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Eating Disorder Recovery Handbook: A Practical Guide to Long-Term Recovery
This empathetic handbook has been created for people affected by any form of disordered eating. Thoughtfully compiled by experienced authors, it will be a comprehensive guide through every stage of your recovery, from recognising and understanding your disorder and learning fully about treatment, to self-help tools and practical advice for maintaining recovery and looking to the future. Each chapter includes suggested objectives, tasks and reflections which are designed to help you think about, engage with, and express your thoughts, feelings and behaviours. It will encourage you to process the discoveries you make about yourself for positive and long-lasting change. Encouraging quotes are included throughout from people who have walked this path and found the help they needed to overcome their own disordered eating. You are not alone on this journey.
240 pages, Paperback
Published October 21, 2016
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September 23, 2024
• ‘I don’t like my body!’ • ‘I can’t accept a healthy weight.’ • ‘If I don’t do well, then I am worthless – I must over-achieve to compensate.’ • ‘I feel like a freak – I need things a certain way in order to cope; I can’t cope with uncertainty.’
• ‘I can’t accept not being the best – if I’m not the best, then I’m not good enough!’
• ‘I can’t accept that I deserve good things.’ • ‘I can’t trust or allow myself to rely on anyone.’ • ‘I can’t accept that someone else could love me.’ • ‘I can never take on board positive compliments.’ • ‘I can’t accept help.’
It’s important to recognise that the above comments are all examples of negative thought processes that stem from a source in your life. Where has the message come from? Who, if anyone, has reinforced this message? What do you do to reinforce this message in your everyday actions.
.............
List the things you find it hard to accept about yourself and any reasons why you might be struggling with this.
How could I begin to be more accepting?
What practical action could I take towards improving my negative beliefs
Often, people fail to get what they want because other people don’t know what they want, not because they don’t want to give it. Suppose you were hungry and would like to eat early. You could be direct and say, ‘I am hungry; would you mind if we ate early?’ Or you could be indirect and say, ‘Are you hungry? Do you want to eat early?’ In either case, the other person may disagree, but by using the direct approach at least they would know what you want. When communicating your needs, try to avoid ‘you’ statements, such as ‘You are so unreliable.’ The person may resent being blamed. Use ‘I’ statements, such as ‘I feel angry when you say you will do something and you don’t do it.’ This expresses your feelings without blaming the other person.
Explanation: State the problem or request clearly, as you see it. • Feelings: Acknowledge your own feelings, using ‘I’ (not ‘you’) statements. • Needs: Outline clearly what you want out of the situation, making as few demands as possible.
• Results: Say what will happen as a result, including the results if your needs are met and the disadvantages if they are not.
For example, if you wanted more help around the house: • Explanation: ‘I seem to be taking on more than my fair share of housework.’
• Feelings: ‘It’s upsetting me because I don’t get enough time to myself any more.’
• Needs: ‘I’d like us to sit down and decide on a fairer system.’ • Results: ‘I’d be much more relaxed and my mood would be better if I had some help with the housework.’
Positive self-talk leads to having positive feelings about the self, which leads to positive treatment of the self. Do you: • catch yourself only ever expecting the worst things to happen? • think bad things about yourself or about how you look? • constantly worry about what other people think of you? • call yourself names like ‘fat’ or ‘stupid’ or ‘a loser’? • engage in any other type of negative thinking?
These patterns of negative thinking can often become habitual and automatic. Therapists call them negative automatic thoughts (NATs), and thinking this way can actually create or worsen much of the stress we are under.
Step 1: Noticing your inner voice. Practise noticing the type of thoughts that occur in your mind as if by habit. For now, just notice them, and let them go. Get into the habit of noticing the way you think and what those thoughts are telling you. Are they negative or positive? Do you notice the same thoughts occurring again and again? Notice the tone of that voice – for example, is it critical, harsh, angry, sneering or pitiful?
• Step 2: Changing the tone of your inner voice. Once you have become used to noticing your self-talk, now start to change the tone of your inner voice. Before you change what those thoughts are saying, just change the tone of your voice so you can imagine hearing a warm, reassuring, friendly and confident voice – as if your inner voice was that of your very best friend who was always on your side, always there for you, always comforting you.
• Step 3: Now change what your inner voice is saying to you. What would you say to your best friend if they were in the same position you are in? What do you really need to hear at this time? What would be a more helpful, more encouraging thing for your inner voice to be saying to you instead of all those negative put-downs? Now hear your inner voice saying helpful, supportive things to you in its new friendly, warm and encouraging tone of voice. It may take some time; many of our negative ways of thinking have become a lifetime habit, often having developed as a result of how others have treated us.
Current belief system: ‘If I don’t binge at night, I won’t be able to sleep.’ Counter belief: ‘I understand I may be anxious that I won’t sleep if I don’t eat at night, and I may need to consider other alternatives to help me sleep, but eating at night really isn’t helping me.’
The Good Child (or Hero). This role is often, but not always, filled by the oldest child in the family. This member of the family is visibly successful in one or more areas – school or sports, for example – and looked up to by younger siblings and those outside the family. Parents often hold the Good Child up as an example to other siblings: ‘Why can’t you be more like your brother?’ This can cause sibling rivalry and can put pressure on the Hero to fill unrealistic expectations.
The Invisible Child (or Lost Child). This is the child who hides away in their room with a book, sacrifices their own needs and figures out how to make do with what they have. In a functional family that includes a member with special needs, the Invisible Child may emerge when the parents are busy caring for the other child. The Invisible Child learns to take care of themselves and as a result may eventually start to believe their needs aren’t important, which of course is untrue.
Women and men with body image issues often use mirrors to check their perceived flaws, reinforcing their negative views of their appearance. The basic idea behind mirror exposure is that learning to look realistically at your own body in objective terms can alter the automatic, negative judgements that would normally arise in those with eating disorders.
One of the key elements of mirror therapy is for individuals to look at themselves in the mirror and describe their bodies in non-judgemental, but honest, ways. So, instead of looking at themselves and saying, ‘I have a big belly,’ they might note that their lower abdomen is rounder than their upper abdomen. The goal is to help people let go of their constant self-criticism and learn how better to respond to distressing thoughts about their bodies
Women in the mirror exposure group stood in front of a three-way mirror
and were asked to describe themselves to a therapist, using objective, realistic terms rather than criticism. The women were directed to focus on their whole body, describing areas they liked as well as ones they disliked. They were also given homework assignments designed to limit any routine visits to the bathroom scales or to the mirror for a ‘check. '
Art Therapy*******
It is especially beneficial for emotional and psychological disorders as it provides a means of communication to express feelings that are too difficult to verbalise.
Here are some ideas of art projects that can help with self-awareness, positive expression and motivation for recovery:
Road drawing****
Draw a road that represents a time line, focusing on significant chapters of your life. Challenging times might be represented by mountains, whereas calmer times might be bordered by level fields or a sunset. The journey should be represented in a personal way, using drawings, colours, textures and metaphors to suit your instincts and personality. The road can be periodically updated, highlighting a capacity to change and progress towards recovery.
Express emotion*****
Spend a moment to reflect on a frequent feeling that you’ve recently experienced. Try to express this feeling on paper by using lines, shapes, colours and textures.
Abstract family portrait***
List the main people involved in your life. Represent them on paper in an abstract way, using metaphors to portray your perception of them. For example, an explosive personality that continually seeks attention might be represented by a firework. You might even like to consider the order and distance between each member of the group in relation to their impact on one another.
Eating disorder and me
Sometimes a person with an eating disorder can feel that the eating disorder is its own entity. Perhaps it would be helpful to represent your eating disorder beside the actual you, giving consideration to the colours, textures and size differences between the two identities.
Tree of life
Create a tree of life, recognising the strength of deep roots, continual growth and adaptation according to surroundings, the cycle of the seasons and the beauty in nature’s differences. Remember, during autumn and winter, leaves will wilt and wither, leaving the tree looking bare and lifeless, but it is these leaves that help to nurture the growth of the tree, enabling it to flourish in the next spring. This cycle of life could represent the ups and downs in life, which could be seen as the necessities that enable growth in the future.
..........
Here are some journal writing ideas to inspire you: • I feel good today because… • I hate it when... • My eating disorder helps/hinders my daily life in the following ways… • When I look in the mirror I feel/see… • My vision of healthy eating is…
• What does ‘recovery’ mean to me? How do I define my vision of ‘recovery’?
• Right now, I see/hear/smell…and this makes me feel/think… • Today, I am thankful for
Practising self-directed empathy entails offering yourself the same attitude you would offer another. The more you practise this, the more forgiving of yourself you will become. It will also lead to greater self-understanding, selfacceptance and self-love. For example, you will realise that as dysfunctional as your eating-disordered behaviour might be, it arose at a time when you thought it was the best option for you, and that originally it was put in place to help you rather than harm you
Many people believe that if they don’t eat, they are the ones in control. The reality is that if you do not allow yourself to eat, the eating disorder is controlling you
Normal eating is not::::: • counting calories, weighing food or following a strict diet • always eating low-calorie foods • eating to lose weight, despite being a healthy size • having to constantly weigh yourself for reassurance • playing games with yourself to prevent eating certain foods – for example, saying to yourself, ‘Dairy products make me feel nauseous’ or ‘I’ve become vegetarian for health reasons,’ when you are trying to justify excessive amounts of fruit and vegetables
Cravings/overwhelming desires. Feeling a compulsion to eat certain foods could be linked to your emotions, although it may also be linked to the body’s physical need for certain nutrients. The food industry also tries to heavily influence our cravings.
• Unconscious eating. Sometimes we eat to create a distraction from our thoughts. Other times we may experience an emotional numbness as we eat. If we are not focused on what we are eating and why we are eating it, there will be a tendency to overeat.
• ‘I can’t accept not being the best – if I’m not the best, then I’m not good enough!’
• ‘I can’t accept that I deserve good things.’ • ‘I can’t trust or allow myself to rely on anyone.’ • ‘I can’t accept that someone else could love me.’ • ‘I can never take on board positive compliments.’ • ‘I can’t accept help.’
It’s important to recognise that the above comments are all examples of negative thought processes that stem from a source in your life. Where has the message come from? Who, if anyone, has reinforced this message? What do you do to reinforce this message in your everyday actions.
.............
List the things you find it hard to accept about yourself and any reasons why you might be struggling with this.
How could I begin to be more accepting?
What practical action could I take towards improving my negative beliefs
Often, people fail to get what they want because other people don’t know what they want, not because they don’t want to give it. Suppose you were hungry and would like to eat early. You could be direct and say, ‘I am hungry; would you mind if we ate early?’ Or you could be indirect and say, ‘Are you hungry? Do you want to eat early?’ In either case, the other person may disagree, but by using the direct approach at least they would know what you want. When communicating your needs, try to avoid ‘you’ statements, such as ‘You are so unreliable.’ The person may resent being blamed. Use ‘I’ statements, such as ‘I feel angry when you say you will do something and you don’t do it.’ This expresses your feelings without blaming the other person.
Explanation: State the problem or request clearly, as you see it. • Feelings: Acknowledge your own feelings, using ‘I’ (not ‘you’) statements. • Needs: Outline clearly what you want out of the situation, making as few demands as possible.
• Results: Say what will happen as a result, including the results if your needs are met and the disadvantages if they are not.
For example, if you wanted more help around the house: • Explanation: ‘I seem to be taking on more than my fair share of housework.’
• Feelings: ‘It’s upsetting me because I don’t get enough time to myself any more.’
• Needs: ‘I’d like us to sit down and decide on a fairer system.’ • Results: ‘I’d be much more relaxed and my mood would be better if I had some help with the housework.’
Positive self-talk leads to having positive feelings about the self, which leads to positive treatment of the self. Do you: • catch yourself only ever expecting the worst things to happen? • think bad things about yourself or about how you look? • constantly worry about what other people think of you? • call yourself names like ‘fat’ or ‘stupid’ or ‘a loser’? • engage in any other type of negative thinking?
These patterns of negative thinking can often become habitual and automatic. Therapists call them negative automatic thoughts (NATs), and thinking this way can actually create or worsen much of the stress we are under.
Step 1: Noticing your inner voice. Practise noticing the type of thoughts that occur in your mind as if by habit. For now, just notice them, and let them go. Get into the habit of noticing the way you think and what those thoughts are telling you. Are they negative or positive? Do you notice the same thoughts occurring again and again? Notice the tone of that voice – for example, is it critical, harsh, angry, sneering or pitiful?
• Step 2: Changing the tone of your inner voice. Once you have become used to noticing your self-talk, now start to change the tone of your inner voice. Before you change what those thoughts are saying, just change the tone of your voice so you can imagine hearing a warm, reassuring, friendly and confident voice – as if your inner voice was that of your very best friend who was always on your side, always there for you, always comforting you.
• Step 3: Now change what your inner voice is saying to you. What would you say to your best friend if they were in the same position you are in? What do you really need to hear at this time? What would be a more helpful, more encouraging thing for your inner voice to be saying to you instead of all those negative put-downs? Now hear your inner voice saying helpful, supportive things to you in its new friendly, warm and encouraging tone of voice. It may take some time; many of our negative ways of thinking have become a lifetime habit, often having developed as a result of how others have treated us.
Current belief system: ‘If I don’t binge at night, I won’t be able to sleep.’ Counter belief: ‘I understand I may be anxious that I won’t sleep if I don’t eat at night, and I may need to consider other alternatives to help me sleep, but eating at night really isn’t helping me.’
The Good Child (or Hero). This role is often, but not always, filled by the oldest child in the family. This member of the family is visibly successful in one or more areas – school or sports, for example – and looked up to by younger siblings and those outside the family. Parents often hold the Good Child up as an example to other siblings: ‘Why can’t you be more like your brother?’ This can cause sibling rivalry and can put pressure on the Hero to fill unrealistic expectations.
The Invisible Child (or Lost Child). This is the child who hides away in their room with a book, sacrifices their own needs and figures out how to make do with what they have. In a functional family that includes a member with special needs, the Invisible Child may emerge when the parents are busy caring for the other child. The Invisible Child learns to take care of themselves and as a result may eventually start to believe their needs aren’t important, which of course is untrue.
Women and men with body image issues often use mirrors to check their perceived flaws, reinforcing their negative views of their appearance. The basic idea behind mirror exposure is that learning to look realistically at your own body in objective terms can alter the automatic, negative judgements that would normally arise in those with eating disorders.
One of the key elements of mirror therapy is for individuals to look at themselves in the mirror and describe their bodies in non-judgemental, but honest, ways. So, instead of looking at themselves and saying, ‘I have a big belly,’ they might note that their lower abdomen is rounder than their upper abdomen. The goal is to help people let go of their constant self-criticism and learn how better to respond to distressing thoughts about their bodies
Women in the mirror exposure group stood in front of a three-way mirror
and were asked to describe themselves to a therapist, using objective, realistic terms rather than criticism. The women were directed to focus on their whole body, describing areas they liked as well as ones they disliked. They were also given homework assignments designed to limit any routine visits to the bathroom scales or to the mirror for a ‘check. '
Art Therapy*******
It is especially beneficial for emotional and psychological disorders as it provides a means of communication to express feelings that are too difficult to verbalise.
Here are some ideas of art projects that can help with self-awareness, positive expression and motivation for recovery:
Road drawing****
Draw a road that represents a time line, focusing on significant chapters of your life. Challenging times might be represented by mountains, whereas calmer times might be bordered by level fields or a sunset. The journey should be represented in a personal way, using drawings, colours, textures and metaphors to suit your instincts and personality. The road can be periodically updated, highlighting a capacity to change and progress towards recovery.
Express emotion*****
Spend a moment to reflect on a frequent feeling that you’ve recently experienced. Try to express this feeling on paper by using lines, shapes, colours and textures.
Abstract family portrait***
List the main people involved in your life. Represent them on paper in an abstract way, using metaphors to portray your perception of them. For example, an explosive personality that continually seeks attention might be represented by a firework. You might even like to consider the order and distance between each member of the group in relation to their impact on one another.
Eating disorder and me
Sometimes a person with an eating disorder can feel that the eating disorder is its own entity. Perhaps it would be helpful to represent your eating disorder beside the actual you, giving consideration to the colours, textures and size differences between the two identities.
Tree of life
Create a tree of life, recognising the strength of deep roots, continual growth and adaptation according to surroundings, the cycle of the seasons and the beauty in nature’s differences. Remember, during autumn and winter, leaves will wilt and wither, leaving the tree looking bare and lifeless, but it is these leaves that help to nurture the growth of the tree, enabling it to flourish in the next spring. This cycle of life could represent the ups and downs in life, which could be seen as the necessities that enable growth in the future.
..........
Here are some journal writing ideas to inspire you: • I feel good today because… • I hate it when... • My eating disorder helps/hinders my daily life in the following ways… • When I look in the mirror I feel/see… • My vision of healthy eating is…
• What does ‘recovery’ mean to me? How do I define my vision of ‘recovery’?
• Right now, I see/hear/smell…and this makes me feel/think… • Today, I am thankful for
Practising self-directed empathy entails offering yourself the same attitude you would offer another. The more you practise this, the more forgiving of yourself you will become. It will also lead to greater self-understanding, selfacceptance and self-love. For example, you will realise that as dysfunctional as your eating-disordered behaviour might be, it arose at a time when you thought it was the best option for you, and that originally it was put in place to help you rather than harm you
Many people believe that if they don’t eat, they are the ones in control. The reality is that if you do not allow yourself to eat, the eating disorder is controlling you
Normal eating is not::::: • counting calories, weighing food or following a strict diet • always eating low-calorie foods • eating to lose weight, despite being a healthy size • having to constantly weigh yourself for reassurance • playing games with yourself to prevent eating certain foods – for example, saying to yourself, ‘Dairy products make me feel nauseous’ or ‘I’ve become vegetarian for health reasons,’ when you are trying to justify excessive amounts of fruit and vegetables
Cravings/overwhelming desires. Feeling a compulsion to eat certain foods could be linked to your emotions, although it may also be linked to the body’s physical need for certain nutrients. The food industry also tries to heavily influence our cravings.
• Unconscious eating. Sometimes we eat to create a distraction from our thoughts. Other times we may experience an emotional numbness as we eat. If we are not focused on what we are eating and why we are eating it, there will be a tendency to overeat.
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April 4, 2022Still using it, in conjunction with therapy
December 2, 2016
This is a clear, accessible guide geared to people dealing with any sort of disordered eating behaviors. It eschews lingo and focuses on practical, doable strategies that can offer immediate relief from problematic behaviors and thoughts, but does not promise any fast, miraculous cures. The book is chock full of activities for reflection, checklists, and other features that help readers to think more deeply about their own behavior and choices. Never preachy or academic, this book would be useful for both teens and adults. #NetGalley
March 30, 2017
Brief explanations. to the point. Not at the emotional level of Geneen Roth's When You Eat At the Refrigerator, Pull Up A Chair., but practical.
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