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For most people, the fall and
winter holidays bring happiness, warmth and excitement.
Traditionally, they are a time when families get together to
reconnect and celebrate. For
many individuals with eating disorders this is far from the case.
Holidays bring up a myriad of
issues for many people that we work with at CEDAR Associates.
The most obvious being Thanksgiving, as it is a holiday that
revolves around food. Common
food concerns are what to eat, how much is appropriate, and just the act
of eating in public, as many of our patients have isolated themselves. Additionally,
for many people with eating disorders, there are conflictual and
difficult issues within their families such as disconnect, enmeshment,
alexithymia, past/present abuse, substance abuse, or mental illness.
Thus, it is at this time of year that we often see the
anticipatory anxiety of these holidays greatly increase.
So, as direct or peripheral
treatment providers, what can we do? There are several dynamic,
cognitive and behavioral interventions that can alleviate a great deal
of this stress and empower our patients to move through the season
successfully. The following
are a few of these interventions, selected to apply to a broader array
of practitioners, rather than just for psychotherapists.
1.
Have the person find out beforehand the logistical information
about the holiday (i.e. where it will be celebrated, who will attend,
what’s being served etc.). This
allows the patient to begin to develop strategies to cope with various
outcomes. If it is
appropriate, encourage the person to have some input about these issues.
2.
If a dietitian is involved, this is a great time to help the
patient structure various meal possibilities so that s/he feels ready to
face some of the specific difficulties of the holiday.
3.
Enlist any supportive family members or friends to be part of the
coping plan, particularly if they will be at the holiday function.
If the patient feels there is no one there who will be
supportive, help him or her come up with a person or two that they can
call, text etc. in the event that they are struggling.
4.
Remind them that, in general, they inflate how much other people
notice their idiosyncrasies (especially in terms of how
they eat), and encourage them to keep the focus on what they need to do,
not what others may or may not be thinking
of them.
5.
If the person is receptive, help them create a new connection
with the holiday that is positive and meaningful. For example, I worked
with a patient who had a tremendous amount of fear about Thanksgiving
and did not have any conscious positive associations.
As part of “reclaiming” the holiday, she decided to bring her
nephew to the Macy’s parade and has continued this
positive tradition annually.
If there is other information
that we can provide about coping with the holiday season, please call at
Scarsdale (914) 472-4019, Mt. Kisco (914) 244-1904 or Nyack (845) 348-7660 |