Relapse Prevention: Strengths and Difficulties

I'm starting this relapse prevention series by going back to the (very) basics. One of the major points of relapse prevention is to anticipate some of the difficulties you might have and create a plan for how to deal with them so that they don't trip you up too much. I think there's another aspect of relapse prevention planning that doesn't seem to get as much attention: assessing your strengths. What can you call upon when the going gets tough and the recovery gets tougher?

Together these strengths and weaknesses will provide a framwork for your relapse prevention plan.

Here is the list I wrote for myself:

Strengths

  • good support system
  • good treatment team
  • good insight
  • motivation to get/stay better
  • can draw upon a wide range of skills
Difficulties
  • body dysmorphia
  • loneliness
  • anxiety
  • perfectionism
  • putting insight into action
  • dealing with change
After I made these lists, I then took each one of these difficulties and made a specific list of how to deal with these issues without using the eating disorder. I'll share the list I made for dealing with body dysmorphia, so I have something concrete to turn to when I have a "fat attack."

Plan for body dysmorphia
  • focus on what my body can do rather than what it looks like
  • participate in sports or dance vs. all solitary exercising
  • repeat mantras: My body is healthy and healing at this weight.
  • continue CBT work on addressing body dysmorphia
  • "objects in mirror are smaller than they appear"
  • talk/share my feelings on body dysmorphia and what else is going on
  • accept the fact that I still have body dysmorphia and move on
  • remind myself: Losing weight won't solve anything. The ED is a short-term solution to a long-term problem
This list isn't going to be the be-all and end-all for dealing with body dysmorphia and relapse--the issue is a pretty major one for me and this list doesn't even come near to covering it all--but it's a start.

Tomorrow, I'll look at another aspect of relapse prevention: Identifying Triggers

posted under |

11 comments:

Cathy (UK) said...

I look forward to this Relapse Prevention programme Carrie...

I can identify with most of the 'Difficulties' you list on this blog post, especially 'loneliness', 'anxiety' and 'dealing with change'. These have always been the primary triggers for my under-eating and over-exercising (which can then lead to weight loss and to relapse back into AN). I therefore look forward to your posts of dealing with these specific issues...

I don't (and have never had) body dysmorphia - in the sense of seeing my body differently to how others see it, or believing that I am too fat when I am not. I don't see my AN has having had anything to do with body dissatisfaction. I would have got stuck in anorexic behaviours regardless of my attitude towards my body shape.

Having said that, I don't especially like my body, which actually IS an odd shape. I am too flat-chested and I have one arm that is wasted at the top (so is thin and puny) caused by a previous shoulder dislocation and collar bone fracture (- in turn caused by falling and fainting when my weight was very low). I find my upper body shape embarrassing in summer when wearing a t-shirt. The shoulder dislocation has also prevented me from playing tennis; a sport I loved as a child.

Cathy (UK) said...

Clearly, BDD does play a significant role in the development and maintenance of many people's ED. However, I'd be interested to ask you (and any others who might wish to answer) the following question:

If you were totally satisfied with you body shape and size, would you still feel the urge to 'indulge' in ED behaviours?

chippingaway said...

THIS IS AWESOME!!! THANK YOU SO MUCH!

I've been a reader for a loooong time - I read years ago, stopped, and am now back as of a couple months ago (as I admit to struggling again and am in recovery... again). Ahem. Yes.

I was around in the days of Hungry for Hunger. 'member him? :)

Thank you so much for this series! I am quite excited about it. :) I am particularly hung up on the LONELINESS bit... that seems to get me every time and it's just a bugger. :-/

happinessiswithin said...

Great plan for overcoming body dysmorphia! It's so helpful to be 'prepared' for these things when they come up!

Dana xo
http://happinessiswithin.wordpress.com/

Katie said...

"Remind myself: Losing weight won't solve anything. The ED is a short-term solution to a long-term problem"

This, essentially, is one of the main things that motivates me to stay in recovery. It's not exactly the same thing, but when I was ill I saw losing weight as the solution to all my problems - it calmed my anxiety, provided an outlet for my obsessiveness, distracted me from traumatic memories, and stabilised my moods. What I didn't take into account was that all of those problems were merely being postponed, not solved, and the longer I stayed ill, the more psychological difficulty I would have to deal with in the future. When I finally had to learn to deal with my anxiety it was pure torture at first, and still is sometimes. I feel now though that it is a small price to pay for escaping the zombified state I was in when I was anorexic though.

I like your lists :) another way in which obsessiveness can be applied in recovery - list making is therapeutic when it's on a recovery related topic!

Carrie Arnold said...

Cathy,

I would guess that even if BDD weren't an issue, I would still feel urges to engage in ED behaviors. Part of the reason I chose the body dysmorphia as my example of the lists I made was that it had the widest range of different "plans."

For me, the BDD is also a way to "justify" eating disorder behaviors and make them seem less problematic. Not that it's not real, but it usually doesn't get me in too much trouble relapse-wise unless I'm also struggling with depression, anxiety, etc.

Does that make sense?

Melissa said...

"If you were totally satisfied with you body shape and size, would you still feel the urge to 'indulge' in ED behaviours?"

Also chiming in on this question...

I've been recovered (for all intents and purposes) for a long time, and I've even reached the point where I can even go on intentional diets without triggering myself into serious relapses. But I've found that whenever I reach my goal weight on a diet, I feel very disappointed. Because being thin was never really the point, at least not the whole point. The process of losing weight was. I've even found myself tempted to binge for a couple weeks and gain some weight, just so I'd have something to lose before hitting my self-imposed "don't go below this or you're in dangerous relapse territory" barrier weight.

Cathy (UK) said...

Thanks for the clarification Carrie and Melissa. I guess I have been wondering what the 'common denominators' are amongst people with and without body dysmorphia who aslo have EDs...

What I have noticed is that almost all people I have ever met with an ED (or history of EDs) 'use' ED behaviours to control mood, emotions - and especially anxiety. They (we) also find ED behaviours 'satisfying' in one way or another (which is kind of masochistic). I certainly did. As Katie so accurately describes: anorexia 'zombifies' us. Yet, there is also a strange sense of achievement or mastery from being skilled at ED behaviours.

I have now been in recovery approx. 2 years, but whenever anything goes wrong, or causes me great anxiety, I still have to fight the urge to restrict and to exercise myself to smithereens. The only thing that deters me when in that state of mind is the fear of another heart attack or seizure...

Carrie Arnold said...

Cathy,

You said: "What I have noticed is that almost all people I have ever met with an ED (or history of EDs) 'use' ED behaviours to control mood, emotions - and especially anxiety. They (we) also find ED behaviours 'satisfying' in one way or another (which is kind of masochistic). I certainly did. As Katie so accurately describes: anorexia 'zombifies' us. Yet, there is also a strange sense of achievement or mastery from being skilled at ED behaviours."

Yes, yes, YES!

For me, the body dysmorphia causes a tremendous amount of anxiety- I've often compared "feeling fat" with "feeling contaminated" in my OCD thoughts. The resulting behaviors are meant to neutralize that anxiety. Often the other anxieties in my life trigger thoughts of "feeling fat," which then spur on ED behaviors. But I continued many of my draconian regimes even when I knew they weren't affecting (and wouldn't really affect) my weight because they did neutralize things beyond the anxieties about my weight/shape.

Cathy (UK) said...

Thanks Carrie... Interesting you associate 'feeling fat' with OCD-related feelings of 'contamination'...

I have often associated eating per se with feeling 'contaminated'... My OCD is worse now that I eat better. It's as though I have unconsciously replaced food and eating rituals with cleaning rituals.

That's how I know that so many of my problems stem from an ever raging anxiety (that my mother tells me I was born with!).

Laur said...

These are VERY HELPFUL!!!

must journal...

Post a Comment

Newer Post Older Post Home

ED Bites on Facebook!

ED Bites is on Twitter!

Search ED Bites

About Me

My photo
I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

Drop me a line!

Have any questions or comments about this blog? Feel free to email me at carrie@edbites.com



nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote



Archives

Popular Posts

Followers


Recent Comments