Staying Focused on Eating Disorder Recovery During Coronavirus

As an eating disorder therapist, listening to my clients over the past weeks has been both heartbreaking and inspiring – sometimes both at the same time.

Because of the pandemic, treatment and care for eating disorder recovery has changed dramatically. Therapists and dietitians move to online sessions for the common good; well-developed strategies of coping aren’t accessible or safe anymore; and exposure challenges, like meal outings, are totally restricted.

It’s natural to feel overwhelmed and saddened by this. You might even question your commitment to full recovery. As a therapist and person who recovered from an eating disorder, I get it. The eating disorder would love this opportunity to help you cope with all the anxiety, distress, and uncertainty we are collectively facing. And yet, although I worry for my clients, I still hold the hope that even in these traumatic times, recovery work is possible. In that spirit, I've put together five gentle ideas for bolstering your eating disorder recovery efforts throughout COVID-19.

Remember why you started your recovery in the first place

As we noted above, wavering motivation is a hallmark part of an eating disorder. However, at some point, you decided to ask for treatment. You made the brave step of reaching out to a therapist, dietician, friend, partner or parent – and stating something is wrong.

What was going through your mind at that time? As you’ve moved through treatment, what keeps you going? Why do you show up and work so hard? What do you want in your life that your ED is presenting you from having? Perhaps your parent forced you into treatment and you’re just starting to consider a life without an eating disorder.

Consider what your eating disorder has given to you. Try to hold compassion for the aspects it’s helped, and consider other ways to get what you need.

Now write down a list of everything the ED has taken from you. Examples can include your health, friendships, or a sense of normalcy. If you get stuck with any of this, ask a trusted loved one or therapist for support.

Identify which coping skills are still available to you  

If your first coping skill for distress was to hang out with friends or go to a store, these are big losses not being able to do that – but at the same time, there are so many additional strategies to distract, self-soothe, and cope.

Consider thinking of your five senses: touch, sound, vision, taste, and smell. Put together a list of actions that can appeal to these sense.

Some examples of these are:

It’s likely you’re going to need a big list of activities right now to manage urges, tolerate distress, and cope with uncomfortable emotions that the work of recovery calls for.

If you’re stuck on ideas, you can always review the Big List of Pleasant Activities that are quarantine-friendly.

Go above and beyond to stay connected with others

I get the temptation to withdraw from friends, family, and your treatment team. Meeting over a virtual platform simply not the same as meeting in person. I truly agree – and strongly miss in-person meetings. It’s also the reality that we just cannot do that right now.

This may lead for some to feel sad and want to isolate, giving up socializing all together. I’m going to encourage you right here to use a skill from Dialectical Behavioral Therapy (DBT) called Opposite Action. This skill teaches us to do the opposite of an action urge when the emotion is very intense or not leading to effective action.

For example, if we disconnect from those who we care about and who care about us, we increase our chances of feeling depressed and having more eating disorder thoughts and urges. Opposite action calls for reaching out to a friend and not isolating then repeating that action over and over again.

If you feel like canceling your treatment sessions and putting your ED recovery work on hold, try to do the opposite of this by attending virtual sessions and talking about what you're experiencing with your team.

Engage in additional support opportunities

Social media can be a tricky world. There’s certainly way too much diet talk going on right now that I’m not even going to give publicity to by discussing in detail. There’s also a number of great sources of support via social media right now.

Two examples (and I’m sure there are many more) are:

If you feel like you need more support than outpatient levels of care, there are numerous treatment centers across the country offering virtual care. This is an opportunity to access care that may not usually be accessible to you due to geographic location.

Practice mindful self-compassion

It’s clear that times are hard and it’s likely your ED voice is getting louder, telling you lies like “You’re not moving enough” or “You’re not being productive enough” or simply “You’re not enough."

Try to label those thoughts as they come in and mindfully let them go, as if they were clouds passing through the sky or leaves on a rushing stream.

Then imagine what someone you love or who loves you would say to those thoughts. What tone would they use? How would you feel after they said them? Make sure it is someone who you find to be supportive and comforting.

If this feels tough, consider listening to self-compassion meditations on Insight Timer or any meditation app. Self-compassion can allow us to practice gentleness with the eating disorder part that often quite mean and rigid.

Self-compassion also makes us able to more resiliently cope with the changes and challenges of life, especially now.

Hopefully, these suggestions give you both a reminder of why recovery matters right now and some suggestions on how to approach the challenges in recovery related to the pandemic.

As always, check-in with your team for more support and guidance. I’ve personally felt inspired to work with my clients during this time and see both their dedication and trials on the messy road to recovery from an eating disorder. Thank you for inspiring me to work harder as we fight this together.

Lastly, in case you haven’t hear it today, or your ED mind is playing tricks on you: You matter so much and there is a big life outside of your eating disorder waiting for you on the other side. Your hard work still matters, now, more than ever.