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Weighing in on the Warning Signs of Relapse in Eating Disorder Recovery
Contributor: Amy M. Klimek, MA, LCPC, Director of Program Development, Eating Disorder Program Coordinator, Timberline Knolls
Recovery from an eating disorder offers many challenges. It is particularly arduous if the person has lived with an eating disorder for an extended period of time. Relapse is not uncommon. Recovery is an ongoing process that is unique to each individual; understanding prompting events and environments can help minimize lapses or slips in recovery.
The Unexplored Territory
After existing with an eating disorder for five, ten or even fifteen years, a person knows the structure of their life, whether it be how they will act, what they will do, what food they will or will not consume. In other words, it is familiar. Living without an eating disorder is not. It is unknown and often extremely frightening. It is unexplored territory, and therefore, even when she desperately wants to rid herself of the disorder, there is great ambivalence.
Relapse, though it will eventually manifest overtly, begins in the mind. Feelings of hopelessness, wanting to escape from stress or problems, wanting to assert more control—these are red flags. Relapse begins in the thought life, usually the reengagement of thoughts previously linked to the eating disorder; these include negative self-talk or sentences such as “I must be _____ (perfect, thin, lovable) or I will be alone, nothing. This emotional/mental relapse can begin weeks or months prior to the actual physical/behavioral relapse.
An Ideal Candidate for Relapse
This is critical for anyone entering recovery to understand. If what is happening in the mind is antithetical to recovery, it is time to take steps to alter that reality. The truth is, if old eating disorder thoughts are allowed in, they can eventually take hold and take over because that is what they do.
Unfortunately, one of the most ideal candidates for relapse is a person who discharges from inpatient treatment and returns directly home.
Transitional or step-down care between the two is essential. Going directly home is just too jarring and difficult. In an article printed in eating disorder review, it was reported the risk for relapse is highest during the first 4 to 12 months after treatment ends. The article went further to share relapse is a common problem among patients with AN, with relapse rates ranging from 9% to 65%.*
The Warnings Signs of Relapse
Certain warning signs can tip off family and friends that a loved one is heading toward relapse. These include missing meetings or appointments, no longer honoring commitments, not showing up to work or school, skipping meals, and especially, not following the meal plan.
Although every component of an aftercare plan is important, the meal plan is one of the most key pieces. By definition, every eating disorder is connected to food; therefore, strict adherence to this plan provided by professionals is imperative.
Another warning sign is alterations in the conversation. A person might begin alluding to the possibility of relapse in an off-hand way. Or she might start indirectly using humor about the disorder such as “I used to just eat my problems away.” Such comments, often delivered in a highly nonchalant fashion, may be a sign of struggle. Conversely, a person in recovery may relapse using a new behavior, one that was not present or identified before as a struggle.
It is important to remember that a slip is not a relapse. If in a state of high anxiety, an individual under or over eats at a meal, that is merely a slip; however if it starts happening everyday or several times daily, that is a relapse.
Instead of viewing any relapse as an utter personal failure, we encourage people to view it as a learning opportunity. It is a time to step back, reevaluate the recovery components and perhaps add more support in some areas, less in others. In other words, intentionally discover what led to the relapse, then make the changes required to get back on the right path.
It is equally important to not forget. Initially, returning to old behaviors might seem positive and comforting, like easing tired feet into those old comfortable slippers, but don’t allow yourself to forget the misery, devastation, and despair you endured when lost in the eating disorder.
Now that living in recovery has been apart of your life, the unknown is now known, your fears have been supported by family, friends, and therapy, and you have a new way of living life, a vastly preferable and healthy way.
Community Discussion – Share your thoughts here!
What tools have your learned to help you stay strong in your recovery? What types of support do you utilize regularly to support you in maintaining focus?
About the Author: As the Eating Disorder Program Coordinator, Amy facilitates supervision for Eating Disorder Specialists, offers support through training to TK staff, and provides education on eating disorders to the community.
Amy started at Timberline Knolls as a Behavioral Health Specialist. As such, she provided support at the milieu level for all residents. She transitioned to Eating Disorder Specialist in 2012, supporting healing in present moment experiences for residents who struggled with eating disorders and body image. Amy earned a Bachelor of Science Degree in Sociology from the University of Illinois. She was awarded a Master’s Degree in Counseling specializing in both community and school counseling from Lewis University.
References:
[1]: http://eatingdisordersreview.com/nl/nl_edr_24_1_4.htmlThe opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on June 8, 2016
Published on EatingDisorderHope.com
The EatingDisorderHope.com editorial team comprises experienced writers, editors, and medical reviewers specializing in eating disorders, treatment, and mental and behavioral health.
