upmc: relapse prevention plan

[prismaticbleed]

(from two consolidated worksheets)


TIMES OF HIGH RISK

- Being at family house/ dad's house
- Thanksgiving
- Church dinners
- Eating next to/ across from people
- Exposure to noise/ commotion; "no escape"
- Eating when scared or triggered
- Restaurants of ANY kind
- Mental overwhelm/ emptiness
- Hearing radio music
- Trauma flashback days
- Food drives
- Eating with people in general
- When feeling anxious/ scared/ lost
- When angry/ self-abusive urges hit
- Shopping without a list


WARNING SIGNS & COMBATING THEM

1. Buying unusual foods to "force them" (binge/ purge trigger)
CHALLENGE: Food is NOT A SELF-ABUSIVE EXPERIMENT. "Knowing" data for ALL food is UNNECESSARY.
PLAN: Shop according to LIST. Stick to SIMPLE foods. Avoid novelty stores/ sections!

2. Feeling "dirty" or "unclean" (purge trigger)
CHALLENGE: Eating while FEELING sick/ gross DOES NOT turn food into "dirt." It is still nourishment.
PLAN: Take a break to clean up a bit; change clothes, wash face; scrub at skin? Exercise?

3. Mania; "I can eat anything" (binge trigger)
CHALLENGE: "NOT EVERYTHING IS EDIFYING." This is treating food as "ACHIEVEMENT" & "RISK TAKING," not AS FOOD!
PLAN: AVOID novelty/ impulse buys // NEVER shop when manic // CALM THE HECK DOWN

4. Hyperfasting for church (restriction trigger)
CHALLENGE: God ALSO made the BODY, and HE lived in one too! So take care of yours. GOD INVENTED FOOD!
PLAN: Eat something TINY right after Mass? Cap fasts at 12 hours maximum? Talk to a priest about it

5. "Hypersocializing"; "people-pleasing"; chatting (binge triggers)
CHALLENGE: Burning myself out/ ignoring my OWN quiet predisposition triggers dissociation & bingeing to "cope"
PLAN: Take time out to breathe & recenter when in public; limit exposure to crowds & noise

6. Feeling hollow, self-loathing, hopeless (restriction OR binge trigger)
CHALLENGE: "This too shall pass"; God loves you & made you WITH worth & purpose, and He WILL help you. HE is your eternal hope!
Expose self to IMMEDIATE positive non-food things, like a game/ movie/ book/ music? READ hopeful reminders

7. Going all day without eating; may not HAVE food (restriction trigger)
CHALLENGE: TRUE fasting DOESN'T reject eating altogether!! Emptying your house of food WON'T make you "safe!" Plan ahead for busy days & travel!
PLAN: PACK tiny snacks on road. Don't feel "obligated" to eat big meals. ALWAYS keep some nonperishables in house/ bag/ car!

8. "I don't need to eat; I feel fine/ happy" "Eating is exhausting" (Restriction trigger)
CHALLENGE: NOT eating WILL quickly MAKE you feel SICK/ SAD/ CONFUSED/ ANGRY. Your body NEEDS food to FUEL your creative thoughts!!
PLAN: PRE-PREP clean, TINY bits of food to nibble on while working WITHOUT it feeling like a "meal" and breaking mental context!!


DEALING WITH SETBACKS

Lapse behavior = OVEREATING
What led to it = "Compulsive" big portions, "must eat ALL of it"; emotion smothering/ numbing/ outlet
What can I do differently next time = Learn to LEAVE LEFTOVERS; it's OK for things to "not be finished NOW"! Get SMALL plates & bowls! Calm yourself/ express stress BEFORE prep, eating, OR shopping!!
How do I get back on track after = TAKE PREVENTATIVE ACTION!! Wear a mask in the kitchen; prep small MEASURED amounts; ONLY eat at the dinner table; DON'T PUSH FOOD IF YOU'RE FULL-- WAIT!!


Lapse behavior = PURGING
What led to it = Eating "too much," "in the wrong order," "bad/ evil food," "poison," or "with trauma"
What can I do differently next time = Food isn't evil or bad. You CAN'T "eat trauma." There is no objectively "right order" to eat foods-- be wise with prep, but don't panic-- you WON'T DIE. If you get indigestion, CARRY THAT CROSS & try different next time!
How do I get back on track after = Clean up, REHYDRATE, and then EAT A SMALL HEALTHY SNACK to stabilize your glucose. Get some sleep; try again. ♥


Lapse behavior = HYPERFASTING
What led to it = Feeling "dirty"/ "sinful" from fullness and/or food weight
What can I do differently next time = KAVOD? Think: "FULL of Grace"! God WANTS you to eat, too! Fasting is ONLY proper IN TANDEM with FEASTING-- God lovingly mandates BOTH in Scripture! Keep your SOUL pure BY CONFESSION. Rest in God.
How do I get back on track after = SLOWLY refuel. Pace several nibbles over a few hours; GET ENOUGH CALORIES but DO NOT make a "full meal" or bowl/ plate!!


Lapse behavior = CALORIE RESTRICTION
What led to it = Terror of "getting fat" / "becoming gluttonous (again)"
What can I do differently next time = Calories are ENERGY, not "heaviness"! Reduce volume if needed, have more little meals, use little plates/ bowls & DON'T OVERPREP. Always pray for temperance. KEEP HOLY REMINDERS in dining area!
How do I get back on track after = GENTLY increase calories with LOW VOLUME options. Exercise, but temperately! Remember, your body's BMR is ESSENTIAL!!


Lapse behavior = FASTING 12-24 HOURS
What led to it = Hyperreligious. Want to escape body; tired of physicality
What can I do differently next time = List & review POSITIVE Scripture verses about food & eating; there are many! Eat REGULAR meals, EVEN a modified "tiny & often" schedule?
How do I get back on track after = EAT SOMETHING SMALL & CONTROLLED. Bring a snack to church for afterwards? Have TINY, SAFE snacks ready to eat!


Lapse behavior = "FORCING FEAR FOOD" BINGE
What led to it = "Challenge/ appease" addiction; "prove I can survive"?
What can I do differently next time = Only try ONE fear food at a time, & NOT THE WHOLE THING AT ONCE to "eliminate it." Stop trying to impress/ appease people with FOOD!
How do I get back on track after = EAT FEAR FOODS IN COMPANY?? DON'T KEEP IN HOUSE!! Get comfortable with NOT KNOWING (fear of helplessness)!!


Lapse behavior = RAGE/ FEAR PURGE
What led to it = Feeling DIRTY, triggered, poisoned, VIOLATED, WRONG
What can I do differently next time = If possible, DON'T EAT IF TRIGGERED! STAY AWAY FROM FOOD WHEN UPSET. Use DBT/ CBT skills ASAP. Positively DISTRACT SELF!
How do I get back on track after = CALM DOWN, get somewhere safe, then eat something SMALL, CLEAN, & LIGHT? Keep practicing coping skills/ tools.


Lapse behavior = DISSOCIATIVE "NUMB" BINGE
What led to it = Trauma overwhelm; trying to bury emotions & "smother" reality
What can I do differently next time = Ride out the dissociation SAFELY; put on Spotify; sit with eyes closed? GROUNDING! Document/ record ALL steps of meals to STAY PRESENT
How do I get back on track after = Rest & pull yourself together. Have SET MEALS for when you can't think straight. STAY OUT OF THE KITCHEN until then!