VISITING FAMILIES WITH EATING DISORDER - LESSONS FROM ENVIRONMENTAL PSYCHOLOGY
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Some data reported in the family therapeutical literature suggest the positive role of home visits, but they are rarely used in everyday practice. In the authors' family therapeutical work visits in the homes of eating disordered patients have become a routine part of the therapeutical process. The paper discusses the experiences of home visits presenting eight case vignettes. The visits were performed once in each case in the middle phase of the therapy. The observation of personal boundaries on the basis of environmental psychology and structural family therapy provided important insights for understanding the family dynamics (e. g. open or missing doors, enmeshed sleeping habits, missing father during the visit, etc.) The advantages of visits are many: therapists can gather first hand information about the family members' privacy and personal boundaries - such information is useful in planning the therapeutical interventions. At the same time the visit is a good opportunity to introduce 'in vivo' structural tasks. The visit can also serve as a tool for strengthening the psychotherapeutic relationship, while as a consequence of entering into personal places and sharing the family atmosphere the traditional doctor role changes; therapists become 'participant observers' as in cultural anthropology. The authors visits corroborated former observations that eating disorders are paradigmatic psychosomatic disorders with characteristic structural changes in the families.
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