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Archive for the ‘Self-help’ Category

negative thoughts and behavioursOften we post lots of information about ‘positive’ signs and skills. After all part of recovery is learning to focus on the positive. But what about the negative, how do you recognise negative coping skills. How do you know that the behaviours you are doing are actually harming you or not promoting recovery. We live inside our heads so much that often negative process are so natural as breathing we think this is normal. Continuing negative behaviours can act as triggers for relapse or harming ourselves even more.

As part of a bigger post, I found a great list of negative behaviours and recognising them as such. Put together by Blake Flannery it is an excellent starting point. You can add your own unique negative behaviours to the list. The full article by Blake ‘List of Coping Skills for Anger, Anxiety and Depression’, also gives a lot of positive skills and how they actually help us by adopting them.

Being aware is the starting point for changing any behaviour.

Negative Coping Skills

Here’s a list of things that will cost you in the long run as coping strategies. These do more harm than good in most cases and can make life more stressful.

Diversions

  1. Procrastination
  2. Abusing drugs or alcohol
  3. Wasting time on unimportant tasks
  4. Shopping (online or malls)

Interpersonal (With Others)

  1. Blaming
  2. Isolating/withdrawing
  3. Mean or hostile joking
  4. Gossiping
  5. Criticizing others
  6. Manipulating others
  7. Refusing help from others
  8. Lying to others
  9. Sabotaging plans
  10. Being late to appointments
  11. Provoking violence from others
  12. Enabling others to take advantage of you

Cognitive (of the Mind)

  1. Denying any problem
  2. Stubbornness/inflexibility
  3. All or nothing/black or white thinking
  4. Catastrophizing
  5. Overgeneralizing

Tension Releasers

  1. Tantrums
  2. Throwing things at people
  3. Hitting people
  4. Yelling at others
  5. Destroying property
  6. Speeding or driving recklessly

Physical

  1. Suicide
  2. Self harm
  3. Developing illnesses

Intrapersonal

  1. Making fun of yourself
  2. Self-sabotaging behaviors
  3. Blaming yourself

Indulging

  1. Spending too much
  2. Gambling
  3. Eating/drinking too much
  4. Setting dangerous fires
  5. Continually crying

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Sophie has been home and gone back to uni. Wow 6 weeks at home just flew. It was wonderful having her for so long. She had the usual depression/anxiety drop down during the peak assignment time, but this time didn’t ring me as much. With her new psychologist she handled it herself. Doesn’t mean it was any easier or less deep, but she made her own decisions and didn’t need to vent to me. I see this as a step forward and wait to see how this semester goes.

This post though is about getting sick. It’s winter here, Melbourne has it’s own strong flu variety this year and lots of other nasty bugs. When http://scu.edu.au/staffdirectory/person_detail.php?person=20601you get sick, it’s normal to cut back on eating. You really don’t feel like food, nor sometimes can you keep it down. If you get the viruses with the killer sore throats or Tonsillitis then you have an extra level added to the pain of eating. You might not eat anything decent apart from some light liquids for anything up to 14 days. It’s the nature of being sick that we all follow.

For those recovered or in recovery getting sick needs extra care. If you are at home or still not fully independent, you then have a team or family support to encourage you to eat. The bottom line for those with anorexia, is you DON’T lose weight. But it’s hard to remember that when you really sick, living independently away from home and figure that you can easily gain any weight loss back or it won’t matter, or being so sick it doesn’t even cross your mind you might be losing weight. Or that it might be an issue if you do lose weight.

After all – if you are fully recovered – you won’t have had any Ana behaviour to stop you eating. You won’t have had any Ana thoughts or heard Ana’s voice either. Your well past that. You may even still see a psychologist, take good care of yourself, see a doctor regularly, have medication for anxiety or other mental health issues. So when you get really sick, you tend to do what we all do – eat when or how much as you are able to.

Sophie learnt her next step in self care and staying recovered. She got the flu and Tonsillitis together – one very sick girl. And she did try to eat and drink. However being unable to eat her normal amount for over 2 weeks, her weight dropped. What it brought home to her, was how quickly during sickness the body can drop in weight. And in the case of a recovered anorexic, weight loss to a certain point can start to bring thinking changes.

As she said, she felt physically ok, and wasn’t anywhere in the realm of Ana thoughts, but her mind ‘darkened’, it was easy to slip back into the habit of not eating a meal or eating enough when getting over the sickness. She found herself a bit defensive about food. Thankfully she was home by this stage, so mother got involved (despite the fact she is now 20 and really beyond me dictating food routines). Yep, I can still be the Food Police. But because she doesn’t want to go back down the Ana path, she drank the sustagen, ate pies, bread, raisin toast, pasta, pizza etc etc. She snacked in-between meals and she brought her weight back up. Not quite as high as I’d like to go back to Melbourne, but still in her good weight range.

It’s a confronting lesson when just being sick can result in weight loss you didn’t plan or want, and the extra strength needed to continue to eat. Whilst recovery teams will tell you that this might happen, until it actually does you don’t plan or really know how you will actually react or be when very sick. Sometimes you learn as situations become a reality for you – rather than a textbook experience. Now she knows.

Third week back in Melbourne she has come down with a similar bug and another round of damned Tonsillitis (sensitive little things once they get sick). This time Soph is more knowledgeable and is eating more and drinking sustagen etc. She also is seeing her psychologist and doctor as well. We are also heading down (we couldn’t do it last semester) for a parent check in of how she is going.

The learning curve can be tricky, sneaky and sometimes ‘left of field’ in recovery, but as long as you take note of the lesson and build toward being strong if sickness happens again, then you have learned another step in the reality of self-care. Getting flu vaccine might also be part of the lesson!

 

 

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All of these are early signs, none of them alone mean much, you may see any combination of them. Most of these comments and behaviours can seem innocent, teenage behaviour. Mostly though they are out of character for your child. They will be a departure from their normal personality and family routines. Watch, ask, challenge. Don’t let any of these go unnoticed or uncommented about. Keep watching, keep asking, keep challenging.

If you do, if you have any suspicion at all, bring your child to the doctor and insist, insist and keep insisting.

early signs of an eating disorderThings they say

I just want to eat healthier
I want to be a vegetarian
My stomach hurts
I am not hungry
I already ate
I think I am allergic to….
(foods they never had an issue before or diagnosed allergy)
I don’t eat this
This is not organic or gmo
I just don’t like this any more
I am so sick
What’s in this food (nutrients)

Things they do

Disappearing after meals
Checking out the nutrition labels
Increased exercise
Pushing food around plate
Cutting food in tiny pieces
Chewing food forever
Stop making plans with friends
Taking forever to make it to the table for meals
Frequent showers (especially after meals)
Spending forever in the bathroom after shower – body checking
Sleeping at meals time
Watching cooking shows, reading cook books none stop
Cooking/baking obsessively without eating it
Going to the grocery store and reading all labels
Buying expensive foods that go uneaten
Frequent body stretching and movement
Wearing baggy clothing (despite temperature)
Refusing to go out with friends if meals are involved
Writing calorie/meal/fitness journals
Taking a lot of body checking selfies
Picking fights at meals so they can be sent to room, or storm out
Eating only low calorie foods
Spitting food into napkins
Having to exercise even when injured or sick
Spitting food into napkins
Having to exercise even when injured or sick
Notice the calories in everything
Dissect the ingredients of a meal
Interested in high metabolism foods
Lots of gum chewing
Taking ice baths
Very emotional response if any of the above is mentioned
Skin picking

Things you can observe

Over dressed in summer, under dressed in winter
Blood shot eyes after meals
Social withdrawal
Unnatural seating positions
Constant foul mood especially at meal times
Weight decrease – A child should never ever lose weight
Anxious, distracted, avoidant behaviour at school
If pets, notice if the dog/cat is seating closer to your child
Cats will gravitate to someone with an illness
Dogs will gravitate for food being dropped
Increased perfectionism, rigidity, ritualistic behaviour
Increase in anxiety, depression, OCD if these are already part of your child’s character
Cold hands and feet
Bad breath or personal smell
Small sores on body which take a long time to heal and can bruise easy
Blue finger nails
Obsessive body checking
Thinning and failing hair
Soft down on skin particularly chest, neck and upper back
Loss of menstruation
Panic attacks out of nowhere
Weight gain despite exercise due to B/P or binging
House plumbing issues from: purged food, hair lumps.

With thanks to The Dirty Laundry Project with additions from me.

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Many therapists use the term ‘Distraction Toolbox’ for recovery strategies. I have written before out this too and what Sophie used as her distraction toolbox. Basically the idea is to use healthy and positive means of taking the attention from eating, or ED thoughts, negativity etc that drag you down into ED behaviour or worse, relapse. Learning to block ED thoughts and behaviours, automatic thoughts, anxieties, fears, black/white thinking is critical to recovery and moving forward.

The below is a visual idea that makes it clear and easy to imprint your mind. Sophie’s biggest problem was trying to remember her tools to use when the ED voice was really loud. She would get distressed and her mind would go blank. So visual for her worked in clearing some of the ‘noise’ and helped her focus.

Thanks to Buzznet and ‘Forbidden’ Blog.

Let's make a Coping Skills Toolbox photo 1
Let's make a Coping Skills Toolbox photo 2
Let's make a Coping Skills Toolbox photo 3
Let's make a Coping Skills Toolbox photo 4
Let's make a Coping Skills Toolbox photo 5
Let's make a Coping Skills Toolbox photo 6
Let's make a Coping Skills Toolbox photo 7
Let's make a Coping Skills Toolbox photo 8
Let's make a Coping Skills Toolbox photo 9

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This wonderful post offers a deeper side of distraction. When your list is working for you, when maybe you are further along and its time to dig a bit deeper in the emotions and mind. I love the part of breaking things down into small manageable pieces and dealing with emotions in bite sized chunks. It helps you not be overwhelmed by it all, solving small pieces and gradually stringing them all together.

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From: http://susanschulherr.com/eating_disorder_recovery_blog/2009/09/coping-beyond-distraction-expanding-skills-for-living-in-eating-disorder-recovery/

Most of you are working on learning better ways to handle distress than turning to your eating disorder. This is an excellent project! Your success with it will go far to help you build a solid recovery.

Many people—with or without eating disorders—turn first to distraction as a way to manage difficult feelings. By distraction I mean diverting your focus from the upsetting thing to something unrelated, to get your mind off the upset. You’ve probably figured out that your eating disorder has been an unhealthy version of distraction. But maybe you’ve also found that listening to music, gardening, going to the movies or laughing with a friend can be healthy distractions.

I personally like distraction as a coping mechanism. I wouldn’t want to face life without it as an option. I find it can be a helpful choice when:

• I need to quiet down so I can consider a problem or upset more calmly and clearly
• I’ve worn out the usefulness of thinking about a problem for the time being
• There’s nothing I can do about a problem or upset

Several potential drawbacks go hand–in–hand with using even healthy distractions to cope, however. Most of these have to do with misuse or overuse.

The most common misuse of distraction comes from confusing it with an actual solution. Distraction at its best is only intended to provide a temporary resting place when you need a break from focusing on resolving your distress. When your distress is too intense or you’ve focused too long, a break is a good idea. Bur when you use distraction as a substitute for working out a problem or coming to terms with distress, you run into trouble. It’s the “ostrich with its head in the sand.” You not only fail to resolve anything, you build a reputation with yourself as someone who can’t handle difficult experiences. The next time something hard comes up, you haven’t developed any confidence in yourself. So you’ll be more likely to turn to distraction as a substitute. It’s a vicious cycle.

Overuse of distraction is likely to occur when you don’t have sufficient alternatives for coping with your distress. When you turn to another focus, you don’t come back. You may tend to get lost in your distraction activities. You start to play video games, surf the net or read a novel and suddenly the whole day is gone. Many addictive activities start out in exactly this way.

There are two coping challenges for which you need more and better coping tools than distraction. The first is problem solving. The second is managing difficult emotions.
Let’s consider some alternatives to distraction for times when either challenge is threatening to overwhelm you.

Problem Solving

Everybody runs into problems that seem overwhelming from the start or bog us down and frustrate us as we try to find resolution. You might try one or more of the following techniques which successful problem solvers use to see themselves through to the end:

• “Talking yourself through” confusion, uncertainty and frustration; for example, offering yourself reassurance or a steadying voice: You can do this or You’ll be okay or Just stay with it.

• Reminding yourself of times when you successfully handled other difficulties that at first seemed overwhelming

• Breaking the problem down into small, more manageable pieces

• Asking for help

Managing Difficult Emotions

There are many approaches to managing difficult emotions. All of them have something to offer as you work on developing this basic life skill. The important thing is that you find approaches that suit you—and that you use them! Here are a few examples:

• Dealing with only small doses of feelings at any given time

• Thinking of soothing, comforting responses

• Imagining yourself in a peaceful place or with a comforting person while you feel the feelings

• Learning to sort out and correct distorted thoughts that are making you feel even worse, such as Nothing ever goes my way; I’m such a loser; Nobody will ever love me, and so forth
.
• Engaging in mindfulness meditation in which you learn to observe your feelings rather than be totally in them

• Praying (if this fits with your beliefs)

• Walking, exercising or practicing yoga while experiencing the feelings

• Sharing your feelings with people who are sympathetic and calming

Remember that none of these techniques is likely to provide instant relief. But your effectiveness in using them will get better with practice. And as you get better, you’ll have more confidence in yourself. You’ll be able and willing to take on more in life.

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Learning distraction techniques is part of the journey to recovery. It isn’t always possible to just ignore or shut out the voices. Sometimes you can work out what triggered the voice to be louder or more insistent and you can distance yourself from the trigger. But that’s not always possible. It is important if you can to at first acknowledge the voice, and try to work out what you were feeling just before it got loud, where you were, what happened etc. That can help you identify vulnerable situations for yourself and help you also learn more about you personally. But when the voice continues distraction techniques are the most important weapon you have. Sophie has been working through several worksheets her counsellor gave her, identifying what works for her, as well as a diary of what she does each time the voices get too loud. Sometimes she is dedicated to working on this and other times it gets shoved aside. Her distraction techniques only work as much as her commitment to the task.

Distraction techniques are not a magic wand, you have to be committed to using them and sticking them.

So what are distraction ideas. This is as unique as you are. It is a case of what works for you. CBT and mindfulness /meditation can help but you will need guidance and help from your counsellor to learn these. Others are as simple as:

  •  going for a walk, exercise, dancing
  • playing with your pet
  • sewing, drawing, painting, listening to music, writing
  • beauty treatments (nail polish, face masks, hair colour)getting outside and just moving
  • visiting, texting, ringing a friend
  • watching a movie or favourite TV shows
  • doing something very physical to get rid of anger, frustration etc (belt your pillow, throw a ball against a wall, use a punching bag)
  • cuddling your favourite stuffed toy
  • clean or re-organise your room

The list goes on. Pick and mix them up. Have a few you know work regardless. Try new things. As long as the moment passes and the voices fade. It can exhausting and be a real struggle to just find the energy to do the distraction techniques but it is worth it. The let down you get when you give into the ED voices is far worse.

For more ideas go to 151 things to do before you self-harm (I know a lot of you don’t self harm, but the ideas they give work for eating disorders, depression and lots of other mental health illnesses.

Another great handout, is the Alternatives to Self-Harm and Distraction Techniques pdf from Royal College of Psychiatrists. It is really worth getting. I have given this to Sophie – who actually seemed interested.

Talk through what works for you with your team, family or friend. Write it down so when you so don’t forget. When the voices get loud it can be really hard to think clearly and remember what you are meant to do. Just grab your written list.

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This was going around Tumblr in the last few weeks. It encouraged me and reminded me of how important this is. What really spoke to me was the things listed. They weren’t huge goals. They weren’t nirvana situations. They were, instead, everyday little things. Grateful things, appreciative things. Things that you could instantly relate to and could achieve.

It is a very good idea and one that focuses you on the present and the future. Far too much of recovery is spent looking back, being caught in the past memories, past behaviours and fighting (exhaustingly and daily) the past. This is the nature of the ED illness and it wants to keep you looking back. It’s all about positive thinking as opposed to negative thinking. Let’s face it, ED’s are all about negative thinking so the more you can find things that help you learn to be positive is essential.

Recovery is about the present and the future. It is new not old and often it isn’t celebrated enough. Nor is enough notice or appreciation given for the small but critical moves forward. Even your therapist can brush over your achievements and focus back on old and past behaviours. Sometimes you just need a session that celebrates your moves forward, what you next move forward could be, how you feel about that.

Some of Sophie’s best good things about recovery were the small things. How good it is to eat strawberries again, how great it was to have her hair not fall out, how lovely it was to feel warm, how good food tasted, how wonderful it was to have people around her that helped her fight.

Other’s were big things: to be back at school, to be able to study, to not have weekly appointments, to have a life and future again.

Her celebrations helped to keep her focussed on the present and the future. Helped her fight back against the anorexic voice in her head. It wasn’t easy and many times the voice was stronger. But by writing down her ‘good things’ she could read them and remind herself any time she needed. Her mind was full enough with her voice, anorexic voice, therapist voices, family voices etc. By writing them down she could always cut across the voices and get out of her overwhelmed mind.

So the challenge for my readers this week is the same (if you struggle to find five, find three):

List 5 good things about recovery

 

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