A letter came in today that may speak to many people this holiday season. The writer, I'll call her Kendra, had an eating disorder slip last night.
Kendra spent successful time in a residential eating disorder treatment center. She continued her recovery work on an outpatient basis at home with a private psychotherapist and a support group. This sounds good to me. Then she had an eating disorder slip.
Eating Disorder Slip
She stopped seeing her therapist and stopped going to the weekly support groups because they became triggering for her. These are red flags for me.
I agree with withdrawing from triggering situations. But withdrawal alone is not the answer. Otherwise the ultimate cure for eating disorders would be remove all triggers. Since that is impossible, the only other way to stop all triggers is first, try to control everything and everyone. When that fails the next choice is to completely withdraw from the world. The next choice is to seek recovery psychotherapy.
If you have an eating disorder you know how appealing isolation can be during particular sensitive times when you feel particularly vulnerable. But isolation has its own negative consequences. So last night she slipped into her eating disorder behavior and got scared.
She's under pressure studying for an exam. If she passes she will qualify for a professional license that will change her life. She is also just about to leave for a trip with her family. I don't know where she's going. But here are three stressors coming in at her at the same time:
- studying for an important and life changing exam;
- going on a trip which involves packing, planning, separation, coordinating and compromising with others;
- coping with the challenges that exist at the destination.
Dear Kendra, You are working to take care of yourself by writing and asking for help. Great. It sounds as if you have done a lot of recovery work.
A slip, at this stage, is information. You are not bingeing and purging as you did "in the old days." You have developed inner strength, wisdom, and a self confidence based on your own growth and your ability to receive love.
This gives you resilience and an ability to allow your creative mind to offer up novel ways of coping with life challenges.
Meaning of eating disorder slip
A slip at this stage in recovery means you are experiencing something in life that falls through a void in you.
It could be a pinprick of a void, a tiny place where you still need to grow and develop.
You most likely have developed a solid presence where your old and larger void used to me. But tiny places of inner absence still exist in you.
A slip calls attention to that inner absence. You act out because the inner something you need in the moment just isn't there. The slip fills in your inner gap.
That inner space of nothing in you needs attention. When you find a way to give yourself what that place in you needs: support, nurturing and encouragement, you can not only develop compassion and understanding for yourself. You can grow to fill in that little place with more solid inner self. Under certain circumstances like what is going on in your life now, knowing how to nourish yourself emotionally is vital to your life.
Difference between full blown acting out and a slip
In the early days of recovery, a binge or purge is part of the disorder. It's a major coping mechanism to hold you together and keep you functioning when so much inside you is fragile or absent.
Later on, like now, a slip is a helpful guide to show you where you need to take care of yourself and do some inner work. But it's only helpful if you pay attention to the message your slip brings.
Possible Message of Current Slip
- Perhaps you went beyond your capacity to tolerate stress in your studies.
- Perhaps preparation for your trip was too taxing.
- Perhaps the trip itself has more stress attached to it than you realized during the original planning.
Or, more likely, each event on it's own is bearable, but the combination of them all is beyond your threshold of tolerance. On the other side of that threshold is nothing to support you except the old eating disorder behavior.
Your Choices You have three choices.
- Stay as you are and let the eating disorder behavior see you through, with all the negative consequences that implies.
- Reduce your stress and demands on yourself. Live within the limits you can bear.
- Grow so you can tolerate and function well in more complex situations. That means doing more inner work.
From my perspective as someone who lived through bulimia for decades and now is an eating disorder recovery psychotherapist, I choose option three.
What about you? Thank you for writing, Kendra.
And to all readers, please be kind and gentle with yourself regardless of your level of activity. Slips are usually frightening. But slips can offer you great moments of opportunity.
Joanna Poppink, MFT, is a psychotherapist in private practice specializing in eating disorder recovery. All appointments are virtual. For a free telephone consultation e-mail her at
See: Eating Disorder Self Care after New Years: Five Tips