Essential Skills for Recovery: Daily Strategies for Coping with Eating Disorders
I tell this to my clients often- recovering from my eating disorder was one of the hardest things I have ever done. It took so long to undue the mental and physical toll anorexia had on my spirit and soul. And when my behaviors shifted to bingeing and purging, as they so often do when trying to refeed yourself after a restrictive eating disorder, I felt so entrenched in shame and desperate for help with what to do when it feels like I am unable to stop myself from engaging in the next restriction-binge-purge cycle. This blog post will highlight a few of the core skills that I help clients in early recovery learn to practice when urges are high to engage in an eating disorder behavior.
Not every person resonates with all of these techniques, and virtually no one feels they are effective at first or easy to use. It takes practice, patience and a lot of repetition. I recommend trying to practice them outside of a time where you are triggered first, and then work up to using them when distressed. This is because it’s going to be easier to do them when not overwhelmed, and when you have some practice with it, it’ll make using it when distressed feel a lot more accessible. These therapy skills draw from Dialectical Behavioral Therapy (DBT) and Acceptance and Commitment Therapy (ACT). In our work at ED and OCD Therapy, we often use tenants of these approaches to help our clients manage the distress that is inevitable in the early recovery stages.
Let’s go over a few of our favorites!
1) Urge Surfing
Urge surfing is a mindfulness-based skill that helps you “ride out” an urge rather than act on it. Think of an urge like a wave: it rises, peaks, and eventually falls. When we act impulsively on an urge, it can feel like the only way to make the discomfort stop. But with practice, you can learn to tolerate the sensations, thoughts, and emotions that come with an urge without needing to obey it. The key is to stay curious: notice where you feel the urge in your body, name it (“I’m noticing the urge to binge,” “I’m noticing the urge to restrict”), and breathe through it as you visualize the wave cresting and subsiding. This skill builds trust that you can coexist with an urge without it controlling you. Even if you still end up acting on the behavior, pausing first and noticing this rise and fall creates a wedge between you and the eating disorder, and that is still a big win. Over time, it gets easier to not act on the behavior all together. Check out a helpful visual aid for urge surfing, here.
2) DBT pro/con List
This skill is about slowing down the decision-making process when you feel pulled toward a behavior. Instead of trying to convince yourself with shame or logic alone, a DBT-style pro/con list asks you to weigh both sides:
The short-term and long-term pros and cons of engaging in the behavior (for example, restriction, bingeing, or purging), and
The short-term and long-term pros and cons of not engaging in the behavior.
Often, the short-term “pro” of an eating disorder behavior is relief from distress, while the long-term consequence is deeper pain and disconnection from your values. Writing this out helps externalize the internal conflict, allowing you to make a choice from a more mindful, empowered place rather than from the emotion of the moment. Access the office DBT Pro/Con list worksheet, here.
3) Behavior-Chain Analysis
This is a reflective tool that helps you unpack what happened before, during, and after a behavior. Instead of viewing an episode as a “failure,” you treat it as information. You look at the links in the chain: vulnerabilities (like skipping meals or stressful events), triggers, thoughts, emotions, physical sensations, and behaviors. This helps identify where the chain can be broken next time. The goal isn’t to blame yourself but to understand your patterns so that you can respond differently in the future. Over time, this builds insight, compassion, and agency. Here is a link to a worksheet that can be used for working through this skill:
4) TIPP (Temperature, Intense Exercise, Paced Breathing, Paired Muscle Relaxation)
TIPP is a DBT crisis coping skill used when emotions are so intense that reasoning or talking yourself through it just isn’t possible. These are physiological regulation techniques that help bring your body back to baseline:
Temperature: Splash your face with cold water or hold an ice pack to your cheeks for 20–30 seconds to trigger the dive reflex and slow your heart rate. You can also jump into a super cold shower to get a similar effect.
Intense Exercise: Move your body vigorously for a few minutes (jumping jacks, running in place, a brisk walk) to release the flood of stress hormones. Note: please do not do this one if you are malnourished, consult your doctor or dietician first!
Paced Breathing: Inhale for 4 counts, exhale for 6 or 8 to activate your parasympathetic (relaxation) nervous system.
Paired Muscle Relaxation: Tense and release muscle groups one by one, noticing the difference between tension and relaxation.
These are body-based ways to lower the intensity of a moment so that your brain can re-engage in problem-solving and distress tolerance.
5) Cope Ahead Plan
Recovery often involves facing situations that trigger urges: holidays, social meals, doctor visits, or stressful events. A Cope Ahead plan helps you mentally rehearse coping before the event happens. Identify what might trigger you, what skills or supports you can use, and visualize yourself successfully navigating it. For example: “If I start to feel anxious about eating with family, I’ll ground myself with slow breaths, remind myself of my “why” for recovery, and text a support person afterward.” This skill helps you feel more prepared and less reactive when stress arises.
6) Thought Defusion
In ACT, defusion means learning to see your thoughts as just thoughts, not absolute truths or commands. When your mind says, “I can’t eat that” or “I have to purge,” instead of arguing with the thought or taking it literally, you might say to yourself, “I’m noticing my mind is telling me that I can’t eat that.” This small shift creates distance and helps you respond to thoughts more flexibly. You don’t have to believe or obey every thought your brain generates, especially when it’s trying to protect you in old, unhelpful ways.
7) ACT Skill: Values Clarification
Values are the guiding principles that give recovery meaning. When urges are strong, reconnecting with your values helps anchor your actions in something deeper than avoidance or control. Ask yourself, “What do I want my life to stand for? What kind of relationship with food, my body, and others feels aligned with my values?” Examples might include freedom, connection, honesty, or compassion. Every time you choose a small recovery action (like eating a meal, being gentle with yourself, or reaching out for support) you are taking a step toward those values. Here is a list of common values, if you don’t know where to start, simply identifying your top 10 values will help you understand yourself more, and from there you can work on aligning your behaviors with them.
Bringing It All Together
Recovery is not easy, and it’s not about using skills perfectly. It’s about slowly building a new relationship with yourself, one where you respond to pain with curiosity and care rather than punishment or control. These skills are not meant to erase the urges or the pain that come with recovery; they’re here to help you ride through them with more stability and self-compassion.
You may not feel like these tools “work” right away and that’s okay. Change takes time, repetition, and lots of self-compassion. Think of skill use as planting small seeds of self-trust. With practice, those seeds grow into a more grounded, flexible, and compassionate way of being with yourself.
You don’t have to do this alone. These skills are most powerful when paired with support, whether that’s a therapist, dietitian, or trusted person who understands your recovery journey.
If you’re looking for compassionate support in your recovery journey, I offer eating disorder therapy in San Diego and virtual sessions throughout California, Utah, Maryland and Florida. My approach is client-centered, grounded in anti-oppression and body liberation values, while integrating modalities like DBT, ACT, ERP and IFS. Together, we’ll work to help you reconnect you with your own inner wisdom and agency.
