Whether you or someone you know, are working in recovery from an eating disorder, substance use disorder, psychiatric crises or other forms of long term behavior change, it is possible that relapse will eventually occur. In the world of recovery, a relapse refers to “a deterioration in someone’s state of health after a temporary improvement,” or a “use of pathological behaviors after a period of abstinence.” These phrases sound cold and ominous but contrary to societal stigma, a relapse does not indicate faulty character or a moral wrong doing. It is actually a rather common occurrence on the road to recovery. Decades of behavior change research literature indicate that long lasting behavior change is rarely linear, and often involves cycling between stages of change, including returning to contemplating change itself. This is especially true in the treatment of eating disorders, as clients and providers often experience a “two steps forward, one step back,” pattern. Given the lack of education regarding this process, clients and treatment teams can sometimes feel defeated, hopeless and a rush of negativity when there is an increase in relapse behaviors. I have found, however, that these moments can actually become encouraging, positive and transformative experiences when re-framed as an opportunity for change.

Instead of labeling behaviors as a relapse and strengthening the accompanying negative associations, I often suggest substituting the word with the concept of “refocus.” Contrasting the notion of the relapsing freefall downward spiral to disorder behaviors, the concept of refocusing calls for a mindful moment of introspection. It encourages everyone to pause and take a deep breath, slow down, and nonjudgmentally observe what is taking place. This practice not only grants space to implement skills with a slight reprieve from mental chaos, but also allows time to challenge dichotomous thinking and contemplate future actions. For some working in recovery who find benefit in the 12-step programs, refocusing opens the possibility of relinquishing the notion that the individual can successfully control the disorder and encourages a return to meetings. For others, refocusing can serve as a time of reflection to understand what is working versus what challenges remain. For many, it is a time to increase communication within a multidisciplinary team or create one, and seek the support of knowledgeable professionals.

During the process of refocusing, an individual and/or team can identify the areas of their recovery that were going well, in addition to highlighting the triggers that possibly resulted in a resurgence of behaviors. Individuals can collaborate to better understand how to decrease current behaviors while formulating new plans to prevent future occurrences. These moments can also help formulate or refine the critical skills required to tolerate and overcome stressful time periods as life is often filled with countless “unknown unknowns” that sometimes only become conscious during the struggle itself.  In moments like these, maybe Friedrich Nietzsche’s saying, “what doesn’t kill you, makes you stronger,” can be applied to recovery and help individuals and teams emerge from these struggles with a new outlook. A period of refocusing can equip recovery warriors with a new arsenal of skills and strategies to strengthen defenses against the disorder. Teams and individuals can instead embrace adversity and the challenge of recovery as opposed to living a life of fear. At the end of the day, everyone can in turn, continue to define their own journey, emerge from these dark moments, and discover the true illuminating strengths deep within oneself that can never be dimmed. To learn more about how to define your own recovery, contact us.


Matt is a licensed registered dietitian nutritionist and certified strength and conditioning specialist. He is a nutritionist and exercise science advisor for the Walden GOALS program. Matt devoted the early part of his career to refining the art of training elite collegiate and professional athletes. In graduate school, he developed expertise in nutrition, behavior change and eating disorders. Matt now devotes his practice to translating nutrition and exercise science into practical solutions. As a lead member of the GOALS team, Matt is known for his dedication to educating and empowering athletes of all backgrounds to facilitate a full and meaningful recovery from disordered eating. Matt holds a B.S. degree in Kinesiology from the Honors College at The University of Massachusetts Amherst, a master’s degree in Applied Exercise Physiology and Nutrition from Columbia University and was a dietetic intern at Boston’s Brigham and Women’s Hospital.