Aftercare: The missing link

January 25th, 2013

“Congratulations. Welcome home!”

…You just graduated from treatment. Now what?

I’m a pretty quick learner, but for some reason recovery has been a drawn out reminder that there is an exception to every rule. I have definitely been an outlier on this journey. Treatment and I have had a long-lasting love-hate relationship over the years. I wish I could say I succeeded with a one shot deal, but it took quite a few takes before I ever hit the ground running.

While I often entered treatment kicking and screaming convinced it would not do any good in the long-run, ironically, I usually grew fond of the safety of being protected from my eating disorder by the time I was “ready” for discharge. Nutrition and nurturance can do that to you. As you feed your brain and begin to heal your body, you switch from an edgy and reactive survival mode to a more rational, calm head space.

I am a woman of independence. I don’t like to be controlled. Tell me what I cannot do and I suddenly want to do it! In treatment, you do not pick and choose when to eat, when to get groceries, when to sleep, when to go out, and so forth. And, there is a very good reason for this. You go to treatment when you realize “your way” is not working. Therefore, these decisions and activities of daily living are programmed for you in an assigned, balanced schedule.

While I certainly longed for the normalcy and freedoms of what we often refer to as “The Real World” beyond the cozy walls of camaraderie and structure found in treatment, I never really found transitioning home very exciting, especially as a serial offender of relapse…, “Oh here we go again!” My attitude was one of fear, fear of my own independence. Would I exercise my independence or be lured back into the hands of ED?

I believe the missing link between effective, intensive treatment and long-lasting recovery is being equipped with a solid aftercare plan. The transition home can be a sharp turn in the course. Dropping from around the clock support to just a couple of hours of professional support a week, 168 hours are reduced to maybe 2. Put that into a ratio, 84:1, and the odds are well, challenging.

Therefore, transitioning home from treatment is a crucial, fragile stage in recovery. Suddenly, you may find yourself facing the gamut of forgotten triggers, old urges, less support, more vulnerability, old fears, new fears, and probably even altered relationships. As harrowing as life was before treatment, the eating disorder has a prime opportunity to promise the comfort of something familiar, but only if you are unprepared.

DO NOT FALL FOR THIS TRAP! Equip yourself with an aftercare plan.

Photo of a journal and weekly schedule

I still find myself reminiscing about being in treatment from time to time, and this is usually a sign that I need more support and structure in my daily life. I hope you find some of these ideas helpful, whether you recently completed intensive treatment or if you simply find yourself longing for more security, like me. It’s a really awesome day when you realize you can give yourself what you once needed from treatment! This is the whole point of recovery, to learn to live freely!

1. Participate in aftercare. If the center you went to offers an aftercare program, please take advantage of this! For one full year following treatment, Mirasol’s aftercare specialists remain in regular contact with their clients, beginning with weekly phone sessions that gradually decrease to monthly calls. Many programs sponsor community-based support groups and some offer private alumni groups, either in person or online.

 2. Build a team. Depending on your needs, the basic members of a treatment team usually include a therapist, nutritionist, physician, and psychiatrist. Family therapy and couples therapy is often helpful as well. If you have therapy groups available in your area, consider them, at least initially. When possible, consider rotating healing arts professionals into your aftercare team. Massage, cranial-sacral therapy, yoga, and acupuncture are all wonderful techniques that can increase comfort as you navigate changes in your body, mind, and spirit. I find the healing arts especially helpful when my body image is aggravated.

3. Make a schedule. Pull out your weekly schedule from treatment and re-work it to include life at home. This will ensure you have balance in your life. I like to color code my schedule by category so that I can take a quick glance and make sure there is a healthy variety to my week. I begin listing what I need to do in the next week under the respective category. Mine would look something like this: therapy (various appointments), work (being self-employed means my work schedule changes weekly), relaxation (yoga, walks, meditation, reading, creative arts time), food (meal planning, meal prep, grocery shopping, & scheduled eating times, including weekly challenges), and social/outings (making effort to spend time with others and out in the community, i.e. coffee dates, dinner out, or movies). Then, I block out the times I need to reserve for those activities. I also make sure there are free spaces to ensure I am not overextending myself. Not only does this impress upon my mind what I hope to accomplish, but I actually find coloring in the spaces a meditative bonus!

4. Social support. It’s also a really good idea to have several different people you can call on at any moment to help you follow-through with your plans and maintain your accountability. Historically, I have had the tendency to latch on to one or two people at a time, but I have learned the painful way that I cannot expect one or two people to always be at my beckoning call. An unfair expectation at best, it also has left me feeling needy, which encourages neither a positive self-image nor sense of empowerment. Have a couple of people you can talk to about recovery, but also include people who share interests separate from the topic of recovery, especially people who will can join in social activities. While it is certainly helpful to have people who you can reach by phone and online, nothing replaces face to face human interaction. Friends and family aren’t your only options, either! You may find support from a 12 step sponsor, recovery mentor, clergy member, or other community leader.

5. Give back. Because my road to recovery has been so extended and included a lot of talk therapy, I believe I have been conditioned to focus a lot on my own problems. The intent was likely to problem solve, but that was lost somewhere in translation. Thus, I am a fan of positive psychology. I appreciate my current therapist’s ability to pull out of me what is working and what I am doing well. Sometimes, it’s really helpful to be able to step away from my own concerns and be able to be there with someone else through theirs, human being to human being. This will unfold a new theme in your life, gratitude. You have a purpose. Your life has meaning. You make a difference. Do not keep this all to yourself. Share it with the world. “You transform all of those who are touched by you.” – Rumi

~Heather (Guest Blogwriter)

4 Responses to “Aftercare: The missing link”

  1. Andrea says:

    I can relate to so much of what you have written. You are so brave for sharing all of this. Really, some parts are like reading my own thoughts and I don’t often have that experience with others. Thank you for this post.
    Best wishes,

  2. faith says:

    this is wonderfully put together and as before mentioned I can relate so much. that is great mirasol offers such extended support. how strong of a role might you say the alternative treatments have played?

  3. Heather says:

    Hi Andrea,

    Thanks so much for taking the time to comment. I have so much gratitude in hearing that you felt a connection between our experiences. I hope it somewhat helps with your journey!

  4. Krista says:

    I am wondering if I could use your story as part of some research I am doing about lack of resources here in British Columbia and what would be helpful. Please email me if this is something you would be interested in.

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