Most people who know about eating disorders or are familiar with someone who has one understand that there are many reasons that contribute to the development of an eating disorder. Each person is unique and therefore the constellation, which contributes to cause, is also unique. Biological, psychological, relational, media, and cultural facts can, and often do, contribute.
Family relationships are deeply impacted during the course of the illness, but often before the symptoms of the disorder make themselves known.
Family System Theory states that usually the person in the family who holds the “symptom,” i.e. eating disorder, is “just” the spokesperson for the problems, pain and dysfunctional dynamics shared by all family members. These are likely to have persisted before the eating disorder developed. The voice of the family’s issues is manifested through the eating disorder.
In my book, “When Food is Family: a loving approach to heal eating disorders,” family dynamics are indeed key ingredients in the eating disorder mix of potential contributors and certainly induce many emotions—fear, anger, despair—throughout the course of the illness. This blog posts addresses how families can contribute to the development of eating disorders. It also addresses how strengthening families and members’ connection to each other is the necessary food in recovery.
Eating disorders are scary for everyone in the family. When a parent watches a child engaging in a behavior that inhibits her ability to nourish her body and grow, it is terrifying. Standing by, watching her starve herself, binge, purge, or engage in other disordered eating behaviors can make families feel completely powerless.
The problem is complicated even further when the disordered eating behavior begins to take hold of the family and contorts or controls day-to-day life for each and every member. Parents may start catering to their child’s anorexic behaviors, e.g., fixing special breakfasts based on her demands, because they are afraid if they don’t, she won’t eat. They may sit staring at each other, unable to speak, as their child spends hours in the bathroom vomiting. All the while resentment of the situation, each other, and even the ill child silently grows.
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Eating disorders are no one’s “fault.” The person with the disorder doesn’t want it (at least, down deep she wishes it didn’t exist), and most parents don’t raise their children hoping they will develop dysfunctional eating patterns. So, judgment, toward the sufferer or family members does not help the situation. That said, eating disorders affect not just the person who has them, but every member of that person’s family. The disorder lives with the family. Eating disorders are often a family affair.
Your family feeds you. Your parents provide you with what you need to help your body grow when you are young. But this is only the most basic way your family feeds you. Your family also nourishes you psychologically and spiritually—feeding you from the well of their own emotional experiences. When it comes to emotional sustenance, the “bread” you are fed is your parents’ language and actions. If their language and actions reflect love, support, empathy, and understanding (even of difficult emotional experiences), a bond is created between you and your parents that become the foundation of your sense of self-worth throughout your life. Healthy bonds make healthy people. Your family becomes your most nourishing “food.”
Sometimes these bonds don’t develop properly due to circumstances unique to the individual. Family strife or stressors, or a predisposing mental health issue, can weaken the family’s capacity to provide support, understanding, and empathy. Sometimes there are real and practical issues that severely impact parents’ availability which may not affect one child in a psychologically debilitating way, but may indeed affect another. These include:
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Both parents need to work fulltime to make ends meet, or there is a single parent household and the parent works one or more full-time jobs to support the family
The mother or father is consumed by a substance disorder and unable/unavailable to parent
The family is unable to identify and articulate emotions in a positive way or does not know how to communicate appropriately (especially in familial conflicts)
Serious mental health issues or psychological issues (i.e. bipolar disorder) in parents or siblings
Triangulation caused by marital problems between parents causes the child with the eating disorder to become the scapegoat for the marital issues and is consciously or unconsciously brought into the marital discord
“Fussy” and “head strong” children do not mesh with a more “laid back” family
A climate of misunderstanding, perceived or actual criticism, frustration and helplessness for both parents and—eating disorders can flourish in response to this mismatch of personalities and sensibilities.
Throughout my career I have practiced, written, and spoken about the necessity of forming healthy attachments, particularly between parents and children. It is the sine qua non of self-worth and self-esteem. Sometimes, there are disruptions to these attachments as life throws many curve balls along the way. The point is that IF an eating disorder develops for one member who utilizes the symptoms of the eating to express and deal with familial issues, families can be helped to respond and heal—even if the family has not yet developed the skills necessary, cannot communicate or lacks emotional or empathic responses.
