What does a Family Therapist do?
Karen Carberry is Orri’s Consultant Family Therapist with over twenty years’ experience. Her job is deeply complex and involves leafing through layers of family history, going back at least three generations to identify events and behaviours that may hold the key to understanding how the eating disorder started.
Her first step is usually to get the client together with their immediate family including siblings, either in the assessment or in subsequent sessions. “It’s important we do this because they’re all dealing with it as a family. They may be a little apprehensive to come initially, but with some understanding of their importance they do eventually. Family members have a lot to bring and they get something out of it as well.”
Once the family has come together, Karen’s job is to establish trust, built on mutual respect, honesty and openness, a space that validates and values everyone present, and where things move at their own pace. We are aware that family members can often feel alienated when information about their loved one is withheld. Orri advocates support for the whole family. “Everyone gets talked to, everybody gets a space. This is exceptional,” Karen says.
“Holding that candle of hope is so important.”
In some cases, Karen will see siblings or parents alone. Eating disorders impact families in many different ways—they can give rise to feelings of grief, repulsion or guilt, and can negatively impact parents’ relationships—so Karen is ever mindful of this.
“That’s what treating an eating disorder is all about—it’s making changes which are going to be sustainable.”
The generational aspects of an eating disorder are not always obvious at first. It could originate with a grandparent or a great-aunt. For this reason, Karen looks into three generations of family history to ascertain patterns, particularly in terms of their relationship to food. Invariably other issues emerge: not just food but drug problems, alcohol, traumatic incidents or abuse. A patient might be carrying around traumatic grief or an attachment issue that has manifested as the problem. One of Karen’s specialisms is adoption. “At any minute they think they’re going to be moved. It’s an unconscious feeling, or a feeling of emptiness within themselves and can result in disordered eating patterns,” she says. She then helps people to talk about these things for the first time.
“We’re in it for the long haul. It’s a huge piece of work”
Some of the hardest cases involve family secrets such as sexual, emotional and physical abuse. In such instances, Karen can spend months preparing families for processing the truth. Clients can expect absolute discretion; therapists share essential information with colleagues only if there is a safeguarding issue. And clients have control over what information they share and with whom. When and if they’re ready, the client tells their family members what has happened. Once they know, Karen supports them intensively to help them through the distress and trauma and develop strategies that enable them to cope.
Like everyone at Orri, Karen makes a compassionate, long-term commitment to every client’s recovery. “We’re in it for the long haul. It’s a huge piece of work,” she says. Often multiple therapists work together and the therapists themselves have to be resilient, to know themselves and to look after each other as a team. “Holding that candle of hope is so important. People come through, people get married and have children, it can be done. People can recover from an eating disorder, and their family members too. It really is an honour to be in this space,” Karen says.