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Coping skills are helpful in the recovery process. When someone with anorexia nervosa has a comorbid diagnosis of anxiety, often the phrase ‘coping skills’ can seem unhelpful.
While working with your therapist, it is important to remember that how you cope with your symptoms can determine the rate of your progress while in treatment.
Coping can be defined as the “energy we use to manage, minimize, or tolerate both external and internal stressors, which can be real or perceived ’.
Individuals can either cope in positive and healthy ways or negative and unhealthy ways with stress.
When you use unhealthy coping skills, it can increase the stress and anxiety a person feels. Utilizing strong copings skills can help reduce the amount of pressure and problematic behaviors or symptoms related to the anxiety and eating disorder.
Coping Tools Broken Down
One way of coping is through cognitive restructuring, or simply, changing thought patterns. Everyone has negative thinking patterns, such as jumping to conclusions, thinking in black-and-white, or catastrophizing events in our mind.
When a person learns cognitive restructuring, it means that a person has control over their self-talk or thoughts from negative to positive.
For example, if someone is struggling with anxiety while trying to complete their full meal plan for lunch, and they are thinking “I cannot eat all of this food; it is too much” a reframing thought could be, “I know that this is right for my body and it was designed by my dietician and treatment team.”
Reframing includes learning how to break down thoughts into smaller pieces to be able to reframe each one. It takes time and patience to work with oneself to be able to go from unhealthy to healthy thinking.
It is about recognizing these thoughts when they happen. Often people will use a thought log or journal to keep track of harmful thinking patterns.
From there, a person’s therapist can work to challenge those thoughts, and help find a reframing statement to fight the anxious and eating disorder belief patterns.
Another coping tool is distraction. This can be beneficial with healthy coping. If a person has an urge to engage in eating disorder behaviors, or anxiety symptoms, they can use distraction.
There are various means to focus on something positive, rather than the action itself. Distractions can be listening to music, going for a gentle walk (as long as approved by your treatment team), coloring, talking to a friend or loved one about your feelings, or just getting out of your current environment.
Coming up with healthy distractions can aid in your treatment progress and help break the cycle of eating disorders as well as constant anxiety.
Meditation, another coping skill, is a healthy and holistic way of approaching your symptoms. Having a phrase, a guided visualization, or taking a yoga class can help you center your mind and body.
Meditation provides thoughtful reflection and has been known to improve mood, focus, promote creativity, and restore balance .
When recovering from anorexia nervosa and anxiety, it is extremely beneficial to build support systems of those who care for you. Being able to include professionals within that support system is also important.
Both can help with reducing stress and building positive coping tools. Have regularly scheduled therapy or group sessions and being able to reach out to loved ones, builds strength and confidence in the sufferer that they are not alone in the process.
It is often the case that individuals will get stuck in the eating disorder or anxious thoughts, and it is hard to see proper thinking or options. Knowing others are there to help guide you is essential in staying motivated and on the path to recovery.
Therapies That Help With Coping
Dialectical Behavioral Therapy (DBT) is a type of therapy that works on a person’s mindfulness, interpersonal relationships, emotional regulation, and distress tolerance.
It is about learning how to balance conflicting emotions and thoughts at the same time and yet still use healthy coping tools .
In recent studies, 40-50% of those with eating disorders have depression, and 30-40% have anxiety . With these trends within the eating disorder population, useful therapies that focus on reducing anxiety and eating disorder symptoms can aid in the recovery process.
DBT can help a person to develop more adaptive ways to identify and regulate emotions, to understand and reframe behaviors and be educated and practice skills training.
Cognitive Behavioral Therapy (CBT) is another type of therapy that focuses on the thoughts, feelings, and behaviors of a person’s symptoms.
It is used to help the person understand where the thoughts are driven from, and how it connects to a person’s sense of emotion and reaction to situations whether internal or external.
According to Matthew Brown, DO, a psychiatrist at Rogers Behavioral Health in Chicago, states that ‘eating disorders can develop from fears around food or behaviors.
It can stem from thoughts of thinking a person is too fat, to anxiety around the fact that they are not ‘perfect’ and therefore not worthy of love ’.
In conclusion, eating disorders and anxiety is often a comorbid diagnosis. With healthy coping skills, positive support system, and treatment team can help you reduce your symptoms and gain life-long coping skills.
About the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.
Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.
 5 Skills (and Real – Life Examples) to Replace Maladaptive Coping Behaviors. (n.d.). Retrieved August 13, 2017, from https://www.waldeneatingdisorders.com/5-skills-and-real-life-examples-to-replace-maladaptive-coping-behaviors/
 Company, I. G. (n.d.). Retrieved August 13, 2017, from http://www.socialworktoday.com/archive/111113p22.shtml
 Rogers. (n.d.). Retrieved August 13, 2017, from https://rogersbh.org/about-us/Newsroom/Blog/comorbid-anxiety-and-eating-disorders-addressing-complexity
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published on November 8, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on November 8, 2017.
Published on EatingDisorderHope.com