Eating Disorder Articles

Jeanne Rust on Family Therapy

From the Sunflower Newsletter, May, 2006

Mirasol's Family Week is the backbone of our treatment program. Eating disorders are family conditions — everyone in the family is affected by the behavior of someone with an active eating disorder.

The goal of Mirasol's family program is to promote a healthy family system that:

• is balanced and able to adapt to change
• is connected across generations
• has minimal fusion (or enmeshment) and distance
• is able deal with problems between family members
• tolerates differences
• is composed of differentiated members
• is aware of what they get from outside and from within
• allows members to have their own emptiness
• preserves a positive emotional climate
• has members who think it's a pretty good family
• uses each other for feedback rather than as emotional crutches

Sometimes Mirasol's family program seems almost magical. We see families learn to express their feelings and develop new communication skills as well as acquiring a tremendous amount of information about eating disorders. Love is deepened and trust is built. We have truly witnessed many miracles during Family Week.

Please feel free to email me with any additional questions you might have about family dynamics and family therapy.

Warmly,
Jeanne Rust, PhD

The information in this article has come from several sources: Richard Nolan, PhD. (see www.psychpage.com), Family Therapy: Concepts and Methods, by Michael Nichols and Richard Schwartz, from the amazing work of Virginia Satir, and from my own experience in family therapy.

Rewiring the Connections: Family Week at Mirasol

From the Sunflower Newsletter, April, 2007

Family "Week" is actually an intensive multi-day program — four days for adults and five for teens — when the client and key family members come to Mirasol with the ambitious goal of transforming the way they communicate.

The client and her primary therapist decide who needs to attend. It's usually the parents, but siblings or even grandparents may also be included. The program usually occurs near the end of the treatment and involves a maximum of four clients.

The women begin preparing for Family Week from the day they arrive at Mirasol. Through individual and group therapy, they learn to use affirmations and "when you ... I feel" statements to build self-esteem and assertiveness. teen clients also draft a detailed "eating disorder letter" that describes the feelings behind the disease and how it affects them.

To avoid surprises, Mirasol mails each participant a detailed schedule with a description of every session. The preceding weekend, while the parents are busy packing their bags for a trip to Tucson, adult clients participate in a ceremonial sweat lodge. Ann Mitchell's web site describes it as 'a Native American ritual used to purify your spirit, mind, emotions, and body to experience a closer connection to the Great Spirit'.

"It gives the women a way to start focusing on family week and what they want their program to be," says Mitchell, who facilitates Mirasol's adult family program.

On the first day of Family Week, the clients find themselves face-to-face with their families in a roomful of strangers. To break the ice, Ann Mitchell gets right down to business with some serious "sculpting" (role-playing). The client plays herself at age five, and picks various people to play her mother, father, inner child, her emotions and the "medicators" — the eating disorder and related behaviors — that she uses to cover up her real feelings.

"It's all visual," says Mitchell, "and it gives parents tremendous insight into their daughters' emotions. Until now, all they've seen is the medicators, and they've tried to cope with them through control or over-protection."

And that's just the first morning. Whew!

Meanwhile, across town, the teen program has the luxury of an extra day and a gentler introduction to Family Week. After an orientation session, the parents and their daughters participate in daily morning workshops that include group therapy and creation of a "genogram", or map of their family system and patterns of interaction that may relate to the eating disorder. Each girl will have an opportunity to read her eating disorder letter in front of the group. Invariably, the letter reveals memories of events that profoundly affected the daughter, but that may have seemed trivial to the parents.

"Children assume that the world revolves around them," explains Katharine Dean, "so they tend to blame themselves for anything that goes wrong." Since they don't understand their emotions, it may be easier to put the blame on their appearance.

Mitchell concurs. "Children have a tendency to translate their parents' actions into stories that have nothing to do with reality," says Mitchell. The point of family week is to rewrite those stories, and to begin changing the way we look at things.

To quote Wayne Dyer, "If you change the way you look at things, the things you look at change."

During Family Week, parents experience residential treatment along with their daughters, sharing meals and participating in workshops on mindful eating, nutrition, neurofeedback, family dynamics, recreational therapy and dance-movement therapy. But the core of the program is creating opportunities to practice new ways of communicating.

On Day Two, adult clients and their families receive a homework assignment that includes identifying behaviors that mirror behaviors of other family members, describing what they want from their relationship with their loved one, and what they're willing to do to achieve it. Meanwhile, Mitchell coaches the parents on body checks, affirmations and other communication tools that their daughters have learned while in treatment at Mirasol.

The stage is set and both the clients and their parents are well prepared for the rest of the program. Most importantly, "they have learned how to listen to what someone else has to say without taking it personally," says Mitchell.

"Women with eating disorders actually have a lot to say about the disease, but they're afraid that Mom will be hurt, or Dad will abandon them". Through affirmations and mirror work, they find out that they can tell their parents how they feel without hurting or alienating them.

One by one, first with one parent, then the other, the daughter reviews her mirror work. She is guided to read a few sentences, look at the other person, and move more deeply into her emotions as she reads.

"I stay with it until they wrap it up and everything looks pretty 'clean'," says Mitchell. On the final day of the program, Mitchell asks everyone who participated to share how it helped them heal in their own lives, and finishes with a closing ceremony.

Mitchell compares her four-day program to "surgery without an anesthetic."

"We can't heal our pain through the intellect," says Mitchell. Mirasol's family program "creates an opportunity for very deep emotional work, and to plant the seeds that will enable these families to have peace in their hearts, peace in their minds and peace in their bodies, no matter what happens."

In addition to her work at Mirasol, Ann Mitchell offers customized individual and family workshops and sweat lodge ceremonies. For more information, visit www.connectionsworkshops.com.