Overcoming Eating Disorder Relapses By Vicki Berkus M.D., Ph.D., CEDS, Remuda Ranch Medical Advisor One of the biggest concerns behavioral health professionals have today about eating disorder treatment is the high relapse rate. This was even a subject of debate in the news recently when the New York Times published an article titled, “Centers to Treat Eating Disorders Are Growing, and Raising Concerns.” The comments section includes a lively discussion on the efficacy of eating disorder treatment. My “aha” moment came when I was listening to Jenni Schaefer, the author of Life without ED, present at an iaedp conference. As she was walking along the edge of the stage, which was about a foot high, she would purposely slide off the edge when talking about her struggles with her own relapses. At one point, she stopped. She explained that it had dawned on her that she didn’t have to walk along the edge of the stage; she had the whole stage behind her to provide safety. She compared this epiphany to one she had in regards to eating disorder recovery.
Recognizing Relapse Triggers I now have my patients complete a relapse prevention exercise based on her comments. I give each patient two pieces of large paper (like from an examining table) and ask them to pick two different colored markers. I then ask them to take the first sheet of paper and write the behaviors that keep them in relapse mode or “on the edge” of recovery around the edges. I encourage them to help one another. After about 30 minutes, they each read what they have written. The second paper is used to write the behaviors that keep them in recovery. They have to draw a square in the middle of the second sheet and stay within the square, away from the edges. They have a lot of fun and gain a lot of insight with this exercise. I have had patients tell me that they want to put them up in their rooms. Some have burnt the relapse behavior sheet at a “burning ceremony” while in treatment. (Thank you Jenni for the inspiration and the work you do.) Relapse is part of any recovery process. “Black and white” thinking keeps patients from understanding that recovery is hard. We don’t expect perfection, only that they try their best. I also tell my patients that I would rather they succeed gradually at each level of treatment than try to take the “flight to health” and try it on their own. Their ability to do well at each level of treatment helps in their recovery. We make door hangers for their rooms and use big letters spelling HALT. It is an old recovery tip to remind them to look for triggers which include letting themselves get too “hungry, angry, lonely or, tired.” Each of these feelings can leave us vulnerable to slipping into old behaviors. It truly takes a village to help eating disorder patients stay in recovery.
Addressing Eating Disorder Relapse at Remuda Ranch At Remuda Ranch at the Meadows, we have the ability to treat the medical, behavioral and spiritual aspects of eating disorders for adolescent girls and women struggling with eating disorders. Our proven medical and clinically intensive treatment program and expert staff can also help those who struggle with dual-diagnoses, emotional trauma, and multiple relapses. Several program components can be blended with a Biblically-based, nondenominational Christian perspectives allowing patients of the Christian faith the opportunity to bring their individual belief into the recovery process. All of this is provided in a beautiful, scenic and home-like environment. For more information, call us today at 866-390-6100.