Coping is a big part of eating disorder recovery. But it’s how you cope that can dictate the progress made both inside and outside of treatment.
By definition, coping is expending conscious energy in an effort to manage, minimize or tolerate internal and external stressors. Eating disorder patients undoubtedly encounter stressful environments, from the presentation of food or dining out with friends to frequent feelings of shame and guilt.
In these situations, there are two types of coping strategies – positive (adaptive) and negative (maladaptive). Maladaptive coping generally increases stress and anxiety, with examples including self-harm, binge eating and substance abuse. The more maladaptive behavior, the more risk a patient faces in either sustaining or increasing the severity of their disorder.
Adaptive coping, on the other hand, can help reduce stress and minimize anxiety amid the most challenging circumstances. Developing these types of behavior can help to more effectively travel the road to recovery.
Below is a list five skills to eliminate maladaptive coping:
1). Cognitive Restructuring: Often times it is an individual’s distorted thoughts that are anxiety producing. The ability to challenge and manage one’s “self-talk” in a moment of high unease – and reshape the thoughts from negative to positive – can minimize the impact of the stress-related episode or event.
EXAMPLE: A patient goes into full panic mode when dining out. They avoid restaurants or meals outside the house at all costs, and as a result, miss meaningful gatherings and celebrations. When questioned about their “self-talk” in those moments, they acknowledge the feeling that everyone is watching to see if and what they’re eating. Challenging this person to examine and identify the distorted thought as one that cannot be substantiated by any facts will help them to replace it with more positive thinking (such as “my presence is valued at this meal.”) This will eventually reduce anxiety the next time they’re presented that situation.
2). Distraction: Distraction can be a very useful tool for positive coping. When urges to participate in unhealthy behaviors occur, patients should be encouraged to distract themselves by focusing their attention on other safe activities – such as listening to music, journaling or drawing – until the urge subsides.
EXAMPLE: A patient routinely engages in bingeing behaviors to calm anxiety about having to spend time at home alone. Upon feeling the urge to binge, he distracts himself by listening to his favorite musical playlist or working on his crossword puzzle book.
3). Meditation: The practice of meditation is a holistic approach of practicing contemplative reflection. The benefits include regulating mood, improving focus, promoting creativity and restoring life balance. Some scientists believe that transcendental meditation significantly reduces emotional eating. Meditation may also be used as a distraction technique as identified above.
EXAMPLE: When presented with the compulsion to engage in a behavior, a patient turns on a guided meditation video or relax in a comfortable chair while trying to focus on her breathing and remaining present. She can pay attention to sounds, textures and smells to bring her back to the moment when an intrusive thought enters her mind.
4).Thought stopping: Thought stopping is used to interrupt negative or unwanted thoughts in the moment. Individuals come up with a responsive action to immediately extinguish it. This response can be replacing it with a more productive thought or triggering a physical reaction.
EXAMPLE: A patient experiences a particularly anxiety-provoking thought such as “this food will make me fat.” He can then either in his head, or out loud, say STOP! The goal is that this action will stop the thought from snowballing into a maladaptive behavior.
5). Building Appropriate Supports: Identifying and securing professional and/or social supports can be extremely helpful in minimizing negative coping strategies. With the right supports in place, individuals are motivated to stay on course and be accountable for following their treatment plans and goals. Having social supports can encourage and help clients to work through problems more effectively and assist them in moving forward toward a life worth living.
EXAMPLE: A patient with anorexia works with an outpatient therapist, support group of peers or an eating disorder treatment provider.
Reframing how one copes in difficult situations, especially within the context of an eating disorder, does not happen overnight. Additionally, all of the mechanisms above might not be applicable for everyone, which is why it’s important to enlist an outside provider for guidance.
In the end, changing the way we cope can make a meaningful difference to last a lifetime.