Families and environment in Eating Disorders

Eating Disorders are serious psychological disorders that affect all aspects of the affected person's life. Although the most visible is the relationship with food, this is only the tip of the iceberg. Its causes are multiple and varied, but there is always a common denominator: low self-esteem.

It is estimated that there are more than 70 million people in the world affected by this type of disorder. When we talk about this figure, we are not counting family members and the environment, who also suffer indirectly from eating disorders on a daily basis.

• Related article: "Eating Disorder, Unspecified: What is it?"

The relationship between Eating Disorders and the family

If we look back, the role of the family in the treatment of eating disorders it has evolved over time.

In the first applied treatments (before the 1970s) the family was excluded because it was considered to be a causal factor or an important part of the disorder. In this way, the person suffering from the disease was isolated, understanding that in this way they would improve.

However, in the late 1970s, Authors such as Minuchin or Palazzoli begin to be aware that this separation is not beneficial, so they begin to apply family therapy.

Psychology has also had the intention of identifying a "Profile of the TCA family" that is repeated from one case to another. This is not entirely possible, since as previously commented, this disorder responds to a multicausal etiology.

Currently, the role of families in treatment is increasingly being taken into account. From my point of view, it is essential that we count on the patient's family members as active agents in the therapeutic process.

How do families get to the consultation?

In general, his psychological state is the following:

Disoriented and lost

They do not understand what happens or how they have been able to get to that situation. On many occasions they are not aware of what is happening, on others they suspected that something was happening but did not know what or the seriousness of the matter. Some even deny the problem.

Scared and distraught

Not being in control of the situation, they feel bad.

Guilty

Family members often feel guilty about their loved one's situation.

With the role of parents blurred

They have lost the role of parents, or do not know how to exercise it. Sometimes the situation leads them to become "police or detectives" trying to search for packaging or food scraps in their child's room, or listening behind the bathroom door.

What can we do for families?

Some recommendations to follow with the family members of people with ED are the following.

1. Listen to them

Give them a space where they can express themselves. Perhaps in the consultation it is the first time that they can express everything they feel since previously it is possible that they have hidden it or see it as a taboo.

2. Inform them

Give them information about the status of their loved one, about the disease you suffer from, what are the symptoms and the prognosis.

3. Support them

It is important that they find support in the psychologist. It is essential that we help them to let go of the guilt they feel, emphasizing the difference between fault and responsibility.

4. Teach them tools

Provide necessary guidelines on a day-to-day basis. It is appropriate to work with them assertively so that they can have good communication at home.

5. Encourage them to regain the role of parents

On the one hand, they must set the necessary limits and proportionate to the situation and age of their family member. And on the other, it is important that they regain the relationship they had before the disease began.

6. Caring for the caregiver

TCA cannot dominate your entire life. They should take care of and pamper themselves, taking time for themselves and their hobbies.

7. Motivate them and encourage their patience

Treating an eating disorder is complicated and ups and downs are frequent, so we can help you be prepared.

Levels of intervention

According to Walter Vandereycken and his collaborators, there are four levels of psychological intervention to consider.

• Educational counseling and guidance: psychoeducation to family members about what ED is and how to deal with it.
• Family therapy: therapy with all family members. Sometimes the psychologist must act as a mediator.
• Couples therapy: if there is a crisis.
• Individual therapy for family members: in those cases whose severity requires it.

Definitely, we must see family and environment as allies in the treatment of eating disorders. In this way we will all row in the same direction to achieve a better evolution and prognosis of your loved one.

Author: Laura Martín Pato, General Health Psychologist, member of the Matía Psychology Center and Online Therapy Center.