July 12, 2017

'To the Bone' on Netflix: Should You Watch?

Eating disorder triggers in Netflix To the BoneThe new Netflix film To the Bone highlights the story of a young female struggling with anorexia.

While this film doesn’t represent all eating disorders — which are far more complex and affect a highly diverse population — we are talking about this film because we know that many of you will be watching.
We recognize that a major film like this may help to raise awareness of eating disorders, even possibly encouraging some people to seek treatment.

We also recognize that those struggling with eating disorder behaviors and those in eating disorder recovery might be negatively impacted by this film.

Triggers and how to deal with them

The term “trigger” is commonly used these days. This term is overused and even misused.

Think about a gun. A trigger causes a bullet to come flying out. The moving bullet is an immediate reaction to the trigger and there is no stopping the bullet once the trigger is pulled.
When it comes to our mental health, on the other hand, when we have a reaction to a “trigger,” we can stop its momentum. For example, you can choose to engage in eating disorder behaviors or you can choose to get help.
We define a trigger as an experience, memory, sensation, thought or emotion that elicits a reaction.
Triggers are very personal and are unique for everyone. Triggers themselves are neutral. They can elicit more negative feelings (such as a photo of a snake eliciting fear) or positive feelings (such as a photo of your child eliciting a joyful response). If we are triggered, it simply means that we are having an internal reaction.
Triggers aren’t always a bad thing! And we don’t have to always avoid them. But we should be smart about them.
We should only approach potential triggers when we feel ready — when we feel strong enough to act in a way that keeps us moving forward, making decisions based on our values.
Remember: if you are triggered, you have the power to make a choice based on your reaction.
You choose what to do next.
If you are triggered by To the Bone, you can choose to listen to the eating disorder or you can choose to talk to people in your support system — and seek professional help, if needed.

Could the film To the Bone trigger an eating disorder relapse?

If you are in treatment or recently recovered, To the Bone could be a powerful trigger for you. And, if you are negatively triggered, remember that you have choices. Talk to your therapist or take advantage of skills learned in DBT to process your feelings around this film. *At the bottom of this blog post, we share two examples of DBT skills that you can use.
If you have been in recovery for a while, think about your state of mind right now: the eating disorder may be wanting you to watch this film; but you know that if you do, the movie could trigger you to start using eating disorder behaviors again.
If you want to watch To the Bone and aren’t sure if you are ready to watch this film, consider talking to your treatment providers, family members or friends and asking them, “Do you think I’m in a healthy place to be able to watch and process this movie?” Even those who are years into eating disorder recovery can slip back into behaviors. Please be mindful and seek help if you need it.
If you are a family member or a friend of someone in recovery, and you know that your loved one could slip back into behaviors after watching this film, consider telling them something like, “I really don’t want you to watch this film. I’m concerned about the impact that this film might have on you. I am here for you. Please know that you are not alone.”

Watching To the Bone in eating disorder recovery

We are hearing from members of our community that they will be watching the film, even though they tell us that they know deep down inside that they “shouldn’t watch it.” We get it. We know that many people with eating disorders and those in recovery are going to watch this film.
If you do choose to watch the film, we recommend that you mindfully watch this film with someone who is a healthy support person for you. Be a critical consumer. Consider these questions as you watch:
  • Is the film romanticizing eating disorders or making them seem attractive or appealing?
  • What seems realistic and what doesn’t seem realistic or accurate in this film?
  • What part of the story is missing? Does the film mention the biological basis of eating disorders or the severe medical effects (like anorexia having the highest mortality rate of any mental health issue)?
  • How does this person’s experience differ from your own?
  • How do you feel as you watch this film? Is your heart racing? Is your head spinning? Notice what you are feeling. 
Be aware of your mental, emotional and physical reactions as you watch. And discuss these reactions with a friend or family member both during the film and after the film ends.
Keep talking about eating disorders
We want to keep discussing topics like this in a healthy way. We want to educate and support those in eating disorder treatment, those in recovery and those who love and care for these amazing people. Let’s keep all lines of communication open. Let’s keep talking about eating disorder triggers, relapse and recovery.
If you are actively using eating disorder behaviors and want to get help, please contact us at (877) 766-1097 and a member of our team can help.
We thank Dr. Ellen Astrachan-Fletcher and Dr. Ashley Solomon for contributing to this piece.
*DBT Skill 1 for Eating Disorder Recovery: List of Pros and Cons
Make a four-point pros and cons list comparing using eating disorder (ED) behaviors vs. using skills or getting help.
  1. List the pros of using ED behaviors and not using skills/getting help.
  2. List the cons of using ED behaviors and not using skills/getting help.
  3. List the pros for using skills/getting help and not using ED behaviors.
  4. List the cons for using skills/getting help and not using ED behaviors.
This list might help you recognize that using ED behaviors in the short term can give you relief — but in the long run it only creates more problems that you will then want relief from. It can be a vicious vortex that continues to suck you in. This exercise can also help you get in touch with the goals and values that can continue pushing you forward in recovery.

*DBT Skill 2 for Eating Disorder Recovery: Stop Skill

S - Stop what you are doing. Do not react. Freeze. 
T - Take a step back. Take a break. Let go and breathe.
O - Observe. Notice what the situation is. What are others doing? What am I feeling?
P - Proceed mindfully with awareness. Consider and decide how to act wisely. 

Photo credit: Gilles Mingasson/Netflix
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