Reviewed by Douglas Bunnell, Ph.D, FAED, CEDS
After spending time at a treatment facility, the transition back to the real world can be a difficult one. When you think about all the elements that were working while you were in treatment, you will need to continue to create these things at home. A treatment program does not “fix” us for life but it can help establish a solid foundation for recovery and also teach us what we need to do for ourselves moving forward. Here is a short list of things you should focus on as you transition out of an intensive treatment program:
- Professional Treatment Team: Make treatment a continued priority. Transitions are often challenging and it’s important to focus on continuing the progress you made at the treatment facility. Many people, if it is accessible, find it helpful to gradually reduce the intensity of treatment. If you are leaving a residential program, make every effort to find a partial hospital program (PHP) or intensive outpatient program (IOP). These outpatient programs can reduce the gap in the intensity of support between residential care and outpatient treatment and reduce the risk for relapse. You can search for a treatment facility in your area here.
- Be Sure to Take Care of Co-Occurring Conditions: Eating disorders often co-occur with other medical and psychological conditions such as depression and anxiety. It is important to have a treatment plan that addresses the full range of these issues. Not treating all of the physical and mental health concerns you may be experiencing may increase your risk of relapse.
- Willingness: Admitting that you need help is hard, but it is a first step toward recovery. It takes willingness to propel us into action. Be an active collaborator in your own treatment; we know that motivation, commitment and ongoing collaboration increase the likelihood of full and lasting recovery.
- Accountability and Support: Eating disorders flourish in secrecy and shame. Connecting with other people who can understand and support you is essential. Make plans in advance that make it as easy as possible to connect with other people. Plan meals with others. Get an accountability coach or another friend in recovery. Find local or online support groups and commit to attending them even when you feel reluctant. Have someone in your life that you have to tell all the sneaky stuff to. You can search for support groups here.
- Structure: Follow your meal plan even when you don’t feel like it. Maintaining a regular pattern of eating is the single best predictor of staying on track. Set up a regular recovery schedule to follow. Before you leave a treatment program it is important to anticipate and plan for predictable challenges. These might include the specifics on how to manage your meal plan at school or work. It might also involve cutting back on past activities or commitments. Have a plan for the situations you know are going to be difficult.
- Avoid Avoidance: Avoiding negative feelings is a key feature of many psychological disorders such as anxiety and depression. We know that this is especially true for people with eating disorders. Developing skills and experience with managing negative feelings without engaging in eating disorder behaviors is one of the most important parts of treatment and recovery. Be willing to feel all feelings, even when they feel awful. Be willing to sit with discomfort by taking one minute at a time. Breathe, don’t run. Use the skills you learned in treatment to work through the negative moments. Running from our feelings just takes us in a circle right back where we started.
- Managing Your Relationships: Many times our eating disorders will have a strong impact on the relationships in our lives. Be sure to explore how the people you care about are reacting to your recovery and your struggles. Some may distance themselves from you while others, perhaps because they’re anxious or afraid, may feel like they need to be more involved in your recovery. While involvement from loved ones can often be helpful in the recovery process, at times it can also feel overwhelming or cause problems. Be honest about how your recovery is impacting others and learn to set boundaries that support your recovery and foster healthier relationships. It’s important to first identify what your needs and wants are and then to communicate them with others in your life. It may be helpful to start by writing down a list of your boundaries or sharing them out loud with someone you trust. Setting limits and saying no can feel uncomfortable at first, but the more you practice, the easier it gets.
- Finding Purpose: Find purpose; do things that help you find spirit, hope, and connection. It’s easy to get distracted by work, media, and material things. Interviews with people who have recovered from their eating disorders often emphasize how important it is to have a clear sense of what they value about their lives. Having clear and valued goals to aim for can help you manage the tough moments and sustain your motivation in the recovery process. Try activities that help you to get outside of yourself like volunteering, doing something that’s fun or that sparks your creativity. Isolating can be triggering for the eating disorder so it’s important to connect with others and with activities that you enjoy or that feel purposeful to you.
- Be Flexible: Learn to be more flexible. It’s common for people with eating disorders to struggle with perfectionism and rigid expectations about themselves and their lives. Remember that you are human and mistakes are inevitable. Recovery from an eating disorder requires being willing and open to learning from our mistakes. No one gets better in a straight line; each time you struggle try to ask yourself “what can I learn from this?” or “what can I do next time this happens?” Have self-compassion for yourself.
- Be Patient: Recovering from an eating disorder is a process and it takes time. Typically early recovery involves addressing the most urgent risks to your physical and emotional health, while other aspects of recovery may take more time and repetition to change. You may feel frustrated when the process seems to be going slowly or there are setbacks. Be patient with yourself and know that you’re not alone and that with help there is hope for long lasting recovery!