May 11, 2018

Coping with Triggers: “I Didn’t Ask to Feel This!” – Nica Stepien

how to deal with eating disorder triggersI stopped subscribing to and buying popular magazines many years ago. 
 
You know the type I’m talking about: the ones scattered like bombs in the checkout aisle of any major grocery store. The ones with glossy covers that scream headlines like “How to Get The Stomach You’ve Always Wanted!” or “5 Days to the New You!” I tend to veer away from these after years of working in eating disorder treatment centers and witnessing the devastating effects these messages can have on a person’s self-worth.
 
Then last week something unusual happened. I received, in the mail, about five women’s magazines in a week — without subscribing to them and without my consent. I was inundated with images and headlines that promised me happiness in the form of a “perfect” body. I simply tossed the magazines in the recycling and didn’t think much of it (other than a mild concern that I had been signed up for a magazine subscription that I was unwittingly paying for). For me, the magazines had the potential to be harder on my wallet than on my psyche.
 
But I started to think: what if I wasn’t in a resilient place in my life? What if I didn’t have access to the resources I have? What if I didn’t have almost a decade of actively fighting diet culture and being an advocate for weight neutrality under my belt? Those magazines were like a time bomb waiting to trigger a person’s relapse into an eating disorder — if they fell into vulnerable hands. 
 
This entire situation got me thinking about triggers.
 
What is a trigger?
 
“Trigger” is an often touchy yet common topic in treatment centers and recovery communities. Trigger is a word used to describe a precipitating event (experience, memory, sensation, or thought) that elicits an intense or overwhelming emotional reaction. 
 
Being triggered can often feel like this: you are simply going about your life, minding your own business, and then BAM! Trigger! Eating disorder triggers can take many different forms:
 
  • Hearing friends talk about dieting or body shaming 
  • Listening to someone talking about a new exercise regime
  • Seeing unhelpful magazine headlines or cover images in the grocery store aisle
  • Observing calorie counts listed on a restaurant menu
  • … Getting certain magazines in your mailbox without an invitation
 
When a person is in treatment for an eating disorder, they are protected as much as possible from triggers like these that could heighten the thoughts and feelings associated with the eating disorder (i.e. talking about foods, naming or using specific behaviors, talking about weight/measurements/numbers, etc).  

And yet, the world is full of eating disorder triggers. After treatment, we can’t always protect ourselves from them. 
 
The reality is that we can't avoid them — and it can actually be helpful to be exposed to triggers! Triggers can help us learn how to navigate our emotions and thoughts — without returning to the eating disorder. 
 
So what do we do about triggers? How can we navigate triggers after treatment — since we can’t control our exposure to them? 
 
Here are some tips to help you deal with triggers as you move forward in recovery:
 
Skills to help you deal with triggers
 
In Dialectical Behavior Therapy (DBT), there’s a module of skills under the umbrella of Distress Tolerance. These are skills that you can use when you are in a panicked or overwhelmed zone. The point of distress tolerance skills isn’t necessarily to feel better; it is to get you through feeling triggered without making matters worse (i.e. using damaging behaviors). 
 
1 - The 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.
 
2 - ACCEPTS
A – Activities: Color, knit, take a walk, watch a movie, do the dishes, do a crossword.
C – Contributing: Help a friend, volunteer at a shelter, open the door for someone.
C – Comparison: Compare yourself to a time when you were doing worse and notice how you’ve improved. 
E – Emotions: Elicit a new emotion. Watch a funny movie, listen to a happy song, get your emotions out through art or writing.
P – Pushing Away: Shelve it. Put the distressing thoughts and emotions in a box and opt to return to them later when you are calmer.
T – Thoughts: Count something, write, think about something pleasant, read, direct your thoughts away from the trigger.
S – Sensations: Take a warm bath, put your face in ice water, smell some lavender, feel your feet on the grass. Let your body feel something good.
 
3 - Name it to Tame It
This is something that my grandpa used to say to me, and boy is it helpful.
  • Name the trigger.
  • Name the resulting thoughts, emotions, and impulses.
  • Then make a choice on how to proceed. 
When you can name what you are thinking and feeling it can help take some of the power away from the thoughts and emotions that are contributing to the eating disorder. Saying something like “I’m having the urge to restrict because I read an article about weight loss” feels a lot different than “I need to skip lunch today.”

4 - Self-Compassion
Give yourself some loving words and kindness. Treat yourself like you would a friend. Think about what you would say to someone else if they were experiencing the same thoughts and feelings as you. Try putting your hands on your heart and taking deep breaths while you say positive affirmations to yourself.

Read more about how to develop a self compassion practice.
 
Triggers are part of recovery

Being triggered is an unavoidable part of life, but triggers can be managed and even used to strengthen your recovery. Recovery is not linear, and you may often feel triggered as you go through life. You may even relapse but none of these things are a sign of failure. Recovery is all about learning, trying new things and not giving up. 

An important cornerstone of any solid recovery is to learn how to navigate triggers without turning to your eating disorder or other destructive coping mechanisms. Keep going, brave one!

Learn more about dealing with triggers after eating disorder treatment.
 
Nica Stepien, LMHC, NCC is an Alumni Family Liaison at Eating Recovery Center. She is passionate about her work in helping to build community, provide education, and engage in advocacy for people who struggle with eating disorders and other mental health issues.
 
 
chat with us

Eating Recovery Center is accredited through the Joint Commission. This organization seeks to enhance the lives of the persons served in healthcare settings through a consultative accreditation process emphasizing quality, value and optimal outcomes of services.

Organizations that earn the Gold Seal of Approval™ have met or exceeded The Joint Commission’s rigorous performance standards to obtain this distinctive and internationally recognized accreditation. Learn more about this accreditation here.

Joint Commission Seal
Schedule for a Free Consultation