Psychological Explanations for Anorexia Nervosa: Family Systems Theory (AQA A Level Psychology): Revision Note

Family systems theory: enmeshment, autonomy & control

• The family systems theory sees anorexia nervosa (AN) as resulting from dysfunctional patterns of family interaction

  • Minuchin et al. (1978) identifies four main features of the 'anorexic family':

    • enmeshment

    • overprotectiveness

    • rigidity

    • conflict avoidance

• More females than males experience AN, and therefore, the focus of family systems theory is often on the mother-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 the problems will worsen unless they accept their role 

• Enmeshment is when family members are overly involved with each other, with poorly defined roles and boundaries, so that identities become tied up with one another and individuality is inhibited

  • 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 are 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

Research which investigates family systems theory as an explanation for AN

• Strauss & Ryan (1987) measured autonomy in individuals with AN compared with controls, and found that those with AN showed greater disturbances of autonomy, a more controlling style of regulating their own behaviour, less clear separation between themselves and other family members, and poorer communication within their families

• Bruch (1978) argued that the mother in particular tends to be domineering, intrusive and dismissive of the daughter's need for independence, so that self-starvation becomes an attempt to gain autonomy and control over her own body

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

Strengths

• Brockmeyer et al. (2013) studied 112 female AN patients and healthy controls, and found that the AN patients showed a significantly greater desire to be autonomous, which corresponds with Strauss & Ryan's earlier findings

  • This suggests that a thwarted desire for autonomy may be a risk factor specifically for AN in daughters

• The family systems explanation has practical applications through behavioural family systems therapy (BFST), which disentangles family relationships and encourages the person with AN to interact more with people outside the family

  • E.g. Robin et al. (1995) found that 67% of 11 female participants had recovered after 16 months, rising to three quarters at one-year follow-up

  • This compared favourably with individual therapy, suggesting that targeting family interactions rather than the individual alone is an effective route to recovery

Limitations

• Aragona et al. (2011) studied the families of 30 Portuguese women with eating disorders and found they were no more enmeshed or rigid than non-eating disordered families, possibly because they used self-report questionnaires rather than observer ratings

  • This suggests research has failed to reliably identify the 'typical anorexic family', as findings differ depending on whether the measure captures family functioning or family members' perceptions of it

• Heightened family tensions could be the result of AN rather than its cause, as enmeshment, rigidity, overprotectiveness and conflict avoidance may all be consequences of living with a family member with AN

  • However, FST supporters argue the direction of cause and effect is irrelevant, as the symptoms become linked to family interactions either way, so understanding this link can still guide treatment

Issues & Debates

• The theory is environmentally deterministic, suggesting anorexia develops from dysfunctional family dynamics, especially enmeshment and lack of autonomy

  • This overlooks individual free will and personal cognitive factors (e.g., distorted thinking about body image), limiting the explanation’s scope

• The theory often focuses on mother–daughter relationships, implying that females are more vulnerable to dysfunctional family processes

  • This may reflect alpha bias, exaggerating gender differences and overlooking males with AN, as FST has difficulty explaining why AN appears in males at all if it assumes the disorder arises from mother-daughter dynamics