“You need to see a treatment team weekly for a year,” is often met with wide-eyed astonishment and/or disbelief. After being inpatient, people are so ready to get back to the “real world” and leave their eating disorder behind. As an inpatient therapist, it’s my job to help them understand that they need to fit their life into their recovery and not their recovery into their life. Recovery has to come first. How do you make this happen?
Most patients say maintaining recovery is really simple and yet the hardest thing they have ever done. Attending appointments is simple; talking about issues and concerns is really hard. Following a structured meal plan is a simple concept but a difficult reality. Contacting a friend is easy enough, being brutally honest about your struggles is really hard. Make the commitment to keep moving toward recovery no matter what. Keep taking steps toward recovery every day.
Before someone leaves inpatient, ask them to take a moment to assess how they feel physically, spiritually, mentally and emotionally and have them write down their answers. Next, have them compare these feelings to how they felt just prior to entering treatment. Keeping a written comparison is often a strong motivator for sustaining a recovery oriented life.
Yes, a recovery oriented life – something much different from the elusive recovery that most patients think about. Shifting to recovery as a fluid process and not something you are “in or out of” helps loosen the rigidity and opens up space for mistakes and the ability to learn from those mistakes. A recovery oriented life involves flexibility and not perfectionism for “struggling well” (recognizing your urges, admitting them, speaking them out loud, getting support to resist them). It is also owning up to any behaviors and immediately getting back on track. Again, continuing to take steps toward recovery.
The steps are many and varied – and like any other skill, one must practice. And practice more. Practice breathing, practice sharing your thoughts and feelings, practice resisting urges, practice journaling, practice meditation or mindfulness, practice thought stopping and reframing beliefs. Practice radical acceptance and opposite action. Practice whatever works and practice it over and over. Years ago we had a patient complain about how “cheesy” group activities were until one day she surprisedly admitted: “This cheesy stuff really works.”
Take the risk to allow your loved ones to support you. Before you leave treatment, let them know what you need to be successful in recovery. Explain to them how to approach you when your eating disorder is loud. Give them ammunition to help you fight your eating disorder neurochemistry – to get you out of the unending loop. You will need the help and support of all of your loved ones since the bulk of recovery happens “in the real world”.
As you rely on your loved ones more and more, your relationships will expand and deepen and become so much more rewarding. It’s these rewarding relationships that will provide the most significant buffer between you and your illness. As you experience how rewarding relationships are, you realize more and more how empty your illness truly is. The true rewards in life come from connections to people. This is probably what I hear most from former patients – how much richer their lives are because of their relationships.
These more fulfilling relationships also help you to understand yourself better. The more honest, connected and intimate your relationships are, the more you can appreciate yourself – foibles and all! You become more patient with yourself and your struggles. You are better able to learn from your mistakes and slips. You have more freedom to live a recovery oriented life – and all those skills you practiced so much become second nature. You accept life as it is even if you don’t always like how it is.
So, little by little, step by step your life transforms. Years later you realize you are living a recovery oriented life! Commit to taking steps toward recovery every day – regardless of the size of the step!