[Role of the family in the pathogenesis of anorexia nervosa]

Previous to the first family studies on schizophrenics, some authors had already called our attention on certain peculiarities to be found among anorexic families. Out of 35 families studied between 1970 and 1981, 20 were selected that met the following conditions (1) Proven diagnosis of primary A.N., (2) A complete family study with researchers making home-visits as 'participant observers', (3) At least, a 6-month psychotherapic treatment, (4) At least, one clinical treatment. The following feature among the total results (1) These are consistant, large families where, usually, daughters outnumber sons (three to one), (2) In almost all these families, one parent suffers from a chronic illness while the healthy one exerts a unilateral domination on all family members, (3) In almost all these families, a so-called 'family mystique' is likely to be discovered. This mystical ideology--already mentioned by other authors--always stresses up (a) An overvaluation of school, job, and intellectual achievements, (b). A total rejection of sex, and (c) A strong drive to 'climbing up' along the social ladder.