Learning from Urges
By Camille Williams, MA, NCC, LCPC, Timberline Knolls Eating Disorder Program Coordinator
Eating disorder (ED) urges can often be relentless, intense, frustrating, and anxiety-provoking. Understandably then, it makes sense that engaging in ED behaviors to quiet the urge will provide relief. Of course that relief and peace never lasts very long. As behaviors decrease in recovery there is an increase in emotional distress and limited skills to manage the distress. This is where hopelessness and frustration in recovery can show up. It is true that the urges and thoughts cannot be prevented or stopped. However, there can be relief in adjusting the response to the urges.
A typical reaction to an ED urge may be rapid or short breath, increased heart rate, racing thoughts, fear, and anxiety. This is an incredibly vulnerable and challenging moment in the recovery process. This is where the STOP skill in dialectical behavior therapy (DBT) is critical to practice. It helps an individual pause instead of immediately reacting. Even after decreasing impulsivity to engage in ED behaviors, there may be secondary behaviors that appear to help continue avoidance of emotional experiences. These can include sleeping as a way to avoid urges and emotions or staying very busy to distract from urges and emotions. It can be helpful and necessary in early recovery to utilize those behaviors just to get through the urges. However, long-lasting recovery requires an awareness and acceptance of emotions.
As recovery progresses and it is easier to not engage in behaviors yet still challenging to sit with emotions, a helpful approach is curiosity. Rather than increasing emotional distress by getting mad about having urges or feeling an emotion, notice it and be curious about what it is trying to communicate. If an urge to binge surfaces, ask, “what do I want to get out of this urge?” Maybe after a binge there is a moment of comfort or peace. If life has been chaotic or stressful, this urge is most likely indicating a need to practice self-care and find ways to cultivate inner peace. Getting curious about the “whys” behind the urges can be effective. Instead of trying to just sit through the emotions and urges with avoidance or distraction, this mindfulness aids in increased awareness of feelings and needs. Being mindful and aware enhances the ability to make informative choices about managing emotions and urges.
The curious approach creates an opportunity to manage emotions more effectively. If a client is having a desire to restrict, and can notice the increase in anxiety that is associated with the urge, then the client can make an effective choice around how to respond to that emotion and urge. Observing and identifying emotions results in responding based on needs in that moment. This allows the client to make a choice of what will help most based on awareness of the current experience. If the person was unable to connect mindfully and select an effective coping skill then the client may end up choosing something that could potentially increase anxiety. Instead, a client may choose to respond more effectively to anxiety with a breathing technique or a warm bath.
This mindful and effective healing happens by leaning into the discomfort or urges and feelings. Avoiding and distracting will only lengthen the distress and prevent awareness and insight of experiences. Feelings and urges can be seen as communication and a warning signal. In recovery, it is important to be curious about THEM. Effective recovery happens through willingness to care for emotional needs in ways other than destructive behaviors.
“Curiosity keeps leading us down new paths” – Walt Disney
TK Contributor: As the Timberline Knolls Eating Disorder Program Coordinator, Camille Williams MA, NCC, LCPC, supports the development of curriculum, supervises the eating disorder specialists, and provides group therapy. She also educates and trains all staff on campus and advocates for eating disorder awareness through publications. Timberline Knolls serves as an iaedp™Presidents Council Member.
*The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders and not intended as endorsement by iaedp Foundation, Inc. or its Board of Directors.*