Relapse Prevention

Relapses are a very normal part of recovery and they are to be expected. For some people they last for a day, for some a week, a month or longer, but a relapse does not mean that you have failed.

Today I will eat like a normal person. I will not have a slip because today is going to be a good day. I will eat ‘enough’ and I will not binge or purge…

Many people suffering with an eating disorder wake up each morning saying those exact words to themselves, or something similar. I think I have said those words to myself every morning for I don’t know how long. I say them more often when I am in a bingeing phase than when I am starving myself but really recovery cannot happen when starving or bingeing but eating normally is a challenge that I am still striving for. Every morning I promised myself I would have a good day, but it never happened.

By promising ourselves that we will not have a slip, we are actually setting ourselves up for that to happen. One of the most important things for someone in recovery to remember and accept is that we cannot recover perfectly. Instead of waking up each day promising yourself that you will not have a slip, try telling yourself…

Today I will do my best. If I have a good day, I will be proud of myself. If I have a bad day, I will not dwell on it. I will forgive myself, I will put it behind me and I will continue to move forward in my recovery.

So many people punish themselves because they believe they are not doing as well as they could and this is what causes the relapse to continue. Instead of focusing on the bad days, try reminding yourself of all the good days that you have had and all the progress you have made.

Warning signs

It can help to recognise what can lead to relapse for you and I have compiled some of the common causes that can be warning signs:

  • Exhaustion:  Allowing yourself to become overly tired or in poor health. Some people replace the control of food with keeping overly busy to the extent where it can impact on health. Getting enough rest is important and it is important to make sure that over activity does not become a new way to burn off more calories.
  • Dishonesty:  This begins with a pattern of unnecessary little lies and deceits with maybe yourself at first and then possibly, family and friends about what you are or are not eating, rationalising that you have been busy, or have eaten enough. It is easy to get caught back in the trap of eating disorder behaviour. Do it enough times and a new pattern is formed and the illness takes hold again.
  • Impatience:  Recovery takes time. It is sometimes hard when we think things are not happening fast enough, or it seems like we take one step forward and two steps back. Recovery will be up and down – it doesn’t go in a straight line but keep with it and you can get there.
  • Depression:  Be on the look out for signs of depression and if you start to feel low talk to someone.
  • Frustration:  This happens for all of us I think and probably towards ourselves most, at least I have found that’s the way it happens for me. I never believe I do anything well enough and blame myself for practically everything. Or you might find you feel frustrated at other people and also because things may not be going your way. It is important to remember that you are making progress even though everything is not always going to be just the way you want it. This is the perfectionist streak that seems to play a big part of this illness for most of us.
  • Self Pity:  Some people experience self pity. Have you ever asked yourself, “Why do these things happen to me?”
  • Complacency:  I think this is quite an important one. It is good to be positive and to feel confident that you are in recovery and making good progress. However, sometimes over confidence can lead to trying to run before you can walk. I would suggest keeping a good support network around you to call on should you need it and remain aware of what you’ve learned about how and why you developed an eating disorder and what helps to keep you well.
  • Keep doing what works:  When I am ill I withdraw from everyone and cut myself off. I lose interest in everything outside of my eating disorder. So if you have built up a new life and interests as you go through recovery keep going with it. Keep seeing friends, family and doing hobbies or whatever works for you.
  • It can’t happen to Me:  Unfortunately relapse can and does happen but if you are aware of possible danger signs you can seek help and take action before the eating disorder really takes hold again. Noticing the early warning signs is vital because once the illness gets its grip again irrational thinking makes it very difficult to come through recovery again without professional help, particularly in the case of anorexia nervosa if severe weight loss occurs.

How to avoid relapse

If you find yourself suffering a relapse there are some steps you can take to help yourself before things slide too far. These include:

  • Speak to your therapist:  If you are experiencing some of the relapse warning signs please consider discussing this with your therapist so that he/she can help you.
  • Avoid punishing yourself: Do not punish yourself after a slip or relapse. Remind yourself that no one can recover perfectly and relapses are a normal part of recovery.
  • Talk to someone:  During difficult times it is important to reach out and talk to someone about how you are feeling and what is happening. Many people tend to isolate themselves during rough periods which only makes things worse. When we keep our feelings and emotions locked up inside ourselves that is when we really rely on our eating disorder as a way to cope with or block out those feelings and emotions.
  • Set achievable goals:  Set goals you can reach in stages if necessary. If you set one big goal that is too far from reach and set yourself up for failure at the very start, it only serves to damage already low self esteem. Lots of smaller goals will help you build confidence and in turn also help you feel better about yourself with each achievement.
  • Identify the cause of relapse:  If you have had a blip or relapse, try to sit down and work out why it happened, because if you can see why it happened, you can make a plan for how to prevent it in the future when faced with a similar situation.
  • Trigger list:  Make a list of situations you feel might cause you to relapse. Look over each situation and make a plan ahead of time for how you might be able to handle them without resorting to eating disorder behaviours as a way of coping.
  • Remind yourself of progress:  You may be looking negatively at your life, concentrating on problems that still exist. It is a good thing to look back from time to time and remember where you started from and how much progress you have made. You will then be able to recognise how much better life is now.
  • Recognise an eating disorder is not just about eating:  Do not fool yourself into believing that you are cured if you are eating normally but have not dealt with the underlying issues causing the eating disorder. Unless those issues are dealt with, relapses will eventually happen.
  • Deal with the underlying issues:  Although this can be very difficult and many people do relapse when faced with painful memories, feelings and emotions. Many people try to isolate when facing these difficult times. However, it is during times like this when you need to reach out for extra help and support.
  • Ask for help: It is important that you have extra support during those difficult times to help you get through them. Being around others that know and understand how you feel can be very helpful. If in therapy, you may need to see your therapist more frequently during difficult times. If your family or friends are supportive, do not be afraid to let them know that you are having a difficult time so that they can help provide you with the extra love and support that you need.
  • Take time out each day to take very special care of yourself:  Most people with eating disorders are too busy trying to please and take care of others that they neglect their own personal needs. Do something that you enjoy and find relaxing. It might be going on a nature walk, reading a good book or taking a nice hot bath. It does not matter what it is, just as long as it is something that you like and it is done for yourself.