13.3.2 Psychological Explanations for Anorexia Nervosa: Family Systems Theory

• The family systems theory sees anorexia nervosa (AN) as resulting from dysfunctional patterns of family interaction (Minuchin et al, 1978)
• More females than males experience AN, and therefore the focus of family systems theory is often on the mother and daughter relationship
• Within these dysfunctional interactions, the development of AN often serves to prevent or reduce arguments as attention becomes focused on the family member with AN 
• Although the dysfunctional family is the problem, the individual with AN takes the responsibility, often fearing worsening the problems unless they accept their role 
• Enmeshment is when the interactions between family members inhibit each family member’s sense of individuality, such as when parents are over-protective of their children, thus preventing any sense of independence developing 
• Adolescent children lacking independence develop AN as a form of protest and to gain a sense of self, to distinguish themselves from the family unit 
• Autonomy and control is the ability of an individual to act independently and make choices according to their free will and not the decisions of others
• It is a normal part of adolescent development to need both autonomy and control, and AN is explained by family systems theory as a struggle for this self-management, identity and effectiveness separate from the family
• The family systems theory argues that disturbances in the development of autonomy and control are a defining feature of AN, and show as distortions of body image, misperceptions of internal states and a paralysing sense of ineffectiveness
• Weight loss becomes viewed by the adolescent as a visible measure of their autonomy and control

Family systems theory explains refusal to eat as a way of exercising autonomy and control.

Research which investigates family systems theory as an explanation for AN

• Strauss & Ryan (1987) used questionnaires to measure the degree of autonomy in 19 individuals with AN and 17 who did not have AN, and found that those with AN had less sense of autonomy, poorer sense of self and dysfunctional family interactions, supporting the family systems theory
• Bruch (1991) argued that the parents of children with AN tend to be domineering, and the AN represents an attempt to gain a sense of autonomy and control over their own bodies

Evaluation of research investigating family systems theory as an explanation for AN

Strengths

• Research has shown that good family relationships result in psychological well-being for adolescents, while enmeshment was seen to have the opposite effect, with these findings supporting the family systems theory, and applying across different cultural groups (Manzi et al, 2006)
• The family systems explanation for anorexia has practical applications as it suggests a way to work with families to improve interactions by reducing enmeshment

Weaknesses

• Family systems theory research is  based on clinical case studies and self-report questionnaires and interviews concerning complex family relationships, which means that the research lacks objectivity as family members may give socially desirable responses
• Rather than being a cause of the development of AN, heightened family tensions could easily be the result of having an individual with AN in the family

Link to Approaches: 

The family systems theory explanation for anorexia is based on the therapeutic approach of the  psychodynamic approach as it views the family system as a complex, deeply-connected changing collection of parts, subsystems and family members, where each member has a known purpose or function that is often unconscious.