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A Family Systems Perspective on Recovery 75 family sessions during holidays or visits when the family is together is also helpful. Family therapists often see adults with eating disorders as well. Just as in Mary’s case, the focus is on reducing stress in the family. In treating an adult with an eating disorder, the focus is on family-of-origin issues. (Of course, concurrent focus must always be on alleviating the eating disorder symptom.) The person is “coached” to understand the events and rules in her family that led to unresolved stress (Carter and McGoldrick-Orfanidis 1976). She is then encouraged to approach her family of origin in a new manner, one designed to release her from the triangulated position. This work has been shown to be a powerful step toward improving relationships in her adult life. When the person with the eating disorder is married, therapy most often should include the spouse. The work done by each member of the family of a person with an eating disorder will have a marked effect on the stress level in the family and the tension experienced by each family member. Having learned to approach issues with one another in a direct manner, stress will not build up and the family and each of its members will be free to carry out the primary business of supporting and nurturing one another’s growth, development, and security. References Carter, B., and M. McGoldrick-Orfanidis. 1976. “Family Therapy with One Person.” In P. J. Guerin Jr., ed., Family Therapy: Theory and Practice. New York: Gardner. ––, eds. 1989. The Changing Family Life Cycle: A Framework for Family Therapy. 2d ed. Boston: Allyn and Bacon. Garner, D. M., P. E. Garfinkel, D. Schwartz, and M. Thompson. 1980. “Cultural Expectation of Thinness in Women.” Psychological Reports 47:483–91. Kerr, M. E., and M. Bowen. 1988. Family Evaluation. New York: Norton. Keys, A., H. L. Taylor, and F. Grande. 1950. The Biology of Human Starvation. Minneapolis: University of Minnesota Press. In K. D. Brownell and J. P. Foreyt, eds., Handbook of Eating Disorders, p. 307. New York: Basic Books, 1986.
76 A Family Systems Perspective on Recovery Orbach, S. 1982. Fat Is a Feminist Issue II. New York: Berkeley Books. Richardson, R. W. 1984. Family Ties That Bind. Vancouver: Self-Counsel Press. Root, M.P.P., P. Fallon, and W. N. Friedrich. 1986. Bulimia: A Systems Approach to Treatment. New York: Norton. Siegel, M., J. Brisman, and M. Weinshel. 1988. Surviving an Eating Disorder: New Perspectives for Families and Friends. New York: Harper and Row.
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editor BARBARA P. KINOY EATING DISO
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Eating Disorders New Directions in
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To our patients’ children and gra
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viii Contents 3. Psychiatric Consul
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x Foreword Although serious deficie
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preface In 1994, in the first editi
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Preface xv psychological hazards to
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Preface xvii partial, complete, or
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acknowledgments We wish to acknowle
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contributors Debra Bader, CSW, BCD:
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Eating Disorders
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Introduction diane w. mickley I am
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Introduction 3 needs of patients wh
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Introduction 5 therapy or on medica
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1 Medical Aspects of Anorexia and B
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Medical Aspects of Anorexia and Bul
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2 Recovery Through Nutritional Coun
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Recovery Through Nutritional Counse
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Lesson 1: Daily Caloric Need and Me
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Recovery Through Nutritional Counse
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Page 54 and 55: ical activity to a normal level. If
Page 56 and 57: patient who binges, it may be helpf
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Page 60 and 61: Figure 2.3 Typical Hunger and Food
Page 62 and 63: herself. She frequently feels hopel
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Page 76 and 77: Psychiatric Consultation 51 standab
Page 78 and 79: Psychiatric Consultation 53 difficu
Page 80 and 81: Psychiatric Consultation 55 Obsessi
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Page 84 and 85: A Family Systems Perspective on Rec
Page 90 and 91: she calls her mother and tells her
Page 102 and 103: 5 Relationship to Food as to the Wo
Page 104 and 105: iors—somehow to integrate the fra
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Page 108 and 109: Relationship to Food as to the Worl
Page 114 and 115: 6 The Therapeutic Use of Humor in t
Page 116 and 117: The Therapeutic Use of Humor 91 Amy
Page 118 and 119: The Therapeutic Use of Humor 93 was
Page 120 and 121: The Therapeutic Use of Humor 95 ass
Page 122 and 123: The Therapeutic Use of Humor 97 Ron
Page 124 and 125: Jodie’s Story 99 capacity to make
Page 126 and 127: Jodie’s Story 101 house and a ter
Page 128 and 129: Jodie’s Story 103 She did not do
Page 130 and 131: adness. The dream also revealed tha
Page 132 and 133: 8 Eating Disorders and Managed Care
Page 134 and 135: Eating Disorders and Managed Care 1
Page 136 and 137: Eating Disorders and Managed Care 1
Page 138 and 139: Cognitive-Behavioral Therapy and Ot
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Cognitive-Behavioral Therapy and Ot
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10 The Nurse’s Role in a Pilot Pr
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The Nurse’s Role in a Pilot Progr
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The Nurse’s Role in a Pilot Progr
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11 Individual Psychotherapy: A Long
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Individual Psychotherapy 135 Such p
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Individual Psychotherapy 137 empath
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weight and shape, as well as change
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Individual Psychotherapy 141 vomiti
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Individual Psychotherapy 143 During
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Individual Psychotherapy 145 and re
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Individual Psychotherapy 147 Mitche
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Young Adult Women 149 to surface an
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Young Adult Women 151 with their at
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Young Adult Women 153 ing; in fact,
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Young Adult Women 155 doomed, and a
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part of a treatment team where the
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13 Recovery margaret goldkopf-woodt
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Recovery 161 I can appreciate both
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Recovery 163 meant. I certainly cou
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Recovery 165 ate other uncomfortabl
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Recovery 167 connection between my
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Recovery 169 safe place, and our ow
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Recovery 171 My pregnancies and mot
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Recovery 173 They seem to be living
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Recovery 175 Self-disclosure remain
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nel. All that I feared, the hurts I
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Afterword 179 surprisingly rapidly
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Afterword 181 With eating disorders
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Treatment helped me to face life, i
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AA/BA. See American Anorexia/Bulimi
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37; prevention of, 29-31; rigid die
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problems and, 19; events triggering
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Keel, P. K., 180 Keller, H., 133 Ke
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Psychoeducational group therapy, 12
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112-20; IPT, 121-22; psychoeducatio
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