Keeping a Lapse From Turning Into a Relapse

By: Rowan Hunt, second year PhD student

“Be gentle with your healing
start over as many times as you need to” - alex elle

It sounds like a cliche, but it’s true: recovery is a journey. You don’t wake up one day, fully recovered. Instead, it can often take days (weeks, months, years) of hard work to overcome an eating disorder. Perhaps that’s why a relapse can seem especially demoralizing.

We don’t know exactly why people relapse from their eating disorders. Some research suggests that signs of relapse can be seen at the end of treatment -- if an individual discharges from a higher level of care with a high level of residual eating disorder symptoms, they may be at increased risk for relapsing (McFarlane et al., 2012). Other research has suggested that stressful work and social life events are significant predictors of relapse (Grilo et al., 2012). Realistically, why people relapse is probably an individual answer. Regardless of why people relapse, we know that relapses often happen slowly. It can begin with a skipped meal here or there, shaving a few calories off of your meal plan, or exercising a little longer than you should. Sometimes, these eating disorder behaviors can just be a blip -- a momentary slip-up. The eating disorder is sneaky, though, and other times these behaviors can accumulate until you’re right back into the eating disorder. These processes describe the difference between a lapse and a relapse.
 The dictionary offers the following definitions of lapse and relapse:

• A lapse as a temporary failure of concentration, memory, or judgment.
• A  relapse, on the other hand, is defined as a recurrence of symptoms of a disease after a period of improvement.

Although there’s only a two-letter difference between relapse and lapse, they are very different. A relapse means diving back into the dark hole of the eating disorder. A lapse means slipping, falling, and getting back up. 

First, an eating disorder is not your fault. Relapses are incredibly common; research suggests that over a third of those with an eating disorder will relapse (Keel et al., 2005). Even though relapses are common, they don’t have to happen. There are things that you can do to avoid letting a lapse turn into a full relapse. Below are a few tips to help you gain power over the eating disorder again before things get out of control:

1. Acknowledge that it happened. It can be very tempting to just ignore that a lapse has happened. You might think to yourself, “what’s the big deal about missing one or two meals?” It’s important that you fight that urge for denial. Ignoring that you’ve lapsed limits your ability to do anything about the lapse, which greatly increases your risk for a full relapse. It’s only after you’ve acknowledged that you’ve had a lapse that can you begin to do something about it.
2. Avoid shame and blame. Often when bad things happen, we want to have someone to blame, and because we know that individuals with eating disorders can be highly self-critical (Dunkley & Grilo, 2013), it makes sense that you might want to blame yourself. We know, however, that approaching yourself with compassion during this time is paramount. Shame and self-criticism are often associated with more severe eating disorder symptomatology (Kelly & Carter, 2013). While criticizing yourself might feel like “taking responsibility”, there’s evidence to suggest that it might just make things worse. Think of how you might treat a close friend who has lapsed on their eating disorder: would you judge them or would you understand and help them through this difficult time?
3. Get support. Reach out to your therapist, a friend, a family member -- anyone that you trust. Even though it can be scary to admit to others that you’ve had a lapse, you can’t do this alone! Letting others know what is happening can help to increase accountability and give you people to lean on during this difficult time. It is better to admit that its happened than to avoid sharing because of shame or guilt.
4. Think of this as a learning opportunity. A lapse or relapse can be an important time to learn about your vulnerability factors. Taking the time to reflect on what contributed to this lapse can help you to do something different in the future. In asking yourself what contributed to this lapse, you can gain insight into your triggers and plan effectively for them in the future.
5. Remind yourself of why you recovered in the first place. Lapsing can make you feel like you’ve failed or increase feelings of hopelessness. Instead, you can use the lapse as a time to recommit to recovery and explore why you recovered in the first place. Recovery is worth it. You’ve done this once and you can do it again.

​The sooner you act on your lapse, the easier you’ll be able to climb out of the hole. Remember -- recovery is not a race. You just need to take things one step at a time.