August 25, 2014

Eating Disorders and the Psychosomatic Family

Recently I saw a 25 year old woman who had experienced bulimia for about 6 years. Her focus was increasingly on her body weight.

She lived at home with her family. When I asked her about her family she reported that she was very close to her mother.

However, her mother constantly spoke to her about her weight and showed her photos of stick-thin women in magazines, suggesting her body should look like theirs. Her mother also asked her frequently about the lack of men in her life and questioned when she was going to get married and have children. My client avoided every conflict with her mom and said she felt like she was caught between her warring parents. She described herself as “a prisoner of guilt” and felt responsible for her parents because they were not doing well in their lives.

The psychosomatic family; Dr. Salvador Minuchin and his colleagues Dr. Bernice Rosman and Dr. Lester Baker described a family organization that maintains the symptoms of eating disorders. There are significant parallels between their description of the psychosomatic family and the organization of my client’s family including conflict avoidance, lack of boundaries, feeling like she did not have a voice, rigidity, feeling that things cannot change, and triangulation or being caught in the middle.

In my clinical experience over a number of decades of working with families with eating disorders I find this description very common. This is both important and hopeful, as when the family structure changes, the eating disorder symptoms can be readily ameliorated. I encourage you to consult my book which you can now rent off Amazon, for further detail and illustration of this.

Please contribute to our community and give your anonymous responses so we can have an open discussion on these issues. We need to support each other.

Leave a Reply

Subscribe by Email

Book: Enduring Changes in Eating Disorders

Enduring Change in Eating Disorders - Book Cover

Endorsements from Clients

  • Hello Charles! I am unsure if you will even remember who I am haha, but this is [name withheld] – I saw you in (I think) 2017 with anorexia.

  • My wife and I felt quite emotional last Monday after our short Zoom session. All three of us hugged. It felt like the end of a relatively short but profoundly enriching journey with you which started in June at your home office on Waiheke Island.

  • Dear Dr Fishman Thank you so much for this website. I have a long history of swinging between bulimia and compulsive over-eating. I am currently a compulsive over-eater.