September 29, 2011

Family dynamics? Really? Still?

I keep being told that the old saw about family dynamics causing eating disorders is dead and gone and stop harping about it.

But, I'm sorry, it still lives. It also causes active harm.

Today I was asked to sign my support to a document created by my own state, one that is supposed to be an up-to-date view of the illness and make recommendations. Unfortunately, the document is poorly sourced (since when is the Huffington Post a scientific citation?), leaves out important information now widely known by researchers and evidence-based clinicians, and includes numerous factual errors.

Among them: that family dynamics cause eating disorders. Why do I care? Because this sort of document, dated in 2011, becomes a reference for OTHER literature. This sort of document becomes government endorsement of ideas and recommendations that cause active harm.

"Factors Influencing the Development of Eating Disorders
Family Dynamics Families used to be viewed as the primary cause of an eating disorder
I.e. an emotionally-distant father or an overly controlling mother While sometimes these dynamics are present, it is most important to
understand how the patient views his or her role in the family (i.e., to be the "good kid")'

This should not go on, and yet it does. Really, this is the total of what you want to say about what causes eating disorders on the topic of family? Really? This is September 2011, right? Not 2001?

Not that I wish to spend time analyzing and refuting and protesting this document - I'd much rather it be a good document that I COULD endorse - but I have to. Not just because it is my state that is affected but because it leads to more.

Please, if you have some time to spare - and mine is very short this week - I could use help with the legwork here. Finding the correct citations and statistics, identifying the most important points.

I plan to focus on the family dynamics issue in this document, myself. Not that some of the other stuff - like the trauma piece - doesn't bother me, but because I am more likely to be successful with a focused protest.

We all need to stand up when we can to bad information. It may not help, but let's not make it any easier for those who would allow weak and faulty information get a government stamp!

5 comments:

  1. Laura I will email you a great article on the biologic factors causing eating disorders. Dinosaurs are big and don't go down easily I guess but family dynamics as the cause of eating disorders is going in the way of the t-rex.

    Raye-Ann

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  2. This is one of my favourites http://www.mendeley.com/research/empirical-theoretical-base-family-therapy-multiple-family-day-therapy-adolescent-anorexia-nervosa/
    It is possible to find the whole article free on the Internet because I've done it, but I can't find it again. Of course it leads on to the whole "families don't cause it but they perpetuate it" debate but it's a very good start from a man who is uniquely willing to publicly tear up his original notes and say "we got it wrong"

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  3. The family dynamics myth is still very much alive and well amongst most clinicians who treat eating disorders. A large percentage of my patients have come to me after continuing to deteriorate under traditional treatment. Often, the prior treating therapist has focused on family issues as an underlying cause and has not included parents in the treatment of their teenage child. This happens far, far more often than it should in this day and age.

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  4. I don't understand why so many disproven myths are still being publicized as fact on levels as serious as state legislation and even ED advocacy organizations. Why is research being ignored? I understand that it's "easy" and "palatable" to blame skinny models or diet culture or daddy issues or controlling moms, but REALLY? Like you said, this is 2011. And as someone living with an ED that was most certainly NOT "caused" (or even catalyzed) by any of those issues, I'm intensely frustrated with the seemingly universal attitude that EDs are a simple, preventable, vanity-based affliction limited to privileged "good girls" from dysfunctional families.

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  5. Why is science ignore? It's easier for self preservation and greed.

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