The biology of family psychotherapy

This article has presented a view of biologic psychiatry consistent with that described by Bowlby, discussed hypotheses concerning the biologic purpose of the primate brain and the human brain, and challenged standard beliefs about the identity of the patient entity in a true biologically based psychiatry. Ideas developed by Whitaker, Malone, and their colleagues almost 50 years ago are consistent with a modern biologic basis of family psychotherapy. The treatment of an anorexic family was used to illustrate possible mechanisms of psychotherapeutic treatment requiring the presence of the whole family. The role of the psychiatrist who treats a family is to understand the biologic or medical importance of treating the family as a whole, communicate this to the family, continually work toward that level of participation, suggest relevant topics for discussion, and catalyze interactions within the family. Psychotherapy with families as a whole is effective because of the power of kin selection and inclusive fitness, biologic processes not usually considered in the practice of medicine or psychiatry.