The word ‘trigger’ wasn’t really in my vocabulary before recovery. Sure, I knew what it meant in literal terms but I didn’t ever notice a feeling of anxiety arising and think to myself ‘oh I am so triggered right now’. Triggers are basically anything that I would most likely ‘eat over’. This may be people, places or things or even just feelings. Before leaving hospital I was asked to list my personal triggers. Things that may urge me to act out on an eating disorder behavior. The first step for me was identifying what these eating disorder behaviors were and then thinking about my life and situations that may arise that may ‘trigger’ me to carry these out.
Eating disorders are crafty little buggers so it is more than just ‘food triggers me’. I looked at the symptoms of my disease.
- Restricting Food (Skipping meals, avoiding certain types of foods or calorie counting)
- Purging after eating
- Obsessing over food
Once I had my symptoms on paper it was much easier to think of scenarios which may ‘trigger’ a want to engage with these behaviors.
The usual suspects were on my list. Emotions like hunger, anger, loneliness and tiredness (We referred to this list as HALT in treatment). Certain foods that I liked ‘alot’ or feared ‘alot’ were on there. Meal times and special occasions were on there.
But there were some others that I hadn’t even expected myself and would be very hard for my family and friends to predict and help support me through. Here are some of the triggers I found took me by surprise or were the least understood by my support network. Being aware of these doesn’t mean I need to avoid them at all costs, it just helped me to prepare my coping strategies for inevitable situations that would occur in day to day life.
#1 The ‘Complimentary’ Trigger
Yes, even compliments can be triggering. ‘You look well’, ‘wow you look so healthy’, ‘It’s great to see you less gaunt’ and other such compliments were interpreted as ‘you gained weight’, and ‘you are fat’.
Top Tips: I found it helped to ask my family and close friends to avoid such terms which they gladly did but I still received some from acquaintances from time to time. For the unavoidable situations I found that positive affirmations were really helpful such as ‘it is beautiful to be well’ and ‘I deserve recovery’. I found CBT techniques (Cognitive Behavioral Therapy) really helped challenge my associations with these phrases too. Through questioning I often admitted to my therapist and myself that I was not fat and that in reality I actually got as many comments on my slim physique as I did my ‘health’. I had to challenge my first thought always. It was usually not my own but my eating disorders. Try asking what the reality of the situation really is.. you may be surprised that you already know the answers.
#2 The ‘Reality Check’ Trigger
When I first came out of treatment and came back to my normal life in Hong Kong, I was surprised by how some day to day activities which had once not triggered me, now did. Going to work was a lot easier when I had food as an escape throughout the day or when I could starve myself or purge so as to avoid the feeling of fullness in the afternoon. Without my coping tools, normal everyday life seemed much harder. And at first this threw me into a spiral of thinking that I had no hope of surviving or ever leading a productive life. The feeling of uselessness was so hard to reconcile. I had always been so good at ‘coping’ with life and now I was raw and exposed.
If you want to paint a room from a dark colour to a light colour, you need to strip the darker paint before you repaint and often the room in progress may look worse than before you started renovating. I like to think of my recovery like this. Recovery is a process, and often I feel like I am going backwards, when in fact I am making room for better things.
Top Tips: Give yourself time to heal. Looking at recovery as a process of healing, just like that of a physical injury is important. Tell yourself that you deserve recovery and that you can accept where you are ‘today’ without judging is a good idea. It is also helpful to focus on your progress, what you can do, rather than what you cannot do. Have you succeeded in not purging today? You may not have been able to do that before. Have you practiced self love and compassion today? You probably weren’t even capable of this before. Celebrate what skills and achievements you make, not lament over what you can no longer do.
#3 Getting Dressed
I found getting dressed was one of the biggest challenges in early recovery. I had struggled to find clothes I liked in the past but adjusting to my healthier weight brought with it the need to readjust on a daily basis. I didn’t gain a lot of weight after my last hospitalization (I was almost a normal weight going in), but the feeling of fullness and my eating disorder thoughts were amplified by the stress of getting back into my old life routines. Even putting on pyjamas was sometimes tough as I would concentrate on the feeling around my waist. It surprised my husband that I was conscious of what I wore inside the flat as well as on nights out.
Top Tips: For me, throwing out old clothes was key. Throw out those clothes that never should have fitted in the first place. Look at it as an opportunity to restyle yourself if you feel ready to do so or do what I did and opt for more stretchy attire while in recovery. Dresses without waist-bands may not have been attractive on me but they helped me to avoid obsessing and leggings are your friend for the early days.
Beyond the wardrobe change, it will still be challenging to deal with body changes. Remember that you were NOT happy being unhealthy and that healthy is beautiful. I also highly recommend finding yourself some role models that are curvier and reminding yourself that beauty is not something you measure on a scale.
#4 A Break From Routine
Planning is my friend today. I plan my meals and snacks and bring some with me if I am going somewhere where I may not have access to something I am comfortable with. But it wasn’t always this way and in-fact I feel somewhat shy about admitting that I like routine and plans. I always considered myself spontaneous and routine seemed to contradict this. In early recovery, I found it very triggering when events ran over snack or lunch time and I had to go long periods without food. Hunger was a trigger and I liked the comfort of knowing when my next meal was. Today, my plan and routine is my default and I can flex from this more readily. But choose to stick with it when I don’t have a good reason not to. I can be more spontaneous in life when I am not triggered.
Top Tips: Get a meal plan and a routine that fits with your life. No point planning for dinner at 6pm if you don’t get home from work until 7.30pm. Once you have a plan then think in advance of what could break the routine and make decisions now for what your reaction will be. I created ‘cards of recovery’ at home for situations of high stress off the routine which listed meals I would default to if I was hungry and triggered. This way, I didn’t have the extra complication of ‘choosing’ when in times of stress. Pack snacks and have them available to stop you getting hungry. And most importantly, don’t be afraid to impose on others. You can tell your friends you will be eating at 7pm even if they turn up late for dinner. You can ask your husband to tell you in advance if he will be late and you can choose to have backup plans for times when commitments cannot be kept. I have a freezer full of backup meals for times when the unexpected happens. You can enjoy a varied and spontaneous life with a safety net underneath you. It doesn’t have to be all or nothing.
#5 Other Peoples Disordered Eating
We live in a society of choice and convenience. Gone are the days when everyone in the village agreed that lunch was 1pm and dinner was 6pm or whatever the norms of your culture were. Gone are the days when meals consisted of meat and two veg (perhaps this is an Irish thing). What is considered healthy is now a lot more complex than before. And displays of ‘disordered eating’ is everywhere, even amongst normies (people who have a normal relationship with food).
There are so many fad diets and cleanses and detox’s which resemble the symptoms of an eating disorder and regardless of whether these are taken up by someone with an eating disorder or a normie, they are just as distressing to someone recovering from an eating disorder. My mum has been on restrictive diets in my recovery, my husband has skipped meals because he just wasn’t hungry and actually eats less than I do in my recovery despite being much bigger. This was very distressing to be around at times and I could say this is one of my largest triggers.
Top Tips: Have a plan for YOU and choose to stick to your plan despite what other people choose. This is much harder than you may think.
Communicate with your loved ones and support network. If something they are doing is triggering it is ok to name it without asking them to change it. For example, I explained to my husband that when he decided he wasn’t hungry enough to eat a dinner I had planned and prepared for us, that I felt more conscious of what I was eating and compared with him. He was very interested in how my mind was different to his in this respect and we discussed things we could both do to avoid future stress in such situations. There was plenty I could do and he could do and we now find it quite easy to eat together ‘or not’. I have my choices, he has his and we enjoy each others company free from my constant resentment.
In this situation I actually decided I would not wait for him to be home to eat. I eat my dinner at my dinner time and he chooses what he wants when he comes in. He also checks in with how I am feeling and calls in advance when we have plans if anything comes up.
Don’t be afraid of your triggers. Be prepared for them. You may even find that noticing how you overcome your fears over time is a great fulfilling experience.