Bulimia nervosa. A treatment concept implying an "integrative painting therapy"

At the Department of Psychiatry, University Hospital Graz, we have been applying a concept for treating bulimia nervosa, using a complementary method involving psychosocial and psychotherapeutic strategy as well as psychotropic medication. Thus we have been able to approach the patients from a holistic view. Painting and drawing as a creative method constitute another salient part of our concept. Between January 1995 and September 1999, 36 in-patients with bulimia were treated in the Psychotherapy Unit of the University Hospital's Department of Psychiatry in Graz; our concept focussed on "Integrative Painting Therapy". The wide variety of treatment methods comprised individual and group therapy, diet counselling and thymoleptics (SSRIs). Teamwork and close links within the team constituted an important part of our work, so that the different types of therapy are process-oriented and thus interrelated. In the initial phase of the symptom-oriented approach patients learn to control and ultimately normalise their eating habits. In the phase of acting out and/or conflict awareness, they try to cope with their disorder on a pictorial level. They gain access to their emotions and become aware of their problems, while their eating habits improve. Self-esteem is eventually stabilised and patients develop a sense of self-responsibility and work on effective strategies to cope with their disorder. This development also manifests itself in their pictorial expressions. "Integrative Painting Therapy" led to a marked improvement of the depressive moods initially prevalent in all patients. It also slightly elevated their Body Mass Index. Moreover, control capacity increased significantly, irregularities in eating habits were reduced and craving for food subsided.