One of my goals this year is to reclaim the holidays from the clutches of commercialism, family drama and the belief that things have to be perfect. It’s ironic that the biggest holiday season of the year is also the most stressful for many people. It’s as if we all decided to throw ourselves a party with the foreknowledge that it’s going to be miserable. Wouldn’t just going to work instead be the more peaceful option?

 How crazy! It’s sobering, though, to remember that for the many people struggling to recover from an eating disorder, the stakes are much, much higher. The holidays aren’t just a challenge to common sense, they can be downright dangerous.

 “Even for patients who are making good progress in overcoming an eating disorder,” says licensed professional counselor Bonnie Brennan, “we may have to hit the ‘reset’ button after the holidays.”

 Brennan, who is cinical director of the Eating Recovery Center's Adult Partial Hospitalization Program in Denver, tells the story of one patient who quailed at the thought of making the annual holiday trek to the family home. The house was usually packed to the rafters with extended family, affording very little privacy and opportunity to escape from the “family ledger of past resentments.”

Even ostensibly warm and nostalgic annual rituals such as posing for the annual family picture could erupt into discussions about past differences, by both the patient and her siblings.

Since she couldn’t put a physical wall between herself and the family, says Brennan, the next best thing her patient could do to set boundaries was to sneak off into the garage or the laundry room, where food for the holiday festivities was temporarily stored. There, she could binge in secret, “taking a time out, but not in the most functional way,” explains Brennan. The sensation of numbness that follows a binge, of “not being emotionally present, was a way of putting an invisible wall around herself.”

So what was Brennan’s advice? To politely tell her family’s inner circle that as much as she loved them, it was not healthy to be at the annual extended family holiday gathering, and instead to plan smaller events with individual family members throughout the year. For the holidays the patient planned to stay in her hometown, where she and her husband and children could visit with family friends in environments she knew she would feel safe.

Instead of being honest about the reason for not coming to the family gathering, some people in this situation might be tempted to finesse their way out of the situation, offering excuses other than the truth. Brennan disagrees with this approach, saying, “Unless there’s some dire consequence to being transparent it’s usually healthier to be straightforward about why you might be making the decision to take care of yourself. You can say to your family member, ‘I love you, I really appreciate you but I need to take care of myself during this family holiday’…eating disorders thrive in secrecy and it’s about how to have relationships that are more meaningful and authentic.”

Fair enough. But what about extended family members? Do you really have that conversation with them too? Brennan believes, yes, not necessarily immediately, but gradually over time letting everyone know the truth. Since there is a strong genetic component to eating disorders, it’s highly possible that you might see evidence of an emerging disorder in a niece, nephew or second cousin. “There is a benefit to letting blood relatives know because 40-50% of the risk of developing an eating disorder is genetic. For example, a woman with a sister or mother with anorexia is 12 times more likely to develop anorexia nervosa and four times more likely to develop bulimia nervosa” explains Brennan. “You might be helping a family member get early access to treatment.”

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