The Hardest Time in Eating Disorder Recovery
By: Nicole Siegfried, Ph.D., CEDS
Although the holiday season is a time when most clients would rather be home with their families than in eating disorder treatment, this is also the time of year that typically brings up the most challenges for a successful transition home.
If you’ve ever spent a winter holiday away from the people you love most, you understand how heartbreaking it can be. We know that this is what many of our Alsana clients and their family members are experiencing around this time of year. Desperate to be with the people they love, many clients getting close to finishing their eating disorder stay will want to leave early to be home for the holidays. However, discharging home from treatment during the holiday season can be particularly difficult for clients and increase their risk of relapse.
Why Do Clients Leave During the Holidays?
For many clients and their family members, leaving treatment just before or during the holiday season seems on the surface like the perfect time to discharge. There are three common reasons why clients choose to discharge during the holiday season:
- The desire to spend the holidays with family, friends, pets, and other loved ones is strong for our clients and their families.
- Many schools resume just after the new year and clients want to start with the new semester. The new year may also be an appealing time to return to work.
- If a client knows they’ll be leaving treatment in January, they may want to avoid paying the new year’s insurance deductible for only a week or two of eating disorder care. These clients usually want to leave at the end of December.
Any one of these three reasons make the holidays seem like the perfect time to leave treatment. Usually, it’s a combination of the three.
The Holidays and Eating Disorder Recovery
While we generally think of holidays as the most wonderful time of the year, most people would also acknowledge that the holidays are a time of great stress. That stress is compounded for a person early in eating disorder recovery.
While the client has certainly done a significant amount of work while in treatment around fear foods, transitioning home can reactivate some of these fears. Clients now have to choose what they eat, how much they plate themselves, and how much they’ll eat. These difficult situations are amplified with a discharge during the holidays.
For clients who have come home near the holidays, they are likely to be exposed to more challenging foods and meal expectations that will make the transition difficult.
For a client fresh out of treatment, carefully following the meal plan is especially important. It’s normal for most people to eat differently during the holidays with more family gatherings centered around food. Trying to follow a meal plan amidst oddly-timed and oddly-sized meals, travel, and celebrations is difficult for anyone, and especially challenging for a person recovering from an eating disorder.
The holidays often include extended families and a wider circle of friends gathering together to celebrate. Within this milieu, there will likely be at least one or two individuals who are less sensitive to (or completely unaware of) a person in recovery. Diet chatter, body bashing and comparisons, comments about what someone is or isn’t eating, or others’ own disordered eating behaviors can be especially difficult to tolerate when a person is early in recovery.
In time and with practice, you or your loved one recovering from an eating disorder will be able to navigate these situations without compromising recovery. But for an individual very new in recovery, this slam of stressors may be too much for them to handle successfully, leading them to revert to the same eating disorder behaviors they’ve used to cope during previous holidays.
When is the Best Time to Leave Treatment?
At this time of year, the best time to discharge from treatment is, of course, after the client has had a full treatment stay and after the holidays–whichever comes later.
No matter the time of year, we always recommend clients step down through PHP and IOP levels of care whenever possible to ease the transition out of 24/7 support and care.
Full Recovery is not only Possible, but Probable
With a full treatment stay at the appropriate level of care, we know that full recovery from an eating disorder is not just possible, it is probable.
At Alsana, we truly understand how hard it is for families to be separated during the holidays and to make the financial, educational, and professional sacrifices that coincide with treating the eating disorder. Equally, we want what research shows us will be best for our clients and their families in the long term. For this reason, we advocate for all our clients to receive a full treatment stay and avoid a holiday season discharge.
As clients, loved ones, and outpatient providers, we urge you to discuss the alternatives to a holiday discharge with each other and, if applicable, the client’s residential, PHP, or IOP treatment team at Alsana. Together, we will create a discharge plan with the highest likelihood of long-term success in eating disorder recovery.