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Coping with Lapses & Relapse

People need support during recovery, to explore what it means to them, to identify fears and to focus on feelings, not just issues around food or weight. During the process of moving away from an eating disorder, people need to feel reassured, they need help to deal with routine, to reduce isolation, to manage potential triggers and to build self-awareness.

There may be times in recovery when a person feels they are slipping back into previous patterns. It is important to remember that recovery is not linear, it is a gradual process that can sometimes feel like one step forward, followed by one step back.

  • We can think of a lapse as a short-term return to using the eating disorder to cope with a current situation. A lapse is a normal part of recovery, i.e. as a person recovers, they will lapse many times and the learning from these lapses allows the person to continue moving forward.
  • A relapse is a more sustained return of eating disorder behaviours and thoughts that cause the person to go back into using their eating disorder to cope for a more sustained period of time. A relapse may happen after a period of time where the person has been well.

Lapses and relapse are a part of the recovery process and can be an opportunity to check in and re-focus on core elements of your recovery, what is working for you and where you might be finding things difficult. Eating disorder patterns (disordered eating behaviours and thoughts) usually re-emerge when something in our life is difficult to manage. When we think of an eating disorder as a coping mechanism it makes sense that when a person is faced with something that they find difficult to cope with, they might ‘use’ their eating disorder as a way of coping. It can feel familiar and comforting to turn towards the eating disorder.

  • A lapse or relapse does not mean a person is back to square one, the person will be in a different situation than they were the first time they managed to move away from using their eating disorder to cope. If we run into a bump on the road in recovery, it tells us that we have an opportunity to pause and take stock of the situation before taking the next steps.

There are always going to be challenging moments in life, and as we continue to turn towards our toolbox of new coping mechanisms, we can continue to build on our recovery over time.

If you feel you are facing a lapse or a relapse, the first step away from using your eating disorder as a way of coping, is being able to notice and acknowledge what is happening and know that there is hope, there are things you can do to prevent the eating disorder taking hold again. Lapses and relapses are common and can be overcome.

Of course, an eating disorder is not just about food and weight, and recovery does not only involve normalising the eating part. Having said that, a regular eating routine is a helpful safety net for people at all stages of their recovery. If a person’s food and eating goes off kilter, it has a knock on effect on the other aspects of the eating disorder. Re-implementing a regular eating routine, if this has changed, is both incredibly difficult and incredibly important.

As a guide it can be helpful to think of the rule of 3:

  • 3 meals
  • 3 snacks
  • Trying not to go longer than 3 hours without eating.

Having this in place, can help a person feel safe, and can also help a person to separate out how they are feeling from how they are eating.

  • Try to think through how your eating has moved away from a regular eating routine.
  • Think through what changes you need to make to reinstate the regular eating pattern.
  • When you have decided what those changes are, rank them in order of difficulty – i.e. think about which changes are most anxiety provoking to which are less anxiety provoking.
  • When you have ranked the changes, choose the EASIEST one and decide when you will make that change. Be careful not to make the change too big – it is more beneficial to make small changes and build on them as your anxiety settles, than to try a really hard change that provokes big anxiety.
  • When you have made the first change, decide when you will move onto the next easiest change. And repeat, until you have managed to reinstate a regular eating routine.

Any change, no matter how small, is a movement towards freedom from the eating disorder.

Once the safety net of a regular eating routine is in place, it might be helpful to try to think about the moment that things began to feel familiar in relation to a returning of old behaviours. It might be helpful to think about:

  • mapping out the weeks and days beforehand
  • what you were doing
  • interactions
  • how you felt
  • how you fed yourself

Thinking through these elements can help to clarify why this might be happening and can help to plan ahead, so that you are prepared for similar challenges that may arise in the future.

Our experience is that when we think through the days and weeks before a lapse or a relapse, thinking through all of these elements, it is possible to decipher what has been going on for a person at an emotional level, and all the pieces fit together making sense of why you might have turned towards your eating disorder as a way of coping. This isn’t easy or straightforward, and doing this piece of work will help you to see that you didn’t turn back to your eating disorder ‘out of the blue’ or for no particular reason – you have turned back to it because you were finding something difficult, or lots of little things built up inside you, overwhelmed you and it makes sense that the familiarity of the comfort the eating disorder gave you became your way of coping.

There is always a reason behind a re/lapse, and figuring out that reason is an opportunity for you to become stronger in your sense of self.

When you find yourself returning to using your eating disorder as a way of coping, it can help to think through what you did in the past, what helped before and what didn’t. If you can remember something that helped before, perhaps there is a small change, something about that, that you could experiment with.

Using an EXPERIMENTAL framework is helpful because your confidence is not tied to the outcome alone. When we experiment, we are being realistic, that something we try may help and it may not and that’s ok. We are learning what helps and what doesn’t. This is a learning experience. It also allows us to stop attaching judgment to our attempts, helping with that perfectionist trait that so many of us have. No matter what happens, it’s all learning.

  • Can you reflect on what you do in your life that makes you feel more like yourself, and less like what you think you ‘should’ be – or less like yourself with an eating disorder? Sometimes these are the things to slip away first when we get into a rut with ‘shoulds’ and the feeling of not being good enough. Can you imagine your day if there were no should in it? How might that day differ from the days you are having at the moment? What can you learn from this to help you to fill your days with more joy and less shoulds?

So much of living life with an eating disorder is about keeping feelings inside and controlling the inside because the feelings feel scary and make us feel out of control. When in reality, processing feelings (which involves naming our feelings, being aware of our feelings and expressing them in a way that feels safe and doesn’t involve disordered eating or exercise behaviours) is a much more effective and kind way of managing how we feel. When we internalise our feelings, and mask them with disordered eating behaviours, they remain inside us, as strong as ever, building up until we feel out of control. Processing them, in fact, means that we stay far more in control of them. Think through ways that you find helpful to clarify and process your feelings

People have told us that some of the following helps to do this:

  • Journaling
  • Writing to a support email, such as Bodywhys:
  • Art
  • Taking a break
  • Watching TV with no guilt or ‘shoulds’
  • Making yourself a playlist that helps you to feel certain ways
  • Being kind to yourself – imagine you are your younger self who was upset, how would you comfort yourself?

There are no rules or ‘shoulds’ about how to do any of this. This is about you finding out what works for you in the moment.

  • Do you have people supporting you?
  • What might it be like to reach out to your support network when things become difficult? This might include a visit to the GP, psychotherapist and/or reaching out to support services.

There are always things that you can do to support your recovery, no matter what type of re/lapse you are experiencing. The eating disorder will not want you to help yourself and will frighten you into not wanting to experiment. However, if you are reading this because you are worried about yourself, remember you have done some of these things before – and nothing awful happened. The eating disorder thinking will frighten you with the ‘What if…’ So, hear us loud and clear when we say that if you look after yourself right here and now, the future will look after itself. You can, for a moment, let go of the ‘What if..’ and be kind to yourself in this moment. We are here to support you.