I have been hesitant to write about the ‘psychological process of the family’, but finally decided to write this one, ‘Families with Eating Disorders’. It is unlikely that the process can be fully interpreted without having worked deeply with the child with an eating disorder as a family unit. Hopefully, this article will give the family and the child common insight and give us more opportunities to work together effectively. Families with Eating Disorders It was a normal afternoon, a normal outpatient workday. My office was busy and organized as usual. Most of my patients on the waiting list were my regular patients, and when I saw the names, I could naturally visualize seeing them – ‘It’s a mother and daughter down there,’ ‘It’s probably a father and daughter this time. These are the ‘eating disorder families’ I am talking about. Eating disorders are a common disorder in adolescent females, and this is the main reason why patients are often accompanied by their parents when they come to the clinic. Other possible reasons are the problem of the patient’s own lack of initiative in seeking medical attention, the problem of overprotective parents, etc. In any case, this gave me a good opportunity to learn about this disorder that some scholars call ‘family disease’. When I say ‘family disease’, I mean that the cause or development and maintenance of the disorder lies in family relationship problems. Below I will describe the characteristics of family relationships that are often seen in families with eating disorders. 1, interpersonal psychological entanglement Refers to the ‘cut and dried’ relationship between family members. We see eating disorder patients who often have an overly close mother and an excluded father. 14-year-old A is inseparable from her mother and has shared a bed since, while her father lives alone in a room because of work and physical problems (coming home late, snoring). When Dad hesitantly raised the question ‘is this appropriate’, Dad’s understanding was ‘this has no impact on our lives, but if it is confirmed from you that this is bad for psychological development, we will change it’. The child’s response was ‘What’s wrong with that? I don’t want to change it’. Here we can easily see the entanglement between Little A and his mother, but what about the father who seems to be far away from the family? Not only does he cooperate with such a relationship by his actions, but he also ‘accepts’ it psychologically. In deeper conversation, the father gave a ‘comprehensive’ interpretation of his daughter’s psychological development, including how she became ill, seemingly assuming that his understanding was the truth and that his daughter’s protestations seemed quite feeble. This is a characteristic of interpersonal psychological entanglement, the ‘thinking instead of others, feeling instead of others’ and then assuming that ‘that’s how you think, that’s how you feel’, this ‘no distinction between you and me This ‘no distinction between you and me’ kind of entanglement. 2. Overprotection The concept of overprotection encompasses many phenomena, including excessive attention among family members, indistinguishability, substitution, exclusion, etc. Accordingly, almost every family member takes on too much responsibility in terms of psychology and behavior. This leaves each person feeling burdened while at the same time having many complex and conflicting emotions such as gratitude, helplessness, anger, guilt, etc. with each other, keeping them close together and even immobilized. The first reaction of most patients with eating disorders I have seen when talking about the effects of the disease is ‘I’m sorry to my parents’, but then they resent the mention of their ‘close protection’. Little B (age 17) began her anorexia in her senior year of high school and began treatment after entering college. The situation improved quickly, but showed a tendency to overeat, and the feeling of being out of control made Little B miserable. In one treatment session she agreed with the therapist to actively find classmates to join her at breakfast and then go to class together, so that overeating might be avoided. The next two times Little B succeeded, eating with her classmates made her feel at ease, but these were limited to breakfast, in the evening when she was on her own Little B still ate on and could not stop. Once she called her dad when she was in pain, he immediately decided to come and eat breakfast with her the next morning, but it turned out to be a meal where Little B started worrying about whether she had eaten too much, and when he left, Little B ran off to buy something to eat again on the way to class. Dad’s attempts to protect Little B made her feel incompetent and abnormal. In other words, Dad’s overprotective behavior turned Little B into a person trapped in a disease. 3. Avoiding Conflict and Involving the Child It has been said that the child is the bond between the couple, and this statement describes the awkward situation of the eating disorder patient from another perspective. When a pair of parents focus all their anxious attention on their children, single-mindedly trying to give everything for them, they have often successfully avoided the conflict between the couple. But often the child becomes the scapegoat who is hard to get out of, and the illness is perpetuated in this way. When Little C (14) finally entered recovery from her anorexia nervosa after painstaking treatment, the question she asked most during the therapy sessions was ‘What if I do this or that to upset someone else? After a few rounds of conversation Little C exclaimed ‘Then there will be conflict! But isn’t conflict bad!’ ‘ ‘Who said that?’ I continued to press on step by step. ”He!” Little C pointed at her father and shouted. Then Little C, who was normally quiet and modest, suddenly cried out in pain and began to tell how Dad had avoided Mom when she started a conflict and entered a cold war, and how he himself had painstakingly created opportunities for the two to make up and for the atmosphere in the house to ease. ‘I feel particularly tired and feel like I must be particularly bad.’ Another conflict avoidance situation is common in the process of parents and children battling illness. When the mother insists that Little D (12), who has been out of the hospital for 3 months, finish her meals according to the diet plan, the father adds in softly to keep his daughter from exploding, saying that she has worked hard and has indeed eaten a lot, rendering the mother’s insistence feeble. This seems to defuse the war between mother and daughter, but actually supports the resurgence of the disease pattern. 4, rigidity of behavior patterns If adolescent children have to go through a metamorphosis from dependence on parents and family to detachment from parents, out of the family and into the world of peers, then the families to which these children belong also have to go through a metamorphosis process. If families continue to try to solve the problems that arise during adolescence by continuing the interaction patterns formed before the child’s adolescence, they are bound to be frustrated. This is the case with Little A’s family mentioned earlier. Little A’s father was the best at reasoning, and before the anorexia, Little A was indeed a good child who listened and understood reason. When Little A began to resist his mother’s over-management, his father’s extensive study assignments, and even his meals, his father began to intensify his reasoning – ‘talking through his mouth’ – and in the end, he began to ‘ loss of control – violence – guilt – more patient reasoning’ cycle, and the problem is still a problem as a result. ‘How can Little A give up so easily when he finally finds something he doesn’t have to listen to you reason about (anorexia)?’ I told Dad. Although psychology places great emphasis on the psychological development of infancy and childhood, and on the importance of building a sense of security, trust and competence in individuals during these periods, the importance of adolescence is gradually being explored more. Practice has shown that this period, if successfully transitioned, can even repair psychological trauma previously suffered, while if not, it can still cause irreparable damage to an individual’s psychological development, even if the previous development was smooth. Eating disorders have been interpreted by some scholars as a product of family interactions during the child’s separation-individuation process in adolescence, which puts the family in crisis and represents both a challenge and an opportunity for the family. If the crisis is effectively addressed, not only may the child truly mature while regaining his or her health, but the family can grow together. So, what can families do to help a crisis become a real opportunity? First, parents can try to take a look at their own family situation – which of our family characteristics do your family relationships fit? Next, rank the importance of several family relationships in your family. They might include the couple relationship, the parent-child relationship, the sibling relationship, the parent-previous generation relationship, etc. The interpretation of the results is that if the spousal relationship in your family is not ranked first in importance, there may be a problem. Then, make a list of the problems that are bothering you in your family, even if they are things that you vaguely feel are not right. Try to categorize them into the above relationships, such as which ones are problems that belong to the couple relationship, which ones belong to the parent-child relationship, and which ones are problems between children. There are some vague categories that can be selected more than once. After that, it is necessary to decide which of these issues are to