Bulimia: How to Recognize Triggers for a Binge or Purge Episode and How to Recognize Six Levels of Recovery. (long title for a brief summary)
In eating disorder recovery you explore your triggering situations in stages.
Explore Your Situation
Please pay attention to what is going on in your life, including your internal life, just prior to a binge or purge activity.
When you feel the urge and then need and then out of control compulsion to binge or throw up or do some other ritualized behavior familiar to you and which numbs you out or which you think relaxes you, explore your situation.
Even if you can’t explore in the moment, be ready to look at that moment later.
First Level
First you look at possible triggers after the fact.
You’ve binged and then purged. You are in the familiar aftermath of mess or sorrow or sense of failure. Or perhaps you are relieved and feel ready to take on the next event in your day.
Before you move on into despair or into a numbed automatic functioning machine, look at what was going on for you earlier in the day. Look at what was going on in your mind and emotional world as well as tangibles in your life.
You may notice something that triggered your binge. If you don’t and you give yourself a moment to attend to your situation after every binge purge episode, you may discover patterns. You may discover that certain events or people or feelings always precede an episode, and perhaps they are triggers.
If you attend in this way you give yourself an opportunity to see what events, relationships, activities, thoughts or feelings seem intolerable. These are the triggers that set off eating disorder actions to help you feel relaxed or numb.
With increased strength, growth and more curiosity, you begin to look before the eating disorder actions.
Second Level
Later you can start to restrain yourself from acting out. This is a stressful time full of anxiety and paradoxical thoughts and feelings.
“I want to.” “I won’t.”
“Just one last time.”
“No.” “Yes.”
“Just a little.” “It’s never a little.”
You might feel dizzy, off balance, afraid. Your vision might go into a light strobe action, as if everything were going through a slight shudder. You might feel your gorge rise and fall as if your body were trying to get ahead of the binge purge cycle and just rumble as if you were going to heave.
You succomb. You binge. You go back to Level One.
You may or may not be able to look at what preceded the episode.
Third Level
Same as second level except this time you succeed. The agony is the same. But this time you call for help from an established and trusted resource person to help get you through the experience without acting out.
You may be so relieved that you didn’t act out that your mind shuts down for a while. Or you may get a window into your situation where you see what triggered you in a way you could never see before.
Fourth Level
Same as second level except this time you have more options than calling a particular person as you did in level three.
At level four you feel the binge urge feelings coming on. You have an idea, if only a vague idea, of what is triggering you.
Now you can call a person or go for a walk or read poetry, or wash the dishes or clean your room or closets or do laundry instead of living through another binge purge episode.
The key word is “instead.” You grab hold of your energy along with your awareness of what is triggering you and you use your energy in a constructive way.
At level four you begin to experience more fully the fact that feelings are temporary. Even the enormous and powerful urge to binge and purge is a feeling that will pass.
At level four you discover the wonderful feeling of living through the urge and instead of seeing food wrappers and feeling groggy from the eating disorder binge purge episode you see something positive. The dishes are done. Or the closet is more orderly. Or your mind holds a moving image from a poem you read.
Or simply and profoundly, you don’t see the aftermath of a binge purge in your home or reflected on your face in the mirror. The presence of the absence of the binge or purge episode seems like a miracle.
Fifth Level
With more practice and more recovery you learn to anticipate what can trigger you. You make self-care arrangements for yourself in advance of compelling urges.
Sixth Level
With solid recovery, you use your stable, healthy, integrated self and positive, realistic sense of yourself to get through periods of stress without the aid of eating disorder actions.
Progress, Not Perfection
Do you ever go backwards? Yes.
Is that failure? No.
Going back levels simply means you need more practice, more growth, and more development.
Raising the Stakes
Also, you might not appreciate that you have raised the stakes during your progression toward health. If you remember the fundamental principle behind these levels, i.e. explore your situation, you may find that some situations are more complex and stressful than others.
Anytime you move back a level you probably have encountered a situation that calls upon you to develop more fully.
For example, if a visit to friends for dinner is a triggering event for you and you overcome it, then you might think you are at level four or even five.
But if you then are to attend a family dinner and find yourself unable to stop a binge or purge episode, that doesn’t mean you are failing. It means you have more issues to explore and resolve with your family than you do with your friends. That’s normal and even predictable.
Failure or Progress?
Once you are on the recovery path, an episode is not a failure. An episode serves you. An episode lets you know that imbedded in the triggering situation are some life lessons for you, some issues that need to be understood and resolved, some strength in you that needs to be more developed.
In your recovery process, wherever you are in your progress toward healing, health and development, please remember to pay attention to what is going on in your life – outside and inside, like it or not. This reflection on your experience gives you the opportunity to recognize your eating disorder episode triggers.
Giving yourself respectful attention as you go through your life experiences is key to creating an eating disorder free life. Plus, you can discover what is genuinely meaningful to you and rally your strength and energy to go for what might give you real and sustained joy.
Comments
9 Responses to “Bulimia: How to Recognize Triggers for a Binge or Purge Episode and How to Recognize Six Levels of Recovery. (long title for a brief summary)”
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Dear Joanna:
I am so grateful to be reading this post of yours. I am at the point in my recovery, where what you are advocating — looking inside, looking outside — before I act on symptoms, is even possible for me. So I thank God that I have given My Self the time and the trust and the space. For too long, all that I gave to My Self was food. I am still new to recovery, but I know now that I am reaching towards more than food, more than binging. I am re-claiming a Self that has been so buried under the avalanche of food obsession. I am like a toddler, I suppose, and I am willing to leave my mother’s glance, long enough to explore more of what is surrounding me. Joanna: I am brave; I am courageous. This is the hardest thing I have done in a very long time. Your ‘long-distance’ help tells me that I am on the right road.
Should I slip backwards — that is ok! — it is simply (God’s) message that I need more time to practice, that I need more time for My Self. I feel an especial sense of calm: I am on the right track. Thank God.
What a joy for me to read your post. You are on your healing path with tender and realistic awareness of your challenges. Brava!
You are so right about being like a toddler. You are going to your beginning places of development and growing up again, but this time with more health and support.
Toddlers need love, patience, guidance and protection from a mature person and freedom to learn from their explorations and occasional blunders. All this development needs to occur in a loving and compassionate environment..
You need that in recovery as you go about the real recovery work that involves looking in, looking out, recognizing your abilities, make decisions based on your abilities, and also nurturing yourself so you can grow beyond your present limitation and expand your abilities.
Yes, I agree with you. You are on the right track. I’m glad to be able to help.
warm regards,
Joanna
Thank you for this post — I feel much better about where I am in my recovery after reading this!
susan’s last blog post..My Brain…it’s A-Changin’
Thank you for letting me know! It means a lot to me to know my writing helps.
warmt regards,
Joanna
This is a wonderful summary of the process of recovery. It is indeed a step by step process, and so much of it has to do with awareness and simply being open to try something new. Your description reminds me of what I went through, and today I am so glad that it is over! 13 years of eating disorder were enough! My life is full now — full of activities that give me happiness and satisfaction. Any fears that I had regarding recovery have been dissipated by the rewards and benefits of health. There are still challenges, but now I am better able to handle them. I trust in my ability to cope and live.
The nice thing about recovery is, you can just jump in anywhere, start any time, and no one will judge you. It is an individual journey, which makes it that much more exciting, because each of us is entitled to find her (or his) own special path. It’s not at all about doing something the “right” way. There are many paths that lead to recovery. It really is possible to recover fully, to eat to fulfill my body’s needs, and thus enable myself to pursue my destiny!
Martha
http://www.recoveredbulimic.wordpress.com
p.s. you can substitute “life” with “recovery” and find it’s still true!
Both are an ongoing process.
Martha’s last blog post..More Info on Avoiding a Binge
[...] up my alley. I think I liked it just because of the title, but also found it to be good reading! How to recognize triggers for a binge or purge episode and how to recognize six levels of recovery (… by Joanna Poppink, Psychotherapist (see my [...]
Awesome article, really sums down the steps of recovery.
A lot of people try to recover from binge eating and are disappointed when they fail. It’s not about being perfect, it’s about slow stead progress.
In my recovery I noticed that at first the length of my binge episodes shortened. So instead of binging on foods for a whole day, I would only do it for half a day.
Then I noticed that the frequency of my binging episodes started decreasing. Instead of binging twice a week, I would binge once a week.
Then I noticed that instead of binging for hours at a time, I would only binge on one meal, and then be able to stop myself etc.
I hope this helps everyone who’s looking for a realistic recovery. For more tips on how to stop binge eating, you can check out my site at:
http://howtostopeating.com/blog
Andrew Bolis
Andrew Bolis’s last blog post..3 Secrets to Stop Binge Eating
dear Johanna:
Hi, im Cleo, and ive been suffering for bulimia for the past 7 years. Every single day, 5, 6 times a day usually. You can imagine how my stomach is reacting. Obviously i dont know what feeling healty, means…lately ive been having very strong pain episodes, i dont know where to go to get help. ..yes, you might wonder why i havent done it before. I went with a psyquiatrist for almost a year, i went on medication, but still…it didnt work. It gets a little worse, I live in Venezuela in the city of Caracas, and over here such a thing as a doctor specialized on eating desorders is very difficult to find..nor an institution.
In this case i want to know…is there something i can do?..am i gonna die?…
thanks/
Good for your for seeking help and reaching out. I’m checking with my internationally connected eating disorder professional organization to see if I can get a lead on someone to help you in Caracas.
In the meantime, please look at: http://www.afterthediet.com/.
Your binging and purging has wrecked havoc with your physical health. Perhaps some nutritional guidance can help you get a toehold on regaining some physical equilibrium.
Yes, you need deep psychological work with someone who knows and understands eating disorders. Let’s try to find someone for you. Maybe we can find someone close to home.
If not, are you in a position to travel where help exists? For example, do you have the financial resources and the personal freedom and support to attend an inpatient program in a different country?
My post to you is getting too long. I’m turning it into a blog post. See your name in the header:
Bulimia Emergency Plan for Help When It Seems No Help is Around. Inspired by Cleo.
Right now, please know that some basic care can help you start to get a grip on your health and your ability to think more clearly.
Please move on to the continuation of this message in the blog post.
Good luck and keep writing so we know how you are doing.
warm regards,
Joanna