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The Struggle to Maintain Accountability in Eating Disorder Recovery When Telemedicine Is Your Only Option

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The stay-at-home orders as part of the COVID-19 pandemic were hard for everyone and so has the phasing out of those orders. It has been especially hard on those with eating disorders and those recovered from an eating disorder. I fall in the recovered category.

It’s OK to struggle at times — even if you are recovered!

These hard times we faced recently have definitely challenged my recovery and even made me question my recovery. My eating disorder has crept up in ways I never thought would be possible. That eating disorder voice has even made its way into my mind without me even knowing. It has come into my brain and left completely without my awareness. It is normal for anyone to struggle during times like this regardless of if they have mental health challenges or not. A disruption in normal life and daily routine is just hard to adjust to.

A big part of my recovery has been accountability. Accountability has given me what was needed to fully recover. During this time of crisis in the world, accountability was sort of taken away from me. Appointments were moved online and things got easier to hide from my team and from myself. I do still consider myself to be recovered and to be experiencing a momentary lapse due to current stressors. That is OK. It is completely understandable for someone to struggle during these times.

Why is it so hard for patients with eating disorders?

An eating disorder thrives on secrecy and denial. When a patient is unable to see their team in person it takes away the ability for their team to pick up on body language and physical cues to get the full story of what is going on. Sessions over zoom (or other video platforms — or phone) can be awkward for a patient. Depending on their home factors they may have trouble fully speaking up due to fear of a family member listening in/being overheard. The awkwardness itself may make it more difficult for one to open up about what is going on.

What are some things that have helped me?

Some things I have found helpful are doing sessions at times when others aren’t around, or when family members may be outside doing yard work. Finding a place in the home (when possible) where I am significantly distanced form others during my session. Sometimes this is my room, sometimes it is the basement. At times it may even involve going for a short drive and parking somewhere where to do the sessions in my car. Using headphones are helpful if I fear someone will hear what my team has to say, but they don’t help if I fear others overhear my words.

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What are some things I wish my team would do to help?

I wish my team would encourage me to have more than just my face in the screen when doing tele sessions. I think it would be helpful to encourage having from the waist up in the screen image because it would allow them to see more of my body language. Another thing that would help with this is to encourage me not to hide under blankets. My biggest “tells” during are a session usually has to do with how much I fidget and if I start to get into a repetitive pattern with my fidgeting. This usually indicates there is something going on that is bothering me that I may not be fully speaking up about. Being encouraged to not cover up with blankets or heavy clothing would be possibly beneficial to an RN, but I have mixed feelings about this. During tele sessions an RN is not able to monitor with regular weight checks, so they have to go based on what they see.

Goals I have set for myself:

The best thing I can do for myself now that I am aware of the situation is to keep making an intentional effort to reflect and identify when things are sneaking in. Using my voice is another important tool I have to keep remembering. Things are going to be hard for a while, so it’s time to learn to do recovery in a different way. It won’t be easy, but it’s needed since all of our communities are changing so much.

Getty image by gpointstudio

Originally published: June 18, 2020
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