I got this email in my inbox last night from the always fabulous Michelle (aka The Fat Nutritionist), and, with her permission, I am sharing it with you. At the end of the list is a little promo for Michelle's Eat Without Drama groups, which I've heard are utterly fabulous. It's not a substitute for professional treatment, but I think they could be useful to some of my readers.

So it's time for another Tip Day Tuesday. I didn't get any emails or requests from you guys (please write! My brain is frazzled!), so I came up with one of my strategies for riding out ED urges.

It's so simple, in fact, I can summarize it in one word: later.

So what do I mean by later? I mean that ED urges usually come in the form of now. Purge now. Exercise now. Take the pills now. Skip the meal now. For me, the ED behaviors help me regulate my emotions, especially anxiety and depression. Over the years, I've gotten used to low levels of anxiety and depression, so by the time I start getting urgey, my emotions are pretty much skyrocketing. This means that I want relief NOW. Not later--now.

Of course, the ED works, but only for a short time and only with a very high price tag. Therapists and my parents would probably like me to say that "ED is not an option," but that feels a little bit fake. After all, the ED really is an option. A crappy option, but it's an option. Unless I'm being physically restrained, the ED is an option. So that line of thinking is a no go for me.

What does help me is to think "later." The ED can be an option in an hour or several hours or tomorrow or whenever. For some reason, knowing I have an "out" is calming in and of itself. It lets me know that if I really, truly, utterly can't hack it, then the ED is there. So the ED is an option...just not right now. I need to try other coping skills first.

So I crochet or snuggle the cat or blog or call a friend or text my therapist or (let's face it) swallow a lorazepam and try to ride out the urge. If the urge is still there at the end of the hour/afternoon/evening/whatever, then I delay again.

What I tell myself is this: if using behaviors is really a good idea, it will still be a good idea after my time is up. Also, I should feel comfortable discussing my decision with my family and treatment team. Feeling the strange urge not to tell someone about my new miracle plan? That's the ED and I should probably delay and talk.

It's not foolproof, and it's probably not workable for everyone, but it does help me. The ED helps me get through a difficult moment, and the idea is ultimately to find something else to work in the meantime. I also use a lot of self-talk to remind myself of the downsides of ED and the benefits of sticking with recovery. I won't lie--it's hard work. Much harder than just giving in to the ED and acting out. But I can also hold my head high and look at myself in the eye in the morning when I actively choose recovery.

In yesterday's post, I shared Dr. H's metaphor about how stress is like coffee and my coping skills are like a coffee cup.  You can have lots of stress and be perfectly fine if you have enough coping skills.  Alternately, you can be royally screwed if you have the coping skills of an espresso cup and half of a normal cup of coffee (which, for me, is like a standard cup.  I have BIG mugs, kids. Okay, wait, that sounds dirty...).

The key to coping with stress is either decreasing your stress/coffee or increasing your coping skills and coffee cup.  Today's tip day is going to focus on how to improve your stress coping skills (ie, making a bigger coffee cup).

1. Find a hobby.  It sounds cheesy, but even lame-sounding hobbies can be a stress reliever.  So you like collecting stamps.  Or latch-hook rugs.  Or ant farms.  It doesn't matter what it is, but having an outside interest can often be a sort of pressure release valve.  Things like crochet and House re-runs and playing the piano might not be the most exciting of hobbies, but when I'm stressed, working on my afghan for a few minutes can be tremendously relaxing.  It also helps me remember that whatever I'm stressing about isn't the entire world.

2. Make a list.  Of your potential coping skills, that is.  What makes you feel better?  Write these things down so that when you're freaking out you don't actually have to retrieve that information from the deep, dark depths of your brainpan.

3. Act like a kid.  I don't mean throw a temper tantrum in the middle of the grocery store--although I have wanted to on more than one occasion!  What I mean is try to remember what you liked to do as a child, and try to re-create that when you're stressed.  I still have a bunny puppet that I got as a baby (his name is Bozzlie) and no, he doesn't cure my stress, but he does bring a smile to my face.  This also explains why I usually have bubbles somewhere.

4. Prioritize.  Part of the problem I have when stressed is that everything seems equally important.  This is where I get into trouble because it's very easy to misjudge what desperately needs to get done and what is the proverbial icing on the cake (make mine cream cheese).  My criteria is "How bad will it be if this doesn't get done? Will it majorly inconvenience anyone else?  How many people will be seriously pissed or even notice?"  Buying cookies to take to your book club instead of making them from scratch doesn't mark you as a bad person.  Most people are like "OMG COOKIES!!!!1!"

5. Delegate.  This is probably my Achilles heel.  I suck at delegating, mostly because I don't really trust anyone else to do the job "right."  It's essentially an open invitation for people to treat you as a doormat.  Even if it wasn't, there will come a time when you have to face the grim inevitability that you can't do it all.  It might mean asking your significant other to cook dinner for a change (or at least pick up some take out).  Or asking someone at work to help you with a project.  It's not a skill that comes naturally to me, but when you're really in a bind, it can be a lifesaver.

6. Positive self-talk.  Often what helps me is not telling myself that it's all going to be okay because, hey, you never know.  What helps me is to remind myself that whatever happens, I can figure out how to handle it.  This usually calms me down because I can start to let myself stop worrying about the outcome and start trying to figure out the solution.

On this past week's Sunday Smorgasbord, one of my readers asked me for hints on breaking free from that maelstrom of worries that so often overwhelms people with eating and/or anxiety disorders.  I'm not saying that I'm an expert on this, because I frequently find myself sucked in to my worries, which never results in anything productive.  Nonetheless, I'm getting better at surviving the worry storms, and here are some of the tricks that I use.

1. Breathe.  It's a classic.  Take a deep breath.  Or several.  Deep breathing is very calming in and of itself.  Besides just breathing, pay attention to your breath as it enters and leaves your body.  Feel your lungs expand.  Feel the tiny hairs on your upper lip ruffle as you exhale.  It's called mindfulness, and it helps bring me back to the present moment and the present problem.

2. Take a break.  It was one of my homework secrets in high school and college: I always started the frustrating work first.  Not just to get it out of the way, but also so that I could take a break and work on something else if and when I got too anxious and frustrated.  Often, walking away from my physics or linear algebra homework, doing something else, and coming back to it after I had calmed down and regrouped made things go so much smoother.  So if balancing your checkbook is causing you to freak out, put the calculator down, do something else, and come back to it.  You will think more clearly and find the task much easier to accomplish.

3. Prepare for the worst.  Yeah, I know, much of The Advice out there is to tell ourselves that our worries are exaggerated and look at them rationally.  Which is a good thing, but often I find it more helpful to just bite the bullet and prepare for the worst.  If the ultimate worry is that I'm going to go broke and end up on the streets, figure out a plan.  What savings do I have?  What resources can I call upon?  What are my other options job-wise?  I don't spend a lot of time on this, but just knowing that even if the worst does happen, I can handle it calms me right down.

4. Animal therapy.  My cat or another furry friend always makes me feel better immediately.  It's like I can exhale just a bit.  Besides, how can a soft, purring kitty not make someone feel better?

5. Distract yourself.  This is a little different from #2, although it can be used as part of the "do something else."  Sometimes what I need isn't another task because I'm too frantic to concentrate.  I need something more distracting and mindless.  For me, watching re-runs of TV shows (I love House) or movies is calming.  They're familiar, as I've probably seen them before, which is soothing in and of itself.  And they get my mind off of whatever I'm worrying about.

6. Talk about it.  This is not something I'm good at.  I hate talking about my worries because what's the point?  Often, no one can help me, and I feel like a burden--or at least a neurotic basketcase.  But even if someone can't do anything about what's got my panties in a knot, just saying it out loud helps.  And many times, my friends and family will have a different way of viewing what's going on that can help, too.

7. Better living through chemistry.  I have a prescription for lorazepam (Ativan) for when I'm freaking out, panicky, and nothing else has worked.  Or I'm so wound up that using a coping skill is just ludicrous.  I resisted for a long time because I was afraid that benzodiazepenes were addictive, and I didn't want to just pop a pill.  But even just knowing that I have the pills in reserve helps me get through bad situations because I know I have something to make it better.

No, a diet isn't the same as an eating disorder, but there are quite a few overlaps.  The obsession with food, the good food/bad food dichotomy, the talk of weight and the losing of it.  When I was still new in recovery, I found this talk tremendously triggering.  Now, I find it insanely annoying but it doesn't trigger ED thoughts and behaviors.  Here are a few tips I learned for how to cope:

1. Avoid the worst offenders.  I've had great conversations with co-workers, but I've also learned to avoid them in food situations.  Honestly?  I don't care how "bad" you were the other day.  In the name of expediency, I just avoid those people when we had our company lunchtime gatherings.  It might be that you can tolerate diet/body talk most of the time, except when you're feeling vulnerable.  So that might be the time to avoid such offenders.

2. Start a new conversation.  "So how 'bout them Yankees?" might be a bit of a cliche--not to mention super-obvious--but try talking about something besides food and weight if the conversation steers that way.  I like what I call micro-conversations in big groups, that conversation within a conversation.  Ask the person sitting next to you what they thought about something, if they caught the homework assignment, if they know of a good place to get their oil changed.  It's much more subtle than a big shift in the discussion, but it still serves the same purpose.

3. Try to educate.  I confess I don't use this tactic very much.  As open as I am on my blog, virtually none of my former classmates and co-workers knew of my eating disorder.  So getting on a big spiel about the diet/binge connection came too close to "outing" myself.  Not that I didn't disagree or raise a new piece of evidence, but I don't like being preachy.  That being said, every now and again someone says something that basically begs me to interject, and I sometimes do. 

4. Create a Diet-Free Zone.  At my old job, the space was pretty informal.  I had already called attention to myself by protesting the Big Fat Loser contest--the last thing I wanted was a confrontation.  That being said, I refused to engage in conversation about the virtues of diet foods and dieting people.  It was astounding how quickly the talk ceased around me.  I didn't engage, they didn't get their "props," and so they looked elsewhere.

5. Determine who's a lost cause.  Some people can't or won't be educated or shut up.  There's not much you can do about this fact.  They are what they are, and your job isn't to convert the world.  It's to preserve your sanity as much as possible during your recovery.  It's not your fault, and it says nothing about who you are.  Once you realize someone is a lost cause, don't waste any more time and energy on them.  If they ask your opinion, you should still feel free to give it, but otherwise, just let them talk.

6. Acknowledge the green-eyed monster.  Oh, jealousy.  It took me many years to realize that one of the things that most annoyed me when people talked about their diets was the fact that I was insanely jealous.  They got to lose weight.  They got the pats on the back, the feeling of accomplishment.  They got to obsess about food and exercise all the time.  And for them, it was all okay.  Totally sanctioned and encouraged.  Whereas any idle talk of wanting to lose weight that happened to come out of my mouth could practically have convened an emergency meeting of the UN.  It wasn't fair, and it drove me bonkers.  Totally crazy.  Realizing that I was jealous allowed me to put those feelings into context.  Of course I was jealous, just as I would imagine an alcoholic would be driven nuts by the advice to drink a glass of red wine every night, or conversations about getting totally wasted.  Letting myself be jealous and miss the eating disorder--while simultaneously commiting to recovery--was remendously empowering.

As always, if you have any tips to add to the list (or any suggestions for future tip days), please share them in the comments!

By almost overwhelming request in last week's scientific random poll, you all wanted to know how to deal with dumb, annoying, and triggering comments about food and weight.  And because I love you all to bits, here are my thoughts.

1. It's unavoidable. People are going to say something stupid.  It's inevitable. You can't prevent it.  There's nothing you can do to stop it, so don't waste time trying.  Save your energy for figuring out how to cope.

2. Take a deep breath. Before you do anything--before you freak out, before you call someone a douchebag, before you start crying--breathe.  Anything you say or do will still be a good idea after you take a few good, deep breaths.  It gives you a few seconds, a little time to calm down and let your wise mind get stronger.

3. It's not about you, it's about them. When someone says something about how you look or what you're eating, it says that that's what they're noticing. It doesn't say anything about you.  People are going to notice things, they are probably going to look, but bringing it up (unless it's a matter of acute concern) is kind of rude.  So don't take it personally.

4. Know your limits. Before you go into a situation, try and get a grip on what you're willing to let slide, what you're going to comment on, and from whom.  There are people in my life who have never understood, will never understand, and there's no point in getting them to understand.  My response is generally grunting or something similar.  I've had other people who have a chance at understanding what's appropriate and helpful and what's not.  So I will speak up with them.  Knowing the difference can save you a lot of hassle.

5. Don't explain.  You don't owe people an explanation for how much you're eating or how much you weigh. You can answer questions and still provide minimal information. If someone comments that you're too thin, you can just say you have trouble keeping weight on.  If they comment on your food, you can say that you're working with a doctor and nutritionist to meet your nutritional needs.  It's your health and your life, and you don't need to explain it to anyone if you don't want to.

6. There's a time and a place for snark. Despite my having plenty of appetite for snark here on my blog, I generally steer away from it in my real life.  I've had complete strangers and random medical professionals tell me idiotic things.  Generally, I let it rip to complete strangers and others I won't have to deal with.  When it's a person I have to deal with a lot, I keep my answers much more aboveboard.

7. You can choose not to answer.  It's not the same as letting people walk all over you.  It's not the same as being evasive.  It's you being in charge of your life.  It might piss some people off.  That's okay.  Your goal isn't to make everyone happy.  And with that, see the next tip.

8. Keep your goals in mind. When dealing with difficult situations, I try to ask myself the goal of this interaction.  Sometimes, it may be to educate the person about stupid things they shouldn't say.  Sometimes, the goal is to get them to shut the hell up.  Others, it might be getting through the interaction without strangling the other person.  That goal will help guide how you choose to respond.

9. You always have a choice.  Your choices can suck.  You might not like any of them.  You might wish you had different ones.  But you can always choose how you respond.  Are you going to choose health, life, and recovery after someone comments on weight gain, or are you going to go back to the eating disorder?  The first one may feel more uncomfortable now, but it's more rewarding in the long run. You can choose to walk away from rude, insensitive conversations. You can avoid people.  You can surround yourself with supportive people. You can choose to attend a holiday dinner to keep the peace and put up with dumb diet talk.

I hope these ideas help.

Share your suggestions in the comments section!

Today's Tip Day can be summarized thusly:

Don't forget it's tip day.

I totally lost track of the fact that yesterday was, in fact, Wednesday, and that Wednesday means Tip Day.  I never forget the smorgasbord, but remembering Tip Day is far harder than it should be.

Compounding this is the fact that I rarely have good ideas floating around to really choose from.

With that in mind, please use the comments section to share topics you would like me to cover for future Tip Days!

I am smack-dab in the middle of trying to find a new therapist.  As I mentioned last week, TNT is leaving clinical practice, and I am left trying to find someone new. 

I hate finding therapists.  It's painful, time-consuming, and really, really tough.  So with me once again playing therapist picker-outer, I thought this week's Tip Day would be a great time to discuss what I've learned about picking out a therapist (this is the 13th time I've done this--I think I qualify as an expert!).

{{I realize some people don't have the fortune of being able to pick out a therapist.  The system where you are is that you get what you get.  If that's the case, I apologize.  However, I hope that what you read is useful for helping you figure out if you can apply for a new treatment provider or help them help you better.  I have choice, but with choice comes really steep medical bills for insurance and co-pays.  Win some, lose some, I guess.}}

1. Get referrals from people you know and trust. It might be a medical doctor.  It might be a friend or someone from the community who has also had an eating disorder or other mental health issue.  Or a guidance counselor at school.  Also check with your insurance company to see who might be covered and in-network. This way, you already know some things about the therapist--the basics of how they practice, that they're reputable, how much you might have to pay, and so on.

2. Don't rely too much on referrals.  Opinions are opinions, and not everyone sees the same thing in every therapist.  What I might find reassuring may drive you bonkers.  It's important when gathering data to separate fact from opinion.  That a particular therapist practices CBT is a fact.  That your friend finds them a total flake-azoid is an opinion.

3. Nice isn't the most important factor.  Of course we want our therapists to be nice.  Most of them are--misanthropes typically don't go into clinical psychology.  There are times when nice and kind and gentle is probably the right response.  But there are lots of times, especially when dealing with eating disorders, that firm and direct needs to take precedence over hand-holding.  The work of recovery is hard and miserable, and I've had therapists that were too nice and didn't push me into recovery.

4. Find out what treatment modalities they use.  I'm not especially keen on overly emotion-focused, insight-oriented psychotherapy.  I know many people find it helpful and useful, which is great.  For me, I like the acronym therapies: CBT, DBT, and ACT.  I like that they have evidence to show they are effective, and I like that they are much more concrete and practical.  So do your homework.  Find out which types of therapies you think would be most effective to help you move into recovery.

5. Ask them what causes eating disorders.  For me, this is the #1 screening question I use.  Because if I hear things like "unresolved childhood issues" or "boundary violations" as what causes eating disorders, I will run for the hills.  It means that, fundamentally, this therapist and I will not get along, will not see eye to eye on what I need to work on, and also that I know more about EDs than my therapist.  It's an easy way to gather information, and I often ask it right off the bat so that they don't have a chance to try and tell me the answer they think I would like to hear (this isn't that I think a therapist would really be blatantly dishonest, but it is human nature--heck, I've done similar things).

6. Find out their professional affiliations.  If you are trying to find a therapist for your eating disorder, then ask them if they're members of NEDA, of AED, of IAEDP.  Not all areas have an ED specialist, so you can also ask things like how many eating disorder patients do they treat, have they had any special training in eating disorders, do they know of a colleague who knows more about eating disorders, that sort of thing.  Good therapists will be impressed that you're asking this, so don't hesitate.

7. Ask hypothetical questions.  No, not the "if a tree fell in the middle of the forest..." types of questions.  But things like "If my parents called with questions, how would you respond?" Or "If I needed a higher level of care, what would you do?"  Or "If my symptoms increased, how would you handle it?"  It's good to know these things before a crisis hits, and it can also give you an idea of how the therapist generally handles issues, and how knowledgeable they are about EDs.

8. Don't let one bad apple ruin everything.  Bad therapists exist.  They might be a bad fit for you, or irresponsible, or whatever.  That's one therapist out of many.  Just because you found one bad apple doesn't mean that therapy doesn't work or that you're never going to get better.  It means you just found a bad therapist.  That's all.

What have you found helpful when searching for a therapist?  Share in the comments!

Much of the "fun" of holidays for people with eating disorders isn't just the food, it's the less-than-helpful comments from everyone around us.  In an ideal world, people would know to zip their lip about diet talk, Aunt Zelda's habit of wearing purple sequined pants, and what you are choosing to eat.  But this isn't an ideal world.  In order to walk through the landmine of interpersonal and familial relationships, you need to do something that therapists like to call "setting boundaries."

It's not something that most people with eating disorders are good at.  Some people wind up as human doormats.  Others (like me) just avoid people altogether.  Or they vacillate between the two.  Boundary setting is a skill--it's not innate like breathing.  You have to learn how to do it, and practice this skill over and over and over.

With the holidays in mind, here are some hints on how to start doing this:

1. Identify your non-negotiables.  Before you go into a challenging situation like a family get together, know ahead of time where you will want to draw the line.  When you're angry or anxious, it's easy to draw battle lines where they shouldn't be drawn.  This probably isn't the first time you've been with these people, so you can at least begin to anticipate what might go wrong.  Know what you are absolutely not willing to tolerate and will speak up about, and also keep in mind what you might prefer to let blow over.

2. Change the subject.  If diet and weight talk make you uncomfortable or drive you crazy, change the subject.  If you are at the gathering, you are part of the conversation.  This means you get to have input on what is discussed.  Of course, topics of conversation are never put up for a vote (at least they aren't in my family), but you can influence what is being said.  Have some topics in mind for these occasions.  It might be a great time to ask how grandma's surgery is healing from last summer.

3. Use "I" statements.  Yes, it's cheesy therapist talk, but it's also remarkably effective.  "I'd rather not discuss that" can frequently end a conversation.  Remember, setting boundaries is about YOU, not them.  It's about treating yourself with respect.  So own it.  Say "I feel uncomfortable when..."  and things like that.  The point isn't to accuse someone of being petty and ridiculous--even if they are.  It's about keeping your recovery strong.

4. Let go of the outcome.  Some people are going to walk all over every boundary you set up.  And there's not a thing you can do about it.  You can, however, make it very clear how you are willing to let yourself be treated and what behavior you expect of others.  You can't control how others are going to react to what you say, but that doesn't mean you shouldn't say it.

5. Know your goals.  When I'm in a difficult situation with another person, I usually ask myself "What's the goal of this interaction?"  Is it a meeting with my boss in which I'm trying to keep my job?  Is it catching up with Uncle Bob?  Is it to do my filial duty by chatting with annoying relatives?  The boundaries you set may be different based on whether you are asking for something or receiving something, how often you have to see this person, and how much you value the relationship.  Some boundaries might be a universal (ie, "Please don't comment on what I'm eating.") whereas others are going to be more specific.  It's tricky, but knowing what you value in the relationship often helps me guide my choices.

6. Know what to let slide.  Some people will tramp all over your boundaries because they're mean.  Others will do it simply because they don't know any better.  Often, that's just the way these people are.  Although I'm notorious at keeping people at a distance, I'm also hesitant to flat-out say "Please don't talk about this."  Sometimes, the best choice is to bite your tongue and soldier on through.  That doesn't mean you're letting yourself be a human doormat; it means you're making the conscious choice not to act at this very moment.

7. Do it ahead of time.  If you can, communicate beforehand if there are any glaring landmines, such as you just started treatment for your eating disorder, you recently got out of the hospital, etc.  Most people truly don't want to be jackasses.  Their ability to respond to your boundaries may vary widely.  Some people will forget, others are just clueless, and there are always those who are petty and mean.  But people often appreciate knowing what is helpful and not helpful.

8. Prepare for the worst.  Boundaries are great, but what are you going to do if people don't respect them?  There's a time to grin and bear it.  There's also a time to reiterate what you're saying, calmly but firmly.  Don't be dramatic and threaten and deliver ultimatums because people will often call your bluff.  You see it in movies all the time, where someone snaps and says "It's me or the dog!"  The dog usually wins because they dog doesn't make you choose.  Having been on the receiving end of these situations, it sucks.  Don't go there.  It just makes you look like an ass.  There's a difference between saying "If you don't shut the hell up, I am walking out that door!" and saying "I'm really uncomfortable, and I need to get going."

What has helped you set boundaries?  Share your tips in the comments!

When I was actively ill with the eating disorder, Thanksgiving was effectively a Day of Torture.  A holiday all about food and eating?  Count me out.

I still don't exactly look forward to thanksgiving, but I don't dread it, either.  After many, many years, I've learned how to cope with the holidays and survive in one piece.  Some of it is the hard work of recovery, and some of it are simple tips that I've figured out over the years.

1. Lower your expectations.  Norman Rockwell may have painted portraits of a nice, happy family sitting around a table with a turkey.  I don't know about you, but my Thanksgiving dinners never looked like that.  People bickered or got drunk.  Dishes got burnt.  Or the slightly deranged second cousin shows up, all gung ho with her new religion/cult/whatever.  It's nice when families get along, but that can be the exception, not the rule.  It gets easier to deal with all those familial imperfections once you stop expecting families to be happy and nice.

2. Ask what you can bring.  Lots of food I'm not preparing was always stressful.  If I brought at least one dish, however, at least I had something I knew was safe.  It helped me make it through the meal.

3. Eat before or after. It would be nice if recovery was nice and easy and you could push through and eat normal-sized portions at dinner.  But recovery isn't nice and easy.  Sometimes, you do the best you can do.  Maybe you're too anxious to eat, or you don't feel comfortable, or you have to eat a lot and you don't want to look odd.  Whatever.  In that case, eat a little before you go and /or eat after you get home.  That way, you can participate in the whole Thanksgiving festivities (keeping in mind point #1) and still meet your nutritional requirements.

4. Find out what's being served.  This is pretty related to points number 2 and 3, but it's still something I have found to be helpful. It helps me decrease anxiety because I know what to expect.  As well, I can figure out what will fit into my meal plan, I can decide what I need to bring (or what several things I want to bring), and what to have before or after.

5. Talk to your treatment team first.  Your therapist, dietician, or whoever can help you troubleshoot any emotional or family issues that may arise, as well as help you deal with the practical aspects around the food part.  It can help to roleplay some of the comments that may arise around weight and food, or other kooky comments.

6. Create an emergency plan.  When I've been in stressful situations, I like to have a sort of safety valve.  Sometimes I've asked a friend to call at a prearranged time so I can go and get some air.  Or I'll find an empty room and do some deep breathing.  I've brought books to read, games to play with the kids, that sort of thing.  It helps to make everything less about the food and more about the crazy people you're related to.

7. 'Fess up. If you feel comfortable with the host/hostess, or at least someone else at the gathering, talk to them about your eating disorder.  They can provide support and help run interference if people make inappropriate comments, you start to get triggered, or you start to use symptoms.

What helps you make it through the holidays? Share your tips in the comments section.

So I totally lost track of the fact that yesterday was Wednesday, and that Wednesday is Tip Day.  Also, my Netflix DVD of House Season One came in the mail, which may or may not have had something to do with yesterday's lack of posts.

Many people with eating disorders tend to eat a very regimented diet.  For me, I typically ate the same few things that caused the least amount of anxiety.  Outside of entering a structured treatment program, I had major difficulties learning to eat a wider variety of foods.  More often than not, I would sort of slide back into a pattern of eating the few same things.

Of course, some people like more food variety than others, but it's also important to eat sufficient variety of foods to get vitamin and mineral intake.  As well, the extreme lack of variety (I'm a creature of habit, and my diet isn't super-varied, but I do think pushing variety was a key part of my recovery) can keep you stuck in ED thoughts and habits.  Today's tips will deal with ways of increasing variety in your diet.

1. Think of it as a game.  One person I knew would only eat veggies of a certain color.  So her therapist had her make a color wheel, and she got a sticker every time she had a different colored fruit or vegetable.  After filling in all the different parts of the chart, she could treat herself to a prize. Yes, it's cheesy and can seem a little infantile, but it's important to remember that fun can be a part of this process.

2. Be a kid.  Look at foods not as "good" or "bad" or by evaluating their nutritional minutiae.  Instead ask yourself what looks interesting or tasty or fun to cook.

3. Try something new.  There are no expectations here.  You don't have to like what you've tried, you don't have to eat it all the time.  But it can be fun to experiment, and you might just find yourself enjoying something you didn't even know you liked.

4. Try something old.  For a while, I was hooked on treats from my childhood: Little Debbie stuff, that kind of thing.  After I tried some, they did lose a bit of their appeal as they were never quite as wonderful as I remembered.  Except the Nutty Bars.  Those things are awesome.  But trying these opened my eyes to many other new foods, and they made me more flexible and willing to try new/old things.

5. Be social.  Social situations can be very threatening for me, but at the same time, it can also be a good push to broaden my horizons.  If your friends order pizza and you normally get something different, that might be a good opportunity to try a slice of pizza.  It makes the experience much more normalized rather than dwelling on being that freaky person who doesn't eat pizza.

6. Stay accountable.  It's easy to say you're going to try something different, but it's not so easy to carry out.  Often, I would enter a situation intended to break the mold a little bit, but as it came time to actually decide, I would back down.  To get around that, I've occasionally had friends or family order for me, or remind me of my goal to order something on the menu besides the salad with grilled chicken.

Next week, I'm going to do tips on surviving Thanksgiving.  I hope you all enjoy!

Wednesday is Tip Day, which means I'll be sharing with you some of my tried and true well-researched often improvised ideas for surviving recovery.

Dealing with Dubious Advice.

In a post a few weeks ago, one of my newest regular readers asked how I handled the ubiquitous health advice that seems to be everywhere.  Places like the American Heart Association recommend about 30 minutes of exercise per day.  Other places talk about limiting fat or carbs, or cutting back on calories and portions.

It's all well and good, but for many people with an eating disorder, it sounds so contradictory to what our treatment teams are telling us.  Eat more fat.  Take some days off exercise.  Pay attention to your hunger signals.  It's pretty crazy-making, trying to recover from an eating disorder and living in a world that is seriously messed up about food and weight.

So here are some ways in which I try to deal with the disconnect:

1. They're not talking about you.  These recommendations are for otherwise healthy adults with no big hangups on eating properly and exercising.  If you have an eating disorder, you're not generally healthy and this good-meaning advice can often backfire.  I often like to think of the recommendations that people drink a glass of red wine everyday.  If you're an alcoholic, drinking red wine is like playing with fire.  Any benefits of red wine will be dramatically overshadowed by the potential for relapse into alcohol abuse.  I'm not sure that cutting back on my fat intake will make me any healthier, but it will probably make me much more crazy.

2. They don't know you.  I hate sweeping generalizations (which may very well be a sweeping generalization in and of itself, but whatever).  They are often mostly true, but they also fail to consider the nuances of individual situations.  Think of something like wearing sunscreen.  It's a great thing to do, but someone with a significant Vitamin D deficiency might want to walk around for a bit without sunscreen to boost their Vitamin D production.

3. These are meant to be guidelines, not rules.  When I was in the midst of the eating disorder, if I read something like "Women should try to eat no more than X-Y grams of fat each day," I made absolutely sure that I only ate X grams of fat.  Not a milligram more.  The thing is, these aren't meant as die-hard rules.  It's hard for me to take guidelines as anything but literal rules akin to the Ten Commandments.  What the person writing this article is probably saying is try to eat around X-Y grams of fat each day, knowing that some days you're going to eat more and some days, less.

4. You're not the only one with eating issues.  Anyone can publish stuff on the web--it's one of the best parts of the Internet, in my opinion.  The problem is that you have have precisely zero in the way of credentials and still be thought of as very credible, even as you give out awful advice.  Sometimes, even the people with credentials are a little off their rockers.  What helps me is to remember the source.  The American Heart Association is really into heart disease and obesity prevention; their advice is going to be skewed in that direction.  Not that it's necessarily bad or wrong, but that's where it's coming from.

5. Talk to your treatment team.  If the advice you want to follow really is good advice, then your treatment team shouldn't have a problem with you following it.  So talk to them about it.  It can help clarify your motivations and help you make sure that your ED isn't trying to sneak back in.  If you're hesitating to tell your team about what changes you want to make to your food and/or exercise, that might be a sign that your motivations are more disordered than you are willing to admit.

6. Avoid it.  It's impossible to avoid all advice that might be bad for you--this kind of thing is everywhere.  But there are certain places (food and diet websites) where it's especially prevalent.  If it bugs you and throws you for a loop, don't go there.  Don't visit those sites.  I don't visit- they don't tell me anything I don't already know about how I can be healthier.

7. You are the exception.  All throughout the eating disorder, I thought I was the exception to the rules of biology.  I wouldn't have health problems.  I could start eating whenever I wanted to.  I couldn't eat that food without instantly getting fat, even though everyone else could.  It was almost laughable and pathetic.  Remember, though, that in terms of much of the "health" advice out there right now,  you are, in fact, the exception.  For you, stopping all physical activity may be the best thing for your health.  Or maybe adding more fat to your diet.  So enjoy the fact that you are special in this respect.

One of my favorite non-ED blogs is The Happiness Project, and the author has designated every Wednesday as "Tip Day."  So taking a nod from her, I'm going to do recovery-related tips every Wednesday.  Keep in mind that I'm basing a lot of these tips off of what has worked for me.  They're not universals.  So take what works and leave the rest.  If I find research to back up what I'm saying, I'll cite it.  Otherwise, consider it the devious work of Yours Truly.

Remember the old song that goes something like:

Nobody likes me,
Everybody hates me,
Guess I'll go eat worms.

(You don't want me to sing it. Trust me.)

That's self-pity.  The world sucks, you have no friends, you are a terrible person.  These feelings are both normal and common.  We're all entitled to a bit of self-pity; the idea is not to treat it like an all-you-can-eat salad bar.  Self-pity is a process that feeds itself.  The more you think about it, the deeper in you sink.  And when you're in deep, it's hard to see the possibility of climbing back out.  But the possibility is there.

1. Get real.  Folks with eating disorders often tend to compare themselves to unrealistic ideals.  Yes, models get thrown around a lot as a culprit, but the truth is I compare myself all the time.  Of course, I don't compare myself to, say, my "average" classmates.  I compare myself to my classmate who is the current Assistant VP of the New York Stock Exchange.  Cue the self-pity.  Many of my classmates have done outwardly amazing things.  Many of my classmates have also lived average lives of more quite amazing-ness.  My VP classmate may be miserable.  So get real.  Are you doing (mostly) the best you can with what you've got?  Okay, then.

2. Accept it. Life isn't fair.  In fact, life downright sucks sometimes.  Once I can stop dwelling on the Unfairness Of It All, I can stop feeling sorry for myself and start trying to find the solution.  Don't get down on yourself for thinking that life sucks here and there.  It does.  That's okay.  Life is gonna suck and you're allowed to hate it.

3. Do something.  Read a book.  Crochet a scarf.  Clean your apartment.  Rake your neighbor's lawn.  Whatever.  But do something positive to get you out of your head and into your life.  Especially when you have a bad case of I-suck-itis, doing something nice for others can really help provide tangible evidence that you are not a crappy person.  Because crappy people don't do nice things for others. 

4. Distract yourself.  Some people watch crappy made-for-TV movies because the silly plots make them feel better about their own life (I am, occasionally, Some People).  Indulging in schadenfreude isn't always the most endearing of human traits, but it's useful in a pinch.

5. Write a statement to yourself.  I'm taking a line from the wonderful folks over at F*ck Feelings, in which they advise the people who write in to compose a statement.  It lays out their goals for the situation, and the values that they're sticking to.  I use this when I get comparing myself to others and feeling that I'm not nearly as successful as they are.  So I tell myself, "I am doing my best to fight a dangerous disease, and I need to give myself credit for the hard work I've done, even though others may not recognize it."

6. When all else fails, wallow in it.  I know- it sounds contradictory to everything I've said above, but if you really can't shake feeling sorry for yourself, then you may as well indulge it.  When I was living in Scotland in college, I had a huge crush on a boy who I later learned had a long-term girlfriend.  I was devastated.  So I locked myself in my dorm room with two little sample bottles of fancy liqueurs I had swiped from the airplane.  (Take it easy- each bottle was maybe one shot. I don't advocate alcohol as a coping mechanism).  I drank the booze, wrote bad love poetry, and cried for a few hours.  And then?  I was so done with it.

I hope you liked this week's tips.  Share your other suggestions in the comments section.