Recognize Signs of an Eating Disorder Relapse

August 12th, 2014 Courtney M

Recognizing Signs of Eating Disorder Relapse

When a person is living with an eating disorder, the effects of the disorder can be felt by everyone in his or her life. It can be extremely difficult to break old habits that lead to developing an eating disorder, which is why it is critical for patients seeking treatment to understand how to recognize the signs of a relapse. By doing so, a person can avoid relapsing and, instead, continue to make strides toward full recovery.

Signs of a Relapse

Patients are at the highest risk of experiencing a relapse between six and 17 months after they are discharged from a treatment center, but many do not know what brings on a relapse. Warning signs to watch for include:

• Feeling hopeless or stressed about your recovery
• Isolating yourself from family and friends
• Obsessing about your appearance or thinking constantly about food
• Hiding information from your treatment professional

Preventing a Relapse

If you notice any of these symptoms, the first thing to do is seek help from your doctor. Even if you feel like you just need someone to speak with about your recovery, talking to a professional is an important first step. This way you will be able to develop the skills you need to confront your disorder head-on and prevent a relapse from occurring.

Be open with your family and friends about your recovery because involving others helps add accountability and shows you how much support you have on your side. Getting treatment, developing a relapse prevention plan, and understanding how your feelings affect your health are all vital steps in your recovery.

Eating Disorder Relapse Signs

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Shame is not just a five letter word…

August 11th, 2014 Heather Purdin

From Mirasol ED Recovery Guest Blogwriter ~ Faith

One of the hardest paths in the journey of recovery and living a wholehearted life is retraining our negative thinking, showing ourselves the compassion that we are worthy and that we do deserve recovery. A major part of this process is learning how to embrace shame, guilt, fear, vulnerability, and worthiness. The eating disorder has trained us into negative thinkers with severe cognitive distortions, especially catastrophizing. We set the bar so high we can never reach it, making us feel flawed and never good enough. This leads to drowning in our fears, shame, and guilt at such a toxic level it sends us into a whirlwind making us sicker adding to anxiety, self-doubt, and lack of worthiness.

I never thought such a chaotic rollercoaster of recovery and relapse would go on for so many years, full of experiences beyond my own imagination, including so many experiences I’d like to just hide from and forget. To maintain recovery, I know I have to get at the roots of the disorder. I have kept them hidden and struggled with lack of worthiness every day for years.

It was only recently my therapist asked me to write a list of my shame. I was scared to death she was going to see what an evil person I was. I never thought I had been that “sick,” but when I looked at the dreaded list I was astonished at all the events that had occurred during the depths of my disorder. This was not me, for I highly valued integrity and being authentic. The person on that page was a monster. Despite being at the full cliff of vulnerability giving this to my therapist, it was the first time I had ever verbalized any of it and just how toxically that list affected me every day.

Author and researcher Brene Brown created “Shame Resilience,” as a process to learn how to deal with shame, guilt, and fear, so one can learn to cultivate compassion.  “If we want to live and love with our whole hearts, and if we want to engage the world from a place of worthiness, we have to talk about the things that get in the way-especially shame, fear, and vulnerability.” She found that shame loses power when it is spoken, so I put myself out there with my therapist and took the first step.

One of the most helpful parts of Brown’s work was separating guilt and shame.

Guilt=I did something bad. It is about our behaviors. It is just as powerful as shame, but the effect is often more positive, because it more tangible, leading to apologizing or changing a behavior.

Shame=I am bad. Shame is about who we are and is extremely destructive. It corrodes the part of us that believes we can change and do better.

Learning shame resilience is tedious and may involve some radical acceptance, but it can be an extremely critical and effective skill on your road to recovery. For those who have struggled for many years, these emotions may have built an ugly, interlaced web over many aspects of your life.  I am still at the very beginning, taking baby steps, for guilt and shame runs deep. In addition, I have to face some things on my list, including consequences, every day—such as filling out job applications, trying to repair relationships, not being defined by the eating disorder, and even trying to find a few supportive people with whom I can share my story with.

Creating worthiness is a constant battle for me. This most likely comes from the fact that shame keeps me away from owning my story, leaving me worried that people will think less of me. I am fearful of being judged by my past and I want people to see me as I am now, not as the monster of my past.  The basis for Brown’s research is that: “Shame resilience is the ability to recognize shame, to move through it constructively while maintaining worthiness and authenticity, and to ultimately develop more courage, compassion, and connection as a result of our experience. The less we talk about shame, the more we have it.”

Shame Resilience 101:

Shame is the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging.

1.       We all have it. Shame is universal and one of the most primitive human emotions that we experience. The only people who don’t experience shame lack the capacity for empathy and human connection.

2.       We’re all afraid to talk about shame. Shame is the fear of being unlovable, yet shame loses power when it’s spoken.

3.       The less we talk about shame, the more control it has over our lives.

The three seeds of shame that grow quickly like weeds and intertwine you with thorny vines are secrecy, silence, and judgment. The basis for shame resilience is to learn how to recognize shame and move through it constructively, yet maintain worthiness and authenticity. These are critical aspects of recovery as we are rebuilding ourselves and redefining our values. Ultimately, developing more courage, compassion, and connection from these experiences and learning to talk about them, the less power they will have. The experiences we have had are all part of our story. While we don’t need to go broadcasting them to everyone, finding a small, supportive group you can process with will help immensely. The eating disorder will quickly grab onto the weeds of shame and guilt, but practicing awareness and talking about it will help you keep growing with authenticity versus drowning in the swamp of unworthiness and fear.

Everyone has a different reaction to shame, and it is important to become mindful and aware of your own reaction. Dr. Linda Hartling, a relational-cultural theorist, found that in order to deal with shame, some withdraw and keep secrets, some move forward and try to please, and some move against by trying to gain power over others or being aggressive.  The bottom line still comes down to the fact that shame is about fear, blame, and disconnection. It is our story that brings about worthiness, courage, compassion, and connection. We all have imperfections, and letting go of the perfectionistic aspect that the eating disorder loves to hold so high is a key value in recovery.

Most people have actual physical symptoms when they become aware of shame, and it’s important to develop that awareness, too. For me, my negative thoughts start racing; my anxiety runs into a panic attack; my fight or flight rises; I want to run, hide, and isolate; and my level of worthiness drops so low it scares me into worrying I may have very negative, impulsive behaviors. However, by acknowledging and becoming aware of this process, I have learned to step back, take a few moments, practice deep breathing, maybe journal, and maybe go for a walk so I can think things through a little bit more. Basically, I have to create space and time for myself.

In order to begin figuring out your own shame-resilience and story claiming, Brown proposes four questions to help you become more aware:

1.       Who do you become when you’re backed into that shame corner?

2.       How do you protect yourself?

3.       Who do you call to work through the mean-nasties, the cry-n-hides, or the people-pleasing?

4.       What’s the most courageous thing you could do for yourself when you feel small and hurt?

Recovery is a process, and the eating disorder is only part of your story. Learning to acknowledge, own, and grow from all the experiences all help build compassion for yourself. I can live with regrets and shame and wish it all away, but there is no such magic wand. I now have to learn how to embrace and work through it, even if it’s just with one supportive person. I have a lot to work through and it’s not easy. Sometimes I just have to practice kindheartedness, even if some days I can’t really believe the words. Rebuilding myself with compassion, love, belonging, and authenticity all starts at the same place: “I am worthy.” And you are too!

Reference

Brown, B. (2010). The Gift ofImperfection. Center City, MN: Hazeldon.

Letting Go of Perfectionism and Discovering Self-Compassion

August 9th, 2014 Heather Purdin

From Mirasol ED Recovery Guest Blogwriter ~ Faith

Author Brene Brown has written an amazing book entitled The Gifts of Imperfection (which I highly recommend getting from your library or online). She goes through 12 guideposts on how to start living a wholehearted life. The first one I wanted to touch base on is how to cultivate compassion for ourselves and begin to let go of perfectionism due to the fact that among those diagnosed with eating disorders, perfectionism is a highly noted characteristic. It runs rampant in our lives, tells us what is good and not good, and makes us believe that the number on the scale determines our worth; it even causes some to believe they have to be a perfectionist at their eating disorder.

In learning to discover ourselves without the eating disorder, we have to start building our whole hearted self, including being able to show ourselves some self-compassion, which can be difficult after abusing ourselves for so many years. Anna Quindlen was quoted, “The thing that is really hard, and really amazing, is giving up on being perfect and beginning the work of becoming yourself.”  Embracing our story and becoming our true authentic self is an exhilarating experience. As the suffocation of the eating disorder lifts more and more, you, too, will understand.

Perfectionism can be toxic and poisonous. It leads to depression, anxiety, addiction, and what Brown terms as “life paralysis.” Life paralysis is missing out on all the opportunities, dreams, and other events/goals because of the fear of being imperfect or failing. This all comes together to determine your self-worth, which of course is a distorted line of thinking and leaves you missing out on this amazing thing called LIFE!

Brown notes there is a definite difference between healthy striving and perfectionism. The following myths will most likely sound very much like the negative tape running over and over in your head, especially at the height of your disorder.

-Perfectionism is not being the best at everything, not looking or acting perfect, nor does it foster growth. Rather, it works as a “twenty-ton” shield that we believe protects us but actually holds us back from making any type of forward process.

-The core of perfectionism is trying to earn approval and acceptance, which does not reinforce self-improvement. This is one of the most common themes found among those with eating disorders. Many are raised or conditioned feeling as though they need to be the best, be people pleasers, and need acceptance all while their self-worth is defined merely by their achievements and what others think of them.

Adversely, Brown came up with her own definitions/guidelines of perfectionism:

-It is a self-destructive and addictive belief system that fields this primary thought. Essentially, if you look beautiful, make great achievements, and do everything perfectly, it minimizes the painful feelings of shame, judgment, and blame.

-Perfectionism is self-destructive because there is no such thing as “perfect.” This unattainable goal is based off illusive perception, and no matter how many awards, no matter what the scale says, you cannot control one’s perception. This is a perfect opportunity to practice some self-compassion.

-Due to the fact that we experience constant shame, judgment, and blame, especially in the midst of our eating disorders, perfection becomes addictive. The false belief that if we were perfect enough we would be able to do everything right leaves us not knowing how to deal with such emotions. This faulty belief encompasses a major root of the eating disorder, because it is wrapped up tightly in shame, judgment, and blame.

-Another common trait among people suffering from an eating disorder is the constant negative voice telling them that “I’ll never be good enough.”  Because they cannot reach such unattainable expectations, feelings of shame and judgment are too much to handle leading to self-blame, resulting in the management of such strong emotions through using the eating disorder.

Beginning to overcome perfectionism, as we disconnect from the eating disorder self and begin to build our authentic identity, we need to be able to identify, understand, and acknowledge our vulnerabilities, including the shame and judgment we carry. In reaction, we need to start allowing for more self-compassion and the process begins with accepting our imperfections. Within this practice, we begin to find courage, compassion, and connection. This is not an easy process as perfectionism and vulnerability often lead to the chronic compulsiveness and addiction the eating disorder imprisoned us with. It’s not a one-step magical process, but by taking one small step at a time and working on the negative tape of thoughts running through your mind, you begin breaking through the trap of perfectionism.

One personal example is that I was extremely compulsive about being prepared for everything and always being on time, usually even thirty minutes early for any appointment or scheduled event.  I had a Mary Poppins bag ready for any situation. A few years ago, I served on a Mercy Ship that served the west coast of Africa, and even the best Mary Poppins bag could not prepare me for what I was in store for there. I learned about “Africa-time” which basically meant when they said they would see you later, it might be eight hours. My first day, I was literally bucketing water from the flooded medical clinic on the ship. I worried, “I am going to sail on this thing?” I did, and it was one of the most amazing experiences of my life. Since my return, I definitely am still on a reduced version of “Africa-time” and am much less compulsive about being prepared, trusting that things will work out somehow. I had to rewrite the negative tape.

Brown breaks down two examples of self-talk: perfectionism self-talk and healthy-striving self-talk.

Perfectionism self-talk: I’m fat and ugly. I cannot reach my expectations. I’m a constant failure. I’ll disappoint everyone; I always mess up. The number on the scale determines my self-worth and it’s never good enough.

Healthy-striving self-talk: I am worthy of love and respect and can be accepted for my authentic self. I will invite courage, compassion, and connection into my life. This journey is for me, and I will take one step at a time. I am strong and I can do this.

As I said, this is not an instantaneous process, but nothing in recovery is. You’ll find it’s all part of the journey.

When Brown further researched healing perfectionism, she discovered that many women spoke of their imperfections honestly without shame and fear. They acknowledged they were doing the best they could and slowed the practice of judgment. A strong root of courage, compassion, and connection was at the core of how they treated themselves. Once again, these can be difficult things to begin to practice: start slowly, one day at a time, and take baby steps if need be. You are doing the best you can!

Self-compassion is at the root of beginning to accept ourselves and being able to live an authentic and wholehearted life. Dr. Kristin Neff, who specializes in research on self-compassion, divides it into three parts:

Self-kindness: Feel our feelings and accept them rather than punish ourselves with inadequacy and beat ourselves up with self-criticism.

Common humanity: Suffering and inadequacy are a shared human experience-it’s not just you! Give yourself a break because nobody is perfect. That’s what makes us all authentic and unique.

Mindfulness: Similar to the DBT practice, we take a balanced approach to all of our emotions, but we don’t get stuck in the sand trap. We let ourselves feel our emotions, but let them run through our “Teflon” mind, so we don’t get stuck in a field of negativity.

At the end of each chapter of Brown’s Gifts of Imperfection, she uses the acronym DIG, get Deliberate, get Inspired, and get Going! (I have used her acronyms before and love them, I am constantly still using TGIF: Thankfulness, Giving, Inspiration, and Faith).

So DIG deep into imperfection and self-compassion:

Deliberate: Brown suggests taking Dr. Neff’s Self-Compassionate scale to help you begin to understand where you are at in terms of compassion, self-kindness, mindfulness, etc. This test can be found at www.self-compassion.org.

Inspired: Take off the mask. The process of recovery is learning to be your authentic self, real and imperfect, letting go of all control. “Imperfections are not inadequacies, they are reminders that we’re all in this together.” You are not alone, and it’s often those vulnerable moments that bring us closer together.

Going: Simply stated, find a mantra for yourself that opens each day up to self-compassion. You are doing the best you can each day, slips or no slips. “Today, I’m going to believe that showing up is just enough.”

Christopher K. Germer once said, “A moment of self-compassion can change your entire day. A string of such moments can change the course of your life.” Moving forward in recovery can be scary, difficult, and hard. We often want to reach back into what we know is controlled and seemingly comfortable.  Learning to treat ourselves with compassion, surrendering vicious routines, and just letting go can change the entire path or the rest of your life. Go DIG!

“The past has no power over the present moment.”-Eckhart Tolle

Brown, B. (2010). The Gift ofImperfection. Center City, MN: Hazeldon.

 

 

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Living in freedom: Declaring independence from your eating disorder

July 4th, 2014 Heather Purdin

From Mirasol ED Recovery Guest Blogwriter ~ Hope

Being afraid of wearing a bathing suit on a summer vacation; having a fear of clothes shopping due to poor body image; feeling trapped in your own body; constantly counting calories; obsessing over food, weight, or shape; exercising out of compulsion; restricting or overeating in reaction to difficult emotions; feeling compelled to follow an energy consuming fad diet; spending time binge eating and risking life by purging unwanted calories; and especially losing things of importance (i.e. dream jobs, close friendships, precious time with loved ones, and other amazing opportunities)…These are all merely a handful of the myriad of losses of freedom that occur when you are trapped inside the monster of an eating disorder.

Today, hundreds of millions of Americans are celebrating Independence Day. Celebrating our many freedoms is one of the greatest privileges of living in the United States.

July4thI’m no great historian, but gaining our independence from the United Kingdom was not an overnight accomplishment. In fact, it took more than a year after the outbreak of the American Revolutionary War before the Continental Congress declared the thirteen American colonies independent sovereign states forming the United States of America. In the process, a committee of five men, including Thomas Jefferson, drafted the Declaration of Independence, a document largely dedicated to honoring human rights.

What stand out of greatest importance to me are the rights to life, liberty, and the pursuit of happiness.

It’s astonishing how much recovering from an eating disorder parallels to this short history lesson.

Life with an eating disorder is an entrapment. Just as with the resolution of the American Revolutionary War, recovering from an eating disorder doesn’t occur overnight. Recovery from an eating disorder parallels war itself because it requires a fight for your life with keen and consistent engagement. From start to finish, it can take several years to fully break free. The more chronic the disorder is, the more difficult it may be to overcome entrenched belief systems that maintain the disorder.

Living with an eating disorder denies several human rights, including the basic right to live. Just yesterday, I learned of another precious life lost to an eating disorder. I’ve sadly witnessed a string of such losses in recent months. In war, it is simple fact that lives are often lost in the fight for freedom. It’s a terrible and irreversible reality. These lives are not lost in vain, but it is incredibly unfortunate to know they have each become another statistic. In fact, eating disorders have the highest mortality rate of all mental health disorders.

So what about liberty? From dictionary.com, “Liberty: freedom from control, interference, obligation, restriction, hampering conditions, etc.; power or right of doing, thinking, speaking, etc., according to choice.” Eating disorders have so much to do with control, or lack thereof: controlling emotions, food, weight, etc. They interfere with health, achievements, healthy and meaningful relationships, education/employment, and peace of mind. Individuals may also feel obligated to follow rules or laws that govern and “protect” their disorders. Restriction may include lack of joy, food, and socialization. Hampering conditions may include things such as negative or irrational thinking and limiting beliefs.

Of course these are all examples and are not a comprehensive list of what may go awry in regards to living a life void of liberty.

Considering these above lists, one can surmise that the chance of living with the pursuit of happiness is nearly impossible for anyone struggling with an eating disorder.

If you are currently suffering with an eating disorder and ambivalent about letting go, hear me out. Please trust me, because I am sadly an expert in this department. I have been “existing” with depression, anxiety, and anorexia for 22 years.

I’ve never truly been happy. Though I have managed to have many great achievements despite being desperately ill, especially mentally ill, very few times have I enjoyed or truly treasured my triumphs. In fact, the majority of the time, I have felt like I’ve been hiding behind a mask like a fraud unable to own them.

If you are suffering, please do not retreat and give up your rights to freedom and independence. Reach out for help now. A soldier does not fight a battle in solitude and recovery is no different. You will need a strong and sound support system and compassionate, experienced treatment team to help you win this war. Begin rallying in the troops, those who will be your allies in this tenacious battle so you can conquer the enemy we call “ED”.

So on this Independence Day, I ask you: Do you want to continue existing rather than living, achieving hard earned successes without appreciation and joy, and staying imprisoned to negative thinking and beliefs?

I hope there is at least some voice inside your soul that wants more for yourself, a part of yourself that wants freedom! I wish I could say this was an easy battle but going to war against your eating disorder will be one of the hardest things you have to do in your life. On the bright side, at least you can begin knocking it out now rather waiting 22 years down the road, only to find yourself living in the trenches alone and hiding from the world that wishes to embrace you, the whole you. Together, we can win our freedom and independence back!

In a fairy tale world, what would your Declaration of Independence look like? What would freedom look like to you? What would living in freedom mean to you?

I wish for you life, liberty, and the pursuit of happiness! Happy Fourth of July! Let freedom ring.

 

Be Bold: Building Self Confidence

July 1st, 2014 Heather Purdin

From Mirasol ED Recovery Guest Blogwriter ~ Faith

A vital part of leaving an eating disorder behind and beginning to regain your sense of self is rebuilding self-confidence. Everyone suffers from some lack in self-confidence.  Confidence doesn’t come in fixed quantities, and sometimes it takes a few introspective lessons and life experiences to begin to build or rebuild a deeper and stronger faith in yourself.

Find your inner light and let it shine!

It is human nature to think negatively, and studies show that negative thoughts and emotions are quicker to form, attract more focus, and more likely to be recalled than positive ones. Try to begin recognizing values and strengths by thinking about one attribute that has served you well in your life, and then get your support system involved as well.

1.       Share your thoughts with your support system and work together to brainstorm a few favorite things about you. Keep an open mind.

2.       You may be surprised at what attributes YOU find strong vs. what others value.

3.       Ask for specific examples of traits in action. This helps the negative voice.

4.       Identify and share your best qualities by repeatedly putting yourself in positive positions so you can build trust in your abilities and assets.

See yourself clearly, flaws and all.

When building self-confidence, everything comes together in balance. Once you’ve identified some of your strengths, be open to identifying some weaknesses–but not in a self-critical or destructive manner.  It has been found that understanding who we are, be it better or for worse, actually improves self-esteem and acceptance. By looking at patterns in your life that may have brought about conflict or “flaws” such as stubbourness, indecision, and hot-temperedness, you will bring light to other character traits that, although we may not find ideal, you can learn to still embrace. Confidence takes commitment. You can’t spend 50% of your time projecting your best assets and 50% trying to hide your “flawed” traits and then expect to strengthen your self-esteem. This is where the practice of balance and acceptance of yourself as a whole comes into play. Your “flaws” do not have to carry a negative connotation; they are just another part of who you are and they allow you to learn to see yourself clearly while you still continue to shine.

Learn to take a compliment.

Somehow, our culture at large has led us to believe in discounting our accomplishments or playing down positive feedback. If you have poor self-esteem and self-confidence, it can be extremely difficult to accept any type of praise because the inner, negative voice can be so strong. Being able to receive constructive, positive feedback can help counteract negative thoughts and build confidence. A first step in practicing learning how to accept a compliment is simply to simply say thank you, whether your mind lets you believe it or not. The more you do this, the more you will begin to find yourself actually beginning to genuinely accept positive feedback. On another note, if you respect someone enough to take their criticism to heart, it’s only fair to also accept their praise. Another exercise is to practice in front of your mirror, and maybe even while driving your car, repeating a positive feedback mantra, “Thanks, I appreciate your saying that. I worked really hard, and the fact that you noticed means a lot.”

Your support system, your cheering squad!

A vital key in recovery, even in general life, is having a passionate group of support that fosters a sense of belonging and security, both of which build more confidence. These may be family members or friends; they may be people who become educated about eating disorders and can support you in recovery. They may also be people who support you in your general life, perhaps new allies and friends you meet through new social experiences. Remember, healthy relationships are two-sided and include healthy boundaries. Just as these people support, inspire, and encourage you, you will have a natural intuition to return the favor, which will feel great.

BUILD A CONFIDENCE TOOLBOX! (ref, Oprah 2013)

1.       Add a photo of those closest to you: When you have a strong support system and feel loved, it provides a source of strength and security that helps you take bold steps forward.

2.       Include a symbol of new endeavor: If you are challenging yourself with a new endeavor, put a reminder in your box. For example, maybe you are learning how to swim. Put one of your first caps or goggles in it. Confidence can be built by reminders that you know you are pushing yourself forward.

3.       Insert a token of improvement or achievement: You have challenged yourself and now met one of your goals or a new accomplishment. Maybe you finally finished your first Sudoku or your first 5k. Save a symbol of this and place it in your box! “Quantifiable achievements provide an instant jolt of self-esteem, because they make it easy to measure progress.”

4.       Enclose a picture or inspirational story of someone you look up to: Research has shown people get inspired by others who have become successful despite setbacks, and having a reminder can help keep you going.

5.       Have a special reminder of an upcoming event: Looking forward to something keeps you focused on good things to come and also reminds you of your supportive relationships. Secondly, it can also be an encouragement that you are no longer being held back and isolated but building relationships and living life!

6.       Include a token reminder of a time you were there for someone: A card, a thank you note, memorable mementos. Contributing to another person’s life boosts your own self-esteem, especially when it helps them make progress toward their own goals.

Be compassionate, be open to new things, be bold! As you build yourself back up, strengthen your self-esteem, & regain your values, you will find you shine with an identity that is unique and all your own.  A few fun quotes to leave you with:

                I’d go after Moby Dick in a row boat and take the tartar sauce with me. (Zig Ziglar)

                I have gone ahead despite the pounding in the heart that says: turn back. (Erica Jong)

Keep climbing forward!