Ready or not, the holidays are upon us! This year I’m reposting my 2009 guide to managing the holidays in recovery. Whether this is a first time read for you, or a refresher, I hope you find it helpful and that it will serve as a reminder that resources are out there to support  you during a time many in recovery find difficult.

My warmest regards for a happy and rewarding holiday season,

Susan

The Five Top Holiday Eating Disorder Traps and How to Outwit Them

The holidays are here! There can be lots to look forward to. But there are also many potential snares to the season that can spoil your good time and make you long for January 2nd. People with eating disorders can be especially vulnerable, and not just because of all that fabulous food. Before you decide to just give up and go into hibernation for the season, I offer these recovery–friendly strategies for the five most common seasonal pitfalls.

1. Exposure to Triggering Foods and Alcohol

Did you know humans are hard–wired to respond to great–looking or novel food with an increase in appetite? If you have an eating disorder, your desire for food has become a battleground of will over nature. You imagine your very worth is determined by your ability to exert control over impulses to eat. The holiday table can ratchet up day–to–day struggles for control to another level. Add alcohol—famous for lowering inhibitions—and food urges can roll right over will. Here are some ways to face the challenge head–on so you don’t have to hide until the New Year:

• Plan ahead Trying to strategize in the heat of the moment is too hard for most of us. Make some decisions ahead of time about how you want to handle food and alcohol at a holiday event. For example, you might decide to take one pass at the goodies and then turn your attention elsewhere. If you’re working with a therapist or nutritionist, ask them to help you with your plan, including any landmines that could throw you off course.
• Visualize Picture yourself carrying out your plan, including managing pitfalls. Repeat, with corrections, until you can imagine all of it comfortably. This kind of rehearsal can really ramp up your chances of success.
• Avoid the temptation to diet! Dieting, a questionable practice at best, is a predictable trigger for eating disordered behavior, thinking and feelings. If your plan is to skip meals the day of the party, fast away a few pounds between events, or start the Lettuce Diet on January 1st, you’re setting in motion a vicious cycle that’s bound to land you in eating disorder territory.

2. Family Gatherings

Family gatherings can be all about showing the love. But, too often, old wounds, rivalries or tensions surface right along with the eggnog. Did you learn to cope by turning to eating disorder behaviors? Do your ED symptoms offer you distraction? Soothing? Relief? Self–punishment? Secret revenge? You probably can’t resolve all the old family fault lines or stop Aunt Cora from commenting on your weight before the next get–together. However, you can use family landmines as opportunities to practice healthy recovery skills. You can:

• Stay aware Paying attention to what you’re feeling gives you the chance to choose how you respond to others rather than acting on impulse or out of old, engrained patterns. If you stay tuned in to what you’re feeling and why, you’re less likely to suddenly find yourself engaging in eating disordered behavior to cope.
• Set limits People with eating disorders often having difficulty believing their own needs, feelings or rights matter. It’s hard to say “no” or “enough” when others intrude or push you in a direction you don’t want to go. Rather than tolerate the potential conflict, you restrict, binge or purge. This holiday, zero in on a predictable intrusion: Mom always insists you have two pieces of her pumpkin pie, your brother regularly chooses a moment of group silence to ask about your love life, or cousin Pete wonders if you’ve put on a few pounds. Now, pick a small limit–setting goal. Practice ahead what you’d like to do or say. Make sure your practice includes being able to reassure yourself inside if the other person is ruffled by your show of self–confidence.
• Manage conflict In ED recovery you may be learning how to stay in conflict until you can arrive at a healthy resolution. But your family holiday gathering may not be the place for this particular practice. Just because your sister is determined to duke it out, you have every right to defer the conversation to a more suitable time. Neither do you need to be drawn in to other people’s disputes, even if that’s what your family expects of you. For the petty stuff that doesn’t call for a day in court, there’s always the option of diversion (“How ’bout those Mets??”)

3. Holiday Parties

Distress for party–goers with eating disorders usually focuses on personal appearance and/or socializing. Self–doubt related to either may lead you to avoid parties altogether or to turn to eating disordered behaviors to cope. Here are some healthier, happier ways to manage:

• Take a different stance with your appearance When you take a too–­critical eye to your body, you are likely to end up with an obsessive focus on what  you find wrong—which in turn kills any potential fun you might have at a social gathering. Starting well before the big event, commit to focusing instead on things you dolike about yourself and your appearance. Do you have great hair? Strong arms? Are you a good story–teller? An insightful listener? You need a list and you need to return to it every time you find yourself fretting about your appearance—before, during and after the party.
• Soothe yourself when you socialize Fears about making small talk, meeting strangers, being focused on, being excluded or rejected can all create party–going nightmares. This isn’t exclusive to people with eating disorders, of course. It’s just that if you have one, you’re more likely to turn to your symptoms to help you through. Instead, start by using that list of positive qualities in yourself (see above) to boost your confidence. Enter the event focusing on examples of you comfortably enjoying yourself with others (Your best friend? Your sister? A co–worker?)  Ask your hostess to help make introductions. And, remember, you don’t have to have Dorothy Parker’s wit to start a conversation. Most people are at least a little uncomfortable at these events and will be grateful if you make an effort, or respond to theirs.

4. Loneliness and Disappointment

The holidays often just shine a harsher light on chronic loneliness. The season can generate expectations that dissolve into disappointment (the friends or family that didn’t come through, the New Year’s Eve date that didn’t materialize, the magic that seemed to visit everyone but you).  Loneliness and disappointment are difficult feelings for anyone to manage. If you have an eating disorder, almost by definition, you have difficulty managing uncomfortable emotions. Here are a few practices to help ydeal:

• Review your assumptions Be skeptical if you’re tempted to believe loneliness or isolation mean you’re unlovable. They’re more likely to mean you’ve been too scared to connect significantly—something you can work on!
• Reach out Do something pro–active and constructive. It’s likely to shift your emotional state. Host a potluck for other friends and acquaintances whose holiday plans are meager. Volunteer. Take a small holiday offering to your neighbors. Join a choir or small theatre group. There’s a world of other humans out there ready to embrace your efforts.
• Be willing to learn how to comfort and soothe yourself . . . even if part of you is screaming you’re entitled to have somebody else do the job. Remember, it has nothing to do with entitlement; you’re entitled to feel better!!

5. Perfectionism

If you have an eating disorder, you are likely to believe that when your efforts—weight­­–related and otherwise—fall short of the mark, you are a failure and therefore worthless. The holidays can crank perfectionistic expectations of yourself up to full throttle: you must buy the perfect gift, wrap it perfectly, throw the perfect party, make the perfect dessert, and so on endlessly. What should be a time of joy becomes a series of joyless tests. Failing marks spoil your enjoyment, undermine your self–worth—and trigger eating disorder symptoms. Here are some things you can do to help tame your perfectionistic monster:

• Change your frame of reference How would you judge a loved friend if she or he had the same experience you’re judging so harshly in yourself? What would that friend say to you about your supposed failure? Would she or he think less of you?
• Find models to emulate If you’re going to compare yourself to others, choose people you admire who aren’t so hard on themselves for being imperfect. Take notes! Here’s an instance where copying is a great idea.
• Cultivate self–acceptance You may not be able to stop those self–critical thoughts from popping up. But you can make a choice to send them packing when they do! This is a great practice to work on. It recognizes the truth that imperfection doesn’t make you worthless, just human.

All of the strategies I’ve just suggested actually represent recovery skills you need year–round. By practicing them now, you’ll not only make the current season brighter, you’ll be building your resilience for the challenges of the coming year. Happy Holidays!

Whether you are still focusing on symptom reduction or you are working on longer term issues of relapse prevention in your eating disorder recovery, resourcing is an important part of your work. What do I mean by resourcing? When you resource, you call on experiences or tools that help you feel calmer when distressed, or more grounded and centered when overwhelmed or out–of–control. Developing confidence in your ability to know and use the resources that help you achieve these outcomes is crucial to recovery.

Resources come in two forms: external and internal. External resources are all those things outside yourself that have a calming or centering effect on you. External resources  can include people, places (your room, a park, a church, a favorite street…), pets or other animals, objects (a stuffed animal, something from nature, like a stone, Grandma’s locket… ) or activities (walking, reading, gardening, journaling, listening to music…). What serves as a resource for someone else might not help you. Or what helps you in one situation might not be the right thing for another situation. You have to be able to tune in to your own feelings and trust what you experience to discover what resources help you the most.

Internal resources are those you evoke inside your mind, using your ability to remember or imagine. Internal resources can be anything you’d use as an external resource, only you experience them inside your mind rather than in real time outside yourself. Internal resources have the valuable extra dimension of including experiences that never were and don’t have to be realistically possible to have the desired effect. Maybe that’s creating your own planet, or a made–up landscape, or feeling the presence of a nurturing person who always gets you, or being cradled or held in a way that feels just right. There are no limits to the internal resources you can develop. You only need to know you need or desire them and they are yours for the asking, anytime, anywhere.

If you’ve  lived through an eating disorder you may be surprised to find internal resourcing can be an effective way to calm, soothe or ground yourself. You may even be outright skeptical or disbelieving. After all, during your eating disorder you put all your faith in the external experiences of food or dieting as the way to achieve these ends.  A number of people who have suffered from an eating disorder feel resistant to working on developing internal resources. Besides not trusting that they can become effective in doing so, I think many people are unconsciously still waiting for the external care they may have missed in childhood to show up and make them feel better. It’s an understandable longing, but I always feel sad when I see people get stuck there since it postpones the development of real capacities that can make them feel better.

Which is better, external or internal resources? I think to be really healthy and resilient as human beings, we all need a balance of the two. Using resources is something that you just get better at with practice. And you can never have too many. Lining up an optimal array of resources is a lifetime journey for all of us. Now is a perfect time to get started!

Warmest wishes,

Susan

Next week I’m so lucky to be headed off for a week’s vacation in Rome. My head is mostly full of Bernini and biscotti. But I got to wondering what’s been happening to the Italian fashion industry’s attempts to deal with eating disorders among their models.

In 2006, after several tragic deaths among models, the industry in neighboring Spain specified that in order for models to participate in the Madrid fashion week shows, they must demonstrate a BMI (body mass index) of at least 18. This roughly means a 5’8 model must weigh at least 120 pounds. Though the BMI is controversial as a way to measure health related to weight, at least the Spanish industry—along with the Spanish government— was saying “Enough!”

The Italian industry took notice. In 2007, Italy’s Chamber of Fashion proposed a licensing procedure for models. The proposal has resulted in a “self–regulating code of ethics” for the industry that requires a BMI of 18.5 in order for a model to be allowed on the fashion week runway and bans models younger than 16 years.

That same year the nude photo of an emaciated model, Isabelle Caro, appeared on a billboard in Rome with the caption “No Anorexia”. The shocking image was intended as yet another wake–up call. Yet within three years Caro — who posed to help others — was dead from the effects of starvation.

Did Caro’s final warning have an impact her brave billboard did not? As the Italians would say, the answer is “mezza–mezza.” The 2010 Milan shows refreshingly  introduced some curvy models said to look more like normal women. Yet last month, just a year after Caro’s death, Milan fashion week attendees were posting in dismay about skin–and–bones models again on the runway.

The usual assortment of bad guys can be found to explain why it’s so hard to promote health on the runway: people who can make a buck from showing clothes on starving women or just prefer a gaunt esthetic, no matter what the cost to models or the people who want to emulate them. But there are also good guys who genuinely care about the well–being of models and those they influence. My soon–to–be hosts, the Italians, offer a fine example: Elena Miroglio, on behalf of her fashion house, Elena Mirò, was awarded the insignia of Cavaliere della Repubblica (Order of Merit of the Italian Republic) in 2007 based on the group’s fashion show featuring size 14-plus women on the catwalk. The president of Italy cited Miroglio for “emancipating women from a constrictive concept of beauty.” The Miroglio Group carries several lines of “”curvy size” clothing brands. This year the group hosted the casting sessions for Ciao Magre’, the first agency in Italy to specialize in “shapely size” models. I have to say “Brava!”

Warmest wishes until I return,

Susan