The “psychosomatic” family system: are families with Eating Disorders more enmeshed and rigid than normal controls?

Traditionally, the key features of the family system of Eating Disorders (EDs) have been considered those originally outlined by Minuchin in his description of the "psychosomatic" family patterns of interaction. This controlled study tests two of the principal characteristics of Minuchin's model, namely enmeshment and rigidity, operationalised as extreme cohesion and low adaptability. Perceived and desired cohesion and adaptability, measured with the FACES III, were compared between 30 clinical families (mothers, fathers and daughters with an ED) and 30 non-clinical families. Differences across ED family members were also considered, as well as differences between ED symptomatological subgroups (restricting anorectics vs EDs with bulimic symptoms). High cohesion scores were found in ED families, but similar findings were also reported in control families. Cohesion scores were significantly higher in restricting anorectics than in patients with bulimic symptoms. Adaptability was normal in both ED and control families. This study does not support Minuchin's observations on family enmeshment and rigidity. Although high levels of cohesion were found in ED families, the same relational pattern was found in the control families, suggesting that a tendency to a hyper-involvement of family members might be "normal" in some sociocultural contexts.