The really good news is that those in treatment for an eating disorder eventually reach that day where they walk in and say that they feel as though their eating disorder is only a small part of his/her life. These are the wonderful days as an eating disorder therapist!
But, what is one to do when that day has been reached. Some look at me and think they no longer are allowed to come see me because I "treat eating disorders." But, no, treating eating disorders is, in the end, just like treating any other issue. It is really about what was underlying the eating disorder all along.
So, do you just stop talking about the eating disorder altogether? Now what?! I think there are a couple questions that can be really helpful to address:
1. At the beginning, it is the most useless question, as almost nobody can answer it; however, by the end, I like to have patients explain to me what their eating disorder was about. This allows them to develop a cohesive understanding of how the ED "helped them" and sets the stage for #2.
2. Given this understanding, what situations in the future are most likely to set you up to relapse?, and
3. What are the "red flags," or early warning signs, that the ED is returning?
Answering these questions can help create a sense of control and power if and when the ED starts to creep back into one's life, and as I tell all my patients, once the ED is understood, it loses a lot of power. It's hard to know EXACTLY what is going on and still do it again; not impossible, but harder. It makes the behavior less effective, which decreases the chances of returning to it. Everyone will face stressors again in life, and the ED will always be a choice. But in my experience, many patients will have developed new coping skills, and whereas they will think ED thoughts again, they do not engage in the behaviors. Or if they do, they catch it early, and choose differently.
There's a lot more hope about recovery from an eating disorder than many seem to think. And it is amazing to see it happen.