Relapse Prevention: Identifying Your Triggers

Ah yes. Identifying triggers. When I was deep in the eating disorder, pretty much everything triggered eating disordered thinking. Even in early recovery, much of that persisted. A glance at a magazine could trigger a storm of self-loathing. The barest hint of reproach from another person could send me spiraling. And any anxiety-provoking situation would leave me fantasizing about slashing my food intake and increasing my exercise.

Things have improved since then, but there are still any number of situations that amplify the eating disordered thinking and make me ever more vulnerable to relapse. Some of the point of identifying your triggers is to anticipate when you might need extra support. The other point of this is to make what I like to call a "mitigation plan" (it's a term I used when I was working in emergency preparedness, a career move that gave me many ideas into relapse prevention planning) so that you can survive the situation with as little lasting damage as possible.

Here is a (partial) list of my triggers:

  • physical illness that affects eating/appetite
  • seeing people running/exercising
  • moving
  • learning of a friend's relapse or weight loss
  • weight gain
  • new job
  • feeling like I don't measure up
  • clothes shopping
  • getting off my schedule (ie, traveling)
  • increase in depression
  • increase in anxiety
  • financial stress
Some of these triggers can be avoided, many of them cannot. Similarly, some of these triggers can be anticipated, but many cannot. Given that we can't avoid these triggers and we can't anticipate them, what else can we do? Like I did when I worked in emergency preparedness, I had to develop a plan (the mitigation plan) to help deal with them.

I created a general "mitigation plan" for all of my triggers and made certain additions as necessary to fit each particular situation.

My trigger mitigation plan looks like this:
  • utilize support system
  • increase frequency of therapy appointments
  • compare and despair: I am doing the best I can at the moment
  • stay to my specific schedule of meals and snacks no matter what
  • BE HONEST about urges
  • relapse is always there for me- I don't need to act on my urges right this second. I can wait and use my wise mind to think it through, and solicit feedback from others
  • distance myself from negative people
  • schedule meals and activities with others
  • my exercise and eating plan are right FOR ME; it doesn't matter what other people are doing
  • relapse only means more clothes shopping so don't go there
Some of these plans are appropriate in a wide variety of situations while others are more specific to certain triggers. The idea is to have a plan that is flexible and can be adapted to a variety of situations but still provide enough guidance on what needs to be done when the going gets tough.

Knowledge is power, they say, and in the case of relapse prevention this is definitely true. The phrase "forewarned is forearmed" is certainly apropos. If, for example, you can anticipate a trigger (maybe having to meet with a difficult family member) then you can start using your mitigation plan even before all hell breaks loose. Even if you can't totally prevent hell from breaking loose, at least you can contain the damage.

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Mimi said...

I love this series on relapse prevention. I'll come back here later today to really go through your posts, because I think carefully applying them to my own life and my own triggers could be incredibly valuable to me. Thanks!

Libby said...

How timely... after being triggered over something this weekend, I was lamenting at therapy last night that there's no way to dodge all the triggers, that there will always be some lurking.

We talked a lot about it. But now that I see this and think back over some of my session last night, I think it might be good to put some of this down on paper for myself.

I agree with Mimi. This is a really awesome series!

Dana said...

Wow, your trigger list is so accurate to what mine would look like. I actually came down with a cold yesterday so this really helps me out a lot. :) Thank you for this list, I'm going to print it out!! :)

Dana xo

elizabeth marley said...

Thank you for doing these posts. I've had a really hard time finding a therapist I feel good about so I've been recovering basically on my own, with just a few people who know for support. I've done really well lately and haven't been restricting for a few months, but lately...I'm just so stressed over a million things and I caught myself planning out a restrictive diet this morning. I took a minute to tell myself that I can't do it, told my boyfriend I felt like I was going to have a rough day, and then I came straight to your blog.

Triggers just come out of nowhere for me, but these posts have inspired me to make similar lists and really take control of the disorder. Thank you!

Kim said...

Great post! I think I expected that when I was "recovered" I wouldn't be triggered anymore. But, triggers are just part of life and the trick is learning how to manage them without restricting. I share many of your triggers. Mine are:

-Increased anxiety and/or depression
-Change in work life
-Being too busy
-Social gatherings

Pretty much, I hate anything that introduces more unpredictability into my life. That's when counting calories and planning food and restricting seems appealing. I guess awareness is the first step ;)

Anonymous said...

This is super helpful..... I've been struggling lately and know that my main relapse prevention strategy is just do the food, no matter what.
I hate when people say to id your triggers so you can avoid them. That's impossible. I am all about identifying so you can come up with a plan of what you will do when they are present.

Crimson Wife said...

The old AA list of "hungry, angry, lonely, tired" is helpful to me when I feel the urge to binge. Once I've identified the negative feeling, I can try to figure out a way to deal with it in a more productive manner than binging.

On a larger scale, I know that certain life changes leave me more vulnerable to a relapse. The biggest ones have been after the birth of my 3 kids. Hormone wonkiness combined with the whole cultural pressure of "bouncing back quickly after baby" like the celebs do. Not a good place to be for someone in recovery from ED.

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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.

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