Category Archives: Eating Disorders

Understanding ARFID: More Than Picky Eating

Understanding ARFID: More Than Picky Eating

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Avoidant/Restrictive Food Intake Disorder (ARFID) often remains underrecognized and misunderstood.

Adults who have struggled with Avoidant/Restrictive Food Intake Disorder for most of their life may feel it is impossible for things to be different. Parents who have a child struggling with ARFID have, more often than not, literally tried everything to help their kiddo eat, but nothing seems to be working. ARFID is often equated with picky eating, but it’s actually much more complex than that.

Although ARFID is a newer diagnosis, there is really nothing new about it.

Prior to being added to the DSM-5, it was included in a broader category called “Feeding Disorder.” It was added to the DSM-5 in order to develop better ways to treat it.

Parenting a Child with ARFID

If you are a parent, well meaning doctors may have minimized your child’s selective eating. This can be particularly true if your child is on track with growth. This can be frustrating for a number of reasons. You spend significant time to figure out how to feed your child – and it takes a lot of mental energy and often can feel very limiting to keep dealing with this challenge day after day.

If it’s left unaddressed, ARFID can lead to nutritional deficits, which can impact both physical health and emotional well-being. Early detection of ARFID is important so it doesn’t turn into a life-long struggle. Understanding ARFID is crucial for effective intervention, and a comprehensive treatment strategy tailored to the individual’s specific needs is necessary.

Understanding ARFID

Avoidant/Restrictive Food Intake Disorder is not just a simple case of picky eating; it is a complex psychological condition that can cause significant nutritional and reduced quality of life, particularly if it endures into adulthood.

Unlike other eating disorders that are often driven by concerns about weight and body image, ARFID is characterized by an avoidance of food based on sensory sensitivity, lack of interest in eating, depressed appetite, and/or fear of adverse consequences such as choking, throwing-up, or an allergic reaction.

Individuals grappling with ARFID may face a persistent difficulty when it comes to eating sufficient quantities or varieties of food. This can stem from deep-seated anxiety, gastrointestinal discomfort, or past negative associations with food.

Recognizing Avoidant/Restrictive Food Intake Disorder Symptoms

Persistent avoidance of specific foods or food groups or low food intake are characteristic of ARFID. Physical responses such as gagging may coincide with this avoidance of certain foods.

The eating patterns of individuals with ARFID reveal a restrictive intake that fails to meet their physiological needs. Without treatment, ARFID can lead to potential nutritional deficiencies, weight loss, or developmental delays, irrespective of age, gender, or body weight.

Behavioral signs and changes in eating that may indicate ARFID include:

  • Poor appetite
  • Getting full quickly
  • Avoiding eating due to fear of choking
  • Picky eating that often gets worse over time

Avoidant Restrictive Food Intake Disorder (ARFID) is often misinterpreted as a phase among children or as mere pickiness in adults; however, it represents a significant feeding or eating disorder that hinders one’s capacity to consume an adequate variety and volume of food.

Impact of ARFID on Everyday Life

ARFID’s restrictive eating patterns in children can lead to low energy, isolation, and anxiety around meal times. For caregivers, it can be a struggle to know how to feed your child, or  it can take lots of effort to prepare foods that you know they will eat in order to support growth.

For older children and adolescents, ARFID can make socializing, which often happens around food (such as parties, sleep overs, family events or team dinners), anxiety provoking for both the child and parents. The disorder’s consequences radiate outward, often simmering into familial tensions and social rifts, as loved ones grapple with the complexities of ARFID.

Adults with ARFID tend to have a decrease in quality of life. Moreover, the fear of eating outside one’s comfort zone can hinder personal and professional growth, particularly when mealtime activities are involved.

Ultimately, the disorder’s grasp can dampen overall quality of life, exerting a significant emotional toll.

Approaches to Treating ARFID

The main goal of treatment for ARFID is supporting the sufferer with eating enough (and enough variety) to keep their body nourished. For children, treatment works to support growth. Treatment for children, adolescents, and adults can help to improve overall quality of life.

Improved quality of life looks different depending on the individual with ARFID. For some, that may mean eating most food. For others, it may mean expanding the variety of food in order to support quality of life and being nourished.

Avoidant/Restrictive Food Intake Disorder treatment usually focuses on making eating or feeding a priority.

That is, for most folks, increasing the number of times each day they eat meals and snacks. Due to the nature of ARFID, eating often gets put off because it is uncomfortable for the person to eat, or they simply aren’t hungry.

Structured meal planning can be an effective strategy for managing ARFID, as it introduces routine and predictability into the dining experience. By brainstorming menus in advance, individuals and families gain clarity and a sense of control over their food choices.

Having structure and making eating a priority can help make sure people are getting adequate nutrition and reduce meal time stress.

In addressing the dietary concerns that stem from Avoidant/Restrictive Food Intake Disorder, we take a gradual approach to food exposure. Food exposures are designed in collaboration with the client and/or the family in order to personalize care.

Incremental exposure to food means starting with foods that are less anxiety-provoking, building up to a more diverse diet over time. Food-related anxieties are meticulously deconstructed, facilitating the individual’s encounters with previously feared foods in a safe and controlled environment.

Efforts are channeled into ensuring balanced nutritional intake while concurrently addressing emotional and cognitive barriers. Over time, the individual learns to associate eating with safety rather than distress, thus gradually dismantling the cycle of avoidance that characterizes ARFID.

My Approach to ARFID Treatment

When I am working with children with ARFID I work closely with their caregivers. I have learned from my training in Cognitive-Behavioral Therapy for ARFID that I can bring the expertise in eating disorders, and the parents & kiddo bring the expertise on their family, food beliefs, culture, and abilities (to name a few).

With adults with ARFID I use a similar mindset. I bring skills to the table to treat the eating disorder and they bring their expert knowledge of themselves.

Are you concerned that you or your child are dealing with Avoidant/Restrictive Food Intake Disorder? Sign up for a free consultation to learn more about how I can help you and your family.

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When Your Loved One Doesn’t Want to Get Better: Understanding Anosognosia in Anorexia Nervosa

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Anorexia nervosa is an eating disorder characterized by severe food restriction, an intense fear of weight gain, and body image disturbance. Anorexia nervosa affects many individuals of all genders, ages, and identities worldwide. 

The consequences of anorexia nervosa can be devastating, both physically and psychologically. However, one of the most challenging aspects of this disorder, particularly for family members and caregivers (and even clinicians!), is the phenomenon known as anosognosia.

What is Anosognosia?

Anosognosia, stemming from the Greek words “nosos” (disease) and “gnosis” (knowledge), refers to a lack of awareness of one’s illness. Anosognosia often can feel and look like denial. 

Denial is a defense mechanism and psychological response to avoid dealing with anxiety or other uncomfortable feelings. In contrast, anosognosia in mental health conditions is better described as a lack of awareness of their own condition.

Anosognosia can affect individuals struggling with bipolar, schizophrenia, eating disorders, and other psychological disorders. 

In anorexia nervosa, individuals may minimize the severity of their condition. They may adamantly believe they are not sick, or that their behaviors are justified, making it incredibly difficult for them to recognize the need for treatment. It can feel like your loved one is being “difficult” and in teenagers it can be especially confusing because during adolescence it is normal for teens to be contrary or contradictory. 

Anosognosia causes a person to be unable to achieve one or more of the following:

  • Accept that they have an illness or disorder.
  • See the signs and symptoms of their condition.
  • Connect their feelings and personal experiences back to that condition. 
  • Understand and agree that the condition is serious and needs treatment.

One of the most dangerous aspects of anosognosia in anorexia nervosa is the individual struggling with insight when the condition becomes life-threatening.

This lack of awareness around a loved one’s illness can further complicate the treatment plan and, many times, prevent treatment from occurring altogether. 

Parents frequently ask me if they should wait for their child to want to recover.

My answer is always no, because I know that anosognosia is most likely operating, and because the devastating effects eating disorders have.

Let’s face it – no teen really wants the devastating effects of an eating disorder. Contrary to popular belief, no one chooses to have an eating disorder.

How Anosognosia May be Affecting You

It’s already difficult enough to observe as a family member or loved one suffers from Anorexia nervosa, but anosognosia can make it incredibly distressing and frustrating. Despite your pleas, watching as your loved one deteriorates physically and emotionally, while they remain unaware of the severity of their condition, can evoke feelings of helplessness and despair.

To best help your loved one, you must recognize that anosognosia is not a choice but rather a symptom of the disorder. 

It is deeply rooted in neurological and psychological mechanisms impairing the individual’s ability to perceive reality accurately. This is completely out of their control, and without professional help,they may be unable to leave behind their problematic and highly dangerous behaviors.

The Role of Brain Connection in Anosognosia

Research suggests that anosognosia in anorexia nervosa may have an anatomical basis. 

Brain imaging studies indicate abnormalities in brain structure and function. According to a study published in the European Eating Disorder Review, up to 80% of individuals with anorexia exhibit some degree of anosognosia.

Malnutrition, a hallmark of anorexia, can lead to significant changes in brain chemistry and structure. This potentially contributes to the development of anosognosia. These neurological alterations can impair the individual’s ability to recognize their illness and hinder their motivation to seek help. This perpetuates the cycle of disordered eating behaviors.

The good news is with nutrition rehabilitation, anosognosia diminishes. 

Navigating Treatment and Recovery

Supporting a loved one with anorexia nervosa requires patience, empathy, and a comprehensive understanding of the disorder. Here are some ways you can help your loved one on their journey to recovery:

Show Compassion and Understanding

When you are speaking to your loved one about their eating disorder, it’s important to approach the conversation with compassion. You want to validate their experiences and avoid judgments, criticism, and shaming.

Encourage Professional Help

Although it may be difficult for someone with an eating disorder to want to receive treatment, it is still important for you to encourage it. Most success is found in early intervention. When the illness is treated, early on, there are often better outcomes than for those struggling without help for years.

Educate Yourself

One of the best things you can do to support your loved one if they are struggling with anorexia and/or anosognosia is to educate yourself on the facts. This should include the common signs and symptoms, possible treatment options, and debunked myths. This information is powerful in helping you better advocate for your loved one and their well-being.

Foster Open Communication

Create a safe and supportive environment where your loved one feels comfortable discussing their thoughts and feelings. Encourage open communication and active listening, allowing them to express themselves without fear of judgment or criticism.

Practice Self-Care

Supporting a loved one with an eating disorder can be emotionally and physically draining. Take care of yourself and prioritize your own well-being, seeking support from friends, family, or mental health professionals if needed.

Be Aware of Triggers

One of the most important things to keep in mind is that even those deep into recovery can and will experience triggers. You can avoid adding to these by educating yourself on avoiding phrases and conversations, such as calorie counts or weight loss.

Expert Eating Disorder Treatment

If you think that a family member, child, or friend of yours is struggling with an eating disorder, it is important to consult a professional. With proper treatment, individuals can overcome their eating disorder and live a healthier life, both physically and mentally.

I am Alison Pelz, a psychotherapist and registered dietitian with over 16 years of experience. I specialize in treating eating disorders in Austin, TX. 

If you or someone you care about is struggling with an eating disorder, don’t hesitate to reach out for help. To learn more about expert eating disorder treatment and schedule a consultation with me today. I am here to help you and your loved ones reclaim their lives and break through the chains of disordered eating.

Are you a clinician? Sign up for my mailing list and CE course!

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5 Tips for College Students in Eating Disorder Recovery

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Starting a new semester (or starting college for the first time) is associated with many positive feelings and excitement. However, along with these positive feelings, college students may experience feelings of isolation, worry, and sadness that often come along with major life transitions.

Unfortunately, these feelings may worsen eating disorder symptoms for college students who are struggling. When you’re already under stress from school and new social situations, it can be tricky to get a handle on your eating disorder symptoms or to move forward in your eating disorder recovery.

Why is it hard for college students to maintain eating disorder recovery?

Increased demands + independence

Returning to college, or going for the first time is exciting! It’s often a breath of fresh air to see friends you haven’t seen all summer, move into your new home for the year, and get into the swing of a new semester of classes. The taste of freedom and independence that college offers is hard to beat! 

If you have already experienced some time at college, though, you know that gaining independence also means more responsibility–which at times can be overwhelming. If you’re attending college for the first time, it’s normal to feel both excited at the opportunity for independence and totally overwhelmed by what that independence means. 

It can be challenging to set boundaries for yourself while managing-the demands of being a student, your social life, caring for yourself, and recovery. Increased demands often mean increased stress, which often is associated with an uptick in eating disorder symptoms.

Changes in Routine

When in recovery for an eating disorder, changes in routine can be tough to deal with. Routines allow for some comfort and dependability. When we have a routine, we know what to expect and when to expect it. It cuts down on the level of uncertainty or stress we feel about the unknown. College students often find that it takes a few weeks or longer to figure out their new routine.

Routines also have very practical uses in recovery. They affect meal planning, treatment appointments, sleeping habits, and more, all of which play a role in recovery! Navigating a new routine can be challenging, and can feel overwhelming. Giving care and consideration to what your new routine will be and how it works for you is important. 

Diet culture on Campus

On a college campus, you’ll be surrounded by other young people, who are also surrounded by the constant messaging on social media about diet and beauty standards. 

Gyms on campus may be full of college level athletes training in ways that other folks who don’t need intense conditioning for a sport shouldn’t be pushing themselves to compete with. 

You might be surrounded by fear of the “freshman fifteen”, or feel pressure to skip meals to study for exams with other students. The culture around food and exercise on a college campus may not be the healthiest one. It’s important to prepare for that with a counselor beforehand so you have coping mechanisms you can use when the need arises. 

Are you wondering what you can do to support eating disorder recovery at the start of a new semester? Here are 5 things college students can do to stay on track with eating disorder recovery.

1. Continue care with your eating disorder treatment team

It’s important to continue the work you’re already doing with your eating disorder treatment team as you transition back to school. The start of a new semester means a changing schedule, routine, and living situation in many cases. Making sure you have the support of your treatment team can help you weather these changes so you can have the best experience possible at schoo.

If you don’t have a treatment team a good place to start is your college health center. Most colleges don’t provide long-term counseling for eating disorders, but they can put you in touch with providers in the community that can support you throughout the school year so you can get the help you need. 

2. Establish a routine

Remember, routines help us all, but they especially help folks with eating disorders. Routines give us peace of mind, comfort, and help us stay on track with eating, which is a crucial part of recovery. 

Just as I am sure it took some time to establish a summer routine, it will take a bit for you to establish a school routine as you find what works for you and your needs. Be patient with yourself!

3. Get to know other college students

Support is crucial in recovery, not just from your treatment team but from the people you care about. It’s easy to get so into your school routine that you forget about reaching out to your friends regularly. Make sure to check in with yourself often to see if you are getting enough socializing in (or if you are getting too much – alone time is also important for self-care). 

If you are new to campus or find yourself feeling isolated consider joining a club. Most campuses have tons of clubs and organizations that cater to a variety of interests and skills for college students. Consider joining a club for fun and a club that has to do with your major to start with so you meet a good mix of people from inside and outside of your academic department.

4. Go to class

This may sound like a no-brainer. But, it feels like since the pandemic more universities still have a fair amount of classes online. If you have a choice, consider taking all of your classes in person. We’ve done enough online for the last two years. It’s also hard enough to concentrate at times, especially in the middle of a lecture, and it can be even trickier to focus when you have all the distractions of home around you.

Actually stepping foot in the classroom can help you get more in the school mindset, and it can also be a great way to meet other college students.

Additionally, I know it is very enticing to skip classes at times (after all, most professors don’t take an attendance grade). It’s always tempting to get a few more hours of sleep or to use your time for something else, but skipping class has some drawbacks.  Missing classes often makes us feel more depressed, isolated, and guilty instead of relieving stress.

5. Practice good self-care 

What’s your self-care routine? It’s important to remember that you’re worthy of being taken care of. Self-care can include getting your nails done, taking a hot bath, or using a face mask. It can also include things like getting enough sleep, taking your medication, setting boundaries, and having hard conversations.

We often have an idea of self-care as fun little treats or splurges, but self-care isn’t only about spending money. It’s about taking care of your emotional and physical needs. 

Self-care can mean different things at different times. Sometimes it might mean decompressing by yourself in front of the TV. Other times it might mean making time for friends and social events with other college students. Try to check in with yourself regularly and ask what your self-care needs are at the moment. Remember, it’s not selfish to take care of yourself- it’s necessary.

Navigating school while in eating disorder recovery can be challenging for college students, but it can be done especially with some planning and the support of a treatment team. If you’re interested in learning more about how I can support you as part of your eating disorder treatment team, contact me here.

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Finding Support as the Parent of a Child with an Eating Disorder

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It’s not easy to be a parent or caregiver for someone who is struggling with an eating disorder, at any age.

Parenthood is often described as having your heart walk around outside of your body, so watching your child struggle with such a complicated disorder can be heartbreaking. It’s scary to feel like your child needs help beyond what you can give.

Eating disorders don’t go away without being treated. It is essential for your child to begin treatment for their eating disorder so they can get relief from the distress they are feeling.

As a parent or caregiver, you are an important pillar of support for your child as they go through eating disorder recovery.

Eating disorders are complicated, and we often don’t learn much about them until someone we know is dealing with one. Much of the ‘common knowledge’ out there about eating disorders are actually myths, like that eating disorders only affect teen girls or that they’re not that serious. Eating disorders don’t discriminate by age or gender- anyone can develop an eating disorder. In fact, a common risk factor for developing an eating disorder is a history of dieting.

As the caregiver of someone with an eating disorder, you naturally want to do what you can to help your child through this. Learning more about eating disorders can help you understand what your child is going through, and connecting with other caregivers can give you an opportunity to feel supported yourself. You don’t have to go through this alone.

Here are some resources for caregivers of children with eating disorders:

Eating Disorder Books For Caregivers:

The following books give practical strategies for families supporting their loved one with an eating disorder. They are all using a family-based treatment (FBT) approach to treating an eating disorder.

Family-based treatment empowers the family to help support their child through nutritonal rehabilitation and eating disorder behaviors.

Support Groups + Other Resources for Caregivers

Here are a list of support groups for caregivers. Many families find it helpful to learn that they are not alone in their struggle.

FEAST Resources

Families Empowered and Supporting Treatment for Eating Disorders (Feast) is a non-profit that supports caregivers and loved ones with eating disorders. FEAST provides free support to caregivers around the world:

  • FEAST’s First 30 Days Educational Service
    • Information delivered right to your inbox on how to care for your loved one.
    • “We want to change the course of a family’s caregiving journey in 30 days. These 30 days of lessons are meant to start the family on a new course of empowerment and good information. Over the 30 days you will learn about eating disorders, caregiving, and the resources available for ongoing learning. We will introduce you to the resources and the peer support of our worldwide community.
  • Forums to get support from other caregivers
    • “This is a free service provided for parents of those suffering from eating disorders. It is moderated by kind, experienced, parent caregivers trained to guide you in how to use the forum and how to find resources to help you support your family member. This forum is for parents of patients with all eating disorder diagnoses, all ages, around the world.”
  • Webinar Series that frequently feature leading researchers and experienced clinicians in the field.
  • FEAST’s Parents Do Not Cause Eating Disorders Info Page
      • This statement may seem obvious, but it is the sad history of eating disorder treatment that parents are sometimes still blamed or feel blamed when a loved one develops an eating disorder. For those families suffering from guilt, from feeling blamed, or unsure of who to believe on this topic, here are some things to keep in mind.”

Are you looking for more ways to support your child as they recover from their eating disorder? Working with a treatment team is the gold-standard for eating disorder recovery, as eating disorders impact health in many ways, from physical to mental health.

Part of a treatment team for eating disorders is a psychotherapist. For more information on how I can help, send me a message.

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Parents: An Essential Part Of Eating Disorder Treatment

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To all the parents out there: you are an important part of your child’s eating disorder treatment team! This is true even if your child is no longer a child, but a young adult or an adult. Even if you don’t live with your child, you have an important role to play in eating disorder recovery. 

Why are parents + caregivers so important in eating disorder recovery? 

Therapists, doctors, and dietitians are must-haves on any eating disorder treatment team. But parents have an important role to play too! Here are a few reasons why parents are important in the recovery process:

  • You spend much more time with your child than the treatment team does. As a therapist, I may spend one to two hours a week with your kiddo, you spend dozens of hours!
  • You are usually involved in feeding or making sure that your teen is fed.
  • You have a relationship with them. They trust and love you. If you are a parent of a teen, I know it may not always feel like it, but it is true!
  • You know your child better than anyone else!

Where do eating disorders come from?

Eating disorders are thought to function as a way to cope with uncomfortable feelings. Feeling distressing emotions is, well, distressing. Eating disorders often develop as a coping mechanism to avoid feeling those painful feelings. It’s possible to learn new ways to cope to manage those distressing feelings. 

As a parent, you can learn tools to help your child manage their feelings without using the eating disorder to cope.

When you hear this you may feel like a deer caught in the headlights. 

  • You may be thinking, “Yeah right! I can’t even get through a conversation with my teen without it turning into a fight.” 
  • Or maybe you’re thinking, “I can’t get them to say more than a few words to me.” 
  • You may even be throwing your arms up in exasperation because your kiddo is in total denial of their eating disorder.

If your child has an eating disorder, you may be feeling a range of emotions all of which are okay. You might feel anger, worry, sadness, resentment, disbelief, panic, and hopelessness, to name a few. And you may be feeling no way equipped to help your child recover from an eating disorder, but you are wrong.

Historically, parents weren’t always involved, and at times even discouraged to participate, in the treatment of eating disorders. In recent years, we are learning that parents can be a really powerful tool in their kid’s recovery process. This holds true not just for eating disorders, but for all mental health conditions. Parents have an important role to play! 

Parents often blame themselves or feel responsible for their child’s eating disorder.

I haven’t met a parent or loved one who doesn’t want what is best for their loved one – to be happy and live a productive, healthy life.

Let me be clear: you are not to blame for your child’s eating disorder. 

Eating disorders are complex. They develop for a variety of different reasons including social, biological, and psychological factors. For example, did you know that being a girl or a history of dieting are risk factors for developing an eating disorder?

As an eating disorder therapist + dietitian, I encourage parents to focus less on why their child has an eating disorder, and more on eliminating the eating disorder. 

For example, if your child developed cancer you would spend less thought on why she got it, but more on getting her good treatment.

While you are not to blame for your child’s eating disorder, you certainly can be part of the treatment and solution. Often, parents don’t feel equipped to help their children recover. Parenting is hard, and parenting a teen with an eating disorder has a unique set of challenges. 

You are right you may not have the eating disorder knowledge (yet!) to help. But, you do have a special connection and bond with your child that is so powerful in the treatment of eating disorders.

Some parents report that their kids don’t want help for their eating disorder, or even that they are in denial about their eating disorder. Certainly, this feels like it is true, but it is not. 

Remember eating disorders are a way for your child to cope with discomfort. Yep that’s right – just like their lovey or security blanket that they had as a kiddo! The disorder is serving a purpose, even if it’s not a healthy way to cope. Since the disorder is filling a need, it might seem like on the surface, your child doesn’t want to acknowledge or deal with it. However, living with an eating disorder can be a miserable existence. Your child deserves better!

Now that I have (hopefully) convinced you that you are an important part of your teens recovery, you may be asking yourself how do I help my teen? 

Here are a few tips to get you started.

  1. Get educated about eating disorders. Here are specific resources for parents.
  2. Make sure that your teen has a complete treatment team.
  3. Verbalize to your teen that while you don’t have all the answers, eating disorders are serious mental health conditions, treatment is needed, and that you are going to be there every step of the way to support them.

Are you looking for more ways to support your child as they navigate eating disorder recovery? Please feel free to book a free 15 minute phone call with me to learn how to better support your teen as they navigate an eating disorder. 

5 Ways Journaling Can Help in Eating Disorder Recovery

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What do Oprah Winfrey, Freda Kahlo, Marie Curie, and Anne Frank all have in common? (Besides being exceptional women, that is.)

They all journaled.

When you read about why these incredible women kept a diary, building a strong connection with one’s emotions and thoughts is the theme that comes up.

People who suffer from eating disorders often really struggle to identify and cope with their emotions and thoughts. (And not just people with eating disorders, lots of people struggle to connect with what they’re feeling and why!) Often the eating disorder then becomes the way to cope with those emotions, unhealthy as it may be.

Having a strong journaling practice doesn’t mean that your eating disorder will just evaporate on its own. But keeping a journal is a tool that can help you in your journey in recovery, and support your work in therapy. If you don’t have a therapist or treatment team click here to learn more.

Journaling can help:

Rid unhelpful, repetitive thoughts swarming around in your head.

Simply writing thoughts down sometimes can provide a reduction of these thoughts. The more we hold onto or try to bury our feelings, the stronger they usually become–and the more it feels like they can start to control us. When you take time to get the thoughts out in some way, your mind is able to release them, instead of clinging onto them.

Identify your fears and worries.

Many people who have eating disorders often experience high levels of anxiety. Journaling can assist in identifying those fears and worries in order to evaluate if they are actually reflective of the truth. Learning to identify when our fear those fears are “real” can help both your problem solving skills and your ability to tolerate some levels of anxiety.

Increase a sense of control by reflecting and processing thoughts and feelings.

Giving yourself a space to review and reflect on what you’re feeling without judgement can help take the power out of those strong feelings. Instead of feeling like they are controlling you, learning to reflect & process them helps to teach you that your feelings are trying to communicate something to you, but they don’t have to dictate your life.

Explore and sort out your emotions.

Identifying, understanding and communicating emotions can be hard, especially for those with eating disorders. Often people with eating disorders use eating disorder behaviors to cope with their emotions. Journaling is a tool that can instead help you to navigate your emotions, so you don’t have to rely on your eating disorder to manage them.

Reduce avoidance of problems & stress.

While avoiding problems and stress may seem helpful particularly in the short-term, in the long-term it actually increases feelings of stress, discomfort, and fear. For example, if you are anticipating a tough conversation with someone the longer you put the conversation off the more stressful it becomes. Usually, once the conversation is completed there is a sense of relief. Merely writing about the anticipated conversation is a great first step to reducing avoidance. Eating disorder behaviors often serve as a way to avoid stress and discomfort, so developing a healthy practice to manage stress can help reduce reliance on those behaviors, as well as strengthen your stress management skills in the long term.

Tips to Get Your Journaling Practice Started

Journaling can be downright daunting–especially if you are not used to talking about emotions. But think of journaling as a practice, something that you may feel “not good at” at the beginning, but over time you will become more confident.

Make it part of your daily routine like brushing your teeth. Perhaps journal at around the same time or point in your day. Maybe start off with journaling five minutes a day and increase the length of time as needed or as your confidence builds around journaling.

What to Journal About:

There is no “right way or wrong way” to journal. The point of the journal is to get your thoughts and feelings out on paper. No need for perfect grammar, spelling, or handwriting.

You may start by writing about your day (what you did, thought, and any feelings that came up), or a particular situation that you felt strongly about–whether it was a good or bad feeling.

It may be handy to keep a list of feeling such as this one next to your journal. This can be a good tool to increase your emotional vocabulary, strengthen your ability to identify what you’re feeling, and really understand your emotions.

If you don’t know where to get started with your journaling practice, try one of these journal prompts:

  • 3-5 things you are most grateful and why.
  • One thing you felt proud about today.
  • Something you recently did that was hard and how you manage it.
  • A stressful situation and how you can cope with it.
  • A letter to a future self.
  • What do you feel most worried about and why.
  • What others would say to you about why they care for you.
  • Eating disorder-specific:
  • Name 5 ways your eating disorder is helpful and 5 ways that your eating disorder is unhelpful.
  • If I didn’t have my eating disorder then I would be doing these five things.
  • If I didn’t have my eating disorder then I would feel these 5 things.
  • I would want my friends and/or family to know about my eating disorder ar these things.

If you are looking for more ways to support yourself in your journey of eating disorder recovery, talking to a therapist may help. Please call for a free 15-minute phone consultation to learn how I work with clients with eating disorders and loved ones.