Coping Skills for Eating Disorders
Disclaimer: this guide is to be used for educational purposes only.
What are coping skills?
One of the most common requests from my clients and their parents is “I need better coping skills!” or “Can you teach my teen better coping skills?”. It’s a very reasonable request and goal for therapy. Let’s start with clarifying what coping skills actually are:
Coping skills are things – sometimes thoughts, sometimes behaviors - that you do to make a feeling, an event, and/or a situation more tolerable and maybe even (but not always) more pleasant. Coping skills may address or fix an issue. Other times the goal of a coping skill is prevent you from making a tricky situation worse or to help a tricky situation feel more tolerable until a solution is possible.
For example, let’s say you’re feeling stressed about an upcoming exam. You’d likely use a couple of coping skills to manage:
Time management coping skills will help you study and prepare for the exam (addressing the issue)
Coping skills that help you tolerate distress may prevent unhelpful procrastination or loss of sleep (avoiding making the situation worse)
Emotion regulation skills will help you stay calm during the exam and while you wait for the results (making it more tolerable)
One of the tricky parts about coping skills is that coping skills may feel vague or intangible. When you learn a new language, you start to build a list of words that you know. A growing list of words you know in the new language can feel satisfying and motivating to continue. When you’re learning coping skills, sometimes it’s hard to list skills in a nice and neat way. We may not have a name for the skill or sometimes we learn something and don’t even realize that it is a coping skill. For this reason, when I’m in session with clients, I often point out when a client is using a skill to make sure my client is:
Recognizing it as an actual coping skill (let’s build that list!)
Giving themselves credit for the skills they have (this builds confidence!)
If you’ve been in session with me, you’ve likely heard my recommendation to make a tangible list or compilation of skills. For example, in the Notes app on your phone, jot down all the coping skills you already have and then add to it as you learn more. Bonus points if you categorize them in a way that makes sense to you, such as “dealing with body image distress”, “dealing with annoying thoughts”, “dealing with hard meals/snacks”, etc. Some of my creative clients draw skills on notecards or popsicle sticks and keep them in cute jars or boxes. If you go this route, it’s helpful to take a picture of each skill to save on your phone so you have them ready to go even when you’re on the go.
Want a fun craft to do? Here is a small wooden tool box that you can decorate and fill with popsicle sticks or notecards to remind you of your coping skills.
What makes a coping skill healthy or unhealthy?
In general, I’m not a fan of labels like “good” “bad” or “healthy” “unhealthy”, especially for feelings, thoughts, or behaviors. And as an eating disorder therapist, you won’t hear me labeling foods or bodies in this way. Coping skills are no exception – I’m not a fan of labeling them. Rather, I prefer to ask clients “Is this really helping you now?”
I believe people are generally doing the best that they can. The coping skills that we use are a reflection of what we’ve learned and mastered so far. Many so-called “unhealthy” coping skills may have worked at one point in time. For example, many of my clients use eating disorder behaviors to cope with really hard feelings or situations. Rather than shame my client for using an eating disorder behavior as an “unhealthy” coping skill, I like to apply a curiosity mindset and explore if that behavior is really helping them now.
Oftentimes, clients realize that coping skills that once worked are no longer working and/or that the consequence of the behavior is too much to actually be helpful to them. For example, a client with purging behaviors may recall that the first time they purged, they felt physical and mental relief from stress but now, the purging behavior is leaving them exhausted, out-of-control, and worried about their health. In therapy, I’d work to help this client lovingly appreciate the behavior for the times when it did work, while firmly acknowledge that it is no longer helpful and it is time to try something different.
Effective coping skills will ease an uncomfortable thought, feeling, or situation/event without causing further harm. Consider the above example: if the client who had been purging to feel relief from stress began journaling honestly about their stresses, might they experience similar relief without the exhaustion that accompanies purging? Or could they take 5 minutes when feeling overwhelmed to flip an affirmation card and listen to a 3 minute meditation? Or lovingly challenged catastrophic thoughts with practiced mantras or a helpful dose of humor? All of these behaviors can be used as coping skills that are likely to provide relief without continuing an unhelpful behavior.
What are coping skills for eating disorders?
I could list out dozens of coping skills but the reality is that few people (maybe even no one?) recover from an eating disorder just by referencing a list of skills. The most effective coping skills are skills that are personalized to your struggles and skills that you’re committed to practicing over and over until they become habitual. Oftentimes, folks need the accountability of a regular session with a trusted therapist to actually practice and master skills. That being said, I’ll describe a few common skills that clients in eating disorder therapy work on:
Name the feeling
Separate yourself from the eating disorder (ED)
Appreciate Dialectics
Have comfy “panic outfit”
Click here for a free guide with more info on these skills!
How do if I know my coping skills are working?
I’ll start with the bad news. Learning a new coping skill is not the same as practicing and integrating a new coping skill. You won’t experience the good stuff – the positive changes – until you practice a skill and incorporate it into your daily life.
Sometimes clients come to therapy and they don’t actually need new coping skills. Rather, they need help figuring out why they aren’t using their skills and they need the accountability to actually practice them. Therapists are really good at both of these!
In general, you’ll know that your coping skills are working when you find yourself turning to unwanted or harmful behaviors less. For many of my clients with eating disorder, they know their skills are working when their urges to use ED behaviors are less frequent and less intense. They are taking actions in alignment with their true/best/highest self as opposed to aligning with their eating disorder’s values and goals.
What if I need more coping skills?
If you need more coping skills, need different coping skills, or need help actually using your skills, this is the perfect thing to explore in therapy. If you live in Michigan and are a teen or an adult struggling with an eating disorder, send me an e-mail at hello@alexishartlmsw.com. I would love to support you!
If you live outside of Michigan, Psychology Today is a great online directory that helps people find therapists in their area.