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Relapse Prevention: Identifying Your Triggers

Posted Jun 30 2010 7:52pm
Ah yes. Identifying triggers. When I was deep in the eating disorder, pretty much everything triggered eating disordered thinking. Even in early recovery, much of that persisted. A glance at a magazine could trigger a storm of self-loathing. The barest hint of reproach from another person could send me spiraling. And any anxiety-provoking situation would leave me fantasizing about slashing my food intake and increasing my exercise.

Things have improved since then, but there are still any number of situations that amplify the eating disordered thinking and make me ever more vulnerable to relapse. Some of the point of identifying your triggers is to anticipate when you might need extra support. The other point of this is to make what I like to call a "mitigation plan" (it's a term I used when I was working in emergency preparedness, a career move that gave me many ideas into relapse prevention planning) so that you can survive the situation with as little lasting damage as possible.

Here is a (partial) list of my triggers
  • physical illness that affects eating/appetite
  • seeing people running/exercising
  • moving
  • learning of a friend's relapse or weight loss
  • weight gain
  • new job
  • feeling like I don't measure up
  • clothes shopping
  • getting off my schedule (ie, traveling)
  • increase in depression
  • increase in anxiety
  • financial stress
Some of these triggers can be avoided, many of them cannot. Similarly, some of these triggers can be anticipated, but many cannot. Given that we can't avoid these triggers and we can't anticipate them, what else can we do? Like I did when I worked in emergency preparedness, I had to develop a plan (the mitigation plan) to help deal with them.

I created a general "mitigation plan" for all of my triggers and made certain additions as necessary to fit each particular situation.

My trigger mitigation plan looks like this
  • utilize support system
  • increase frequency of therapy appointments
  • compare and despair: I am doing the best I can at the moment
  • stay to my specific schedule of meals and snacks no matter what
  • BE HONEST about urges
  • relapse is always there for me- I don't need to act on my urges right this second. I can wait and use my wise mind to think it through, and solicit feedback from others
  • distance myself from negative people
  • schedule meals and activities with others
  • my exercise and eating plan are right FOR ME; it doesn't matter what other people are doing
  • relapse only means more clothes shopping so don't go there
Some of these plans are appropriate in a wide variety of situations while others are more specific to certain triggers. The idea is to have a plan that is flexible and can be adapted to a variety of situations but still provide enough guidance on what needs to be done when the going gets tough.

Knowledge is power, they say, and in the case of relapse prevention this is definitely true. The phrase "forewarned is forearmed" is certainly apropos. If, for example, you can anticipate a trigger (maybe having to meet with a difficult family member) then you can start using your mitigation plan even before all hell breaks loose. Even if you can't totally prevent hell from breaking loose, at least you can contain the damage.
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