Eating Disorder Treatment During the Holidays

Contributor: Nan Shaw, LCSW, Nan is Program Director for The Healthy Teen Project

The holidays signify many things – time with family and friends, travel, stress, joy, feasting and festivity as well as an inherent break from school and work routines.

For those struggling with an eating disorder, it represents both a very challenging time for recovery as well as a window of opportunity to seek help, either for relapse prevention or for more intensive treatment.

Whether making use of the culturally sanctioned time off, stepping out of a potentially stressful situation, recreating a new meaning of what the holidays may mean for your recovery, or simply finding extra support, the holidays can provide the perfect opportunity for treatment.

The Holidays Can Cause Anxiety

For adults, eating disorder treatment during the holidays can offer a legitimate alternative to what can be a stressful time. Family gatherings, in the best of times, can be difficult and there is often an increase in food-focused activities.

Simply put- holidays can feel like “too much” to those even without an eating disorder. Seeking treatment is a way to respectfully bow out of those situations while also strengthening one’s recovery resolve.

To be clear, this is not an indictment of families or food-focused traditions. Family dynamics can be trying for anyone – the remembered slight from an in-law, the shame we recall from not staying connected and the resentments we may feel from childhood rivalries.

Finding Joy in the Holidays

With the addition of a general over-value of appearance, past trauma, negative self-talk, and the resulting feeling of vulnerability, these gatherings, though sincerely meant to be wonderful, can actually be very difficult.

Enjoying special foods on specific holidays is part of all rituals and customs. How we eat, and how we feed each other, is a longstanding, lovely part of all cultures. Not wanting to “have to” participate in family or food-focused occasions can certainly be a step in someone’s recovery, and it can also be a symptom of an eating disorder and avoidance.

Seeking Treatment during the Holidays

For teens, seeking treatment during the holidays can offer families additional resources as well as capitalizing on parents being more available to participate in treatment, due to their own time off from routine responsibilities.

While it is certainly difficult to consider treatment during what is normally a time of celebration, it provides an opportunity as well. No one picks illness, nor can we typically conveniently schedule treatment, but the holidays can offer families a block of less-structured time to get further support or traction in their treatment.

Doing something more intensive during this time, could save much more time later.

Gifting Yourself with Treatment and Recovery

Giving yourself the “gift” of treatment also has the potential of reestablishing a new association of the meaning of the holidays for you and your loved ones. That is, the holidays can become a memorable time of recovery and self-care, instead of being an anniversary of relapse, avoidance, conflict or eating disorder behaviors.

This is particularly true of the whole phenomenon of the New Year’s Eve “Resolution” that implies all the ways one “should” make changes, and usually in the areas of appearance, diet, weight loss, and exercise commitments.

Imagine the power of infusing this annual ritual with positive associations and recovery goals that have nothing to do with appearance! And this could be true for the whole family, not just the eating disorder sufferer.

Finding Support during the Holidays

Finally, agreeing to treatment over the holidays can provide strong support during a time that may typically lack targeted support. With everyone tending to be engaged in their own traditions, and also themselves engaging in different eating and drinking habits (more!), it can be wise to explore outside support systems to counter eating disorder thoughts and behaviors.

This is particularly true if one is dealing with challenges around substance abuse. Surrounding yourself with a “sober” support system becomes very important.

Keeping Realistic Goals for Treatment

Given that the holidays mark a bookended amount of time, it is often considered wise to seek the most intensive treatment available to make the most of the limited time you have. However, keeping realistic goals of what amount of recovery work can happen over a discrete and arbitrary period of time is also important, and most providers would encourage a “curious not critical” approach to the question “is this time for recovery, in this setting, what YOU and your family need right now?”

Often, seeking treatment around the holidays can help eating disorder sufferers and their families appreciate how much pain they are in, and that it may be in their best interest to take more time off to treat this serious illness.

“Checking in” with oneself at a time that often is associated with “checking out” can offer real benefits. It must be remembered that the holidays are an external opportunity, and one that may or may not fit with your internal needs.

Choosing the Right Time for Treatment

So, whether you are an adult trying to navigate recovery in the context of the holidays, or a teen and her/his family trying to determine how best to make use of this time off, considering the pros and cons of treatment during the holidays is worth doing, and doing so compassionately.

If this is simply an arbitrary slice of time that doesn’t reflect one’s level of illness or needs for recovery, treatment during the holidays may be frustrating, insufficient and ineffective.

Alternatively, if this time offers the opportunities of treatment without disruption of other responsibilities, of increased targeted support, of capitalizing on parents being off of work, of recreating the meaning of the holidays for you and preventing relapse, then treatment during the holidays may be a great choice. It could be a real “gift”.

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About the Author:

Nan Shaw, LCSW:

Nan recently joined The Healthy Teen Project as Program Director from Kaiser Permanente where she was Program Lead and Best Practices Chair for Eating Disorders.