4 Reflection Practices for Therapy for Eating Disorders

Talking with a trauma-informed, licensed mental health professional is the key to overcoming an eating disorder in the long term. While some patients may need short-term emergent interventions such as hospitalization or being under the care of a physician for immediate physical health monitoring, a team approach will work well as a patient gets stronger and wants to thrive over time.

Therapy for eating disorders needs to be the main component of a layered treatment plan that includes a registered dietician, a physician, family members, and a close friend who can support you through the journey.

If you or someone you love has a treatment team in place, one of their first initiatives will be to set up a treatment plan. This could include visiting the registered dietician regularly to establish healthy boundaries using a mood-and-food tracker, a specific number of visits to your counselor each month, or check-ins with family members you identify as part of your treatment team.

Meeting with these professionals, in collaboration with you and your family, guides you to learn how to set realistic, healthy goals in recovery.

One of the most common treatment types of therapy for eating disorders is cognitive behavioral therapy, which helps patients recognize dangerous or unhelpful thought patterns and learn new patterns and behaviors to help them cope with life in healthy ways.

A major myth about disordered eating is that it’s only about the food intake or how a person with disordered patterns relates to his or her food. Therapy for eating disorders doesn’t focus on food. It focuses on how to process emotions in ways that aren’t tied up in eating, food, overexercising, or purging.

4 Reflection Practices for Therapy for Eating Disorders

Because CBT gives you a framework for how to identify distorted thinking, reflection can be a useful tool. Here are four reflection practices for therapy for eating disorders:

1) A Beginning Treatment Check-In

When you’re just starting treatment and you have your team in place, it can feel a little chaotic and hard to know how you’ll handle the journey. This is when it’s a good time to check in with yourself. Asking clarifying questions can be helpful to remind you why you wanted to or needed to be in treatment.

Questions may include: Why am I here? Who identified my need for treatment? Was it a joint decision with a family member, or did I decide I needed help? What was the pivotal point that led to this decision?

2) Three-Month Journal

After your first three months in treatment, it’s a good idea to look at the obstacles you have faced, the hurdles you have overcome, and the support you’re receiving – or wish you were receiving – along the way.

Some reflection questions that can help you evaluate the highs and lows include:

• What did progress look like when I first started?
• What does progress look like now?
• What goals did I set for myself in the beginning, and how are those going?
• Who did I originally think was going to help me in treatment, and how has that gone?
• What kinds of questions, encouragement, or support would be helpful as I continue my journey?
• Is there anyone actively in my life right now that is hindering my ability to get healthier and change old mindsets?
• Are there hobbies or pursuits that have helped me?
• Are there hobbies or pursuits that are hindering me from meeting my recovery goals?

You don’t need to include every single question at this three-month check-in. You can choose a few to help you in your therapy for eating disorders. You can and should also run your questions and answers by your counselor.

A trained, licensed counselor can help you evaluate if your questions are acting as triggers for specific emotions. They can also inspire questions that aren’t listed here – those that spark thought and give you the kind of information you need to keep moving forward.

3) A Monthly Journal

As you embark on your treatment plan with your team, you may want to keep a monthly journal that doesn’t involve specific question-based reflection. Many find it helpful to process their recovery in a 12-month calendar-style journal that includes drawings, poetry, and song titles that have been helpful that month.

For example, you might record that in your first month, what helped you was a photo of your pet, a beloved Taylor Swift song, and scribbling a few lines from one of your favorite books that you’ve been reading. Focusing on artistic means of monitoring your recovery can be refreshing because it allows you to see a snapshot of what interested you, what motivated or inspired you, and where hope for the future can fuel your ability to stick with it amid life’s inevitable curveballs.

4) Daily or Weekly Reflective Mood and Emotion Questions

Asking yourself these questions either daily or weekly can give you an awareness of your well-being that helps you understand the ebbs and flows of treatment. Some of these questions give you awareness about your emotions while others help you recognize thoughts that are not helpful on your journey.

It’s also a great tool for when you see your counselor or you need to share with a family member ways they can help you. You can use some of the information you discover as a springboard for conversation. Remember the goal is not to be constantly measuring yourself against your own expectations or the expectations of others; it’s to reflect on your journey yesterday and today to help you envision a better tomorrow for yourself.

Questions to reflect on daily or weekly for eating disorder therapy include:

• Where am I confused today?
• What do I feel in my body or think about in my brain that’s hindering me today?
• What emotions have given me cause for concern today?
• What hobbies or activities from today made me forget about disordered patterns of eating?
• What hobbies or activities made me fixate on old patterns?
• Was there something that triggered those old thoughts or habits that I’ve identified aren’t healthy for me?
• Is there something I can change about the order of my day to make my journey smoother?
• If I were to write a movie review of this week, how many stars would I give my mood? My actions and behaviors? My thought patterns? My interactions with friends or family? Explain my reasoning for that movie review.
• If my week has been positive overall, what is one thing I’ve noticed that has helped this week?
• If my week has been difficult, what is something that I think made it especially challenging?
• As I move into next week, what is one thing from this week that I’d like to leave behind?

When you are working with a team of professionals and your family, it may feel like you can’t change, or you will never overcome certain thought and behavior patterns. If you experience these thoughts or heightened emotions, write them down; even just recording the date and a one-word emotion or thought summary is helpful.

Talking to your counselor about these moments can give you the perspective you need to keep going, to look back at how far you’ve come, and to have hope for how things can change in the future. Remember that just as you will have ups and downs, your family members will too.
But as you keep your big-picture, overall desires in mind, the effort you put into your recovery will feel purposeful and doable – and your family’s effort will too. No one is perfect, and that’s okay.

Next Steps

Therapy for eating disorders is a worthwhile part of your recovery, and we can connect you with a counselor near you. Our offices will work with you to find a counselor who will take your needs, history, and goals into account. It’s not a one-chance window either; we can help you find the right counselor at any point in your recovery.

Maybe you’ve been through treatment in the past, made progress, and then decided you could take care of the journey on your own. If you think you might need someone to check-in with from time to time, our offices have counselors who can be that safe place for your recovery to continue. Contact us today.