A qualitative exploration of relationship and attachment themes in families with an eating disorder

A qualitative study is described which explored the experiences of four families each of which contained a young person who had suffered with anorexia nervosa. The focus included an exploration of current relationships in the family, transgenerational patterns of relating, and the role of food in relation to comfort. Individual interviews were conducted with the young person with anorexia, a key sibling, both parents, and a joint family interview was also conducted. Interpretative theme analysis and discourse analysis were combined to generate a set of common themes across the families: False or Fragile Reality, Troubled Relationships, Arguments and Triangulation, Lack of Comfort, and Negative Relationships with Food. The findings suggest that experiences of relationships as conflictual and of communicational processes as confusing was common to all family members. Across all four families it appeared that the young person with anorexia was playing a pivotal role in the parents' attempts to correct their negative experiences from their own childhoods. The article concludes with an attempt to extend our understanding of eating disorders by offering an integration of concepts from attachment and systemic perspectives. Implications are offered for clinical work with families.