The Anorectic Process in the Family: A Six-Stage Model as a Guide for Individual Therapy

This article presents a conceptual framework for individual treatment with chronic anorectic patients. In the first part of the article, the six-stage model for the anorectic process developed over the past years by M. Selvini-Palazzoli and her team is briefly explained. After presenting the model, we then discuss some related concepts, namely, "family game," "rule," and "strategy." Finally, the therapeutic technique in individual treatment is discussed. Two basic assumptions underlie this technique: first, the therapeutic relationship is instrumental, its main purpose being to improve the patient's personal relations outside therapy; second, the focus of the treatment is on the strategic incapacity of the patient who is caught up in and unable to cope with the "concealed family game."     

Case Report: Smuggling Family Therapy Through

Therapists with a family systems orientation are, on occasion, called upon to work in settings where political constraint, cultural patterns or the unchangeable expectations of the clinical population make it impossible to identify the treatment as being directed at the family. Under these circumstances, family therapy concepts and techniques may be employed by smuggling them in under another label. This article describes a setting in which such a strategy was necessary.     

Getting and Giving Information: Analysis of a Family-Interview Strategy

This paper reports on a videotape study of particular aspects of the two-part interview developed by Selvini-Palazzoli et al. ( 8 , 9 ). The first segment is a “search for information,” the second part the application of an intervention based on the information gathered in the first part. The study focused on the strategies of information retrieval on the premise that they are significant for the quality of information gathered and for the criteria implicitly conveyed by the therapist that in turn have their own substantial impact on the system. We have employed theories of communication, particularly conversational analysis, that are a departure from the epistemological premises of systems theory and communication pragmatics proposed by Selvini-Palazzoli et al. as the theoretical underpinning of their interview technique.     

Session-Intersession Sequences in the Treatment of Chronic Anorexic-Bulimic Patients: Following the Model of "Family Games"

In this article, the author presents some technical aspects of a psychotherapeutic approach for treating chronic anorectic patients. Two basic principles underlie the approach. First, the main purpose of the treatment is to improve the patient's relational skills in order to enable her to cope with her family's "game". Second, the therapeutic relationship is considered hierarchically subordinate to her relationships outside the therapeutic context. Mastering the model of families with anorectics is essential if the therapist is to be consistent with these principles. Specialized training in verbal and nonverbal communication is considered a useful tool.