The holidays usually mean lots of time with family and frankly, that can sometimes spell stress. Recovering from an eating disorder while trying to manage triggers and deal with family can really be an overwhelming endeavor. Many eating disorder treatment programs utilize Dialectical Behavior Therapy (DBT) to help clients develop skills for distress tolerance, mindfulness, interpersonal effectiveness, and emotion regulation. Treatment with DBT utilizes individual therapy and coaching as well as skills training to help clients develop mindful awareness, tolerate difficult situations, gain assertiveness skills, and regulate overwhelming emotions. DBT makes use of acronyms within these focus areas to help clients remember the important skills they are learning.
Holidays are a time for family gatherings and cheer. Unfortunately, those same family gatherings can also be a catalyst for stress and drama. Dealing with this is uncomfortable for anyone, but when you struggle with a mental illness it can be even more unbearable. How can you make it though the holidays unscathed?
It’s That Time of the Year: Trick or Treat The Holiday Season is Upon Us!
Fall has officially arrived, and with it balmy days, chilly nights, sweaters, lovely foliage, and…Halloween. The popular October holiday is legendary fun for children and adults with trick or treating and costume parties the highlights of the day. It is also a holiday that is “food-centric.” Candy and treats abound, with children bringing their treats home after a night out in the neighborhood visiting neighbors for candy. Halloween also kicks off the fall/winter holiday season full of days that bring family and food together. For people with eating disorders, this can be a scary, isolating time. But it doesn’t have to be! Read on for tips to survive Halloween!
Overcoming Eating Disorder Challenges During the Holidays
It seems like the holiday season is completely centered around food and eating. The holiday season kicks off with Halloween, a holiday filled with candy, caramel apples, and sweet ciders. Then we move into Thanksgiving, an even more extensive food holiday. Every food imaginable is set in front of you, with plenty to spare. And then comes Christmas, where the eggnog and cookies seem to be endless. By the time New Years rolls around and you head out for an evening full of eating and drinking, you are usually at your breaking point and about ready to swear off food all together. This is typical of anyone during the holiday season, let alone if you have an Eating Disorder. There are many eating disorder challenges during the holidays. When the holidays are filled with food it can often cause your stress level and anxieties to sky rocket, potentially leading to eating disorders.
Decorations, family, work parties, pumpkin pie, black Friday, one more glass of eggnog, travel, New Year’s resolutions… the holiday season is a unique time of year. Even for those that are healthy-minded and well-balanced, this “uniqueness” often brings along some additional seasonal stress.
For individuals with eating disorders, the extra food, family interaction, media messaging, and social stress may be experienced at a greatly magnified level. As a professional in the field, how can you help your clients tackle the challenges that arise during this difficult time of year?
Try using the APPLE approach. APPLE stands for Anticipate, Plan, PLay it Out, and Evaluate. The approach is a systemic method for handling specific holiday challenges, before they actually arise.
Anticipate: Help your client identify the specific holiday triggers or scenarios they are concerned about. For example: “I’m having dinner at my mom’s this Christmas. She always makes at least 3 kind of pie and I’m worried I’m going to binge on pie.”
Plan: Help your client develop a plan for the triggers or scenarios they identified in the Anticipate stage. This plan needs to be specific, concrete, comprehensive (i.e. planning for before, during, and after), and realistic (do not set your client up for failure!). It is also best if the plan involves another player such as a significant other, family member, or friend who knows what the plan is and can lend support in the moment. Some planning tools: behavior contracts, menu plans, coping skills cards, a timeline for the event, or pre-determined back-pocket responses.
PLay it out: Have your client practice their plan. Visualizing themselves going through each step, and being successful, can be extremely empowering. You can also engage your client in role play, e.g. mimicking a difficult dialogue they anticipate happening with a family member.
Evaluate: After your client has encountered their anticipated trigger or scenario, help them process it. Focus on drawing meaning from the experience, acceptance of what happened, and sometimes, forgiveness. Despite careful anticipation, planning, and practice, things never go exactly according to plan. What went well? What didn’t go well? What would they do differently next time? What did you learn from the experience?
“There is no such thing as failure, there are only results.”
– Tony Robbins