The Unintentional Relapse

I’ve only seen Trainspotting once, and it was probably 20 years ago. But there is a line in it that I still remember.

The line is by Ewan McGregor’s character, and it’s after a period of abstinence and trying to keep clean from heroin. He says, “[we] made a healthy, informed, democratic decision to get back on drugs as soon as possible. It took about twelve hours.”

I have no idea why this line implanted its way into my brain the way that it did. There are undoubtedly many more over the top lines and scenes that I’ve inadvertently forgotten.

But it’s a line I’ve thought about a lot over the years as I’ve worked with clients battling with an eating disorder. 

Part of the reason it’s stuck out is that it’s so at odds with what I have experienced. 

With all my work with clients, rarely am I concerned about someone intentionally going back to an eating disorder. 

But what I am always on the look for, is the unintentional relapse. 

The Slide Into Relapse

Recovery is hard, and it takes time, and time here normally means years. And as part of recovery, there will be many ups and downs; it is by no stretch a linear process. 

There’s an experience that’s occurred with a number of clients that I want to describe, as it may resonate with you. 

We have been working together for a decent amount of time. The client is committed to recovery and making huge strides in the right direction. 

They are eating more. 

They have curbed the exercise. 

They are bringing in fear foods. 

They are challenging the negative thoughts and patterns of behaviour. 

They are squarely on the recovery journey. 

But then something will happen.

For one client, their workload drastically increased. They were working extra hours each day. But it wasn’t just the extra time; it was also more pressure and juggling projects in multiple locations around the world.  

For another client, they started renovating their house. This small job should have lasted 7-10 days, but six weeks later, the place was still a building site. 

While I’m referring to two examples here, many other circumstances can create the same situation.

• Splitting from a partner
• Moving an elderly parent to a care home
• A death of a cousin or childhood friend
• Being made redundant
• A struggle with a child at school
• Getting a bout of food poisoning

The same can be true with more “positive changes.” Starting a new job, starting a new relationship, moving to or buying a new house. Whatever the drive, the outcome is the same. 

Life Changes Interfere With Recovery Habits

Because of the changes in their circumstances, food slips from its previous position on the priority ladder. 

Snacks become less frequent until they aren’t happening anymore. Breakfast becomes smaller again. Lunch is happening later and later. 

None of this is intentional; it just happened because of the overwhelm of life. 

And hand in hand with these changes, clients notice some recognisable signs.

Symptoms Have Come Back 

Their sleep is worse again. They were in a routine of sleeping reasonably well, mostly making it through the night. Now they are back waking to urinate multiple times. Falling asleep is a struggle, and they may awaken in the night and be unable to get back to sleep. 

Digestion is misbehaving too. The client had got back to being regular, going every day. But now it’s more like every other day, or just a couple of times a week. 

Same thing with their period. This month it was much lighter than usual, basically just spotting. This change is significant and different from recent cycles.

They’re also finding that they are cold again. One client had this sweater at work that they used to only wear very occasionally on cold days. Suddenly, they are living in it. 

It’s Easy To Rationalise Away These Changes

To start with, clients chalk it all up to stress. Their life is just so full-on at the moment that, of course, their sleep is going to be a little worse. Or their digestion is going to suffer. That’s what stress does. 

But at some point, it dawns on them what’s really going on. That this isn’t merely stress-induced; this is something far more concerning. 

Typically the alarm bells go off when they decide to make food a priority again. Rather than instantly going back to what they were eating before, they’re stuck again. They realise this is eating-disorder induced.  

Foods and meals that only two months ago had become normalised, now feel like a monumental challenge. 

Changes in body image are another telltale sign. While body image had still been a work in progress, things had been moving in the right direction. But since the under eating and worsening of their physical symptoms, their fear of weight gain comes roaring back.  

Thoughts and beliefs that had melted away are crystalising again. 

From Guide To Spectator

As a practitioner, it’s hard watching this all unfold. In both cases, I aired my concerns about the changes that were occurring. Like watching a car crash in slow motion, all I wanted to do was intervene. 

But as the adage goes, “you can lead a horse to water, but you can’t make it drink.” And so if the client feels it’s just down to stress and they have bigger things to worry about, they will respond accordingly, irrespective of my warnings. 

But eventually, they recognised what was going on, and we commenced making recovery the number one focus again. 

Fears That Arise During A Relapse

Interestingly, when this has happened, clients have typically had the same sets of two fears.

1. How do they stop this descent? Moments like this can feel like a freefall, and not the fun skydiving kind.
2. How much time is this detour going to cost them? They know how long recovery has been taking them, are they now starting from the beginning again?

Thankfully, there is good news on both these fronts. 

How to stop the slide is simply a matter of getting back to the recent habits that were occurring before this life blip. Now, this may not feel easy, but I remind clients that it was only a handful of weeks ago when they were doing this. They have the strength and the ability, and it’s just about getting back into the routine. 

And in terms of the time cost, this is also fairly quick to repair. Just as their sleep and digestion degraded in a matter of weeks, it can equally improve just as quickly. As long as they are getting the appropriate food and rest in, things can turn around. 

Timing Is Everything

The thing that does make it urgent is that the longer the relapse goes on, the harder it can become psychologically. It’s like the new pathways in the brain start to close over quickly. And the old pathways rise up again. 

And so when this does start to occur, catching it as early as possible is hugely important. Which isn’t always easy because of the messiness of life and the insidiousness of eating disorder thoughts. 

Life Doesn’t Have To Be Put On Hold 

I should also make clear that when in recovery, the point isn’t to avoid all new experiences. Often, these decisions aren’t in your hands; it’s not like you get to choose when someone gets sick, or you lose your job.

But even when you can make a choice, like deciding to start a new job or to move to a new place, these opportunities don’t have to be turned down.  

What does need to happen, whatever the change, is for recovery to still be at the top of the list. And “recovery” means prioritising eating, prioritising resting, and continuing all the other habits that are assisting you to get to a better place. 

From Recovering To Recovered

Even while get help, recovery is messy and isn’t linear. And this is probably a good thing. It’s when things get worse again that clients have the most insights, and real progress occurs. 

By learning better coping skills. 

By learning how to deal with life when it gets tough. 

By seeing how far they’ve come.

By learning that life is a procession of better moments and more sucky moments. “This too shall pass” isn’t just a maxim for life; it’s a factual statement. 

Would you like help?

Are you currently experiencing a relapse and struggling to know what to do?

Or are things going well in recovery, but you’re concerned about the fragility of your recovery and that a relapse feels like it’s just around the corner?

I’m a leading expert and advocate for full recovery. I’ve been working with clients for over 15 years and understand what needs to happen to recover.

I truly believe that you can reach a place where the eating disorder is a thing of the past and I want to help you get there. If you want to fully recover and drastically increase the quality of your life, I’d love to help.

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