Thanksgiving Survival Guide: Utilizing DBT & RO-DBT Skills to Navigate Disordered Eating Symptoms & Triggers

Thanksgiving can be a challenging time for individuals managing an eating disorder. The combination of food-focused gatherings and complex family dynamics often creates stress and triggers that can feel overwhelming. Using specific Dialectical Behavior Therapy (DBT) and Radically Open DBT (RO-DBT) skills can help you navigate these moments with greater ease and confidence.

This guide offers practical strategies to support emotion regulation and healthy interpersonal interactions at Thanksgiving.

Understanding the Challenges of Thanksgiving with an Eating Disorder

The Thanksgiving holiday centers around food, which is a significant source of anxiety for most people with an eating disorder. The pressure to eat certain dishes, the unpredictability of family conversations, and the presence of judgment or misunderstandings about eating habits can all contribute to distress.

Family dynamics can intensify these uncomfortable feelings. Old patterns of communication, expectations, or conflicts can resurface, making it harder to focus on your well-being and recovery.

Recognizing these challenges is the first step toward managing them effectively.

Using DBT Skills to Manage Emotional Overwhelm

DBT offers several skills that can help regulate emotions and reduce distress during difficult moments.

1. Wise Mind

Wise Mind is the balance between emotion and reason. When you feel overwhelmed by anxiety or guilt around food or family interactions, pause and ask yourself:

• What do I feel right now?

• What do I know logically about this situation?

• How can I respond in a way that honors both my feelings and my goals?

  
  

For example, if a family member pressures you to eat more or less, Wise Mind can help ground you so that you can calmly assert your boundaries without guilt or shame.

2. TIPP Skills

TIPP stands for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation. These skills quickly reduce intense emotional arousal.

• Temperature: Splash cold water on your face or hold an ice cube to calm your nervous system.

• Intense exercise*: Do jumping jacks or a quick sprint to release tension (*only if this is within the boundaries of your specific treatment plan).

• Paced breathing: Breathe deeply and slowly, counting to four on the inhale, pausing for four, and six on the exhale.

• Paired muscle relaxation: Tense and then relax muscle groups to ease physical stress — you might have specific muscle groups that feel more relaxing or you can move top-down or bottom-up.

  
  

Using TIPP can help you stay present and avoid impulsive reactions during stressful family moments.

3. DEAR MAN for Assertive Communication

DEAR MAN helps you express your needs clearly and respectfully:

• Describe the situation

• Express your feelings

• Assert your needs

• Reinforce the benefits of your request

• Mindfully stay focused on your goal

• Appear confident

• Negotiate if needed

  
  

If a relative questions your eating behavior, use DEAR MAN to set boundaries without escalating conflict.

Applying RO-DBT Skills to Navigate Social and Family Dynamics

RO-DBT focuses on openness and social signaling, which can be especially useful in managing family dynamics during Thanksgiving.

1. Radical Openness

Radical openness means being willing to consider new perspectives and accept uncertainty. Family conversations may bring up old wounds or differing opinions. Practicing radical openness allows you to listen without immediately defending yourself or shutting down.

For example, if a family member makes a comment about your eating, try to be curious about their perspective rather than reactive. This can reduce tension and open space for understanding.

2. Social Signaling

Your body language and tone communicate a lot. RO-DBT encourages using calm, open postures and gentle eye contact to signal safety and connection. This can help de-escalate conflicts and foster more supportive interactions.

Before entering a room where others are gathered, take a moment to check your posture: relax your shoulders, soften your gaze, and breathe evenly. This nonverbal communication can influence how others respond to you.

3. Self-Enquiry

Self-enquiry involves reflecting on your own thoughts and feelings without judgment. During Thanksgiving, you might notice urges to control food or withdraw socially. Instead of giving in to these urges, pause and ask:

• What am I feeling right now?

• What thoughts are running through my mind?

• How can I respond with kindness toward myself?

  
  

This practice builds emotional flexibility and reduces the power of triggers.

Practical Tips for a Smooth Thanksgiving

• Plan ahead: Identify potential triggers and prepare coping strategies using DBT and RO-DBT skills.

• Set boundaries: Decide in advance with your care team what you will eating and how to manage time with family members who could be distressing.

• Bring a support person: If possible, attend with someone who understands your needs and can provide encouragement.

• Use distraction: If conversations become too intense, excuse yourself and engage in a calming or soothing activity.

• Practice self-compassion: Remind yourself that managing an eating disorder during holidays is inherently challenging and that every small step counts.

  
  
  
  

Staying Connected While Protecting Your Well-Being

Thanksgiving is about connection, but do not feel pressured to connect if it means derailing your recovery progress. Using DBT or RO-DBT skills can help you engage with family while maintaining your boundaries and emotional limits.

Remember, you are not alone in facing these challenges. The majority of individuals with an eating disorder find holidays particularly challenging. It is okay (and encouraged!) to seek support from your care team, support groups, and trusted friends.

Further support: Here is a list of various mindfulness-based exercises to practice leading up to the holidays.