CBT During the Holidays – May Your Holidays Be Mindful and Bright . . . Although You Can’t Always Be Right!

Contributor: Elizabeth Hoffman, Ph.D. and Barb Gershenson, Ph.D., Penn State Hershey Eating Disorder Programs

Can we agree that as the holidays bring food and family together there will be difficult moments? This is especially true for individuals with eating disorders! Research has shown that concern over mistakes and doubts about actions are more strongly associated with eating disorders than other psychological issues (1).

Cognitive Behavior Therapy (CBT) is based on the fact that, with awareness, we can change our feelings, thoughts and actions. CBT has been enhanced (CBT-E) to address eating disorders more specifically (2) We’d like to highlight some of the ways this can be helpful in continuing recovery from an eating disorder during the holidays:

Make time to connect to your thoughts and feelings:

CBT starts with being aware of our thoughts feelings and behaviors, so we know where to start working on change. As the holidays approach we seem to get busier and busier, bustling around purchasing gifts, attending social gatherings, and spending time with family.

It can be easy to disconnect from our inner experience. Take some time out to reach inside of yourself so that you are aware of your thoughts and feelings. You can do this by:

• Journaling
• Sitting in a bubble bath
• Taking a walk
• Sitting quietly at your desk

This provides you with the opportunity to understand how you are thinking, feeling, and behaving and what changes you might like to make to enhance your recovery through the holidays.

Keep perspective:

As our stress level rises, it becomes easier to lose perspective and become overwhelmed. Little issues can seem much bigger, and it feels like we have to do everything. Look around you in shopping mall parking lots and you’ll see evidence that it is hard to keep things in perspective.

A little trick that can help is to use a rating scale – on a scale from 1-10 (1 being low and 10 high) to stop and consider how much is this issue going to matter in one year and how much am I acting like it is going to matter. If the numbers are too far apart work on changing the way you are acting as you are struggling with keeping perspective.

Let yourself focus on the important things:

Keep telling yourself that, even if it’s hard to believe, you don’t have to do it all. Maybe you are going to a dinner party and you feel like you have to try all the different foods and socialize with everyone at the same time.

What if you focus on a recovery goal of trying one new or different food while speaking with some of the people there? Your chances of being successful – and having a good time – are greatly increased. Go over your list of things to do, and see what you need to focus on for recovery and what you can let go of.

Your needs are what you need to focus on:

Taking care of others is very easy. Try to think about what you need. Maybe put together a support team –

• Friends
• Relatives
• Teachers
• Coaches
• Books
• Inspirational
• Positive websites

– and plan to stay in touch with your supports.

It’s OK to plan some events that you’ll enjoy, some quiet times for you to relax and recover. Give yourself permission to skip some events so you can keep yourself and your recovery on track.

Separate food from feelings:

See if you can separate the social stress from the food stress.

Consider planning your meals in advance for the holidays so that you can meet your nutritional needs while trying to incorporate other foods that you may only eat once or twice a year at the holidays.

Allow yourself to bring your own items to family or social gatherings if that would help increase your comfort level. It is the season for gift giving! Think about who you would like to sit with at social events that might also help with reducing potential anxiety.

Predict the rough spots:

You know your family, your history. Instead of waiting for someone to be critical, try to predict what someone will say, how or when they will say it. It takes you out of the moment if you can tell yourself “I knew this would happen!”

Maybe one of your support team would like to do this with you, to see who can be “right” the most. There are actually different variations on this – try searching on-line for variations of “family holiday bingo stress” Really.

Plan coping ahead:

Conversation heading in a direction you would like to avoid – be ready with a topic your comfortable discussing. For you, politics may be better than new diet fads, religion may be better than comparing clothing sizes.

Take a few moments to look at the news, pick out some interesting stories or topics to discuss and go in prepared.

Be willing to change:

Instead of going on auto pilot and doing things the way that you have always done them, work on becoming aware of how things are impacting you and plan to make some changes.

For example, if you tend to spend 8 hours straight at your extended family members’ home during the holidays with lots of family members and it is chaotic and this is very stressful for you, make a decision to shorten your visit in an effort to take better care of yourself.

Be kind to yourself:

Please allow yourself time to learn and improve. It’s OK to get a calendar for next year and make some timely notes to help better plan for the holidays in 2015!

Community Discussion – Share your thoughts here!

What are some ways that you have found to take care of yourself while in eating disorder recovery?

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References:

1. Bulik, C. M., Tozzi, F., Anderson, C., Mazzeo, S. E., Aggen, S., & Sullivan, P. F. (2003). The relation between eating disorders and components of perfectionism. American Journal of Psychiatry, 160(2), 366-368.
2. Byrne, S. M., Fursland, A., Allen, K. L., & Watson, H. (2011). The effectiveness of enhanced cognitive behavioural therapy for eating disorders: An open trial. Behaviour research and therapy, 49(4), 219-226.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 27th, 2014
Published on EatingDisorderHope.com