Mar 29, 2010
Eating disorder treatment affects the whole family and needs to be addressed at the family level to maximize the efficacy of a treatment program.
When family members bring their loved ones to treatment for substance abuse and eating disorder issues, the hopeful anticipation is that at discharge, they will be ‘fixed’. Despite the fact that my magic wand holds a special place in my office, it seldom works the way family members want it to. Healing from substance abuse and eating disorder behaviors is a complex and complicated endeavor and requires more than simply work on the sufferer’s behalf. From my perspective, healing is a family affair revolving around the building of open and honest lines of communication. Getting to this point can be challenging and oftentimes the clinician has to overcome significant defenses inherent within the family system.
The goal of family healing is to subvert any notion of blame. Rather the intention is to move from self-absorption or self- flagellation to a place without guilt and shame – a place of openness focused on utilizing the past only for self-discovery and growth. The creation of substance abuse and eating disorder behaviors usually develops from multiple factors rather than one single cause. There is no need to expend time and energy on examining these factors ad infinitum. Most important is to begin with a willingness to create the open, honest lines of communication towards the development of new behaviors and discovery; a willingness to listen and tackle those issues in a significant enough way that allow for listening closely to the sufferer’s story.
Let’s examine what we know about the complexities of substance abuse and eating disorder behaviors. For the most part, these behaviors are utilized as coping mechanisms by the sufferer to act as numbing behaviors to separate them from ‘feeling states’. But if we look closely with open hearts and eyes, it soon becomes revealed that these behaviors when extreme, become a cry for help, a cry for attention by the sufferer.
There are many contributing factors to the rise of substance abuse and eating disorder behaviors. We live in a world where the media barrage of diet fads and obsessive attention to body image is excessive to say the least. We live in a world where family structures are dissipating which in turn leaves adolescents vulnerable to define their own acceptable sense of self. We live in a world where perfectionism is a common denominator between those who are born to believe they are capable and those who are not. Most importantly there are many exemplifying factors to consider such as stress, depression, socioeconomic positioning, and the list continues.
But let’s get to the bottom line here – the healing process is indeed a family affair.
My goal when working with families is to help understand each individuals’ fears surrounding the sufferer, and to help each person in the system become empowered by creating honest, trusting, and deep bonds with the other. This development is not an overnight process, nor does my ‘magic wand’ help in the endeavor. Rather it is a slow, pedantic process requiring an open heart, mind, and most importantly, the willingness to be vulnerable, introspective, and supportive in a healthy way to the sufferer. I firmly believe that if these elements are in place, magic can happen in the healing process.
The most significant factor of all is that the identified sufferer gleans a new perspective on life as do those in the family system who come to the witness the metamorphosis. Oftentimes the metamorphosis is their very own.
Dr. Michele Lob PsyD MFT has a private practice working with families and children in Newport Beach.