Pre-Mortems and Eating Disorder Bashing

You all know what a post-mortem is. A process carried out when a disastrous situation has occurred and the events are evaluated in minute detail to work out what went wrong, how and why, in order to learn lessons from them. A post-mortem after any disaster is an essential and valuable exercise.

But should we wait for a disaster to happen before we consider what might go wrong in a particular situation and why? Surely it makes sense to evaluate a situation and put measures in place to minimise the risk of any disaster arising in the first place? This is exactly what happens when you do a pre-mortem.

Why though am I talking about post and pre-mortems in a blog post about eating disorder recovery? Well, let me explain.

What is the Role of a Pre-Mortem as you Overcome an Eating Disorder?

The process to overcome an eating disorder is stressful. You need to put yourself in stressful situations multiple times a day (particularly as you first embark on the process). And if you aren't facing stressful situations that regularly, then you probably need to ask yourself if you really are taking meaningful steps forward.

Unexpected stressful situations will all too often go wrong because we are unprepared for them.

When your brain is under stress, it releases cortisol and adrenaline and your body shuts down all non-essential functions, like digestion, the immune system and the ability to feel emotions other than fear. Your brain becomes cloudy and foggy so that you lose the ability to think clearly and rationally, making your ability to systematically deal with the stressful situation almost impossible.

This is why you can have the best of intentions when you are in a calm and rational frame of mind to charge at the eating disorder and bash it hard but find that when it comes to putting those intentions into action, your stress response kicks in and takes over. This is because your brain wants to hold onto the safety and reward it perceives from behaviours that lead to or maintain energy deficit and will create an anxiety or fear response to deter you from anything that might take you to energy surplus. When these fear reactions occur, your ability for rational thought disappears in an instant and all your best intentions are forgotten. You instead find that you can't think clearly and can't remember why you were ever planning to eat or rest more. You find that you have resorted to auto-pilot with your usual disordered habits and the restriction that your brain mistakenly perceives as safe.

Can you begin to see now why I started out this post talking about the value of a pre-mortem to minimise the risk of disaster (perhaps disaster is a strong word here) when you are in a stressful situation?

It is because, one way to help manage the common and frustrating scenario in which your brain under stress takes over and stalls your hard efforts, is to carry out regular PRE-MORTEMS of your eating disorder bashing process and those momentous and victory building events that you are planning.

What Exactly is a Pre-Mortem in Relation to ED Bashing?

In a pre-mortem, you look towards an upcoming situation and imagine you have a crystal ball to gaze into where you know that the event in question has gone really badly. Then you use those imagined disastrous scenarios to work out what can be done before the event to prevent those things from happening or at least apply some damage limitation.

This exercise is you recognising that when you are in the situation and trying to deal with it, you are likely to be under a high level of stress and not able to apply the clarity of thought you would have liked. As a result of a pre-mortem you can put systems in place for when you are really in the situation to ensure that things go better than they otherwise might have done, even if you are in a cloudy and non rational frame of mind with high anxiety levels.

Hopefully this makes sense up to now, but let's apply this to a typical scenario that you will very possibly face in overcoming the eating disorder.

Applying a Pre-Mortem to a Typical Eating Disorder Bashing Situation

Let's say that you have a big family party coming up. It's going to be a sit down meal with lots of family members. You haven't been to such a gathering for years because of the eating disorder but this time you know that you are in the process of overcoming it and you cannot keep avoiding situations like this any longer. You are determined that you will go, join in, eat the delicious foods and then sit and relax with your loved ones for the rest of the day.

In an ideal world, just having this plan would be enough to ensure that the situation I have just described is actually what happens, but let's not forget one little detail. You do still have an eating disorder. Despite the fact that you are making great efforts in your process to overcome it, big family meals are not something you are comfortable with or have yet faced, so in reality, it's likely to make your brain a bit stressed when you are actually there.

Now, if you apply the pre-mortem exercise before you go, you will use your crystal ball and imagine all the ways in which things could go badly on the day of the party. This is where you need to get creative.

• Perhaps Aunty Mildred comments that you are looking a little plump and are you sure you do want that many roast potatoes.

• Maybe you take one look at the feast laid out and your brain goes into such a spasm and panic that you find yourself making an excuse for why you have to leave. You are bolting for the door faster than the speed of light before anyone can stop you or you can stop yourself.

• Maybe you find yourself making excuses to be away from any situation that actually involves sitting and eating the food and you are one being helpful with bringing dishes in and out, washing up, tidying etc.... This has the result that you then find you have made it through the meal-time without actually eating much at all.

• Perhaps you do get through the meal but then find yourself so anxious that you decide to go for a nice long innocent stroll afterwards, which is actually the result of an ongoing exercise compulsion and feeling a need to compensate for the food you have eaten.

I am sure that if you carry out your own pre-mortem of such a scenario, the predicted ways in which things could go wrong will be unique to you, what you know about yourself and how the eating disorder manifests. Everyone with an eating disorder is unique so if some of these scenarios are things you cannot relate to, that does not invalidate your experience with an eating disorder or the strength of it.

Once you have looked at all the possible ways you think things might go wrong in the upcoming situation, you can take each one and consider what you can do to minimise the risk of it occurring or plan how to deal with it if it does.

When you do carry out pre-mortems, apply them to all types of situations and eventualities. It might be that plans change at the last minute for something, things happen outside your control or influence, other people are less reliable than you hoped and not present to provide support. Use the pre-mortem to come up with ways you can adapt and react in any situation so that you can roll with the punches and stay on top.

Pre-mortems can be applied equally to things on a wide scale in the process of overcoming the eating disorder and to much smaller situations.

It might be that you decide to take a broad view and carry out a pre-mortem of your whole process and what might jeopardise it or it might be something much more detailed and specific such as pushing yourself to start eating much earlier in the day than you usually would.

Use the crystal ball method for whatever the situation is and look at it with the certain knowledge that the plan has been an absolute fiasco.

Imagine all the ways in which things could have gone wrong and why and list them. If you have an eating disorder bashing support person then they could do this with you and use their insight to come up with some additional ideas.

Use the Pre-Mortem to Prevent and Manage any Disasters

Going through the above exercise alone will help raise your awareness as to what might hold you back from getting the results you want in the planned situation so that if they do then occur, your brain will be much more likely to instantly recognise them in the moment.

But take the pre-mortem a step further and with each of the things that you identified that could go wrong, establish steps you can take to minimise the risk of them happening or if they do occur, what you can do to prevent them from turning the entire situation into a real life fiasco.

In an earlier post I wrote about using If-Then planning to help make your journey more successful, so have a read of that if you haven't yet. Effectively though, now is the time in your pre-mortem to combine your crystal ball scenarios with some if-then plans.

As I explained in the if-then post, when your brain has predicted a situation ahead of time and that situation does occur, your brain will be more likely to recognise it and remember, I had a plan for this rather than resorting to complete brain fog and fight or flight mode.

If we return then to our imagined family party and some of the predicted ways in which it might not go as hoped.

You might plan ahead of time exactly what you will say if anyone does comment on your recent weight changes or on how much you are eating. If this does happen, then you might plan to respond with a proud, "Thank you, yes I have gained weight because I have been overcoming a devastating eating disorder and I'm proud of my new curves and most definitely will have more potatoes!".

If you do find yourself tempted to charge out the door rather than stay at the party because the fear response has taken over, then you might tell yourself that you predicted this could happen but that you do want to stay and enjoy this day. Remind yourself that you are determined to stay focused on beating the eating disorder which means that you will bloody well eat the food, sit and enjoy the company and not let the illness ruin another opportunity to be with loved ones. You might also plan in such a situation to have someone there who is a support to you for the day who you can turn to if needed.

Try It!!

Using regular pre-mortems in the process to overcome the eating disorder might just help you achieve overall success a little faster and with more ease than you would otherwise. They can then have the effect of helping you feel less frustrated that another challenge failed or that another day has been wasted because you didn't manage to do what you had wanted.

Give it a go. It might just work. And if you do carry out a pre-mortem and situations still go wrong (which they inevitably will because overcoming an eating disorder is never linear), then there is still the good old post-mortem exercise to perform so that things definitely do go better next time!

**As I touched on in this post, if you did find this post helpful then you will very likely also find the post about using 'if-then' planning in eating disorder recovery helpful too. The use of carrying out a pre-mortem in terms of recovery situations and if-then planning go together very well, where the pre-mortem can be used to really predict every tiny thing that might go wrong in real terms when it comes to a recovery situation and if-then plans are then put in place to deal with some of the imagined specifics... Check out the if-then planning post (or have a listen to my podcast episode about it) and I am sure it will all make sense!**

If you like to listen, as well as (or instead of read!) then this blog post is a transcript of a podcast episode which you will find on my podcast series,

Feck it, Fun, Fabulous and Free in Eating Disorder Recovery...

available on this website, on all mainstream podcast platforms and on YouTube!