Creating a Relapse Prevention Plan

Relapse is normal Whether you are in recovery for an eating disorder, addiction, self-harm, or some other maladaptive behavior, you have probably heard these words from either treatment providers, loved ones, the general public, or online.

Relapse happens to everyone at some point, so it is nothing to be ashamed of and it does not mean that you are a “failure” at recovery or that full recovery isn’t possible.

However, in my opinion it is dangerous to embrace this mindset to the point where relapse seems like it’s not really a big deal, because that may make you less likely to remain vigilant about avoiding relapse. I once heard someone compare relapse to tripping and falling down, saying something along the lines of:

“Everyone trips. But that doesn’t mean you shouldn’t try to avoid falling or that you should fall on purpose, because that is just painful and un-neccesary. Relapse is similar.”

I have been in recovery from Anorexia and restrictive EDNOS for two years, and in that time I have had one major relapse and several slip-ups that I managed to stop from becoming full-blown relapses.

The difference between my relapse and my slip-ups were that during my relapse I had not adequately prepared myself for difficulties in the future.

I did not know what struggles to anticipate, so when ED temptations came along I had no idea how to combat them. However, after my relapse, I was instructed in treatment to create a Relapse Prevention Plan, which is a detailed plan of how to avoid relapse in the future. I think a major reason why my slip-ups didn’t become relapses was because I had a plan in place.

There are many Relapse Prevention templates online that you can use to create your own plan.

Here I will fill in a bit of my own Relapse Prevention Plan as an example of what a Relapse Prevention Plan can look like:

Sample Eating Disorder Relapse Prevention Plan

1) Create a list of situations and emotions that may cause you to have a relapse (aka your triggers).

1- Loss- whether through death or losing contact with a loved one.
2- School Stress
3- Dealing with underlying issues in treatment.
4-  Feelings of failure, loneliness, anxiety, depression, shame.
5- Interpersonal problems (with friends or family)
6- Social Anxiety
7- Being around people actively engaging in ED behaviors.
8- Weight gain/body changes.

2) Take each trigger and write a healthier way of coping with it.

1) Journal, listen to music, talk to a friend, let myself cry, self-care (like getting a manicure)
2) Plan breaks from schoolwork that are solely for fun and relaxation. Talk to an academic advisor if need encouragement or study strategies.
3) Find little ways to reward yourself for getting to the root of your issues. Remind yourself that the discomfort will pass. Talk to treatment team about anxiety.
4) See #1; also go on mindful walk, re-frame from negative thoughts, watch favorite TV shows, talk to treatment team about feelings.
5) Talk to the person you’re upset with calmly and rationally, try to work it through. If it can’t be solved, spend time with other friends.
6) Deep breathing, positive affirmations, re-frame negative thoughts.
7)  Remove yourself from the situation with people engaging in ED; cut ties with negative influences in your recovery. Remind yourself that just because they are struggling doesn’t mean you have to be struggling, too.
8) Positive body affirmations, write a letter to your body, wear clothes that fit, reward yourself with a new outfit that fits more comfortably.

3) List negative dialogue you use on yourself or hear from others. Then, challenge those statements and replace them with positive statements. Look at the positive statements when you are overwhelmed with negative thoughts.

One example:

Negative Thought– “What I’ve gone through in my life has broken me. I’ll never recover.” Positive Thought– “I have gone through so much and I’m still standing strong. I’m a successful student, a loving daughter, and a caring friend. I have such a bright future ahead of me and every day I get closer to it. I am not broken. What I’ve been through has only made me so much stronger, and I continue to grow each day. Never give up on yourself. This thought is irrational and it will pass.”

4) Make a list of people you can call if you need support in preventing a relapse, whether it is to vent, get advice, or take your mind off of a trigger.

Some people on my list: My whole treatment team minus my primary care physician, my mom, my dad, friends from treatment, and my closest friends that I trust and that know what I need when I’m struggling with my eating disorder.

The best part of a Relapse Prevention Plan is that it gives you insight into your negative behaviours that you may not have had before, and that makes all the difference. When my eating disorder was a part of my life that I wasn’t trying to fight and that I didn’t even believe was a problem, I wouldn’t have made the connection between my social anxiety and restrictive eating for example. Now that I am aware of that trigger, if I go to a large social gathering where I don’t know people, I can go into that situation anticipating that I may have urges to restrict and plan accordingly with positive affirmations and a very detailed plan of what, where, and how I will eat during, before, or after the social event. That way, I can stop my ED right in its tracks!

Remember, it is nothing to be ashamed of if you do everything above and relapse anyway.

 After a relapse, try to think about what your triggers were and the emotions that preceded your relapse. Then, come up with some new strategies that could help the next time you’re in a similar emotional state.

Most importantly, never give up on yourself.

You’re worth recovery and you can do it!