond).

1. Change your filter.  So often, the eating disorder voice shines such a powerful spotlight on everything negative that it can be easy to get caught up in what went “wrong” on Thanksgiving day and ignore everything that was positive.  This is an example of a cognitive distortion called filtering.  In the days and weeks that follow, try not to allow your eating disorder to dictate how you will remember this holiday.  Instead, sit down with positive intention and make a point to reflect on what went well, what worked and who was integral to those successes.

2. Don’t skip therapy. (Sound familiar?)  If you had a hard time during the holiday and find yourself feeling frustrated or ashamed that you acted on symptoms, do not cancel appointments with providers.  Right after slip-ups is the ideal time to meet with a therapist or dietitian to process what happened, what the trigger was and how to prevent a holiday-induced downward spiral.  If your first appointment with a provider won’t be for another few days, take some time to jot down your observations and feelings about the holiday and what you want to remember to discuss with your therapist or dietitian.

3. Accept post-holiday compliments gracefully.  Individuals with eating disorders often have a hard time accepting positive feedback, especially when it clashes with their own negative beliefs about themselves or their abilities.  If someone is genuinely telling you that you did a good job with something, before you refute them, consider how your reaction will affect you and them. When Aunt Martha calls you this week and says  “Thanks for hosting us this weekend.  Your house looked beautiful all decorated for the holiday and the meal was just great,”  your instinct might be to say ”Oh please, the turkey was dry and the house was a mess! I just didn’t have time to clean it the way I wanted to.”   When you completely reject a compliment it sends a message to the other person that you may be overly critical in general or that their opinion is not valued.  Additionally, if you deflect compliments from the same people repeatedly, they may be conditioned not to give them at all.  Most importantly, when you reject compliments you deny yourself the opportunity to absorb a positive belief which could go a long way in helping to boost your self-esteem and overall self worth.  Even if you’re struggling to believe that a compliment is true, allow yourself to receive it and entertain the idea that it just might have some validity.  Instead of deflecting, consider simple statements, such as “Thank you so much – that means a lot to me” or even, “Thanks” will work just fine.

4. Move On. If this holiday wasn’t what you had hoped for, let it go.  Don’t continue to blame yourself for things that may have been beyond your control.  Assess what can be changed in similar situations in the future and make note of them, then allow your mind to move on. Getting stuck in thoughts about how disastrous/boring/disappointing/etc. your Thanksgiving was is not going to help you make today the best it can be.  Remember that non-holidays are just as important in the long run of recovery.  Make today a good day; do the best thing for you and your recovery in this moment.

5. Keep the gratitude going.  Thanksgiving does a great job in helping to promote gratitude.  Even if you haven’t yet jumped on the #thanksvember bandwagon via Twitter or Facebook, it’s not too late to start. Take some time tonight to be grateful and send a genuine “thank you” to the support people that helped you enjoy the holiday…

• If your mom changed the subject at dinner when a relative was harping on you for not taking seconds of her casserole, tell your mom later how much you appreciated her speaking up.  (If you live close by, give her a hug while you’re at it.)
• If your friend answered frantic text messages you were sending on Thanksgiving day, let him know how much that meant to you that he was available for support in the thick of the holiday.
• If your little nieces and nephews forced you into hysterical laughter with their impromptu Thanksgiving skit, send them little notes in the mail to let them know you can’t wait for their Christmas or Hanukkah performances too.
• When it comes to gratitude, remember to use your voice.  It’s an  excellent opportunity to nourish the positives and create more of what you need for your recovery.

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Is there someone you relied on this Thanksgiving to help you through?   If you have feedback or comments about positive ways in which your support people helped out this holiday, we’d love to hear.  Share in the comments below or join the conversation on our Facebook page.

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Tried and True Strategies for a Recovery-Focused Holiday – Part I: BEFORE the Holiday

Tried and True Strategies for a Recovery-Focused Holiday – Part II: The Day OF Thanksgiving

Above photo courtesy of psychcentral.com (click on the photo to link to interesting research about the benefits of gratitude on health and wellness)

Holiday gatherings and celebratory feasts can pose some significant challenges, regardless of where you’re at in treatment or recovery. Being aware of them, planning for them and setting yourself up for an enjoyable holiday is important. That’s why we asked all of our clinical staff at CED to share their best advice for having a safe and successful holiday while maintaining or working towards recovery from an eating disorder. They had so much to share that we couldn’t fit it all in just one post so this is just the first of a 3-part series to help you through the before, during and after of the holidays.  

Through the years, these are some of the strategies and suggestions that our therapists have seen the most success with and we hope you will too.  Happy Thanksgiving from all of us here at the Center for Eating Disorders at Sheppard Pratt.

Part I: BEFORE the Holiday…

• Plan, Plan, Plan…..with your treatment team and with your primary supports. Develop a very specific, detailed plan for managing all the stressors that come along with the holidays.
• Challenge predictable thoughts before the holiday. If you notice you have predictable patterns of negative thinking pop up at family gatherings or the same triggering thoughts sneak up on you every Thanksgiving day, take time to identify them in advance. Write them down and work on challenging the thoughts ahead of time (on your own or with a therapist) so you’re better prepared to defend against these specific negative/irrational thoughts on the actual day.  You might even consider keeping a list of your positive affirmations or challenge statements with you on Thanksgiving for easy access.  (If you know you’ll have your phone handy, you could even send a text to yourself the day before).
• Identify one or two major positives about the holiday. No matter how anxious or depressed you may feel about an approaching holiday, there IS a positive hidden somewhere, even if it’s as simple as getting time off from school or work.
• Make a list of your top 3 most reliable coping strategies and keep it handy in a notebook or on your phone.

Decrease stress and increase relaxation. Only say “yes” to events that you would like to attend and believe you can attend with success. Keep your daily schedule of activities and gatherings manageable.

~ Kim Anderson, Ph.D., Therapist and CED Psychology Coordinator

• RSVP with a time limit. For example, “Thanks so much for inviting me. I’ll be able to be there from 3:00 to 5:00.” This provides you with some boundaries and an opportunity to leave the situation if it’s becoming detrimental to your recovery. However, if things are going better than expected (which often happens) and you want to stay longer, then you can.
• Choose a worry chair.  If the anxiety is overwhelming or interfering with life, set up an appointment for yourself to “worry” about your concern at a specified time, date and place- this allows you to “delay” the worry and frees you up to take care of business at hand until then.

• Identify a “safe person” you can go to that is aware of your struggle and will support, distract, and protect you on the day of the holiday gathering. Talk with that person ahead of time so they know exactly how to support you during the meal and in specific situations. These things are not always obvious and support people may need a little “coaching” in advance. Some people even like to arrange a “code word” with their support person that they can say when they’re feeling really triggered and need an opportunity to remove him or herself from the situation.
• A day ahead, you may want to plan out the timing for your meals, especially if Thanksgiving meal is falling at an atypical meal time. Refuse to use that timing issue as an excuse to skip meals or go off your meal plan. Simply juggle around your mealtimes a bit so that you can still fit in breakfast, lunch, dinner and one or two snacks. If you don’t do this in advance, it probably won’t happen.
• Create a holiday project that will provide you with some distraction and also give you something positive to look forward to on the day of the holiday. Consider creating a scrapbook of past family holidays or a hand-made gift for your host/hostess.
• Set realistic expectations. Work on decreasing expectations about decorations, food, family time, and any other areas in which you’re feeling pressure to be perfect.

Real-life holidays, like many things, will not resemble the advertisements and commercials that portray them. Holiday gatherings will not be perfect…someone will spill their drink all over the carpet, your relatives will arrive late (or unexpectedly early!), kids will have tantrums, arguments may occur, and at least some of the food will get overcooked. The great thing is, that’s all okay and normal. If you find yourself expecting a picture perfect Thanksgiving, take time to adjust your vision and agree to embrace the day in all its imperfection. Ultimately, that is exactly what will make it memorable.

~ Kate Clemmer, LCSW-C, CED Community Outreach Coordinator

• Focus on the bigger picture. Research causes or charities that interest you where you might be able to volunteer during the holiday season; focus on the meaning of the holiday rather than the food specifically.
• Don’t skip therapy appointments. With all of the preparations and traveling and extra time committments, many people find themselves tempted to cancel pre-holiday meetings with therapists and dietitians or skip regular support groups.  We’ve encountered this many times before and unfortunately, it rarely results in positive outcomes.  This is exactly the time when extra support is crucial.  Instead of cancelling, consider other options like adjusting your appointment time to an earlier slot before you leave town.
• Begin a daily practice of gratitude. Start each day by reflecting on something you are grateful for. You could write them each down in a journal or even post them on Facebook. This is a great way to head into the holiday with a fresh and positive outlook.

Stay tuned for tomorrow’s post with more insight and suggestions from our therapists and dietitians in Tried and True Strategies for a Recovery-Focused Holiday, Part 2: The Day Of Thanksgiving. 

[UPDATE]: Part II is now live here. 

[UPDATE]: Part III is available here: Tried & True Strategies for a Recovery-Focused Holiday, Part III: AFTER Thanksgiving has Come and Gone

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You might also be interested in these posts from past holidays…

 Tips for Overcoming Holiday Stress and Anxiety – Part I: The Food

Tips for Overcoming Holiday Stress & Anxiety – Part II: The Stress

Nutrition Tips for a Healthy and Happy Holiday!

Thanksgiving with an Eating Disorder: 10 Tips to Help You Get Through the Holiday

Photo courtesy of examiner.com

This is a special blog in advance National Eating Disorders Awareness Week (Feb 26th – March 3rd) and an upcoming free workshop, When Your Loved One has an Eating Disorder: Helping Them Heal on the Road to Recovery. You can find details about all of our upcoming NEDAWeek events at the end of the post.

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Guilt.  Shame.  Frustration.  Sadness.  Fear.  Anger.  These are just some of the emotions commonly experienced and expressed by support people when someone they love is struggling with an eating disorder (ED).  While each family experiences an ED, and the recovery process, in a unique way, there can be some commonalities that are important to talk about. Attending support groups, information sessions, and community workshops facilitated by treatment professionals are all great ways for support people to gain understanding and insight into the difficult journey their loved one is on.  It’s also a great way for family and friends to get feedback and support around their own feelings while they help their loved one navigate their way back to health.   A few of the most common struggles faced by family members are discussed below.    

Often times, parents and caregivers feel guilty and express concern that they may be to blame for their loved one’s eating disorder.

It can be terrifying for caregivers to find out that their loved one has an ED, especially as they begin to understand the level of suffering that comes with that.  A common reaction among parents is self-blame or intense guilt over the possibility that they may have contributed to their daughter’s or son’s illness.  This guilt can understandably create resistance or defensiveness and can be paralyzing for loved ones in the treatment process.  As long as the focus remains on “It’s all my fault.” it can be difficult to move towards “How can we as a family work together to support our loved one’s recovery?“ 

While these illnesses have a complex combination of contributing factors, research has found them to be highly heritable, meaning 50-80% of one’s risk for developing an ED is dependent upon genetic factors. It’s important for families to receive reassurance that they are not to blame for their loved one’s illness while understanding that there are important ways they can help in the recovery process.  In fact, evidence-based treatment of EDs suggests educating family members and involving them in the treatment process greatly improves outcomes.  By identifying ways in which the ED has affected the family functioning and discussing dynamics that may be maintaining some of the person’s symptoms, families can work together towards improved communication, positive interactions and healing that extends far beyond the eating disorder.

Support people often feel anxious or frustrated about what to say vs. what not to say to a loved one with an eating disorder.  This can lead to fear that they are making their loved one worse because they don’t know how to respond in difficult situations involving food or body image.  Support people report that they often feel that they are “walking on eggshells” around their friend or family member with the eating disorder.

One of the most common examples of this dilemma occurs during the recovery process when support people may say something like “You look so much healthier,” but it is interpreted as “You look fat”.  Anyone who has been through an ED will tell you that they often feel irritable, and so much of their energy and time is spent thinking about weight and food that most comments people make about their appearance will automatically be construed in a negative way, even when they come from a place of care and concern.  Alternative comments that may be easier for your loved one to hear as they recover might be, “I’ve noticed you have a lot more energy lately” or “It is so nice to see you smiling today.”  One of the most helpful things support people can do is to communicate with their loved one by asking for a specific list of things that they can say or do that would be helpful to them when they are struggling.  Examples of things that are triggering or are not helpful to recovery could be useful as well.  Keep in mind that these lists may change at various points in the recovery process; communicate and revise often.

Also important to note: supporting someone through recovery from an ED is uniquely difficult compared to some other illnesses because of the cultural environment we live in.  Our society encourages and applauds hyper vigilance around weight, food and perfection yet recovery from an ED involves giving up some level of control over all three of those things.  Learning to filter unhelpful information and help your loved one resist damaging cultural messages about weight/food can feel like an uphill battle.  However, it does get easier with continued education about media literacy and guidance from therapists and registered dietitians who specialize in treating individuals with EDs.    

Support people are often so worried about the individual with the eating disorder that they focus 100% their energy on their loved one’s safety and recovery.   It becomes very easy to forget to seek their own support, neglect to keep up with their own self-care or let other personal priorities fall to the wayside. This can lead to mounting  feelings of exhaustion, depression or hopelessness.

Helping a loved one through the process of recovery from an ED can feel all-encompassing, especially when it’s your child or a spouse.   It often must become the family’s priority to get them back to a place of safety and stability, both physically and mentally.  However, support people can only offer stable, strong support when they are caring for themselves and staying stable, strong and rested themselves.  It’s important for caregivers to stay connected to their own friends, to seek out their own support and to set aside time to replenish themselves emotionally.  It could be as simple as sending a quick email to a friend every night before bed or scheduling a day trip to a favorite place. Whatever it is, remember the advice you get when you fly…you have to put on your own oxygen mask before you can effectively help those around you.

The truth is recovery can be a challenging process for all involved.  Even as progress is made, there are often set-backs or plateaus that can be confusing and frustrating .   Can you relate to the experiences discussed above?  Did you encounter other difficulties and roadblocks while learning to support a loved one in recovery?  Leave us a comment below or join in the discussion on our Facebook page.

At the Center for Eating Disorders, we recognize that there is a special need for education and support for the supporters themselves.  When Your Loved One Has an Eating Disorder: Helping Them Heal on the Road to Recovery is a FREE workshop designed to help family members and friends receive specialized education about EDs and their treatment, as well as insight into various care giving tools that can help facilitate the recovery process. Check out the details below, and don’t forget to RSVP by calling (410) 427-3886.

MARCH 1st, 2012  ~ When Your Loved One Has an Eating Disorder: Helping Them Heal on the Road to Recovery [download the event flyer], 7:00 - 8:30 pm in  Baltimore, MD

Visit our Events Page for a full listing of upcoming events, including our NEDAWeek kick-off event, Invisible Victory: An Athlete’s Story of Hope & Triumph in Eating Disorder Recovery.

 www.eatingdisorder.org

Each time we face our fear, we gain strength, courage, and confidence in the doing. ~anonymous

Fear is a powerful emotion.   At it’s best, fear can serve to alert and protect us from legitimate danger.  At it’s worst, fear is debilitating and it can prevent us from taking any action at all, especially in the direction of our goals.  When individuals with eating disorders (EDs) are faced with the possibility of  recovery,  fear can quickly become a primary motivation to maintain the status quo of symptoms and the illness.  Often the fears are so strong and so many, that there’s a feeling of being paralyzed in a place of chaos and discontent.

To want to recover but to simultaneously be afraid of recovery is a common sentiment.   Many people fear the physical changes of recovery…what will my body look like if I recover?… How will it change?… Can I tolerate the physical discomfort? And while these are often the fears most verbally expressed, many of the most paralyzing fears occupy more significant arenas… Who am I without the ED?… What will happen to my relationships if I recover?… What if I can’t recover? When author and recovery advocate, Johanna Kandel visited The Center for Eating Disorders she touched on the topic of fear in her talk and found the answers to these questions on her own journey to recovery…

Click here to view the embedded video.

“Ultimately we know deeply that the other side of every fear is freedom.” ~ Marilyn Ferguson

It can be hard to push through the fear of the unknown and the uncertainty of what recovery will look like, but you can’t get past a fear you don’t acknowledge.  Tune into your fears, become aware of what they are, and then you can begin to address them one-by-one.   Talk about them out loud with a friend or loved one.  Write them down in a journal or share them anonymously on our discussion board.  Find a support group where you can listen to other people process similar fears about recovery from an ED.  Most importantly, don’t let fear keep you from becoming the best and most authentic version of yourself.

Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness, that most frightens us. We ask ourselves, who am I to be brilliant, gorgeous, talented, and fabulous? Actually, who are you not to be? ~Marianne Williamson

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This was the fourth of several recovery blogs inspired by the February 2011 presentation by Johanna Kandel at The Center for Eating Disorders at Sheppard Pratt. Follow CED on  Facebook to stay tuned as we continue to post additional recovery-focused blogs and video clips.  Johanna shares more about her own recovery journey in her highly influential book, Life Beyond Your Eating Disorder,  and continues to support others through her role as the Executive Director of The Alliance for Eating Disorders Awareness, a non-profit organization based in Florida. You can learn more about Johanna and her incredible book in these previous blogs as well:

• Eating Disorders and the “All-or-Nothing” Trap (video clip)
• You Are So Much More Than Your Eating Disorder (video clip)
• “There is Hope” for Eating Disorder Recovery (video clip)