How to Help Patients Navigate the Holiday Season in Recovery
With the abundance of food, shared mealtimes, and large social gatherings, the holiday season can be immensely difficult for anyone living with or recovering from an eating disorder. Even as we shift into a more “normal” routine after pandemic-related disruptions, we continue to witness the impact of the last few years on people with eating disorders.
According to Hilmar Wagner, MPH, RDN, LN, CD, there are four key aspects of successfully navigating the holiday season while in eating disorder recovery. His method for a successful holiday is called P.R.E.P., which you can use in your work with your patients to support them this holiday season and beyond.
P – Plan
One of the most important steps your patients can take to improve their holiday experience in recovery is creating a structured plan. Wagner recommends having your patients consider the following areas:
Identify what events, gatherings, and situations have been difficult in the past. If they occur again this year, how can your patient handle them? Strategies may include not putting themselves in that situation, minimizing their exposure, or ensuring that they have support people surrounding them. “Be clear as possible on the details of an upcoming event – how long will it last, who will be there, what food will/will not be available, and what the expectations are while you’re there,” Wagner says to those in recovery. “Make sure you will be able to meet your meal plan or your body’s needs if the event falls over a meal or snack time.”
Anticipate situations that give you stress. Thinking of possible scenarios that could give high stress gives your patients the greatest ability to handle them. Stressors are inevitable and sometimes unavoidable, but you can work with your patient to have a practiced response ready, including coping skills they have learned in recovery. Help them create an escape plan or fallback plan if necessary.
Think of alternate activities if needed. Unfortunately, the holidays tend to focus heavily on food. If the emphasis on food is something that triggers your patient, suggesting other activities or new traditions can be a great way to pull some of the attention away from food!
R – Routine
Once you formulate a plan – stick to it! People in eating disorder recovery can never be too prepared. Having a consistent routine can be just what they need in order to manage the stress caused by the hectic and unpredictable holiday season. Wagner also encourages people to focus on what they can control. “Keep to your meal plan if you follow one, having regularly planned (and eaten!) meals and snacks set the base for a well-regulated physical system and mental/emotional state,” he says. Consistently getting the proper amount of sleep, as well as maintaining a moderate movement routine can help immensely when trying to cope with anything the holidays bring. Avoiding or limiting troublesome stimulants or food/beverages is also important.
Focus on the overall goal. Inevitably, there are going to be things that get in the way of your patient’s recovery routine. But getting bogged down by every little thing that doesn’t go according to plan will take them away from their larger recovery goals. Encourage your patients to focus on their overall objective instead of any deviations.
E – Express Yourself
Don’t suffer in silence. Encourage your patients to rely on their support people and providers during this often triggering season. It’s so important that they practice asking for what they need and not assuming that others know how to help. The more honest they can be, the more helpful others can be for them!
Lay down boundaries. Setting boundaries in recovery is also important. Remind your patients that there is no need to feel ashamed or guilty for saying “no” if they feel overwhelmed or inadequately supported to stay safe in their recovery. In order to avoid getting trapped in eating disorder patterns, encourage your patients to contemplate what barriers or difficulties may come up and what actions they need to take.
Celebrate your achievements. Don’t forget that preparing for the worst is just as important as celebrating the good things that happen. “It’s not just about letting people know what you are struggling with but sharing your successes, insights, and small day-to-day victories as well,” Wagner reminds those with eating disorders. “Allow yourself to take in and internalize your strengths and abilities.”
P – Pause
Finally, Wagner encourages you to remind your patients to pause and check in with themselves during periods of heightened stress. Consider sharing the following mindfulness-based interventions:
Take a pause when needed. The chaotic nature of the holidays can make any of us feel ungrounded and overwhelmed. Remind your patients to hit pause to allow themselves the room to check in with how they’re feeling. It’s a time to listen to their bodies and ask themselves what is best for them at that moment.
Prioritize self-care. Prioritizing physical, mental, and emotional needs among competing demands is essential in recovery in general, but especially during the holidays. “Grounding or centering exercises, as well as calming, relaxing routines and rituals, can be especially useful when things get busy or in times of greater activation or anxiety,” says Wagner.
Embrace mindfulness. Wagner advocates for patients being as present or mindful as possible; this will help them take the most supportive action when they are feeling stressed or overwhelmed. Being present in the moment can help patients not to dwell on what’s in the past or the fears for the future, but instead can give them a new appreciation for the good things.
We hope that these tips and strategies will help make your patients’ holiday season the best it can be!