What should I say?

helping someone with eating disorder

When a friend or loved one is in recovery from an eating disorder, you may find yourself stressing out about what to/not to say.

What if I say something that will make him/her relapse? How do I know if something he/she says signals a relapse?

In order to help you, I have created the following as a resource. It contains information to help you navigate the difficult space of supporting someone in recovery.

Recovery is not about perfection

When a person is in recovery, it is very often not a linear experience. Most of the time there are ups and downs. In recovery speak, the downs are referred to as slips, and the goal is to not have a slip become a slide. When someone experiences a hard patch and has a slip, he/she can learn a lot from that experience, such as what made him/her vulnerable and which tools were/weren't  useful. Experiencing a slip can actually make the recovery stronger and hopefully give the person more confidence in the fact they can overcome obstacles.

Disordered thoughts and feelings hang around

Long after the destructive behaviors have ceased to exist, difficult thoughts and feelings will still be there. Sometimes loved ones get very nervous when they hear things like “I miss my eating disorder and wish I could go back” or “I feel so fat. I hate my body”. It is very normal for someone to still have these thoughts, but what is important to notice is that they are speaking them out loud, as opposed to acting on them with destructive behaviors. As always, try to be nonjudgmental and supportive. Ask how you can help, and offer to hang out with them until the urge or feeling passes.

A strong support system is vital for a strong recovery

There are mounds of research that attest to the fact that a healthy, stable support system is beneficial to a strong recovery. Anyone can be a part of a support system from significant others to family members, friends to co-workers. It isn’t the relationship that’s important, it’s the level of comfort and encouragement it provides to the individual.

Don’t talk, listen

There’s not much more I can say here, except what a person needs most often is someone who will listen to all the crazy shit running through his/her head in recovery and not judge. This can be difficult, because hearing some of the dangerous and irrational thoughts created by an eating disorder to suck the person back in is intense. Trust me, what he/she needs is a nonjudgmental supportive ear that will hear it all and still be there.

Don’t freak

Remember, disordered thoughts and feelings are normal, even in recovery. Not every thought is a relapse in the making. The important thing to focus on is that he/she is sharing with you instead of running back into the eating disorder. Be calm, help him/her remember the tools taught in treatment, and encourage him/her to bring these things up in therapy.

Validate, validate, validate

Yes, hearing your loved one say he/she feels fat is difficult. Hearing your loved one talk about planning all day for a binge and saying they are scared to be alone can be worrisome. Internally you are probably freaking out right now, because you know that these thoughts are common in eating disorders, but they are also common in recovery and it’s important not to freak. What should you do then? Try to uncover what is really going on, below the surface. Maybe he/she feels out of control, scared, or angry. Talk to your loved one about how returning to old coping mechanisms is common and probably feels a lot safer. Understand what he or she is feeling without trying to talk him/her out of it.

Example conversation

            Loved one: “I feel fat.”

            You: “Oh yeah, what’s going on right now that’s causing old thoughts to come up?”

            Loved one: <opens up about what they are thinking, feeling, experiencing>

            You: “Wow, that’s a lot. Sounds really stressful. It makes sense that you’re feeling all this old stuff. What new tools do you have to help get through it? How can I help?”

Take away: Just be there. That’s the most important thing you can do.

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Tamara Duarte

Tamara Duarte is a counselor, author, speaker, and activist. Her private practice, Get Centered Counseling in Vancouver WA, helps women with food and body issues learn to love themselves, their body, their life, and their relationships. Her life’s work is steeped in personal experience, having fifteen years in recovery for anorexia, in addition to being a breast cancer survivor. An up and coming force in the counseling community, Tamara has been published in a textbook called Treatment Strategies for Substance and Process Addictions, and has sat on a panel at the American Counseling Association Conference, where she spoke to her peers on strategies and tools to use with clients struggling with eating disorders. Having a deep, personal understanding of what it takes to recover from this condition, she seeks to be an example to those she treats, to let them know that recovery is possible. Currently developing a podcast which addresses the cultural issues that promote body shame, self-esteem issues and eating disorders, Tamara lives in Vancouver, Washington, with her husband and best friend, Adam, enjoying life to the fullest with their two beautiful children, Jacob and Chloe.