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

 

plan-ahead-sunsetHoliday 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.

I really try to highlight for my patients that they are not alone in experiencing high stress around the holidays and that other members of their family are likely struggling with similar anxieties and negative thoughts. Some are able to manage extra stressors in healthy ways like talking about how they’re feeling, getting enough sleep, setting limits, or adding in extra self-care. Other family members may turn to unhealthy management strategies like drinking too much, getting into arguments, withdrawing, avoiding, hiding their feelings, or eating too much/too little. I try to use this to help my patients see that the problem isn’t the food itself, it is ultimately the thoughts and feelings, that can lead to intensified eating disorder urges. Being aware of this can free you up to move forward and choose more constructive and beneficial ways to cope.

~Laura Sproch, Ph.D., Individual and Family Therapist and CED Research Coordinator

  • 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

 

Eating Disorders and the “All-or-Nothing” Trap

There are several types of cognitive distortions frequently experienced by individuals who struggle with eating disorders. These negative thought patterns are often longstanding and can play an integral role in maintaining depressive thoughts, anxiety, low self-esteem and reliance on eating disorder symptoms.  One of the primary cognitive distortions identified by individuals who struggle with anorexia, bulimia and binge eating disorder is often referred to as “all-or-nothing” thinking.  Also called “black-and-white” thinking, this thought pattern is akin to the belief that “If I can’t do it perfectly, I might as well not do it at all.”

In the same way that all-or-nothing thoughts can perpetuate harmful eating disorder behaviors (ex: periods of severe restricting followed by frequent binging) , they can also sabotage efforts at recovery.  In this clip, recovery advocate Johanna Kandel talks about how all-or-nothing thoughts crept into her nutrition appointment…

Many individuals can probably relate to this experience in therapy where it becomes difficult/impossible to recover perfectly and immediately.  Setting insurmountable goals (i.e. perfection) makes it really easy to feel like you failed even when, by all other accounts, you are actually making progress.  This often leads to  someone feeling completely defeated and makes it easy to do a u-turn back towards the symptoms, isolation and secrecy that allow the eating disorder to spiral out of control.

For others, all-or-nothing thoughts may be an initial barrier to seeking treatment.  Its not unusual for individuals to hold off on making that first appointment until they are absolutely, positively, completely 100% ready to get well. Sound familiar?  As Johanna discusses in this clip, very few people are ever really going to be 100% ready for recovery but the good news is that you don’t have to be…

Identifying all-or-nothing thoughts that are impacting you and your recovery is an important step towards change.  Once you identify the cognitive distortions, you can begin to challenge them during therapy sessions, thought logs, journaling, and reality-testing.  If you aren’t sure where to start you can use the simple questions listed in this previous post to test validity of any suspected all-or-nothing thoughts. When you start exploring your negative thoughts you might be surprised at how many of them simply don’t stand up to the test.  Once you free yourself to think outside of the automatic negative thoughts you will learn, as Johanna did, that you are not an exception;  you CAN recover and you DESERVE to get better.

How did you overcome all-or-nothing thinking?  What role did it play in your eating disorder?  Join the discussion on CED’s Facebook page or leave a comment below.

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This was the third 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: