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(How not to do) Family Therapy

Posted Jan 15 2010 12:00am

I have stayed away from mentioning my family on this blog. This is, possibly, a lingering lesson from family therapy. There is little value in throwing around recriminations and blame and hurt. Family therapy’s a good tool but it comes with a few words of caution: get a good therapist; work together; and, remember that you can only ever change yourself.

The trick to effective family therapy is in the “family”. For some reason, it can be hard for the word – and the people – to stick. In the first few attempts, we fell at this crucial hurdle; and, what began as a group affair, quickly reverted back to the therapist and me.

This kind of defeats the object, although it’s relatively easy to see where it all went wrong…

Contrary to what a younger and more angry me believed, family work is not about pointing a finger and shrugging off the responsibility; it’s about listening to what other people have to say. And not starting out on the offensive.

Having missed this crucial proviso, take one was an unmitigated disaster. In the anticipation of a them versus me scenario, and the expectation of a force by numbers approach; the defences were up, and the shutters, bolted down.

Talking to a shut door is pretty pointless: we didn’t last long and we didn’t get very far.

The second attempt was equally unsuccessful – for very different reasons. Instead of digging my heels in and sewing my mouth shut, I participated in a particularly unhelpful version of pin the blame on the family member and an equally destructive game of pass the accountability buck.

Family therapy doesn’t work if you’re constantly dodging the accusations that are flying round the air or the responsibility that is being passed, like a hot potato. It can be hard to keep the focus in sight when the air is muddy with anger and hurt and fear – or the room, heavy, with the awkward and embarrassed silence of suddenly remembering that you’re being observed…

Given the nature of eating disorders, a few emotional outbursts are probably to be expected; but, finding a therapist that can manage them – and not one that opens up a can of worms and then walks out of the door – is advisable. Selecting one that doesn’t feel like an uninvited guest is also wise.

Of course, the difficulty in agreeing who this therapist should be hits the challenge of family therapy on the head: different people have different perceptions, and different preferences, and, sometimes, vastly different priorities….

Third time lucky appreciated this; the secret of effective family therapy is found in the space that is created to accommodate the different people, with their different perceptions and preferences and priorities. It’s about letting these differences be voiced – and heard – because, the huge benefit of the family approach is that you uncover all the versions of the story.

My eating disorder had a bit of an off-kilter take on the world and its inhabitants. It also tended to take over . With a good facilitator, this couldn’t happen. In the space to speak, I learnt a whole heap about my family that helped challenge my eating disorder’s perception – and gave me a glimpse into other people’s perspectives.

In the management of the fear (“she can’t handle that”) and the threat (“she’ll get worse”) and the prioritising of feelings (“her feelings are more important”), a few things got cleared up and a few misunderstandings, addressed.

Together.

So, whilst I might not be able to change anyone else, I at least understand how they work a little better (and vice versa). And, although family therapy was a little divisive to begin with, the later learning helped to bridge the gaps in a far more meaningful way. And, whilst I’m still sticking to my slight warning (make sure they’re up to the job), there’s no doubt that working as a family is important –

Because they’re often the most special people you’ve got –

And an eating disorder has the potential to leave a trail of destruction in its wake.

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