If you have an eating disorder and a partner, your disorder becomes a “member” of the family. As a couple you have to work out how this third family member fits in as you continue in recovery. You’ll need to come to terms with its impact on the relationship as well as each of you individually.

How does an eating disorder become a couples problem? For one, an eating disorder can affect your relationship by becoming a source of conflict between you and your partner. An eating disorder can also gain a dysfunctional role in managing typical relationship challenges. The following are tips on what you should look out for to make sure neither kind of problem interferes with successful recovery or the soundness of your relationship.

Conflicts can easily sprout as couples try to accommodate their relationship to the demands of eating disorder recovery. Common topics of disagreement include:

• The cause(s) of your eating disorder

• The appropriate steps for you to take in order to get better

• The role, if any, your partner should take with your eating disorder symptoms

• Your partner’s involvement in your treatment

• Your family–of–origin’s role with your symptoms and treatment

As you consider this list, here are some questions you might ask yourself:

• Where do you and your partner each stand on these potential conflicts?

• Have you openly acknowledged any differences you might have?

• Are you stuck or progressing on resolving your differences?

• Is unresolved conflict negatively affecting your recovery? Your relationship?

• What steps, if any, have you and your partner already taken to try to resolve your differences? How is your approach going?

If you and your partner can’t resolve your conflicts, it may be time to consider some kind of couples counseling. The stakes are too high to let things fester!

An eating disorder can also acquire a role your relationship, managing sticky issues or communicating what feels too difficult to express openly. For example, the presence of an eating disorder can:

• Create distance (boundary–making) You may be more closely involved with your eating disorder than with your partner.

• Allow one or both of you to avoid conflict Topics of disagreement may get swept under the rug because the eating disorder is always treated as more important.

• Give you an indirect way to ask for caretaking Some people feel so unentitled to ask for attention, affection or other needs, they fall back on their eating disorder and the demands of recovery to do the “asking” for them.

• Give you an indirect way to express anger Some people fear that they or the relationship won’t be able to tolerate open expressions of anger. If your eating disorder symptoms frustrate or rankle your partner, they can provide a back channel for getting your unhappiness across.

• Give you a way to experience control No one can make you stop restricting or bingeing or purging. No one can force you to participate in treatment. Sometimes this is the only power a person with an eating disorder has ever felt in relation to others. It can be a potent weapon to render a partner powerless.

It may surprise you to realize how your eating disorder has become entangled in the relationship with your partner. Most of the inappropriate “roles” for an eating disorder highlight an area where personal or couple growth is needed. Recognition can be a great call to action. If you’re really stuck, this may be another place where counseling could be helpful.

The way you resolve the relationship issues raised by your eating disorder will be unique to you as a couple. Working out individual needs and areas of conflict is good for your recovery—it protects a key part of your support system. But it is also good for your relationship. You and your partner are learning how to cope with adversity as a team. This always makes a relationship stronger.

“I can’t stand it anymore!” This may be what you feel when you’ve taken the courageous plunge into eating disorder recovery but aren’t yet experiencing relief. The sentiment may apply to your eating disorder symptoms, your weight or shape, or bad feelings about yourself. I never doubt the reality of the pain and despair behind the plea to get better right now. And I never fail to wish it could actually happen.  

If only eating disorder symptoms were like the what–was–I–thinking? fashion purchase you discarded quickly and quietly once you saw the light. Unlike fashion, your symptoms aren’t put on at whim. Rather, they are held in place by misguided internal patterns of belief, thought, feeling and behavior. What we might call the basic infrastructure of you needs some fundamental repair and upgrading if your eating disorder is to become a thing of the past.

So why not just dig in and get through it as fast as you can? The project sounds “shovel–ready”! An answer lies in the survival structures of your brain and nervous system. These are structures that alert and alarm you whenever you encounter danger. Well and good for poisonous snakes or nighttime intruders. The problem comes when unfortunate early experiences have programmed your alarms to go off even when there’s no actual danger involved, like the person who becomes phobic about water or elevators.

What does this have to do with your eating disorder? Let’s go back to those underlying thoughts, feelings and beliefs that are holding your symptoms in place. For example, you may have learned your anger isn’t safe, so you turn to food automatically when you are close to getting angry. Or, if intimacy feels threatening, you may have learned to use weight—too much or too little—as a protective barrier. Patterns like these took hold in your “infrastructure” because they were the best you could do to manage at the time you developed them. Certain patterns helped you cope and survive, so your brain perceives a danger and digs in to resist if you try to change them.

The good news is that your brain can unlearn false danger signals—but usually not quickly. Go too fast and a threatened system will fight, flee or shut down. This is where “Turtle Therapy” comes in. Some therapies, primarily so–called body–based therapies, are actually designed to help you track and carefully dose the amount of threat you expose your system to with any request for change. But it can also be considered Turtle Therapy any time you commit to settle in and tolerate frustration, anxiety or impatience when the going is slow. (Note: This is not the same as ignoring when things aren’t progressing. If you aren’t sure of the difference, talk it over with your therapist or other helping professional.)

What kinds of tiny–step infrastructure repair might you need to invest in? The answer to this will be as individual as you are. But the following three kinds of faulty infrastructure show up commonly in people with eating disorders and frequently respond well to a turtle approach:

Insufficient emotion management skills

If you are going to quit—and I mean quit for the long run—turning to food to manage your feelings, you’ll need to acquire safe alternative coping skills. You’ll also need to discover that big emotions, however unpleasant, are not dangerous to you. Your system will learn best on small practice doses as it gradually gains capacity and confidence.

Negative beliefs about yourself and the world

“I’m a loser if I make mistakes.” “Nobody will ever love me as I am.” “People basically can’t be trusted.” These are examples of the faulty conclusions we can draw from faulty experiences growing up. Such beliefs don’t yield easily to contrary evidence, even when part of you knows better. Actually, some therapy approaches can help you make quick work of distorted beliefs in many instances. CBT and EMDR are examples. But when a belief holds on like a barnacle on a ship’s hull, this may signal that your system isn’t ready to trust a healthier belief so fast. A turtle style bit–by–bit dismantling may be called for.

Trauma

Trauma is capable of disrupting any aspect of the basic human infrastructure: physical, emotional or psychological. The earlier the trauma occurred, the longer it lasted, the more it involved trusted people on whom you relied, the more disruptive it was likely to be to your ongoing functioning and sense of well–being. Daily living, full of trauma triggers, can set off internal alarms at every turn. Eating disorders frequently develop to help people buffer the daily disruption and threat that are unhealed trauma’s legacy. A tiny–step recovery approach is often the only lifeline such a highly–sensitized and leery internal system can tolerate.

Here are some extra benefits you get when Turtle Therapy is necessary and you stick with it:

• You build tolerance for frustration 
• You improve your “stick–to–itiveness”
• You develop confidence that you can accomplish difficult things
• You aren’t daunted by challenges that will take awhile to master

You may wish to compare the demands and benefits of Turtle Therapy to our nation’s current dilemma. Even though we are in the midst of a severe economic crisis, we need to invest in future technology and infrastructure if we want a sturdier, more secure national future. And just as we want our taxpayer dollars to go to projects and investments that will truly lay the groundwork for a more secure tomorrow, you will want to invest your precious time, money and energy in recovery work that will lay the groundwork for a more secure, resilient you in the future. Even if it seems time–consuming and tedious now.

(Alert! Do NOT think “turtle” when your symptoms are life–threatening! Starvation, dangerously low weight, extreme levels of purging, suicidal impulses you can’t control all require immediate attention, possibly a protective environment until you are back in a safe zone. Only then can you consider the longer–term aspects of your recovery.)