Addressing Caregiver Concern of an Eating Disorder with a Spouse/Partner

Establishing effective communication patterns and ways of supporting a partner struggling with an eating disorder can be challenging.

Two of the most common communication problems among couples include secrecy or lack of disclosure regarding the eating disorder, and difficulty resolving conflict (Dick, Renes, Morotti & Strange, 2013).

Both barriers may make it difficult for a partner to identify and address eating disorder warning signs, or begin a constructive conversation about possible eating disorder treatment options. These conversations may be negated by a caregiver’s fear of possible negative outcomes.

As a spouse or significant other of someone with an eating disorder, it is common to feel frustrated, afraid and to experience some level of self-blame regarding your loved one’s disorder (Stillar, Strahan, Nash, Files, Scarborogh & Mayman, 2016).
 
When experiencing a level of intense emotion such as anger, fear or shame, research supports that caregivers may lose access to instincts such as knowledge of tools or some rational thought processes (Stillar et al., 2016).

Partners may feel like they are stunted when trying to communicate concerns to their partner. In addition, the more fear and self-blame caregivers experience, the less self-efficacy or empowerment they will have in addressing their loved one’s disorder (Stillar et al., 2016).

Caregivers may find themselves enabling the disorder or allowing it to control the family as a result of the intense emotions, loss of instincts or lack of empowerment, therefore reinforcing their ideas that they are to blame for the disorder, and perpetuating any unhelpful behaviors. At this point, it is common for the caregiver to feel helpless and responsible for their loved one’s struggles (Dick, et al.)
 
Here are five things a partner can do to weaken some of these barriers:
 

1. Address caregiver fears and self-blame (Stillar, et al.) The caregiver can practice reframing thoughts like “I can’t handle this—I just keep making it worse” or “If I try to approach this topic again, they’ll shut me off completely.” Keeping a thought record can help address these thoughts. A thought record usually includes the following: what situation preceded the thought, what emotions were felt, what the automatic thought was, a rational thought to challenge the automatic thought, and what response might be most effective (Gabbard, Beck, Holmes, 2006, p. 118).
2. Self-educate and self-support (Hibbs, Rhind, Leppanen & Treasure, 2015) Seek out workbooks or other literature specifically about caregiving for a loved one with an eating disorder and/or fear, self-blame and shame. Research demonstrates that those paralyzing caregiver emotions can be lessened with “self-directed help using materials that are widely available” (Hibbs et al., 2015). For a list of helpful resources, visit ERC’s  Recommended Reading page, visit Eating Disorders Information Gateway and select “consumer resources,” or email [email protected].
3. Find in-person or online support that is specific to caregivers or family members (Dick, et al.). It is common to feel isolated and alone in the caregiver role. Having a group to talk to can diminish feelings of helplessness and give another platform to process and reconcile fears or self-blame. ERC offers free family support groups in some locations, as well as Family Days for family of ERC patients and ERC alumni.The Eating Disorder Hope website also offer support group forums and lists of support groups based on location.
4. Act based on values. The caregiver can ask these questions to identify their values: “What kind of partner do I want to be? What are my values in this relationship? If I could be my vision of an ideal partner, how would I respond?” Chose actions based on those values and answers (Harris, 2009).
5. Avoid trying to “fix” or stop your loved one from behaviors. Evidence-based interventions suggest partners should aim to support their loved one without monitoring or adopting the role of policeman (Bulik, Baucom, Kirby & Pisetsky, 2011). Asking a partner how they are feeling and how the spouse can best support them is usually more effective. This will allow a platform to successfully discuss possible treatment options.  

References Used:

• Bulik, C.M., Baucom, D., Kirby, J. & Pisetsky, E. (2011). Uniting couples (in the treatment of anorexia nervosa (ucan). International Journal of Eating Disorders, 44(1), 19-18, doi: 10.1002/eat.20790.
• Dick, C.H., Renes, S.L., Morotti, A., & Strange, A.T. (2013). Understanding and assisting couples affected by an eating disorder. The American Journal of Family Therapy, 41(3), 232-244, doi: 10.1080/01926187.2012.677728.
• Gabbard, G.O., Beck, J.S., Holmes, J. (Eds.). (2006). Oxford textbook of psychotherapy. New York: Oxford University Press.
• Harris, R. (2009). The complete worksheets for act with love. Retrieved from http://thehappinesstrap.com/upimages/The_Complete_Worksheets_for_ACT_With_Love.pdf
• Hibbs, R., Rhind, C., Leppanen, J. & Treasure, J. (2015). Interventions for caregivers of someone with an eating disorder: A meta-analysis. International Journal of Eating Disorders, 48(1), 349-361.
• Stillar, A., Strahan, E., Nash, P., Files, N., Scarborogh, J., Mayman, S., Henderson, K., Gusella, J., Connors, L., Orr, E.S., Marchand, P., Dolhanty, J., Robinson, A.L. (2016). The influence of carer fear and self-blame when supporting a loved one with an eating disorder. Eating Disorders: Journal of Treatment & Prevention, 1, 1-13, doi: 10.1080/10640266.2015.1133210.