Navigating Through the Holidays with OCD and Eating Disorders

The holiday season brings many things to look forward to including time off from busy life schedules, spending time with loved ones, and for those of us that live in Phoenix – the beginning of a four-month reprieve from the heat. While many people consider this to be the “happiest time of the year”, for individuals with Obsessive-Compulsive Disorder and/or Eating Disorders it can be a time of stress as triggers have the potential to become unavoidable all while feeling pressured by society to be joyful and relaxed. When dealing with eating disorders and OCD, there are a few things you can do both offensively and defensively to help navigate though the holiday season with intention – just like the Dallas Cowboys (or your favorite football team) this Thanksgiving.

Offense

A big part of offensive work is understanding what potential triggers may arise and making a game plan. Triggers are specific to each person’s subtypes of OCD and/or their specific eating disorder so it is not possible to cover them all – but here are a few examples:

OCD

• Due to the large amount of time spent cooking during the holidays, sharp objects are everywhere! This could be challenging for those that struggle with harm obsessions, especially if around people they love. People with harm obsessions often fear harming themselves or someone else.
• The act of cooking itself can serve as a trigger for those with contamination obsessions – all the raw meats, potential for germs, and people handling your food may or may not know OCD’s rules. Those struggling with these fears may excessively seek reassurance, check, or participate in cleaning rituals.
• Speaking of people not knowing OCD’s rules, allowing loved ones into your home could provoke anxiety. They might not put something back where it belongs or follow the hygiene standards in which OCD is comfortable. They may also avoid shaking hands or hugging family members.
• Gift giving or receiving can represent a trigger – especially white elephant parties. Who touched what last? This can provoke tremendous anxiety and can trigger the OCD brain into performing cleaning rituals.
• The holidays are also filled with “cozy” dangers such as electric blankets, lights on trees, lit candles, and kitchen appliances that remain on for a lengthy amount of time which can trigger many OCD subtypes such as fears of something bad happening or starting a house fire. These triggers elicit prolonged exposure to anxiety and sitting with the urges to engage in compulsions can be challenging but important work!
• Being around young family members could serve as a trigger for those with sexual obsessions. Fears around harming their loved ones may cause them to isolate and not participate in holiday celebrations.
• Being around other people in romantic relationships can be challenging to those with relationship OCD. They may feel the need to compare their own relationship to make sure they are in the right relationship or do rituals insuring they really love their partner.
• The holiday season is filled with religious and moral references that could serve as a trigger for someone struggling with scrupulosity obsessions. Those struggling with scrupulosity or moral OCD often avoid religious events or participate in many compulsions around their religious based fears.

Eating Disorders

• While you deeply care for those you spend time with on the holidays, sometimes their diet culture food talk or negative body talk can be incredibly triggering for someone with an eating disorder.
• Being around or feeling pressured to eat “fear foods” or foods that you have not tried before can be challenging.
• Similarly, to individuals with OCD, the unknown around food preparation and cooking and what is in the food can elicit anxiety.
• Someone making a comment on your eating patterns or what foods you choose to eat can be difficult just as being around others that are engaging in disordered eating can be triggering.
• Going home for the holidays can also mean coming face to face with old images of yourself – which can provoke negative body talk for individuals with an eating disorder.
• Being in colder weather can mean having to wear clothes that you have not worn in a while, which can lead to the urge to body check or compare.
• Going to a new environment for a holiday can mean being exposed to things that have been removed from your home – like the scale in your relatives’ bathroom.
• The act of cooking can be distressing as recipes can be filled with diet culture language and nutritional labels on each item needed for the recipe.
• Family traditions such as running the Turkey Trot as family prior to Thanksgiving dinner can serve as a triggering experience.

After contemplating what triggers could arise during the holiday season for you, talk with your support system and your healthcare professionals to build a game plan tailored for you! The game plan can be filled with intentional exposures designed by you and your therapist, added self-care, reducing accommodations, setting realistic expectations, speaking with your dietitian about holiday meals, and accessing your support system. One of the values you can lean into during the holiday season is togetherness – in recovery you don’t have to struggle alone. Speaking of togetherness, another play to add to the game plan is setting healthy boundaries. This could look like asking family to not engage in diet talk during holiday dinners or to make comments about food being healthy or unhealthy. Boundaries can also look like sharing with loved ones about how reassurance functions within the OCD cycle and how they can encourage you during difficult moments to stick to your treatment goals rather than engaging in compulsions. Whatever your game plan looks like, you are working to do your best to engage in recovery offensively!

Defense

Defense work stipulates there are going to be things you cannot foresee with our game plan. I encourage you to respond to these moments with self-compassion – that pesky concept of being kind to yourself when things do not go just right or when you don’t respond perfectly according to your treatment goals. Added life stressors can exacerbate both OCD and eating disorder symptoms, this does not make you a failure nor does it negate all the hard work you have done while in treatment. Having increased symptoms simply means that you have OCD and/or an eating disorder and maybe today was a more difficult day along your journey. It is easy to get caught in the trap of perfectionism especially if experiencing any added pressure from others to be “in the holiday spirit”.  Allow yourself to identify what parts of the holiday season are valuable to you and how you would like to reflect those values during your holiday rather than allowing another voice to dictate more rules of how you should or should not be or feel.

Give yourself permission to make space for any difficult emotions that may arise during this holiday season and sit with them using mindfulness skills rather than attempting to control them via OCD or the eating disorder. In each moment of noticing the emotions that come up for you and sitting with them, you are working to build up your tolerance for challenging emotions even if it does not look pretty. Take time to reflect on how far you have come since beginning treatment and recognize the achievements you have made along the way rather than ruminating and being unkind to yourself about the compulsions you engaged in or calories you consumed in the day. One of the best parts of defensive work is that if you have been in treatment prior to the holidays- you have been preparing for this moment each time you have engaged in an exposure, resisted an urge, or went to a therapy session! The response prevention skills and coping strategies you have practiced in treatment will serve you for the unknown triggers that may or may not lie ahead. The holidays are around the corner, and you are ready this year!