Re- does not always precede lapse
Let’s Get Real About Lapse Vs. Relapse.
Re- does not always precede lapse.
A lapse does not automatically turn into a relapse. Lapse can stop at lapse. And for those faced with the terrifying reality of a lapse, the power is in you, and only you, to make the stop. And to make the switch.
To re-set.
To re-claim.
To re-act.
To re-build.
To re-cover.
Using the re- that could have turned lapse into relapse and using it to recover instead.
Before I delve further into the steps of preventing a relapse, I feel it necessary to provide definitions for both lapse and relapse. Or at least put forth my best effort at defining them, as this is a very complicated and, at times, confusing subject to articulate. So here is my best shot.
A lapse is a temporary stumble, a bump in the path of recovery. A temporary setback, a temporary use of behaviors, a temporary dip in recovery. A key word being temporary. But just as a stumble can be caught and a bump can be navigated around, a lapse occurs and is moved past. A lapse is temporary.
A relapse is a harder fall, unfortunately draining so much energy and strength that it can no longer be classified as temporary. A full setback, a full reversion back to maladaptive behaviors, patterns, and mindsets, a full revival of the eating disorder.
But full does not mean permanent. Full most certainly does not mean that all hope is lost. Full only means that the energy and strength required to recover from the fall, pick yourself up, and dust yourself off will be a bit more than for a stumble.
The re- in relapse stands for more than just returning to the past, to the same, exhaustive, painful behaviors. Returning to the eating disorder can happen. But returning to the life of freedom, happiness, and opportunity, the life of YOU, your goals, your successes, and your dreams, the life in recovery you know is so absolutely possible because you have personally experienced it, is equally as attainable and realistic of a step. And this time, a step in the right direction.
The re- in relapse can be placed at any time in recovery. You have the power to relocate your re-. The power is in your hands to make the decision to replace the life of relapse currently overtaking your life with the life of recovery your body and healthy mind so desperately desire. The power is yours. And only yours.
As I mentioned earlier, however, a lapse does not always mean a relapse, and it is crucial to identify and reverse a lapse before it progresses into the ever-present possibility of a relapse. I have come to realize that this is much easier said than done. This is not an easy task, as many times, the eating disorder disguises the lapse and hides it from both you and the outside world until it is, unfortunately, too late. The eating disorder doesn’t want you to catch it. It is sneaky, manipulative, and deceiving, convincing you that no one will notice if you engage in behaviors JUST this time, that the behaviors aren’t THAT bad, that you will only have to listen to it this ONE time for your life to be improved. And with a death grip, as you turn around to obey its commands, searching for its deceitful, lying promises, it grasps onto you, your life, and your future and drags you down into its all-consuming power. The relapse that felt so distant suddenly becomes depressingly real. The eating disorder has manipulated you, lied to your vulnerable face, and stripped the re- from recovery to plague your life with relapse.
Look at the bold words. JUST THAT ONE. This is a crucial message. Just that one meal skipped. Just that one extra mile run. Just that one trip to the bathroom. Just that one pound lost. Just that one step back, listening to the eating disorder instead of recovery. Just that one is the lie the eating disorder uses to disguise its death grip. Just that one is the foundation the eating disorder uses to build your relapse. Just that one is enough to initiate a lapse. And, unfortunately, a lapse has the threatening possibility of a relapse.
So, how can we prevent ourselves from falling into the “Just that one’s” that bring us closer and closer to relapse? The key is knowing yourself, knowing your warning signs, your earliest signs of a lapse, your “Just that one’s”, in order to catch the manipulation of the eating disorder before it grasps on for good. Self-awareness is essential to fighting the re- that the eating disorder so desperately wants to place with lapse. And self-awareness is by no means an easy skill to acquire, it must be practiced and developed, a skill that involves active engagement and continual effort. Self-awareness begins with you. You are the only one that knows you best. You are the only one that knows the eating disorder best. And you are the only one that can use this awareness to stop the eating disorder from turning a lapse into a relapse.
As I have journeyed through many lapses and relapses over the course of my ten year battle with an eating disorder, I have found that the most important tool in self-awareness is a list of warning signs, specific to me, that have the possibility of turning my lapse into a relapse and that indicate whether I am at a mild, moderate, or severe risk of relapse. This list includes behaviors engaged in and frequency of behaviors, thought processes and frequency of thoughts, and my level of hopefulness, motivation, and desire for recovery. By having a concrete list that I can use to pinpoint negative changes in my behavior and thoughts, I can be more perceptive to the true wellbeing of my own mind and body, which ultimately helps me to catch the lies of the eating disorder as it attempts to cover up a relapse. A list is concrete and prevents the eating disorder from creating alternative, false truths regarding the reality of a lapse. Self-awareness includes being proactive. So, what better way to be proactive than beating your eating disorder to a lapse and knowing the signs ahead of time, saving yourself from a long, downhill road away from recovery?
I encourage anyone struggling with an eating disorder or any mental illness to create your own list of early, moderate, and severe warning signs of a relapse. Write this list out and have it accessible so that whenever a lapse finds its way into your life, you are prepared to identify it and choose to use this as a warning to avoid relapse. I have included my list below as an example to inspire your lists!
Early warning signs:
Slightly decreasing caloric intake once or twice
Adding an extra walk or run once or twice during week
Counting calories of meals and snacks
Weighing myself more than frequently than I have agreed to
More concentration on body appearance
Increased thought about food choices, although not actively avoiding specific foods
Increased anxiety around increases in weight
Increased anxiety after meals and snacks
Slight depression and anxiety about future
Slightly hopeful that recovery is possible and continued desire for recovery
Moderate warning signs:
Moderate and consistent decrease in caloric level to a restriction level intake
Adding exercise into daily routine consistently, multiple times during week or daily
Allowing thoughts about my weight to last throughout the day
Concentration on body appearance and dissatisfaction begins to distract from daily life activities
Significantly worse body image that becomes main focus of day
Engaging in OCD tendencies relating to food, on occasion
Measuring most foods and increased anxiety when I am not able to measure food
Choosing to occasionally avoid fear foods
Body checking at least once per day
Anxiety after meals that lasts for at least an hour
Increased tension and arguing with family around meal time
Moderate depression and exhaustion from constant mental turmoil
Recovery no longer seems achievable, however, still slight desire to eventually reach recovery
Severe warning signs:
Severe restriction that has extended to each meal and snack
Increase in activity level that exceeds recommendations of treatment team and impacts functioning in daily life
Using a calorie-counting app to micromanage every calorie, nutrient, and macronutrient that I consume
Tracking my steps with phone or watch and setting an unreasonably high step goal
Constant thoughts about food, exercise, body shape and size, and behaviors
Engaging in OCD tendencies consistently, especially those related to the ED
Using a food scale to measure all foods, not trusting any serving portions
Avoiding eating out at all costs, preparing all of my own meals
Missing out on social events that involve food
Very regimented eating pattern, strict food rules and times when I allow myself to eat
Body checking whenever I get the urge, not able to resist urge
Following orthorexia rules, only eating “clean foods”
Wearing baggy clothing to avoid my body and hide body from others
Frequent arguing and tension within family regarding behaviors
Lack of motivation for daily activities and aspirations I have set for myself
Constant anxiety that is not solely exclusive to the ED
Increase in depression, isolation, and motivation
Recovery no longer seems possible or desirable
This is a developing list, and I am constantly modifying and adding items to the list whenever I encounter myself struggling and feel the possibility of a lapse or relapse in the future. The key message to be taken from this list is that even the early warning signs are warning signs, and the identification of any one item on any of the lists is an indicator to take extra caution, remove the behavior or thought from your life, and examine the underlying struggles that may be contributing to your setback. As soon as a warning sign is identified, it is crucial to identify the behavior or thought and how you can prevent it from occurring again or continuing. Then explore the underlying reasons that this behavior or thought has emerged, as this knowledge is key to understanding your trigger and resolving it before it escalates to an unmanageable level with an ever-increasing risk of relapse. Early intervention is the most important step in preventing a relapse. Know yourself. Know your warning signs. And know that a lapse does not have to turn into a relapse.
I hope this post can act as a useful resource for those who are struggling or have struggled in the past, providing helpful tools for preventing relapses and inspiring recovery. I also hope this post can bring clarity to the idea of lapses and relapses, as this is a very complicated topic that is often misunderstood, and in the spirit of the week, I aim to clear up as much misunderstanding as I can regarding eating disorders and mental illnesses. I cannot reiterate enough that knowledge and speaking up about eating disorders is crucial to achieving the ultimate goal of eliminating eating disorders from our world. So let’s work together to spread as much knowledge, clarity, and hope as we can to get real in our fight for freedom.
And don’t forget that Re- does not always precede lapse. You have the power to:
Reset, react, rebuild, redirect, rediscover, reflect, refocus, reform, reframe, refresh, rejuvenate, restore, refuel, refeed, regulate, rehabilitate, reignite, reimagine, reinforce, reinitiate, relax, release, remember, remind, remotivate, rebuild, reflect, reclaim.
And most importantly, you have the power to RECOVER.
