In other instances, a partner might truly not see any changes, what Gayle Lewis, a New York psychologist who specializes in eating disorders and works with couples, calls “unconscious collusion.” “I’ve worked with anorexics who are incredibly thin to the point of needing hospitalization,” she said. “I once asked a spouse, ‘Did you notice she was losing weight, or that her moods were changing?’ His conscious response was, ‘I see her every day, I didn’t notice.’ Her family didn’t notice. No one confronted her about it.”
When he did discover the truth, he felt betrayed. Like any addiction, eating disorders involve hidden worlds that are kept secret from others. “The sense is, ‘if you’re lying to me about this, what else are you lying about?’” said Dr. Lewis.
There has been scant research focusing on romantic partners of people with eating disorders. But experts are now recognizing how critical a partner’s response can be to recovery, and how partners are a critical part of treatment.
Since the late ’90s, family-based treatment, previously called the Maudsley approach, has been the therapy of choice for treating children and adolescents with anorexia and bulimia. But adult patients were usually treated individually. “We would never involve the partners in actual treatment,” said Dr. Bulik.
In 2006, Dr. Bulik and Donald H. Baucom, a professor of psychology at the University of North Carolina, Chapel Hill, decided to do just that, enlisting partners in the treatment process in a study of 20 couples, one of whom had anorexia. Results showed encouraging improvements in weight-gain and a lessening of anxiety and depression along with a low dropout rate, a perennial problem when treating any kind of eating disorder.
“That’s really a significant outcome, because in other treatments up to 50 percent of people leave outpatient treatment,” said Dr. Bulik. “We can’t treat people if they don’t come to the office.”
In a recent study of 11 couples working with a therapist — this one focused on binge eating disorders — researchers, including Dr. Bulik and Dr. Baucom, found that by the end of the trial, after 22 weeks, 82 percent of patients had stopped binge eating, which they maintained for up to three months (the researchers had funding for only three months of follow-up). The researchers also noticed a major reduction in depression, along with a low dropout rate.
Source : Nytimes
