Family Therapy and Eating Disorders

by Stanley Selinger, PhD - Family Therapist

Families are systems that shape us, motivate us, but also leave us vulnerable with wounds and expectations.  Families with a member that has an eating disorder have often been characterized as enmeshed, overprotective, overly rigid, or as having a strong tendency to avoid conflict with a lack of conflict resolution.

These families create poor boundaries and roles that are problematic for everyone.  Those with eating disorders often have developed a severe problem with the expression of anger.  As a result, either they suppress or externalize emotions.Those that adopt an eating disorder to cope, are attempting to control their bodies and their emotions with the obsession of food and the preoccupation with purging and restricting.

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The secret of the work with families, is to engage the whole family in the recovery process. This will help keep the family members from repeating the patterns that led to the dysfunctions within the family.

Therapy is like guiding them through an emotional forest. They carry shame and don’t know how to soothe themselves. They need therapy to take them beyond the land of hopelessness, teaching them they are not alone, yet simultaneously helping them to face their ambivalence, resistance and accept help. They have to learn to stop the harsh self-judgments and punishing themselves.

There are conflicts between wishes and needs, hurts that have never been healed, and expectations that may be unrealistic in families. In addition, some insist that their traumas are exclusively their fault. Their distorted thinking may lead them to perceive themselves as the “fattest” person in the room, even though everyone else views them as emaciated.

The person with an eating disorder is terrified of giving it up, because it is their major way of coping with very difficult feelings, the stresses in their lives and having a sense of control.  Actually they are seeking unconditional acceptance and have not learned to openly and effectively communicate.  With this knowledge they can be challenged to identify their real emotions and view them through a healthier lens. This requires not only the family member with the eating disorder, but the entire family to understand that positive change requires awareness, new skills and the support to experiment with new options.  Improvement and recovery are always possible even for those who felt hopeless and helpless. Sharing your hopes and dreams together might be a first step.

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