How This DBT Skill Revolutionized My Recovery

How This DBT Skill Revolutionized My Recovery

Colleen Werner

I am in recovery from an eating disorder and an anxiety disorder, and part of my recovery is Dialectical Behavior Therapy (DBT).

DBT was created in the 1980s by Dr. Marsha Linehan. It consists of four modules — mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Each module consists of several skills that work together to help “build a life worth living.”

One DBT skill that has made a huge impact on my recovery is called Effective Rethinking with Paired Muscle Relaxation. This is a distress tolerance skill that combines effective self-statements with paced breathing and muscle relaxation.

The skill starts with writing down a prompting event that is triggering distressing emotions. In my case, some typical triggering prompting events that I have experienced are having a bad body image day, having someone make a comment about my body or a food choice, feeling like my clothing was too tight, and encountering a fear food.

The next step is asking yourself what interpretations and thoughts you have surrounding that prompting event that could be causing the emotion response. These interpretations take up a lot of headspace, and the high levels of emotion that they can trigger often make it hard to carry on with life in an effective way. Some common interpretations that come up for me are:

“If someone makes a comment about my body, it must be true.”
“My body defines me.”
“If I outgrow my clothing, I’m not good enough.”
“If someone says I should avoid some type of food, I should listen to them.”
“There are ‘good’ foods and ‘bad’ foods.”

After writing down your interpretations, it’s time to challenge them! Create statements that rethink the situation and its surrounding feelings such as:

“My worth isn’t defined by my body, weight, size, or appearance, and my view of myself may be distorted.”
“Food isn’t good or bad. Food is just food.”
“Just because someone says something doesn’t mean it’s true, constructive, or healthy for me.”

These challenge statements can be effective by themselves, but combining them with paired muscle relaxation is even more beneficial. While sitting or lying down, take a deep breath in, say one of the challenge statements to yourself, and tense a muscle (I often start with my forehead and work my way down to my toes.) As you breathe out, say “relax”, and then relax all of your muscles. The key is to start practicing this skill in non-stressful situations so that when stressful situations inevitably arise, using the skill is instinctive.

One of the reasons why I think this skill has been so effective for me in my recovery is because it combines a physical action with a mental action. Not only does it involve letting go of mental tension, but it involves letting go of physical tension, as well. Mental and emotional symptoms can cause physical symptoms, and vice versa.

When I first learned this skill, I started practicing it every night before going to sleep. It’s an excellent way to unwind before bed, and it helps to diffuse any stress from the day so that you can wake up in a refreshed, relaxed headspace the next morning. In addition, by making this skill a part of my nighttime routine, it’s helped make the skill feel natural so that I can use it in the moment when triggering situations pop up.

At first, I didn’t want to believe these challenge statements, and I didn’t want to believe that this skill would have a huge impact. However, from the first time I practiced it, it had a great amount of power. I remember pairing one of the challenge statements with tensing and relaxing my lower back muscles, and I experienced a huge release both physically and mentally. As my muscles softened, my mind slowed down. The negative thoughts and judgments decreased, and I felt some much-needed clarity.

Practicing effective rethinking with paired muscle relaxation has contributed hugely to my progress in recovery. It has helped me truly believe the challenge statements that I created, and it has also shown me the reality of the mind-body connection. It has helped me “rewire” a lot of of unhealthy thought patterns and replace them with more effective ways of thinking.

While this skill isn’t the only reason why I’ve made so much progress in my recovery, it’s definitely a huge contributor, and I think that it’s something everyone needs to try.

Colleen Werner is a writer, dancer, and future therapist from Long Island, NY. She’s studying Psychology at SUNY Old Westbury and plans on going to graduate school for Mental Health Counseling. She aspires to start an eating disorder treatment program for dancers. Colleen’s experiences in recovery from an eating disorder and anxiety disorder have inspired her to share her story in an effort to help others, end the stigma, and create a sense of community. She is a National Ambassador for Project HEAL, a Campus Editor-at-Large for HuffPost, and a contributor for HerCampus and The Mighty. Colleen’s Instagram, @leenahlovesherself, inspires thousands every day with her posts about authenticity and mental health.

If I'm Detaching From My Eating Disorder Identity, Then Who Am I?

If I'm Detaching From My Eating Disorder Identity, Then Who Am I?

Jennifer Kreatsoulas, PhD, RYT 500

Photo by Chris Barbalis on Unsplash

When a diagnosis becomes our identity and our identity a diagnosis, we unknowingly become walking, talking containers of illness, pain, and even hopelessness. 

We separate ourselves from others in the belief we are different or broken. As we embody the disease we believe precedes us, we disconnect from our unique gifts and passions. Our bodies hurt, our minds become one dimensional, and our spirits wither. Our world narrows to a single dark point chained to the fear of not knowing who we are without our diagnosis identity. 

It's only having lived to come out the other side of shedding the diagnosis identity of an eating disorder that I can say with conviction that you have permission to detach from yours too. I understand the fear, anxiety, confusion, and uncertainty that accompanies even the smallest of steps to let go of that which you believe keeps you safe, in control, and put together. For decades I fiercely resisted detaching from the diagnosis of anorexia. From my hair style to how my clothes hung on my body to the bags under my eyes to the food on (or not on) my plate, I dedicated my every action, word, and thought to fulfilling my identity as an anorexic. That diagnosis was the lens through which I viewed the world and my place in it, and it was a dead end.   

With time, persistence, willingness, and a whole lot of support, my eyes opened to the shadow I was living in, the shadow of my diagnosis identity. Once I spotted this identity as a menacing shadow and not the entirety of who I was, I realized I had the power to walk out into the light.

As I inched away from the shadow, new possibilities for healing came into my life as did new relationships and opportunities. 

Slowly but surely, I began to resent the shadow for holding me back from embracing more and more of the world around me and the food, people, and sensations in it. The stronger my resentment grew, the more willing I became to detach from the diagnosis identity and replace it with the gifts, talents, and passions that were buried but by no means dead. 

It took practice giving myself permission to detach from the eating disorder identity. Every morning for months I asked myself Who are you? until the words anorexia, anorexic, and eating disorder were not my first answer. Little by little, more answers surfaced in my mind, like mother, daughter, wife, yogini, writer, creative soul, kind person, etc. I did this exercise over and over until the words related to my diagnosis identity moved down the list and one day slid right off it. Getting to this point took perseverance, and it wasn't a straight line, just as recovery is not.

With the help of a therapist, other supports, and my Yoga practice, I was able to arrive at complete permission to detach from the diagnosis identity. Now the words anorexia and eating disorder do not define me, nor do I strive to embody them. Rather, I respect and honor these words for the profound experiences in my life they represent and the gifts they provided: self-awareness, empathy, resilience, compassion, and ultimately my life's purpose to support others healing from eating disorders through yoga. 

My friend, you are capable of detaching from any identity that keeps you trapped in shadows. Once you give yourself permission to do so, the possibilities for goodness to fill your life are endless. Take a few moments and reflect on these questions: 

How would your life change if you shed your diagnosis identity?
What dreams would become possible?
How much more fulfilled would you be?
How much more connected would you be?
How much more whole would you be?

Don't be afraid to ask yourself who you are. Let the answers come as they are in this very moment. Ask again tomorrow, and the day after, and the day after that until new words bubble up. With permission, they will. Be patient and gentle with yourself as you step away from the shadow, but trust you can do it. I fiercely believe you are more than a diagnosis. You have permission to detach from your diagnosis identity. You have permission to explore who you are without it. You have permission to move through this world as a whole, vital individual. 

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Jennifer Kreatsoulas, PhD, RYT 500 is the founder of Chime Yoga Therapy and specializes in eating disorders and body image. In addition to her private yoga therapy practice, Jennifer leads yoga therapy groups at the Monte Nido Eating Disorder Center of Philadelphia, is cofounder of the Body Kindness Project, and a partner with both the Yoga and Body Image Coalition and the Transformation Yoga Project. She is the creator of the home video series Yoga to Strengthen Body Image and Support Eating Disorder Recovery. Her writing on the topics of yoga, body image, motherhood, and eating disorder recovery can be found on her blog as well as several influential online publications. Connect with Jennifer.

Are You Restricting Without Realizing It?

Are You Restricting Without Realizing It?

Josée Sovinsky, RD

In my practice as a non-diet and eating disorder dietitian in Toronto, Canada, I work with a variety of clients looking to embrace intuitive eating principles. This radical approach to eating can facilitate food peace, balance and freedom. One of the concepts we often work on is letting go of restriction and dieting. This can have many benefits, such as being more nourished, reducing cravings, and feeling less shame around food.

However, after being introduced to this concept and trying it out, many clients return to sessions claiming this didn’t work for them. Even though they ate all types of foods and enough food, they still felt out of control with their eating patterns.

This can happen when we see restriction as only behavior; instead of recognizing it is a mentality. 

Restrictive behaviors include avoiding certain foods, counting calories, and cutting down on portion sizes. These are usually easier to identify. On the other hand, restrictive thoughts, or a restrictive mentality, can be sneakier. Even when we don’t engage in restrictive behaviors, we can still be subscribing to a restrictive mentality.

Signs you may still have a restrictive mentality:

·      You feel guilt after eating specific foods

·      You feel shame when you eat more than others around you

·      You describe yourself as “bad” or “naughty” when you eat certain foods

·      You believe certain foods will make you gain weight

·      You think there is a perfect way to eat

·      You believe some foods are “healthy” and others are “unhealthy”

·      You think you will binge if you keep certain foods in the house

·      You worry about what other people think of your eating habits

·      You view food as an enemy

·      You view your days as “good” or “bad” based on what you ate

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Restrictive behaviors are what we do or don’t do.

A restrictive mentality is what we think, feel and believe.

Restriction includes both of these concepts.

The Bottom Line:

Letting go of restriction goes far beyond changing our behaviors. Don’t get me wrong, modifying behaviors is certainly part of the battle and can prove to be extremely challenging. However, even if we manage to change our behaviors, we will never truly find food peace if we don’t also work on our thought patterns and mentality.

Remember, intuitive eating and finding food peace is a process. Be kind to yourself.

Josée Sovinsky, RD is a passionate Registered Dietitian working in a community setting in Toronto, Ontario. After facing her own struggles with disordered eating during her degree, she developed a strong interest in helping those affected by eating disorders and mental illness. She decided to learn more about intuitive and mindful eating, body acceptance and Health at Every Size®, which now strongly guide her work. She dreams of a world free from mental health stigma, body shaming, and disordered eating. When she is not helping others make peace with food, she enjoys baking, photography and doing yoga in her living room. Visit Josée's website and connect with her on social media.

What happens in Vagus, Doesn’t stay in Vagus

What happens in Vagus, Doesn’t stay in Vagus

Rebecca McConville, MS, RD, LD, CSSD

For a country that prides itself on medicals advancements, we seem to be moving further away from the recipe for true health. Often when working with clients who struggle with digestion, hunger awareness, satiety (fullness), performance anxiety or the ability to relax, my first question is “do you breathe while doing these things?” I tend to get a look that says “get out of here” but then I start my scientific spiel and they are hooked.

You see, you have an amazing built-in radar in your body called the “gut instinct” and there is actual science to support it. In your stomach is a small nerve that has the power to be a fountain of health. The vagus nerve comprises of afferent nerves (80%-90%) conveying sensory information about the state of the body’s organs to the central nervous system. Basically making the vagus nerve the motherboard connecting the parasympathetic system: the heart, lung, brain/mind and digestive tract. When we think of this related to body functions the vagus nerve controls: heart rate, gastrointestinal movement, sweating and muscle movements in the mouth - to name a few. So—for example—you don’t really have butterflies in your stomach but you do have muscles that can contract similar to a butterfly’s wing’s flutter when they are nervous.

You are likely wondering how does this translate to impacting my health….

Dr. John Sullivan, author The Brain Always Wins, shares in his book how he believes that we should view the brain and the mind as separate entities. The brain perceives emotional information then acts upon it. This emotional information is the first to develop and allows us to survive and thrive. Like a baby’s conditioned response is to cry when he/she is hungry or needs to be held.

The mind and body do connect signaling the hypothalamic-pituitary axis that generates hormones and neurotransmitter and neuroendocrine responses such as epinephrine/norepinephrine (heart rate), cortisol (stress), serotonin (calmness) and dopamine (feel good). If the feedback to the brain and body is chronic or acute it will depict if you respond by either: fight, flight or freeze.

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These are three factors that you have the power to control of if YOU fight, flight or freeze:

Emotions

• We have grown to believe that our thoughts are what generates emotions. However, it is actually the opposite.

• If we can have a more neutral response or a more manageable response, then there is less stress on the body and the ability to decipher what to do with that emotion.
  Example: “I avoid all sugar as it is 'BAD'.” What kind of emotion does BAD typically invoke?

• Sit with an emotion and try to understand it. It's very likely that the reaction has nothing to do with the food but a memory of it or a false teaching.

Environment

• When you are distracted at work while eating you are taking the stress of your work straight into your meal.

• Eating at restaurants that are chaotic may overstimulate the nerve, making it hard to connect “friction” with body signals.

• Is your workplace, home life or school a place of stress? This can impact your ability to relax as well and connect with your body signals.

Energy

• Being depleted of energy whether due to the restriction of fuel or depletion of fuel secondary to exercise can cause a friction in the connection of the vagus nerve.

• Just like any friction, there is a moment of relief where you believe it makes “everything” better but what happens over time it makes the nerve overstimulated due to stress.

Now, remember that damn cupcake and how it made you anxious at the sight of its cute pink frosting and buttercream frosting? Instantly you are starting to feel a tension in between your ribcage, an elevated heart rate a mind racing with thoughts of "should I or should I not". You have activated your vagus nerve that you are in danger. Should a cupcake generate this kind of bodily reaction?

Rebecca McConville, MS, RD, LD, CSSD is a Master’s Level Registered Dietitian & a Board Certified Sports Specialist. She specializes in the treatment of anorexia, bulimia, compulsive overeating & exercise addiction. She also treats the female athlete triad & athlete-associated disordered eating. Becca understands that the drive for peak performance may lead to disordered eating. Her goal is to help you fuel your body, so that you can fuel your life! Visit her website.

Heavy Hearts: Subtle Shifts to Cope When The World Feels Too Scary

Heavy Hearts: Subtle Shifts to Cope When The World Feels Too Scary

Angie Viets, LCP, CEDS

Photo by Cathal Mac an Bheatha

This article has originally been published on Psychology Today.

Friday morning in between sessions with clients a colleague called. A teenager at a high school nearby had committed suicide after arriving at school that morning. My heart sank. She informed me that the school had released all of the students for the day and that they’d canceled the football game scheduled that evening. 

The remainder of the day it looked as though it was business as usual for me. Meeting with clients, picking up my kids from school and ordering in pizza—our Friday night ritual, yet, I couldn’t shake the sadness of the seventeen-year-old girl who ended her life that morning. I carried her around with me wondering how we might have spared her from suffering so intensely. My thoughts drifted to the trauma for the teens entering the building that morning, worried they weren’t fully prepared for a chemistry exam or frustrated about some drama amongst their peers, and then the unimaginable happens, and everyone is shuffled back onto buses and into worried parents’ cars. The faculty, I imagine, remain to deal with the aftermath. Oh, but the family—my heart drops further—how do they go on when their sweet girl is no longer? 

Still asleep, my five-year-old rushed in on Saturday morning, “Momma, it’s a home day!” Yes, today is a home day (i.e., a non-school day) and with the sun shining brightly through proclaimed black-out curtains I thought of the family who didn’t have the gift of a very typical Saturday. 

I’ve trained myself in times like these to send love to those hurting in my mind’s eye and to bring myself back into the present moment—the list I need to make for the grocery store, the laundry that must be started, and the endless errands I need to run. Present moment attention helps those of us highly sensitive creatures not to get caught so profoundly in a web of sadness. Dwelling on the news of another’s tragedy is just as unhealthy as ignoring it altogether. 

Sunday morning as I sit in a driveway, waiting—as mothers endlessly do—for my thirteen-year-old to gather his things from a sleepover I check Facebook. I’ve barely begun the mindless scrolling and then the headline from my local newspaper takes my breath away, “Three Murdered on Mass Street.”

Interrupted by my oldest, the one I’m attempting to allow a little more freedom, he hops into the car with bedhead and big news, “Mom, last night was insane. Lil Yachty was seriously like five feet away from me.” 

He’d gone to Late Night at Allen Fieldhouse the night before, the celebratory kick off for the University of Kansas’s basketball season and they’d brought in one of my son’s favorite rappers to “hype everyone up.” Later, while my son and his buds played X-Box until wee hours of the morning, three kids in their early twenties were murdered after leaving the bars in our sweet little college town.          

My brain couldn’t fathom the scene. Mass Street, the same street where we spend countless hours at quaint restaurants, shopping at locally owned stores, and hanging out at coffee shops while writing my first book was a crime scene only hours before. For years, I too wandered out of bars on that same street as a college kid, eager to make plans for the afterparty as I imagine they were also until shots were fired and the scattering ensued. The fear, terror and grief others experienced nagged at me. How could we have intervened? How could this happen? I spin out. I’m missing the excitement of my son as he tells the story of his favorite basketball players. Present moment, I think. Be here. Right now. First, pause, send love to those hurting today.

Monday morning I groggily make my way into the kitchen to pour the elixir into my favorite coffee cup. My husband, already busy packing lunches for the kids, nods at the tv, “You’re never going to believe what’s on CNN this morning.”

I walked into the living room where images of the Mandalay Bay in Las Vegas, the same Las Vegas my dad said he and my step-mom are headed to this week, flashed on the screen. Blurred images of a stampede of people fleeing in the dark, beneath it the words scrolled across, “Deadliest Mass Shooting in US History.” At the time it was believed fifty were dead and over two hundred injured.         

Horrified and aware of the time I started the shower, woke up sleeping children and began the usual routine of getting ready for work and rushing kids off to school. I thought of my son’s excitement to see a performer he loved on Saturday night. I imagined that same level of excitement of all the fans enjoying an outdoor concert of one of their favorite country musicians, and then, in what initially seemed like fireworks to enhance the performance, the utter terror of somehow comprehending the bullets pouring from the sky and penetrating innocent friends and family members without warning. How on earth can we live in a place where this happens? 

The toll from the teen’s suicide on Friday, the three college-age kids dead from a shooting just a short distance away while I slept, and the largest mass shooting in our country's history settled in. I felt myself shifting from sadness into fear. Without realizing it I unconsciously began creating a mental list of all the things we wouldn’t do or would change in an effort to keep safe. 

1. No outdoor concerts. (I recall the outdoor concert I took my son and his friends to this Summer. The joy in their faces as their idols hit the stage). Nope, don’t think about that. We won’t be going anymore. Too unsafe.

2.  Do my kid’s need to attend private schools so they don’t witness a classmates suicide while in high school? That’s absurd; I know the stats, suicide is rampant, the second leading cause of death among those ages 10-24, suicide doesn’t care what school you attend. 

I shifted into a place of helplessness and hopelessness. I can’t protect them, those I love most, from tragedy. I shift to Glennon Doyle, my favorite author saying, in a talk while I sat in the front row, “We are going to lose each other.” She too, a yellow canary, a highly sensitive soul couldn’t bear the pain of this life for many years, and she hid out in an eating disorder and substance dependence. She shared in her book, Carry On Warrior, that addiction was a safe place to numb out and protect herself. She recognized, as she sat with a positive pregnancy test, that such self-destructive behaviors had to end. Becoming a mother was her invitation to find a new way of being. She realized, as she sat in one hospital holding her newborn niece on the same day that in another hospital she said goodbye to her beloved grandmother that life is ‘brutiful.” Glennon encourages us to embrace both the beautiful and brutal parts of life. “We can’t have one without the other.”

Resistance.

My brain fights against this notion as the death toll rises in Vegas. I recall a conversation, not so long ago when I learned of several untimely deaths of people around my age, with my therapist (yes, therapists have therapists!). Nearing forty I was bumping up against my mortality, and I wasn’t too happy about it. At all. Not one part of it. I looked at her, the same way I remember looking at my mom when I was in labor for the first time, my eyes pleading, “I can’t do this. And PS: Why the hell didn’t you tell me it was going to be this painful?” 

“You know those documentaries about the inhumane treatment of animals?” I say. “I just keep thinking of us, much like all the cows that are crammed up against each other while being herded towards the slaughter area. I feel like we are the cows, all just crammed together waiting to die.” (I know this is morbid and dark, but this is how it felt in the moment). 

She looked at me, more reasonable, more comfortable with the truth, that yes, in fact, we all are going to die. “What would it be like for you, instead of being trapped in terror, to look at those who are shoulder to shoulder with you and find some comfort that at least we are all in this together.”?

Ah, yes. There’s that. I felt some relief as I recalled my favorite quote, “We are all just walking each other home.” Together.

Although today is not an ordinary day for many who are suffering, I think the best any of us can do is be present to each other and our lives when we do have the extraordinary gift of a typical day. To extend ourselves to those who are most in need in whatever form that takes for you—a donation of your time, a monetary contribution towards efforts to relieve those suffering in some small way, or simply sending healing energy to those in pain. 

As I walked past my coffee table on Monday evening, weighted and worried, I saw the title of a book a dear friend sent me, Only Love Today. What would I do right now, this very second if I was only to give love today? My golden retriever, eager for my attention, was my answer. If I focused on love instead of fear I would turn off the news for awhile. Mosley and I took a long walk and as we tiredly made our way up the hill back home, I stopped as at least fifty geese flew by in their hallmark V-shaped formation. I felt a sense of wonder as it seemed the number of geese flying overhead would never end. They poured endlessly, effortlessly from the sky. I heard a little girl down the block excitedly saying, “Daddy, daddy! Do you see all of the birds?” 

When the last of them had passed Mosley and I found our way back home. My heart was softened. Only love today. Only. Love. Today.

Angie Viets, LCP, CEDS is a clinical psychotherapist and certified eating disorders specialist in private practice. She specializes in the treatment of eating disorders, body image, and overeating. Angie is dedicated to empowering others to nurture their body, mend their relationship with food, and to embody their most authentic self. Her passion for the field was born out of her own hard-won battle with an eating disorder. She believes that full recovery is possible!

Angie has a thriving website that offers resources for people in recovery and was voted #1 on Healthline's list of the Best Eating Disorders Blogs of 2017. She is currently in the process of writing her first book, where she will demystify eating disorder recovery and offer inspiration and guidance to those suffering in silence. Her writing is featured in Huffington Post and recognized eating disorder treatment centers throughout the country.

Be Careful What You Tell Your Brain

Be Careful What You Tell Your Brain

Karen R. Koenig, M.Ed., LCSW

You are not only what you eat, but what you tell yourself. Nearly every week, a client comes into my office and tells me how “overwhelmed” she is. She’ll say it multiple times: “I’m so overwhelmed” or “I’m really overwhelmed” or “Boy, am I overwhelmed.” Although I encourage clients to connect to their emotions, I don’t encourage them to keep reminding themselves of feelings they don’t need to be having.

Our brain more or less understands only commands and translates more complex ideas into them. It hears our self-talk and does what it thinks we want it to do. So that, “I’m overwhelmed” tells the brain to feel pressured, “I’m miserable” instructs it to be unhappy, and “I’m scared” signals it to feel fear. This is, of course, the exact opposite of what you want to be telling your brain when you’re overwhelmed, miserable or scared. 

Try an experiment. Set a timer and for one minute repeat to yourself that you’re overwhelmed, scared, miserable, sad, fatigued, or some other “negative” emotion. Make sure to say it as if you really mean it, the way you would when you actually feel it. When one minute is up, check your feelings. Notice your bodily sensations and posture and what you’re thinking about. Generally, people end up feeling what they’ve been saying. If you don’t, continue the experiment for five minutes and check in with yourself again.

Then, follow this procedure and this time tell yourself that you’re happy, proud, joyful or glad to be alive. Again, notice your bodily sensations and emotional state. Extend the experiment to five minutes if needed and do another assessment.

I’m not telling you to deny your emotions. You just want to be careful that you’re not causing an emotion to happen because you keep repeating that you feel a certain way. Obviously, if you’re feeling hurt or mistreated by someone, you don’t want to brush that off or turn it into a positive feeling because this is crucial information for your happiness. But, there’s a big difference between self-talk that allows you to explore, say, feeling hurt, betrayed, or invalidated and directing your brain to make you unhappy.

If you tend toward focusing on negative emotions, just be careful what you tell yourself and aren’t reinforcing them. Rather, tell yourself how you wish to be feeling, not how you currently feel. Turn “I can’t stand this” into “I can manage this” and “I’m overwhelmed” into “I’m really busy.” There’s even a big difference between calling yourself “overwhelmed” and “busy.” Use the past tense to describe how you don’t want to feel—“I’ve been unhappy”—and the present tense to direct your brain how you wish to feel—“I’m feeling better and better every day.”

Karen R. Koenig, M.Ed., LCSW, is an international, award-winning author of seven books on eating, weight and body image, a psychotherapist with 30 years of experience, a health educator, and a popular blogger. Her expertise is in eating psychology and helping over-eaters and binge-eaters improve their self-care and become “normal” eaters. She lives and practices in Sarasota, Florida.
Visit her website

Expert Tips: When You Want To Give Up On Recovery (+ Journaling Prompts)

Expert Tips: When You Want To Give Up On Recovery (+ Journaling Prompts)

Josée Sovinsky, RD

Photo Credit: Shutterstock

Recovery from an eating disorder (or any other mental illness) is a journey. With my clients, I celebrate many recovery wins, but I also support them through difficult moments. Let's get real here: Recovery is HARD. It requires a lot of work, patience and dedication. Because we are human, this can sometimes become very overwhelming.

To help get you through those moments, I connected with colleagues in order to put together a list of tips for when you feel like giving up on recovery. For those who find journaling helpful, I also included some prompts. 

1. Remember Why You Want To Recover

Somewhere in your initial struggle, you decided it was time to heal. There is a reason why you started this journey. In those difficult moments, think of what makes recovery important to you. Will it allow you to spend more time on your hobbies and passions? Will it make you more available for connection?

Blair Mize, MS, RDN, CSSD, LDN, owner of Memphis Nutrition Group says : "Before giving up on recovery, take some time to think about and write down why you started pursuing recovery in the first place. By taking a look at where you started and noting milestones along the way, you may begin to see how far you've come and why making a full recovery still feels worthwhile."

Journaling Prompt: Why did you start your recovery/healing process?

2. Consider How Recovery Fits Into Your Goals and Values

A very powerful tool when working on recovery is thinking about your goals and values. Once you have established your values, you can think about how these are connected to recovery. For example, you may value family. Recovery is then in line with your values since it might allow you to spend more quality time with your family. 

Before giving up on recovery, Paige Smathers, RDN, CD encourages you to take a step back and look at the big picture of your life. What do you want? As in, what do you REALLY want? Then, ask yourself how you get there. Check in with yourself by recognizing when your thoughts and desires for life are coming from a place of trust, respect, and fulfillment and when your desires might be coming from a space of bullying yourself and/or punishing yourself. 

As Poonam Sahasrabudhe MSW, LSW reminds us, giving up on recovery and giving in to the eating disorder can be very tempting. Going back to what is known can be comforting. Try to remember how you felt in the eating disorder and ask yourself: Will going back to the eating disorder get you to your values? Will it help you feel more authentic and fulfilled? Will it help you feel more connected in relationships? Will it launch you toward your goals? Remember that you are amazing for your awareness and even considering changing what isn't working for you. 

Journaling Prompt: What are your 3 most important values? How does working on recovery relate to these values?

3. Remember This: Recovery Isn't Linear

Recovery is a journey with many twists and turns. Annina Schmid (M.A., CCPA, OACCPP, CACCF) shares that recovery isn't a linear process, and a so-called "relapse" won't take you back to the place that you started from. It is important to acknowledge the good and the difficult days. Don't act on impulse, think about your choice today as a long-term investment in your future. 

Journaling Prompt: What are 3 things you have learned in your healing process?

4. Be Kind With Yourself

I'll say it again: Recovery takes hard work. When we are being hard on ourselves in the process, it adds an extra layer of difficulty. I recognize it's easier said than done but do your best to approach yourself with kindness and compassion.

Remember you are doing the best you can with the tools you have. 

I couldn't agree more with Edith Shreckengast, MS, RDN, CSSD who shares, "You are a warrior and recovery is sincerely and utterly allowing yourself to live again. Take a deep breath and ask yourself what your truest desire out of recovery is? There is no right or wrong way of recovery, but there is your way. That way is beautiful and unique in which no one else can replicate."

Dr. Maria Paredes, LPCS, CEDS, Licensed Professional Counselor, Clinical Supervisor, Certified Eating Disorders Specialist and owner of Three Birds Counseling reminds us that unlike the diet industry's messaging of "just do these 5 steps" or "take this silver bullet pill" or "30 days of this and you'll be happy," the recovery road is long and windy and complicated and often exhausting. But, it's worth it. YOU are worth it. The best advice she has is just to be kind to yourself. No matter what *steps back* or *wagons* you think you've fallen off or *mistakes* you feel you've made, still. Even then, be kind to yourself. 

Journaling Prompt: What are 3 ways you can show yourself compassion?

The Bottom Line

There will be many ups and downs during recovery. This is normal. In those moments of despair, remembers why you want to recover and how recovery aligns with your values. Approach the situation which as much self-compassion as possible and as Dory said, "Just keep swimming". 

You've got this, recovery warrior!

Josée Sovinsky is a passionate Registered Dietitian working in a community setting in Toronto, Ontario. After facing her own struggles with disordered eating during her degree, she developed a strong interest in helping those affected by eating disorders and mental illness. She decided to learn more about intuitive and mindful eating, body acceptance and Health at Every Size®, which now strongly guide her work. She dreams of a world free from mental health stigma, body shaming, and disordered eating. When she is not helping others make peace with food, she enjoys baking, photography and doing yoga in her living room. Visit Josée's website and connect with her on social media.