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12/16/2018, 03:18, Vienna  DEUTSCH / ENGLISH




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(04/20/2016)
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Eating disorders such as bulimia nervosa are often treated within specially aligned clinical settings, but in analytical practice, one encounters bulimic patients. I believe that the analytic treatment is an excellent and promising option for a disease like bulimia, not least with a view to the Consumer Reports Study of Seligman {Seligman, 1996, 965}, which indicates that a longer term psychotherapy has a clear advantage over a shorter treatment when it comes to their effectiveness.

Experience has shown that in stationary processes a high focus is placed on the normalization of eating behavior, behavioral interventions occur, structured eating plans are presented and tools of all kinds used. Often one can observe a relatively rapid symptom improvement during the hospitalization, but frequently not as sustainable as desired. Are the patients discharged, they often fall quickly back into their old behavioral model. Taking into account that on the one hand, the defense organization of bulimic patient with the appropriation of a "false self", one can already suspect that they may tend to be "good patients", on the other hand the institutional (and therefore seemingly "maternal") accommodation also plays a role, because the patients are initially provided for and feel safe, but suddenly with the discharge they are "ejected" again and now should do all for themselves what previously the institution regulated for them. Besides, it appears that in focusing on the topics weight (daily weighing), nutrition (pre-meal plans, close supervision) etc. almost as if one gets involved in the patients’ defense mechanism of displacement or to participate in the rationalization. Often one can observe struggles there(for example in terms of increase in weight, food intake, etc.) that are completely out of place in my opinion and miss the goal of treatment altogether.
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