The Open Door: A Structural Approach to a Family With an Anorectic Child

This commentary on a videotape of an initial interview with a family of an anorectic girl demonstrates a set of therapeutic techniques based on a structural view of family organization and dysfunction. In the commentary, the interventions of the therapists are analyzed move by move throughout the session. The goal of the therapists is to assist the family to reorganize itself so that its dysfunctional structure will not support the symptom in the child. During the interview, they probe the characteristic interaction patterns of the family and engage with the family subsystems, making changes in the husband-wife relationship, the parent-child relationships, and the sibling relationships. The connection between the anorectic symptom and the structural organization of the family becomes clearer as the interview unfolds, with the result that the child's eating at the end seems incidental compared to the many changes in family relationships that precede it.