Family meaning of self-starvation: themes discerned in family treatment in Hong Kong

This study aims to identify themes from the treatment of Chinese families with an adolescent or an adult member suffering from anorexia nervosa (AN), through a multiple case study. This study reveals that self-starvation may be regarded as a cultural metaphor. Four major themes emerged at the family level: self-starvation as an expression of love and control, coalition of the AN daughter with the mother, family loyalty, and the powerlessness and helplessness of the mother. The themes identified are narrative accounts of the Hong Kong Chinese families, rather than causal explanations proposed by Western literature. The emerging themes are believed to be constructed and legitimized by traditional Chinese cultural values, with females being subordinated to and dependent on males and the self being subjugated to or sacrificed for the collective. Treatment implications are discussed.