(5) Family Systems Theory and Anorexia Nervosa

  • Created by: bintahall
  • Created on: 27-03-19 19:27

The Psychosomatic Family

Psychosomatic: Conditions where no physcial basis can be found so the illness is due to psychological factors. Minuchin et al developed this model - states the prerequisite for the development of AN was a dysfunctional family with a physiological vunerability in the child.

Enmeshment: Extreme form of proximity and intensity in family interaction. Over-involved with each other - lack of boundaries. Researchers suggest that enmeshment stifles the development of children's skills to deal adequately with common social stressors - makes development of AN more likely.

Autonomy: Enmeshed families put great constraints on it's members - they aren't allow to be independent and develop autonomy unlike in a normal family. 

Control: Family has overprotective control over it's members. This can prevent an individual from knowing the extent to which they are able to control influence outcomes on their lives - teen may rebel by refusing to eat.

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Other Characteristics of the Psychosomatic Family

Rigidity: Families show a lack of flexibility in their adaptation to new situation - in stress they increase the rigidity.

Lack of conflict resolution: Low tolerance for conflict and difficulty in acknowledging and resolving problems. AN families in a state of constant unresolved conflict - evident in AN familied that present a facade of togetherness and a tendancy tp avoid overt conflict.

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Support for the concept of enmeshment: Manzi et al showed a distinction between family factors that promote positive emotional development and those that stifle it. Family cohesion - indicative of supportive family interactions, whereas enmeshment was rooted in manipultion and control. Also found that cohesion amoung family members was linked to positive outcomes and psychological well-being amound teens - enmeshment has opposite effects. (Applied for different cultural groups)

Problems with the psychosomatic family model: Research unable to find characteristics specific to families in which a member has AN. Growing evidence that families in which someone has an eating disorder are a diverse group in terms of the nature of family relationships, the emotional climate and pattrerns of family interaction.

Inconclusive support from family-based therapy: Success of family therapies shows families are a key part of recovery from AN. Carr et al - there is compelling evidence for the effectiveness of family interventions for teen AN. However, other researchers point out that whilst there are some evidence that family therapy is accompanied by changes in family functioning, these changes aren't necessarily predicted by the psychosomatic family model and may not happen in all families.

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Evaluation (continued)

Gender bias in family systems theory: Researchers claim there is a gender bias in family system becuase this mainly focuses on mother-daughter relationships. Argues that enmeshmet is always seen as maternal in origin. Results in therapy for enmeshed families focusing on reforming dysfuctional mothers rather than acknowledging the fathers roles even though they do play a role. Argued that fathers' tend to be overly controlling and this is often overlooked in the development of AN symptoms.

Research support for lack of conflict resolution: Researchers carried out an observational study comparing patterns of conflict resolution in 40 families of teen daughters with AN and 40 matched families without an AN member. Parents and daughters asked to choose 2 areas of disagreement between them and to keep off the topic of food and eating. Results: Daughters with AN - more difficulty choosing other topics and staying focused. Findings support Minuchin et al's claim of the pathological avoidance of conflict in families with an AN member.

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