Family systems theory of AN

• Psychosomatic approach to eating disorders:

  • Minuchin et al (1978)- family systems approach.
  • The term 'psychosomatic' usually refers to a disorder with no biological basis, therefore thought to be psychological in origin.
  • Minuchin developed the idea of the psychosomatic family, stating that a dysfunctional family alongside a biological vulnerability is what leads to the development of an eating disorder such as AN.
• Characteristics of a psychosomatic family- control:

  • Control is characterised by over-protective behaviour- parent(s) are overly concerned for the welfare of the child.
  • This can lead the child to feel a lack of control over their own destiny & outcomes, and may ultimately cause them to rebel against this control by taking strict control over their own eating.
• Evaluation of Control in psychosomatic family- weakness:

  • Gremillion points out the gender bias in the family systems theory, as it largely focuses on mother-daughter relationships.
  • Because of this, therapy tends to focus on this relationship, ignoring the role of the father.
  • Argued that the role of a controlling father who demands action & change from their child is often overlooked when establishing potential causes of AN.
• Characteristics of a psychosomatic family- emmeshment:

  • Is a highly intense family relationship, which gives people a lack of sense of individuality & personal identity.
  • Involves high proximity, over-involvement and a lack of boundaries which can lead to anxiety in individuals of such families.
  • The intense nature of over-involvement means that children do not develop their adequate coping strategies for common/ usual stressors, and this leads to high anxiety which can increase the likelihood of the development of an ED.
• Evaluation of Emmeshment in psychosomatic family- strength:

  • Manzi et al looked into emmeshment & family cohesion, which was basically the opposite: supporting, understanding families that promote positivity & coping strategies.
  • Found positive correlation between cohesion & well-being, and a negative correlation for emmeshment & well-being.
  • Supports Minuchin's theories & can be applied across different cultural backgrounds.
• Characteristics of a psychosomatic family- autonomy:

  • Individuals are stifled & unable to develop their own individuality.
  • Children are not encouraged/ allowed to become independent, self-sufficient individuals, so we can say they do not develop autonomy (the ability to look after themselves).
• Autonomy:

  • In healthy family relationship- adolescent child encouraged & supported in becoming more responsible & independent.
  • In psychosomatic family- individuals treated much like they're still a child, as their families don't adapt to the changing needs of the child & stick with rigid patterns of established behaviours.
• Evaluation of Autonomy in psychosomatic family- weakness:

  • Kog et al looked into the families of AN sufferers & actually failed to find evidence of the characteristics predicted by the family systems theory (emmeshment & autonomy etc).
  • What actually found was that the families of AN sufferers were a diverse bunch with differing family relationships, emotional climates & patterns in family interactions.
  • With such inconsistent findings, seems that family systems theory cannot alone explain/ predict the development of an ED.
• Lack of conflict resolution:

  • A psychosomatic family dislikes conflict, so they go out of their way to avoid it.
  • This doesn't mean that there aren't any, but rather that when there are tensions/ disagreements, they are left to stew & fester, rather than being openly discussed & resolved.
  • The issues/ sources of the tensions are not dealt with, and the family may appear to be happy, but beneath the facade, you find deep unresolved conflicts.
• Evaluation of family systems approach to ED- weaknesses:

  • Evidence is mainly from case studies, therefore meaning a lack of reliability & therefore scientific credibility, as not easily replicated.
  • Difficult to test using scientific methods, due to individuality.