Theoretical and empirical models around caring for someone with an eating disorder: The reorganization of family life and inter-personal maintenance factors

Background: Previous theoretical models regarding family functioning have proposed that dysfunctional family interactions may play a causal role in the development of eating disorders. Such models, while historically important, have been unhelpful in blaming families and are poorly supported by empirical evidence.Aims: The aim of this paper was to expand and develop models around familial patterns which may be more clinically valuable.Method: Recent empirical and theoretical evidence around family's experiences of caring for someone with an eating disorder were explored.Results: Recent literature supports the view that families may become “reorganized” around the illness. The following processes are discussed: (i) The central role of the symptoms in family life, (ii) The narrowing of time focus on the here-and-now, (iii) The restriction of the available patterns of family interaction processes, (iv) The amplification of aspects of family functioning, (v) The diminishing ability to meet family life-cycle needs, and (vi) The loss of a sense of agency (helplessness).Conclusions: Families may become stuck in unhelpful interactions and lose sight of their own strengths and resources. Professionals should address unhelpful processes within the family, using a collaborative approach.Declaration of interest: J. Whitney has been funded by RIED through the charitable organization, Psychiatry Research Trust.