One of things we struggle with as professionals is bridging the divide between the cultural norms of a family and how that allows an adolescent’s eating disorder to flourish. As a social worker by training, I spent much of my graduate education emphasizing respect for cultural norms and differences in family relationships. As a result, I’m always making sure our staff takes the same into consideration. But there are times when that becomes a struggle.
An example was an Israeli family whose child had the typical run of the home prior to having to move back to the US for a period for the father’s work. The young girl was used to having few boundaries, talking back to her parents, and prone to emotional outbursts without significant consequence. It’s the norm to give children much more leeway in Israel, particularly as there is the expectation of military service at age 18 for every citizen. Childhood there ends abruptly, and so allowing for freedom of expression and childhood angst is allowed much more so there. However, that was now causing problems. Their daughter was ruling the family. Determining if treatment was going to be done or not, and on what terms.
This is a tough position to be in. As therapists we had to work to embolden the parents, to teach them the clinical significant of eating disorders and the need for taking control of the disorder for their daughter to save her life. It was a balancing act, but one that was necessary to help create a recovery-focused home for the whole family.
Similar issues have come up in families we’ve seen from Korea and Japan, Egypt and other Arab nations, South and Central American backgrounds, and others. There may be a household that is strongly paternal, and getting the father to participate requires breaking traditional parenting roles. There may be a mother who’s so concerned about meeting the emotional desires of the child that they dare not challenge them, and in fact are even frightened of their child’s emotional states. Sometimes, the parental norm is to be so controlling that the child is suffocating and rebelling. We have to be aware that these are normal childhood reactions, but that the eating disorder has nothing to do with the parents or their cultural heritage. Instead we have to put it in context of being a brain disease that we can treat with parental and full-family cooperation.
Even if you think that you are uncomfortable with seeking treatment for your child, or even for yourself, know that solid programs with good cultural awareness exist. Treatment and recovery is possible for everyone.
By Andrew Walen, LCSW-C - Founder, Executive Director, Psychotherapist at The Body Image Therapy Center. If you would like to get in touch with Andrew please call 443-602-6515 or email firstname.lastname@example.org.