Category Archives: Coping skills

Because you can’t talk about mental health without using the term “coping skill” …

Get dressed in the dark

First, in case you don’t know what “body checking” is, there’s a great description at Eating Disorder Hope:

The truth is, everyone checks their body on occasion; perhaps it’s taking note of how clothes fit or grabbing a quick peek at the reflection in a store window. However, those with eating disorders repeatedly check their bodies in ways that are unusual. In fact, for these people, body and weight checking becomes second nature. Often individuals with eating disorders don’t even realize they’re doing it. Typically, they check to feel for fatness, bones and any physical change in their body. And the problem is, this checking rarely results in anything positive. These are not people who glance in the mirror and think, “I really look good today.” On the contrary, due to low self-esteem and negative body issues, they will undoubtedly say to themselves, “I am fat,” or “This sweater makes me look huge.”

For me (and a lot of other girls that I know), a kind of body checking that I do is to try on clothing over and over (and over and over) again…. every morning. Seriously, getting dressed in the morning can take an hour — just to choose clothing! Nothing seems to fit right, or look right, or coordinate how I want it to, etc etc. It’s frustrating.

Something that I have “challenged” myself to in the past is choosing my clothing the night before. This works pretty well for me — get up, put on said clothing, and move on with my life.

There are several advantages to this:

Sleeping in an additional 45 minutes (yes, 45!).
Not tearing my closet apart (saves me 20 minutes in the afternoon, putting it back together).
Not driving my dogs crazy as they sit there patiently, begging to go outside to go to the bathroom.
Maybe slightly better body image… just because I can’t try on every pair of jeans and decide that two of them are soooooo much tighter than they were yesterday (and I know this for sure, since I a) tried on every pair of jeans yesterday and b) am so objective).

As with everything, there are disadvantages:

Previously unaccounted-for changes in weather (don’t even get me started on the inaccuracy of weather forecasting…).
Having to be organized / motivated the previous night (often unlikely).
The risk of still trying everything in my closet on… just doing it at night, rather than in the morning (fortunately, I’m usually tired at night and don’t care as much).
Hating what I picked out.
Making poor clothing decisions the previous night (“wait, did I really just pair khaki pants with boots?”)
Feeling uncomfortable in my clothing (and therefore skin) all day

Anyway, I have now come up with a new level to this challenge — getting dressed in the DARK.

My husband and I are staying at my parents’ house for the holidays, and I get up hours before him (thanks to having a puppy who is soooooo excited to see everyone at 7am). I’m an over-packer, so my suitcase is really heavy and awkward, and there is no way I am dragging it across the hall to the bathroom to go through every item of clothing and choose my outfit. So, I’ve been getting dressed in the dark…. which has proved to be… interesting. Luckily mismatched socks are in right now, huh? As frustrating as this is every morning, it has saved me from re-re-re-re-re-revaluating what to wear.

Way to find the silver lining in an inconvenient situation… right?

Eating disorder benefits

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Today officially marks the start of National Eating Disorders Awareness Week. I’m glad that there IS a week dedicated to eating disorder awareness, although I confess that I’ve never been much of a participant.

There’s lots of great stuff out there this week, and this afternoon I stumbled upon a blog post over at BlogHer: The benefits of staying in my insanity

It may be hard to believe, but eating disorders serve a purpose for someone struggling with one.

Like what?

Control – while I hate the “I developed an eating disorder because it was the one thing I could control in my life” statement, it’s not not completely wrong. There is definitely something to be said about the role of control in EDs. Of course, you are NOT in control when you’re suffering… but sometimes it sure feels like it.

Distraction — this was big for me. I would make a list of all the things I DON’T want to think about, but it could go on forever. Work stress, relationship problems, and money, just to name a few. Oh, and then there are all the negative emotions that I want to avoid: loneliness, hurt, fear, etc. I’m all about avoidance — I don’t even want to think about uncomfortable things. So instead, it’s “I’m not hurt that my mom didn’t visit… I would have to eat a big dinner with her, anyway.” Or “My weight was down today! Down! Oh, that work project that I am afraid I screwed up? Whatever, at least my weight is down.” Maybe those aren’t the best examples, but my therapist would ask me “What were you avoiding this week?” whenever I had a bad ED behavior week.
Care / Concern – when you get sick, people around you are suddenly concerned. Somehow you make the connection that “I need to be sick to be cared about.” There sure seems to be a linear relationship there sometimes. I also have friends who said the eating disorder made them feel “special.”
Safety – this one is hard for me to explain, but there’s something that feels “safe” about the eating disorder. You are essentially simplifying your life by creating a world that revolves around food and weight. There’s this fear that you alone are not enough, or you’re a disappointment, or that everyone around you handles life so much better than you do. I remember telling my therapist in college that “I have to hold onto the eating disorder, just in case I suck at life.” The eating disorder felt like a safety net.
Self-Punishment – I think the ED can be a type of self-harm… a way to hurt yourself for “screwing up.” Unless you have a history of self-injury, this probably sounds like something negative that the ED would provide.

I think it’s safe to say that the eating disorder is a coping mechanism. Maladaptive, sure, but it does serve a purpose in your life. There’s a reason that people hold onto it and end up in treatment multiple times. However, the eating disorder is not a solution. It doesn’t make you in control, the problems you are ignoring don’t just disappear, friends/family get worn out from years of being concerned, you feel like you are missing out on your life because you’re so stuck in your safe (and really really boring) ED world, and you don’t need to be punishing yourself.

I’d argue with the original writer that “there are no benefits.” Maybe there are no long-term benefits… but in the moment, the eating disorder does something for you.

Note: I am by no means suggesting that eating disorders are okay… just that the process of recovery isn’t so black-and-white.

Avoidance: Not always a bad thing

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ostrich-head-In-Sand I was reading some new research out of UNC Chapel Hill: “Differences in Coping Across Stages of Recovery from Eating Disorder.” I’ve been on a coping skills streak for awhile now (hence my series on coping skills), so I was excited to see the study.

The introduction contains the best definition for “coping” that I’ve seen to date:

Coping refers to the thoughts and behaviors that people engage in so as to manage, tolerate, or reduce internal or external demands that are appraised as exceeding an individual’s resources and is typically thought of as a factor that mediates the relation between stress and the onset of psychiatrist illness. Coping is often depicted as a multi-dimensional construct, including task-, emotion-, and avoidance-oriented skills.

The whole article is definitely worth the read (and you can download the whole text for free), but there were two things in particular that I found interesting:

The healthy controls had the highest level of avoidance-oriented coping skills
Partially-recovered individuals were closer to those with active eating disorders, while fully-recovered individuals coped more similarly to the healthy controls.

The avoidance finding was a pleasant surprise (for me). I’ve always believed that avoidance is a healthy coping skill to some extent… but have had therapists who insist that it is maladaptive. The article makes a good point about this:

[Avoidant] strategies can be effective in the short-term for reducing pain, stress, or anxiety, and can include some adaptive strategies (e.g., spending time with a special person or going for a walk…)

The second finding about partially-recovered vs. fully-recovered was also validating to see. The only distinguishing criteria between fully and partially-recovered individuals was the presence of psychological recovery. I think that sometimes in treatment, individuals can be deemed “recovered” even when they are still struggling with a lot of the old, destructive thoughts. Personally, I have found this partially-recovered stage to possibly be the toughest. You’re not using your eating disorder to cope and you don’t have the level of care and/or support as you did at the height of your disorder, but you’re still struggling psychologically.

There are lots of other great points made in the article, so I highly suggest that you take a look!

Alternative coping – a tough sell

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I thought that these quotes would be especially appropriate after my series on coping skills.

Dr. Meredith Grey: In the hospital, we see addiction every day. It’s shocking, how many kinds of addiction exist. It would be too easy if it was just drugs and booze and cigarettes. I think the hardest part of kicking a habit is wanting to kick it. I mean, we get addicted for a reason, right? Often, too often, things that start out as just a normal part of your life at some point cross the line to obsessive, compulsive, out of control. It’s the high we’re chasing, the high that makes everything else fade away.

Dr. Meredith Grey: The thing about addiction is, it never ends well. Because eventually, whatever it is that was getting us high, stops feeling good, and starts to hurt. Still, they say you don’t kick the habit until you hit rock bottom. But how do you know when you are there? Because no matter how badly a thing is hurting us, sometimes, letting it go hurts even worse.

I’ve talked about this before, but I think that wanting to want to recover is a big roadblock in eating disorder treatment. Meredith explains it very well — we get addicted for a reason. The ED plays a role in our lives. You don’t go seeking an eating disorder… but for whatever reason (I’m sure largely biological), coping via food / exercise works for you. Restricting did give me some kind of a high, but more importantly it did make “everything else fade away.” Of course it didn’t SOLVE any issues… but it did somehow mask them and make them less important to me.

The eating disorder doesn’t “work” for me like it used to. It doesn’t give me that relief that I’m looking for. It doesn’t make stressors go away. 10 years ago, I felt some kind of sick accomplishment from restricting. Like somehow not eating made everything better. These days, maybe it deadens things a little bit, but largely it throws off my blood sugar and makes me feel like crap.

I’ll admit that for whatever reason, in many situations it’s still my first instinct to use the ED to cope. All the coping mechanisms I mentioned are attempts to replace the disorderedness with something healthier. But really, it takes three “healthy” coping mechanisms to offset one unhealthy one. The kudos chart is an everyday thing and a bad day might require coloring AND card shops.

I think a lot of people struggle with feeling like they still need their ED. Even if it is kinda ruining their lives and not working like it did in the past, they still feel like they won’t be able to deal without it. If you’re trying to replace that disorderedness with bubble baths and crafts — well, that’s a tough sell.

I’m not saying it’s not worth it or that EDs are just unhealthy coping skills… I’m just saying that recovery takes a lot of coping skills. You burn some of them out (for instance, reading does not help me like it used to) and have to be creative and come up with new ones. And sometimes they feel ridiculous. Heck, I’m in my mid-20s and googling “print complicated coloring pages.” My kudos chart is remarkably similar to the sticker chore chart that I had when I was seven. I’m not sure any of this is “normal,” but hey, it helps. Ridiculous or not — just go with it.

Underrated coping skill: DVDs

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This is the sixth post in the Grey Thinking series, Five of the most underrated coping skills.

versus-house-md-vs-greys-anatomy

This isn’t going to come as any surprise to those of you who have followed Grey Thinking for any length of time…. but watching DVDs of TV series is one of my favorite “coping skills.” I may be stretching the idea of a “coping skill” a little bit here, but anything to justify my House marathons…

I like to watch four hours of old Grey’s Anatomy episodes (especially during evenings that I’m depressed) because I can check out. I can focus on Meredith’s dark and twisty issues and secretly hope that Meredith and Derek get back together (clearly I’m in the middle of season three right now). And it’s not that House’s misery or Meredith’s really screwed up love life makes me feel better about my own or anything. I just like relationships. And sarcasm.

Checking out like this is probably not THE healthiest coping mechanism – but it’s much better than the eating disorder. Sometimes I am overwhelmed and I need to check out. It’s hard for me to turn off my brain, in a sense. My mind can wander while I read a book, exercise, walk the dog, clean, etc. For some reason though, my mind doesn’t wander when I’m watching House. Things seem so still and the chaos of my life is put on hold.

I say “DVDs” rather than House / Grey’s Anatomy because I have friends who use movies to cope. Personally, I get really impatient with movies and spend a lot of time thinking “is it over yet?” They’re more frustrating to me than soothing… but to each her/his own.

photo credit: holamun2

Underrated coping skill: crafting

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This is the fifth post in the Grey Thinking series, Five of the most underrated coping skills.

I’m not sure that “crafting” really encompasses the coping skill that I want to mention, but it’s the best term that I could come up with. When I say “crafting,” I mean any of the following:

coloring
making collages
sudoku /crossword puzzles
word searches
computer solitaire
kitting
drawing / painting
origami

…see my point? Semi-creative (and low-stress) activities that keep your hands busy. I don’t know what it is about keeping my hands busy, but it really helps with the anxiety.

Personally, I prefer coloring & sudoku… mainly because they don’t really require any thought. I can stress out about drawing because I don’t know where to start or I am worried about screwing it up. With coloring… it’s way harder to screw up and limited decisions have to be made. I know people who really get a lot more out of art than just being distracted and it can really be therapeutic for them. I have days like that, but usually I’m just looking for a good, basically mindless activity.

Underrated coping skill: kudos charts

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This is the fourth post in the Grey Thinking series, Five of the most underrated coping skills.

If you don’t know what a “kudos chart is” – it’s a sticker chart. You know those charts that your mom made when you were five that had actions like “make bed” and “brush teeth” on it? Yep, those. I heard someone refer to them as “kudos charts” on twitter several months back, and since my current chart is not actually using stickers, I’m going to go with that terminology.

My explanation is simple: a kudos chart worked for me when I was five, and twenty years later it is still a helpful tool.

What kind of things do I have on my kudos chart?

Follow meal plan
Take calcium supplement
Get 7+ hours of sleep
Go through the mail
Blog

That’s not all, but you get the picture – it’s a mixture of eating disorder goals and regular life tasks. I never have more than 7 goals, for three main reasons:

then I’m not really focusing on the important tasks
it gets cumbersome to remember and record too many things
only seven fit on my chart

Not only do I get satisfaction of checking off items each day, but at the end of the day / week I add up all my “kudos” for my “kudos score.” It’s a quick and satisfying way to motivate myself… and I think that other people could definitely benefit from such a tool.

Underrated coping skill: bulletin boards

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This is the third post in the Grey Thinking series, Five of the most underrated coping skills.

Out of sight, out of mind.

This idiom definitely proves true for me. I get so wrapped up in everything going on in life that I forget about all these health / self-care / positive affirmations / you name it that I’m trying to convince myself of.

I wrote about this in a previous post, I’m going to need that in writing, but it’s definitely worth mentioning again. I have a bulletin board above my desk with little things on it – quotes, pictures, etc. – that mean something to me. For example, there’s a fortune cookie fortune that says, “Remember there are people who care deeply about you.” There’s also a copy of my meal plan and clips from meaningful emails. Granted… there are also pictures of my dog, a yearly calendar, and sometimes a to-do list… but my point is, I put stuff up there that I need to remember. And it helps, a lot.

I know that in treatment and recovery, I need to hear the a lot of the same things over and over. Seeing some of these concepts concretely and being reminded of them regularly has proven to be very helpful.

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photo credit: kitchenknife

Underrated coping skill: card stores

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This is the second post in the Grey Thinking series, Five of the most underrated coping skills.

I don’t know why more people don’t hang out in card stores. Just think about it… when you have a friend that’s upset, it’s not uncommon to send them some kind of “cheer up / feel better” card. So, if you’re upset… doesn’t it just make sense to spend an hour in a card shop and read 100 of those?

I know that there is more to getting cards than the card itself (say… the thought behind it), but funny cards make people feel better. I scan the aisles at Barnes & Noble nearly weekly for new stickmen cards and can’t help but laugh at Hoops & Yoyo. Card stores are just a win-win for everyone.

Five of the most underrated coping skills

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…according to Grey Thinking, at least. I’ve seen so many coping skills lists full of bubble baths, deep breathing, positive affirmations, etc, and really am just bored with them. Someone needs to come up with some creative and new alternative coping mechanisms! I might as well start. Here’s a list of some of my favorite / most-helpful coping skills, that I’ve never seen (or very rarely seen) on any “learning to cope” list.

Five of the most underrated coping skills:

card stores
bulletin boards
kudos charts
crafting
dvds

I have a lot to say about each one of these, so I’m going to break them up into different posts. However, I’d love to hear you feedback and any alternative or underrated coping skills that you might use.