As anyone who has ever suffered from an eating disorder will know only too well, recovery is rarely without its ups and downs along the way. This is why understanding relapse triggers and methods of prevention is such a valuable aspect of treatment.
Identifying Relapses in Eating Disorder Patients
The ability to identify whether an anorexia, bulimia or binge eating sufferer is in a state of relapse is absolutely key to recovery. Many books use different terminology to describe stages associated with the downward spiral to relapsing back into old behaviours. In Regaining Your Self, Dr. Ira Sacker, a renowned specialist in the field, highlighted four phases of declining into the "eating disorder self," including:
- Slips – disordered thoughts (based in the irrational mind)
- Lapses – behaviours (illness becomes active again for a short period)
- Relapses – recycled eating disorder actions triggered
- Collapses – complete return to full-blown anorexia, bulimia or binge eating disorder
Understanding Triggers
Everyone has the potential to get triggered or negatively affected by things going on outside and inside of us. However, it is how we cope or react to such issues that determines whether we maintain recovery or retreat back into the illness. A very helpful exercise to do with your therapist or alone is to make a list of key triggers and then identify ways to avoid or minimize their impact. For example, many sufferers have difficulty with family relationships. If you are feeling wobbly, it is important to also include where to go for support and encouragement as a means of avoiding pitfalls.
Relapse Prevention Tools
In addition to being able to identify different phases of returning to previous ways of coping and recognising your triggers, it is useful to have a personal toolbox for strengthening recovery. Here are some examples of practical relapse prevention tools:
- CBT skills – cognitive behavioural therapy thought records, challenging core beliefs, identify negative automatic thoughts
- Warning signs – know the signs that all is not well, changes in mood/weight/thoughts/behaviors
- Recovery journal – ideal way to log thoughts, feelings, strengths and weaknesses
- Scrapbook – perfect for storing happy memories, encouraging emails, letters, quotes
- Workbooks – practical work in recovery helps you to remain focused
- Contact list – support groups, understanding friends, therapist, people to turn to who you can trust
- Crisis plan – clear points of what to do when you are really struggling and need immediate help
As highlighted above, relapse prevention is vital for those affected by anorexia, bulimia and binge eating disorder. The ability to identify potential triggers, spot warning signs and put skills and tools into practice will help make maintaining recover and preventing relapse, slips and lapses significantly easier.
Sources:
Hubert et al. (2010) Bulimia, Binge-eating and their Treatment. London: Sheldon Press.
Sacker, Ira. (2010) Regaining Your Self. Florida: Health Communications.
Kate Le Page - Kate Henning-Le Page writes about eating disorders, body image and recovery issues. She specializes in anorexia recovery.
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