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Family transactional patterns associated with the symptom of anorexia nervosa Grigg, Darryl Norman 1986

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FAMILY TRANSACTIONAL PATTERNS ASSOCIATED WITH THE SYMPTOM OF ANOREXIA NERVOSA by DARRYL NORMAN GRIGG B . A . , Univers i ty Of Waterloo, 1980 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES (Department of Counsell ing Psychology) We accept th i s thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA A p r i l 1986 (c) Darryl Norman Grigg, 1986 <9 In presenting t h i s thes is i n p a r t i a l fu l f i lment of the requirements for an advanced degree at the Univers i ty of B r i t i s h Columbia, I agree that the L ib ra ry s h a l l make i t f ree ly ava i l ab le for reference and study. I further agree that permission for extensive copying of t h i s thes i s for scho la r ly purposes may be granted by the head of my department or by h i s or her representat ives . I t i s understood that copying or pub l i c a t i on of t h i s thes is for f i n a n c i a l gain s h a l l not be allowed without my wr i t t en permission. Department The Unive r s i ty of B r i t i s h Columbia 2075 Wesbrook Place Vancouver, Canada V6T 1W5 i i ABSTRACT A family systems perspective was taken for exploring intra-familial transactional patterns of relationship related to anorexia nervosa. Father, mother, and daughter assessments of parental initiative and daughter responsive behaviors as reported on Benjamin's Structural Analysis of Social Behavior (SASB) are combined to serve as data for a hierarchical cluster analysis. Out of the 22 families with an anorexic child and the 22 matched control families, 7 family clusters were identified by the clustering procedure with unique family dynamics differentiating one from another. Average family cluster profiles are established and examined. Benjamin's program Figure (FIG) is used to explicate central family transactional dynamics of the family clusters, 3 of which were exclusively comprized with an anorexic daughter. With no single family pattern of relationship characterizing the families of the symptomatic children being identified, the study challenges earlier family theories which postulated an anorexogenic family system, and supports a broader, complex multi-familial view of anorexics and their fami l ies . i i i TABLE OF CONTENTS ABSTRACT i i LIST OF TABLES v LIST OF FIGURES v i ACKNOWLEDGEMENTS v i i CHAPTER I - INTRODUCTION 1 Nature of the Problem 2 Transactional Research 5 CHAPTER II - REVIEW OF THE LITERATURE 11 Theoret ica l Considerations 11 St ruc tura l Theory 12 Maturana's Theory 16 Family Theory of Anorexia Nervosa 18 S e l v i n i ' s Descript ions of Anorexic Famil ies 19 Minuchin's Descr ipt ion of Anorexic Famil ies 22 Other Family Descript ions of Anorexic Functioning . . . 27 Family Research of Anorexia Nervosa 28 Demographic Data 28 Transactional Data 31 Statement of the Problem 36 CHAPTER III - METHODOLOGY 40 Purpose of the Study 40 Subjects 40 Instrumentation 42 Method of Analys is 47 iv S t a t i s t i c a l Procedures 48 CHAPTER IV - RESULTS 53 Hie ra rch ica l Cluster Analysis 53 Composition of Family Clusters 55 Interpretat ion of Family Clusters 57 Family Cluster 7: "The Harmonious Transactional Family" • ••• 57 Family Cluster 6: "The Perfect Family" 63 Family Cluster 2: "The Marginal Trans i t iona l Family" 69 Family Cluster 4: "The Discordant Distancing Family" 76 Family Cluster 5: "The Hos t i l e Conf l ic ted Family". 84 Family Cluster 3: "The Ambivalently Dif ferent ia ted Family" 93 Family Cluster 1: "The Symmetrical Family" 103 Comparison of Family Clusters 112 CHAPTER V - DISCUSSION 119 Discussion of Family Transactive Patterns 119 Limi ta t ions to the Study 123 Implications and Concluding Remarks 126 REFERENCES 131 Appendix A: Intrex Questionaire 142 Appendix B: F u l l Version SASB 149 Appendix C: Cluster Version SASB 151 Appendix D: Example of Output Generated by Program FIG . . . . 155 Appendix E: Tree Diagram Establ ished by Cluster Analysis ..157 V LIST OF TABLES Table 1 . Demographic Findings 28 Table 2. Transactional Behavior Clusters Measured on SASB . 45 Table 3. Psychological Names for Bes t -F i t Curves from Program FIG 50 Table 4. Composition of Family Clusters 55 v i LIST OF FIGURES Figure 1. Family Clusters Establ ished Through 55 Hie ra rch ica l Cluster Analysis 55 The Harmonious Transactional Family 61 The Perfect Family 67 The Marginal Trans i t iona l Family 69 The Discordant Distancing Family 76 The Hos t i l e Conf l ic ted Family 84 The Ambivalently Di f fe ren t ia ted Family 93 The Symmetrical Family 103 v i i ACKNOWLEDGEMENTS I would l i k e to express my hear t fe l t appreciat ion to members of the committee, Dr. J . D . Fr iesen, Dr. L . Woolsey, and Dr. R.A. Young, for the i r d i r ec t ion and support over the course of wr i t ing th i s thes i s . In pa r t i cu la r I would l i k e to thank John Friesen for the many ways in which he has helped me over the course of the l a s t three years. Thanks also go to Dr. W.B. Boldt for h i s assistance on the Methodology sec t ion . I would also l i k e to share my appreciat ion for my partner and companion Jennifer Newman for her enduring patience and understanding during the ups and downs of working on th i s research and also to my family who are always with me. Grateful acknowledgements are also in order to my friends and fellow classmates for the i r i n sp i r a t ion and hope when mine ran low. To Ian Pennington who has worked so hard on the production of the f i n a l paper, I am indebted. 1 CHAPTER I INTRODUCTION The condi t ion known as anorexia nervosa i s a complex syndrome which includes phys io log i ca l , emotional and behavioral factors wi thin ind iv idua l s who starve themselves ostensibly for fear of weight gain (Bemis, 1978; Cr i sp , 1980; Garf inkel & Garner, 1982). I t i s also believed to be a communicative, interpersonal phenomenon, ex i s t i ng wi th in pa r t i cu l a r mileaus or enviroments (Minuchin, 1970; Minuchin, Rosman & Baker, 1978; S e l v i n i , 1974; Nor r i s , 1979). Anorexia nervosa occurs mainly in female adolescents (Cr isp , Harding, & McGuinness, 1974; C r i s p , 1980) with outcomes varying from a s ingle mild episode, to a l i f e l o n g , persis tent disorder or death. This dramatic symptom has received widespread consideration and thought, grasping the at tent ion of c l i n i c i a n s , researchers, and the media. In reviewing the present l i t e r a t u r e on anorexia, one cannot help but be impressed by the myriad of theore t i ca l and c l i n i c a l approaches to the same problem (Garner & Gar f inke l , 1985). The condit ion has been described from many perspectives including psychodynamic, behavioral , family i n t e r a c t i o n a l , phys io log ica l and s o c i o - c u l t u r a l theories (Bemis, 1978; Richardson, 1980). Indeed, the search for e t io logy has led some researchers to a mult icausal or multidimensional view (Garf inkel & Garner, 1982). Thus, the e lus ive essen t ia l ingredients for anorexia have been construed as a complex fusion of many in te r re la ted factors . While no s ingle approach can explain the condit ion (Sheppy; 1985), no comprehensive representation of anorexic symptomology 2 i s complete without the inc lus ion of the soc i a l domain in which i t occurs (Norris & Jones, 1979). The present study invest igated the family in teract ions associated with anorexia nervosa, in hopes of expanding empi r ica l ly based knowledge of t ransact ional factors related to i t . Nature of the Problem The e a r l i e s t reported cases of anorexia nervosa note pecul iar manners of family in t e rac t ion , which were in someway seen as being detrimental to the patient (Laseque, 1873;°Gull , 1888). The oft c i t ed comment by Laseque (1873) exemplifies the concern that: The r e l a t ives and friends begin to regard the case as desperate. It must not cause suprise to f ind me thus always placing in p a r a l l e l the morbid condit ion of the h y s t e r i c a l subject and the preoccupations of those who surround her. These two circumstances are int imately connected, and we should acquire an erroneous idea of the disease by confining ourselves to an examination of the pa t ien t . (p. 152) These words have not gone unnoticed. The famil ies of anorexics have in fact recently received extensive emphasis by a number of theor is t s notably: Bruch (1978); Cr isp et a l . (1974); Minuchin et a l . (1978); Garf inkel and Garner (1982); S e l v i n i (1978); Sours (1980); Masterson (1977) and Yager (1985). While the theore t i ca l pos i t ion of these and other invest igators span a var ie ty of f a m i l i a l perspectives, a degree of convergence in theory allows for a stereotypic composite of anorexic famil ies to emerge. Yager (1982) characterizes such family systems as fo l lows: 3 Upper middle c l a s s , highly achievement oriented family, mother, and often others are constantly v i g i l a n t about the i r weights and they a l l value slimness and physical exerc ise . S u p e r f i c i a l l y , t h i s i s a healthy family, but, excessively concerned with external appearances and with avoiding s o c i a l shame, i t i s d i l i g e n t about putt ing up a congenial facade. Certain unadressed c o n f l i c t s between the parents lurk below the surface. There i s a lack of fu l f i l lmen t as a couple (often manifest in part in sexual d i f f i c u l t i e s ) and the ch ron ica l ly depressed parents f ind themselves s t r i v i n g for other fu l f i l lmen t s -mother with her chi ldren and father with his work. The family communicates along narrow l ines and r i g i d l y denies or minimizes that anyone i s angry towards anyone e l se . Parental stresses and concerns are channeled and deflected towards the ch i l d r en , so that the mother becomes excessively involved with them. Because of the i r own l i m i t a t i o n s , the parents are somewhat fearful of the c h i l d r e n ' s adolescent psychosexual development and impending separation. This parental overinvestment and overdirectiveness leads to a s i tua t ion in which a vulnerable daughter (most often) becomes concerned with external parental approval than with her own in te rna l s a t i s f a c t i o n . Furthermore, the parents inadequately acknowledge the c h i l d s . i n d i v i d u a l i t y , so •* that she develops a f r ag i l e se l f image and feels , that there are no rea l areas of se l f c o n t r o l . Her poor sense of se l f and accompanying sense of ineffect iveness are ignored by the parents. She t r i e s to f i l l her void with parental approval in place of autonomy. At a point of family d i sequ i l ib r ium during her adolescence (perhaps due to increasing parental f r i c t i o n , the i l l n e s s or death of a r e l a t i v e , moving to school , or a mother's increased tearfulness that her daughter's adolescent s t r i v i n g s toward separation may produce an 'empty n e s t ' ) , anorexia nervosa begins, (p.44) Clea r ly there are l i m i t a t i o n s to any sketch of t h i s nature and reasons for discarding i t . In that such presentations oversimplify highly complex family t ransact ional patterns, " t y p i c a l " family composites f a l s e ly represent the r i c h d i v e r s i t y of f a m i l i a l i n t e r ac t i on . Thus, the present stereotype i s inaccurate. A review of the research reveals that anorexia nervosa i s 4 not r e s t r i c t e d by socio-economic status (Kay, Schapira, & Brandon, 1967; Theander, 1970; Kalucy, C r i sp , 6c Harding, 1977; Crisp et a l . , 1980; Garner, Ga r f inke l , Schwartz, & Thompson, 1980). While mar i ta l discord has been noted as prevalent, these f indings are inconclusive and perhaps no more frequent than in other nonsymptomatic family groups (Halmi, 1974; Kalucy et a l . , 1977; Cr i sp et a l . , 1980). Age of onset has been reported as ear ly as 9 years (Yager, 1982). Furthermore the range of anorexic ego development, psychosexual development, peer group s i z e , academic and s o c i a l s t r i v ings as wel l as family composition seems diverse (Yager, 1982). In addi t ion to suffering from empir ical inconsis tencies , any stereographic representation of an "anorexogenic" family implies a f a m i l i a l causative e t io logy . While an impl ica t ion of t h i s nature may have i t s place in other theore t i ca l formulations, i t i s incongruent with the assumptions' on which family systemic theory i s b u i l t (Keeney, 1983; D e l l , 1980). A theore t i ca l formulation which reduces the range of systemic motion and complexity into a s ingle dominant, pathogenic t ransac t ional pattern "A" which generates a pa r t i cu l a r symptom " B " , and simultaneously holds a systemic theore t i ca l view ( including the notion of c i r c u l a r causa l i ty ) i s inherently se l f cont rad ic tory . This problem w i l l be more f u l l y addressed l a t e r , but for the present the conclusions of Garf inkel and Garner (1982) relevant . These c l i n i c i a n s have postulated that anorexia nervosa i s not caused by a s ingle pathogen, but i s rather a f i n a l pathway that i s the outcome of a group of in te rac t ing 5 fac tors . The log ic of th i s pos i t ion seemingly f i t s apt ly with family systemic theory, however, i t has not received wide acclaim by family theo r i s t s . Transactional Research With the growing theore t i ca l acceptence of the family systems perspective of anorexia, so too has the need for quant i f iab le research increased. Bemis (1979) states that family therapy, though promising, i s "too new to permit a conclusive assessment of i t s e f f icacy" (p. 602). In h is review of family l i t e r a tu re , related to the symptom, Yager (1982) concludes that there i s a dearth of substantive research in the area as wel l as a need for more sophis t ica ted , r e l i a b l e and v a l i d measurement t oo l s . These sentiments are not unwarranted. Transactional research in general has proven to be more d i f f i c u l t than what might be imagined. Because transactions have no physical substance which can be measured or weighed and since they are by d e f i n i t i o n outside the realm of causal th ink ing , t ransact ional research has tended to lag behind theore t i ca l innovation. The pos i t ion of Gurman and Kniskern (1981) emphasizes th i s point . They asserted that family assessment i s s t i l l l im i t ed by "serious de f ic ienc ies" in measuring core theore t i ca l constructs that have been r e i f i e d among c l i n i c i a n s " (p. 105). These authors express a very rea l concern for the f i e l d of family therapy. Sal ient issues in th i s connection w i l l be considered before turning to a review of family research d i r e c t l y related 6 to anorexia nervosa. Perhaps the most comprehensive review of family research was presented by Jacob (1975). In th i s examination of the l i t e r a t u r e on disturbed and normal family in te rac t ion patterns Jacob concludes, that in te rac t iona l research has f a i l e d to successfully d i f fe ren t i a te cons is tent ly between these two family in te rac t ion s t y l e s . While there remains some debate around th i s issue,- (Deane, 1978; Jacob & Grounds, 1978), i t seems safe to suggest that at best, family in t e rac t iona l research has thus far , by and large , not been as conclusive as o r i g i n a l l y hoped. Transaction patterns have been invest igated in a host of c l i n i c a l areas. These inves t igat ions range from schizophrenic (Mischler & Waxier 1965, 1975) and substance abuse (Chi les , Strauss & Benjamin, 1980; Davis & Klagsbrun, 1977) to mar i ta l problems (Sullaway & Christensen, 1980) and d i f f i c u l t i e s with adolescents (Schapira, Fisher & Gayton, 1974). Despite th i s impressive spectrum of c l i n i c a l questions which have been analysed in a systemic framework there remains serious c r i t i c i s m of th i s type of research. Fisher (1982) states that: . . . On the one hand famil ies seem more complex and subtle than are ref lected in present methods of assessment, whereas on the other hand d iv ing into the complexity often y ie lds a mass of var iables from which l i t t l e meaningful structure can be derived. (p. 313) Therefore i t appears as i f t h i s type of research must f ind a compromise between exclusive reductionism and overwhelming complexity. This problem has generated a number of responses; however 7 from a family systems point of view, not a l l are e n t i r e l y sa t i s fac to ry . In the i r review of a l l studies published in the i r wel l known family journals between 1969 and 1976 ( Family  Process , Family Coordinator and Journal of Marriage and the  Family ), Hodgson and Lewis (1979) reported that the family as a system was the object of ana lys is in only 7 percent of the studies reviewed. S i m i l a r l y , the inves t iga t ive focus was on the mar i ta l dyad in only 10 percent of the s tudies . In contrast the object of study in 56 percent of the "family studies" viewed was on the i n d i v i d u a l . In l i g h t of the above, i t would seem that the systemic family research tends to question i t s own precepts in terms of the dominant focus of a t t en t ion . This d i f f i c u l t y may wel l a r i se out of differences around how researchers punctuate the i r research questions and u l t imate ly act ion and behavior i t s e l f . Spieg.el (1971) suggests these ways of viewing act ion and behaviour. The f i r s t i s " se l f ac t ion" in which ind iv idua l s are seen as act ing independently under the i r own power. The second view i s that of in te rac t ion in which ind iv idua l s are balanced against other ind iv idua l s in causal interconnect ion. In th i s second view, ind iv idua l s are seen as cont r ibut ing r ec ip roca l ly to one another while maintaining a separateness in a l l the stages of i n t e rac t ion . The impl ica t ion of punctuating behaviour in t h i s manner is that ind iv idua l s do not need to be defined or i d e n t i f i e d by the other with whom they in terac t although they have effects on one another. The t h i r d punctuation of ac t ion and the most complex i s the 8 t ransact ional view. From th i s perspective the notion of i n d i v i d u a l i t y i s set aside in favor of patterns of transaction which connect parts of a whole. Since members i n t e r r e l a t e , each i s at some l eve l defined in part by the other members. In th i s sense, " ind iv idua l s " have no actual d e f i n i t i o n outside the r e l a t i o n a l d e f i n i t i o n which i s observed and described. While a stress on in terac t ion and re l a t ionsh ip has been suggested much e a r l i e r by Su l l i van (1953, 1954, 1956), th i s view strays farther from notions of i n d i v i d u a l i t y towards an e s sen t i a l ly systemic view. Since transaction implies a consistancy of r e l a t ionsh ip , t h i s t h i r d perspective i n t r i n s i c a l l y suggests that cause and effect can be i so la ted only out of context. Considerations of t h i s impl ica t ion i s repeatedly stressed in D e l l ' s (1980) review of the epistemological confusion in family research re la ted to schizophrenia. Fisher (1982) attempts to expose the problem of family systems research which tends to approach problems with a t ransact ional theory but u l t imate ly employ i n d i v i d u a l i s t i c ( l i n e a l ) methods of ana ly s i s . In so doing, he h igh l igh t s the need for researchers to view the family as a t ransact ing unit and to develop research tools which may r e l i a b l y measure t ransact ional phenomena. In response to these issues, the present study attempted to view the unit of analysis as the family. Thus the inves t iga t ion strove to examine the in t e r - r e l a t i onsh ips wi thin famil ies in an effor t to apprehend the i n t r a f a m i l i a l r e l a t i o n a l structures related to the symptom of anorexia nervosa. In defining the 9 family system as the unit of analys is as the t ransact ional composite of i nd iv idua l members in t h i s manner, the inves t iga t ion remained t heo re t i c a l l y consistent with the d e f i n i t i o n of a family system as proposed by Maturana (Del l 1985). In a recent interview (Family Networker, June, 1985) Maturana expl icates th i s view s t a t ing : . . . t ha t there i s no absolute, objective family . . . For each member there i s a d i f ferent family, and that each of these i s absolutely v a l i d . (p.36) Thus in the present inves t igat ion the family system was defined as a combination of ind iv idua l t ransact ional response patterns of the family components. In accepting th i s form of punctuation i t was recognized that by d e f i n i t i o n cause and effect could not be tested. Despite th i s l i m i t a t i o n , the present inquiry hoped to es tab l i sh some form of descr ip t ion of the behavioural manifestations of symptomatic famil ies and the patterns which connect the t ransact ing components of the system. In l i m i t i n g the scope of the study to the family systems l e v e l , other l eve l s of focus and theory w i l l not be included in th i s ana lys i s . At the onset, the author would l i k e to stress that c r i t i c i s m s of other views are not necessar i ly intended. Rather, the contention of the invest igator i s that each lens of ana lys is may wel l contribute to the o v e r a l l understanding of t h i s complex symptom, be i t a tomist ic or systemic. The present study i s one response to the c a l l of Yager (1982) and Garf inkel and Garner (1982) for a broadened empir ica l base for understanding anorexia nervosa including family t ransact ional 10 patterns. The study was t heo re t i c a l l y influenced by Maturana's notions of on to logica l biology (Maturana, 1975, 1978, 1980), as wel l as the s t ructural-systemic view of Minuchin (Minuchin et a l . , 1975, 1978, 1981). Sal ient features of these and related theore t i ca l perspectives are presented in the fol lowing chapter, providing a contextual ra t ionale for the i nves t i ga t i on . 11 CHAPTER II REVIEW OF THE LITERATURE Theoret ica l Considerations The notion that the family i s the " soc i a l playground" in which ch i ld ren develop and learn about the world in which they l i v e i s i n t u i t i v e l y obvious to most observers. What may not be as c lear i s the degree to which t h i s ac tua l ly occurs. Psychoanalytic theory contends that in the very ear ly stages of l i f e an i n d i v i d u a l ' s personal i ty i s profoundly affected by those around him/her. In pa r t i cu l a r they tend to underline the import of the c h i l d ' s r e l a t ionsh ip to her mother (Masterson, 1977; Goodsi t t , 1979). Minuchin ( 1 978 ) , ' borrowing from Bateson, put forward a more r ad i ca l p o s i t i o n . He postulates that i t i s in the family that a c h i l d learns how to "punctuate the flow of experience" (p.59). The c h i l d ' s punctuation of experiencing determines the r e a l i t y he/she perceives. In th i s view then, i t i s not just the development of personal i ty structure but rather the evolut ion of a world view which i s establ ished through f a m i l i a l experiencing. For b i o l o g i s t Humberto Maturana, the family i s viewed as a system or composite unity which i s defined and delineated as separate by i t s organizat ion, which i s observed by an observer (Maturana, 1978). Since the organizat ion forms the d e f i n i t i o n a l base of the system i t must remain invarient or else face d i s i n t e g r a t i o n . A r t i c u l a t i n g t h i s , Maturana (1970), states that " i t i s the c i r c u l a r i t y of i t s organizat ion that makes a l i v i n g 1 2 system a unit of in tegra t ion , and i t i s t h i s c i r c u l a t i r y that i t must maintain in order to remain a l i v i n g system" (p. 9) . Thus, the family may be viewed as a system that adapts and changes i t s in te rna l structure in order to maintain i t s iden t i ty and avoid d i s i n t eg ra t i on . S t ruc tura l Theory A family system i s b u i l t upon pa r t i cu l a r re la t ionships between i t s members (or components). The structure of a pa r t i cu l a r family may a l t e r form while the organizat ion remains i n t ac t . The concept of a family l i f e cycle (Friesen, 1983) re f l ec t s an appreciat ion for th i s process. Thus, while the organizat ion of a system places rea l l i m i t s on the range of potentia-1 perturbations and in teract ions that family members may undergo, i t i s the family structure which i s the actual r e a l i z a t i o n of the perturbations and in teract ions that a pa r t i cu l a r family es tab l i shes . In th i s way, while structures may vary from family to family, the i r organization remains constant so long as they are considered a family. Minuchin and Fishman (1981) see the family as a s t ruc tu ra l system i n i t i a l l y made up of ind iv idua l s which may be grouped into subsystems, or holons. These u l t imate ly form the family unit and are referred to as the spousal, parenta l , and s i b l i n g subsystems. Each i s delineated by i t s task, function and r o l e . By these operations of d i s t i n c t i o n , Minuchin characterizes the component of the composite unity and delineates boundaries which seperate the par ts . 1 3 Structure, from the l a t i n verb "struere" meaning to b u i l d , refers to the subsystems and the domain of in te rac t ion which the component parts r e a l i z e . For example, i f ind iv idua l s and subsystems are viewed as bu i ld ing blocks, then in te rac t ions , are the cement which bonds them in a pa r t i cu l a r s t ruc tu ra l arrangement. Seen in th i s manner, each family members iden t i ty i s founded on, and maybe characterized by the transactions v i s - a -v i s one another. It i s the t ransact ional phenomenon which gives the subsystems (which subsumes i nd iv idua l s ' systems) the i r respective i d e n t i t i e s and as such they are co-dependent and interwoven rather than independent and i so la ted par ts . An appreciat ion for th i s i s ref lec ted in Minuchin's view of the roles and functions of family subsystems which fol lows. The spousal subsystem allows for the negotiat ion of both the physica l and psychological needs of the adults in the family (Sargent, Liebman, & S i l v e r , 1985). It i s i dea l l y conceptualized as a supportive re la t ionsh ip which i s character ized by t ransact ional patterns which over time may be seen as roles which are expected and performed for example provider/nurturer (Minuchin, 1981). I t i s seen as a model of intimate re la t ions for ch i ldren and as having profound impl ica t ions for c h i l d r e n . Minuchin and Fishman (1981) contend that "I f there i s any major dysfunction within the spousal subsystem, t h i s w i l l reverberate throughout the family" (p.17). The s i b l i n g subsystem i s another family component which Minuchin has del ineated. In t h i s , the c h i l d ' s f i r s t peer group, 14 chi ldren learn and experience competition and co-operation (Sargent et a l . , 1985). Through the i r transactions with one another s i b l i n g s further the i r perception of i nd iv idua l iden t i ty and autonomy as wel l as possible a l t e rna t ive ways of being wi th in a system. These patterns are thought to be p a r t i c u l a r l y important as chi ldren move into extra f a m i l i a l peer groups (Minuchin & Fishman, 1981). Transactions wi thin the parental subsystem may be character ized by the fami l ia r c h i l d rearing and s o c i a l i z i n g functions ca r r i ed out by those who are charged with the r e s p o n s i b i l i t y of r a i s ing and educating the chi ldren of a family . Though the members of the spousal subsystem are often the same members of the parental subsystem th i s i s not necessar i ly so. Defined by i t s r o l e , the parental subsystem can vary widely in composition and include older s i b l i n g s grandparents, e tc . Through the i r dealings with ch i l d r en , parents provide both physica l and psychological nurturance to a c h i l d which includes maintaining appropriate developmental expectations for the c h i l d ' s behavior (Minuchin et a l . , 1978). As the c h i l d grows and her /h is needs change, the parents must correspondingly adapt the i r behavior and expectations. S i m i l a r l y , as the needs and wants of the parents undergo change, as in the case of spousal separation, so too must the c h i l d ' s expectations and behaviors a l t e r . In t h i s regard i t i s apparent that the t ransact ional re la t ionsh ips between parents and chi ldren are i n t r i c a t e l y co-determined and interdependent. Thus the behavior of one can be 1 5 best understood through the inc lus ion of the other (Minuchin, 1978). For th i s reason the term pa ren t a l / ch i ld subsystem w i l l be employed rather than simply parental subsystem in the remainder of the study. Through the re la t ionsh ip with the i r parents ch i ldren learn about themselves as in te rac t ing beings. Minuchin and Fishman, (1981) h igh l igh t the importance of pa ren ta l / ch i ld transactions s t a t i ng : Here the c h i l d learns what to expect from people who have greater resources and strength. She learns to think of authori ty as r a t i ona l or as a r b i t r a r y . She learns whether her needs w i l l be supported, and she learns the most e f fec t ive ways of communicating what she wants wi thin her own family s t y l e . Her sense of adequacy i s shaped by how her elders respond to her and by whether t h i s response i s age appropriate. She learns which behaviors are rewarded and which are discouraged . . . The c h i l d experiences her fami ly ' s s ty le of dealing with c o n f l i c t and negot ia t ion. (p.18) With t h i s kind of emphasis, i t i s not surpr i s ing that family therapy in general views the pa ren ta l / ch i ld interface as being c r i t i c a l to the existence of symptomatic and non symptomatic behavior in the family. A s imi l a r in te rac t ive concern i s re f lec ted in the thinking of other c l i n i c a l theor i s t s (Murray, 1938; S u l l i v a n , 1953, 1954, 1956; Anchin & K i e s l e r , 1982). S i m i l a r l y , the present study i s focused p r imar i ly on the pa ren t a l / ch i l d subsystem. 1 6 Maturana's Theory The issues of structure and in te rac t ion becomes increas ingly important when systems are considered in l i gh t of Maturana's notions of s t ruc tu ra l determinism (Maturana, 1975, 1978). He postulates that the behavior of a l l composite un i t i es are determined by the i r s t ructures . This i s so because the structure speci f ies which events in i t s medium an ind iv idua l can interact with as wel l as how i t w i l l behave under each and every i n t e r ac t i on . I t i s e ssen t ia l to remember in order to not confuse Maturana's view of structure with other views of s t ructure , that structure i s not a stable framework. Structure a l t e r s with every in te rac t ion i t undergoes (Maturana, 1978). This i s e spec ia l ly true as D e l l (1985) asserts , "with regard to dynamic l i v i n g systems which are constantly undergoing changes in the i r components and the re la t ions among those components" (p .7) . Thus the family unit may be viewed as a natural group which over time has establ ished patterns of in te rac t ing which are in a state of evo lu t ion . These evolutionary t ransact ional patterns make up the fami ly ' s s t ructure . The transactions of a family system from th i s point of view are sequences of in ter locked mutually perturbing behavior where in the reaction of one member (A) i s an act ion for the other (B) and serves to perturb (B) to react and so on. Maturana refers to t h i s kind of in te r - locked behavior as a consensual domain (Maturana, 1975, 1978). Returning to the pa ren t a l / ch i l d subsystem i t can be seen that Maturana's view allows us to r ea l i ze that parents and 1 7 chi ldren in teract as they do as a resul t of the t ransact ional h is tory which came before them and which i s manifested as the observed s t ruc tu ra l arrangements between them. The structure of the i r r e l a t ionsh ip i s constantly undergoing change with each new transact ion yet at any given moment the structure of the system determines how a pa r t i cu l a r parent or c h i l d w i l l behave. Some of the impl ica t ions of th i s view are: 1) No behavior can be understood unto i t s e l f without considering how i t f i t s into the patterns of sequences of behavior wi thin the consensual domain in which i t i s observed. 2) Any search for causative factors w i l l invar iab ly prove f r u i t l e s s since by i t s nature, t ransact ional phenomena have no r e l i a b l e temporal marker of "beginning". (3) Notions of "purposeful" behavior have l imi t ed explanatory value since the a t t r i b u t i o n of motivation of another u l t imate ly l i e s with the observer. From a s t r u c t u r a l l y determined point of view, beings do not th ink, f e e l , or do what they want to at any given instance, they experience and act in accordance with s t ruc tu ra l spec i f i ca t ion at any given moment in t ime. It i s beyond the scope of the present paper to present a comprehensive representation of the theore t i ca l posi t ions of ei ther Maturana and Minuchin. Rather an attempt has been made to wed some of the theore t i ca l posi t ions of the two perspectives to provide a theore t i ca l framework with which to understand family systems. Growing in popular i ty , Maturana's notions have profound ramif icat ions for both pract ice and research in the area of family therapy (Del l 1982, 1985). Consequently some of 18 the terminology used in the present inves t iga t ion i s drawn from h is work. Minuchin 1 s s t ruc tu ra l view has served as conceptual framework for understanding the functioning of family systems. It i s the view of the author that many of these concepts remain useful and indeed serve to be enriched by Maturana's theore t i ca l innovations. Minuchin has been credi ted with developing the f i r s t , and perhaps the most comprehensive systemic view of anorexia nervosa (Sheppy, 1985; Rumney, 1983). This view and related theory w i l l be presented in the fol lowing sec t ion . Family Theory of Anorexia Nervosa Family related factors have been extensively considered in theories of anorexia nervosa (Bemis, 1978). With the upsurge of family therapy, there has been add i t iona l a t tent ion payed to the role important others may play in the development and maintenance of the symptom (Bruch, 1977, 1983; Fromm, 1981; Minuchin et a l . , 1978; Norr i s & Jones, 1979; S e l v i n i , 1978; Yager, 1985; Masterson, 1977). The way in which family var iables have been considered can be broken into two leve l s of ana lys i s : (A) i n d i v i d u a l i s t i c and (B) systemic. In the case of the i n d i v i d u a l i s t i c lens , the family i s seen as being comprised of autonomous, separate parts which have effects on one another. Viewed through a systemic lens, the family i s seen as a t ransact ing unit with component members ex i s t i ng in an i n t r i c a t e web of transactions and e s sen t i a l l y inex t r i cab le from one another. The present study i s p r imar i ly interested in theories with systemic family views. However, i n d i v i d u a l i s t i c family 19 perspectives, aside from being quite popular, provide important issues to be considered in l i g h t of systemic theory. Psychodynamically oriented theories have related the anorexic symptom to early mother-child r e l a t i o n a l disturbances (Bruch, 1975, 1978, 1983, 1985; Cr i sp , 1965; S e l v i n i , 1970, 1972; Goodsi t t , 1979; Masterson, 1977; Sours, 1974). S i m i l a r l y , others have paid pa r t i cu l a r a t tent ion to current dyadic re la t ions between the mother-child dyad ( S e l v i n i , 1972; D a l l y , 1969). Father-daughter dyads have also been implicated as pathological in nature in the case of anorexia (Aponte & Hoffman, 1973; Kalucy, 1978; Wold, 1973). F i n a l l y , c o n f l i c t between the mar i ta l dyad has been suggested as a factor in the emmergence of anorexia nervosa in the c h i l d (Dal ly , 1969; S e l v i n i , 1978; Wold, 1973). These invest igat ions a l l tend to study anorexia nervosa as a resul t of h i s t o r i c occasions in which the c h i l d plays a passive role and has something done to her/him. While psychodynamic accounts can be c r i t i c i z e d for the i r propensity to re ly on c l i n i c a l data and i n f e r e n t i a l conclusions about e t io logy (Bemis, 1978, Yager, 1982), they s t i l l point to some important interpersonal issues in the famil ies of anorexics. S e l v i n i ' s Descript ions of Anorexic Famil ies The perceptual sh i f t to a systemic lense of symptomology i s a r t i cu l a t ed by S e l v i n i (1978). In t h i s account, she provides a c lear p ic ture of the way the countenance of anorexia nervosa i s transformed when the observer- theoris ts adopt a broader, 20 systemic view of the anorexic ' s behavior. A systemic perspective allowed S e l v i n i and her co-workers to view anorexia as a meaningful behavior in a pattern of int imately connected in teract ions between c h i l d and parents rather than the i so la ted behavior of a disturbed c h i l d . Noting a constant state of tension, evidenced by a preponderance of t r i v i a l arguments between parents, S e l v i n i (1978) observed a symmetrical r e l a t ionsh ip between the parents of anorexics, in which the fathers were seemingly emotionally absent or d i s t an t , and the mothers complemented them by being overinvolved and dominant. Transactional sequences, in which a fa ther ' s attempts to move closer to the family, were met with a mother's enlistment of the support of the ch i ld ren , were frequently observed by S e l v i n i . In the absence of the i r fathers, anorexic g i r l s were seen as entrapped by the i r a l l -powerful, r e l en t l e s s , in tolerant mothers. In terms of communication, S e l v i n i (1978) sees the anorexic as being an ind iv idua l in an impossible pos i t ion in which both of her parents i n v i t e her to form a c o a l i t i o n with them. The s i tua t ion seems further exacerbated by parental expectations for the i r daughter to compensate for the other par tner ' s s h o r t f a l l s . Thus, anorexics f ind themselves torn between the i r mothers and fathers, each one "playing the role of secret husband and secret wife a l l at once" ( S e l v i n i , 1978, p.211). These c o a l i t i o n s which form are never stable over time and were characterized as constantly f luc tua t ing . S e l v i n i (1978) explains the anorexic ' s precarious pos i t ion as con f l i c t ed and ambivalent because: 21 If she attempts to engage in a real dialogue with the father, he w i l l reject her out of fear, while her mother w i l l reject her out of jealousy. If she gives into her mother, she i s taken over completely as i f she were s t i l l a baby, and hence rejected as a person: at the same time her father w i l l rebuff her because of i n f a n t i l e behavior. I f she attacks e i ther of her parents, the other immediately rejects her for rushing to h is (or her) defense. If . She attempts to abandon the unequal struggle and t r i e s to stand on her own feet, she w i l l . . . Find herself opposed by a united couple, determined to reject her bid for independence. (p. 216) Thus, S e l v i n i views the s tarving behavior of the anorexic, as l o g i c a l in the context of in t e rac t iona l patterns which are characterized by re j ec t ion . It should be noted that S e l v i n i ' s comments were based on a l im i t ed sample s ize (n=12) and that her comments were by and large impress ionis t ic in nature. In her study, S e l v i n i (1978) reported that the anorexic famil ies q u a l i f i e d the i r communication in a coherent manner, however, messages were commonly rejected or ignored by other family members. Parents were found to be reluctant to accept a leadership role and showed a tendency to blame the other partner in a se l f righteous manner. Furthermore, S e l v i n i (1978) noted a s u p e r f i c i a l qua l i ty to the parents re la t ionships as wel l as unacknowledged or unresolved d i s i l lus ionment . Family rules were covert and secretive and s i m i l a r l y family problems were hidden or glossed over to outsiders of the family. 22 Minuchin's Descr ipt ion of Anorexic Famil ies Another systemic view of fami l ies with an anorexic member has been offered by Mihuchin and h is colleagues (Minuchin, 1970; Minuchin, Baker, Rosman, Liebman, Milman & Todd, 1975; Rosman, Minuchin, Liebman & Baker 1977; Minuchin et a l . , 1978; Sargent, Liebman & S i l v e r , 1985). In the i r work, these researchers have i d e n t i f i e d f ive predominent cha rac te r i s t i c s of family in te rac t ion which are seen as "excessively present and detrimental to ove ra l l family funct ioning: enmeshment, overprotectiveness, r i g i d i t y , lack of c o n f l i c t r eso lu t ion , and involvement of the sick c h i l d ' in unresolved parental c o n f l i c t " (Sargent, Liebman & S i l v e r , 1985, p. 259). I t i s important to bear in mind that these cha rac t e r i s t i c s are not s t a t i c features of family r e l a t ionsh ip , but rather form a matrix for ongoing in te rac t ions . Though they do not propose an "anorexic type" of family, a family structure which may predispose-, support and/or maintain somatic symptoms i s described which often tends to take on e t i o l o g i c a l character for readers. "Enmeshment" i s character ized by poor boundaries between ind iv idua l s and subsystems (Norris & Jones, 1979). I t i s an unusually t igh t web of family connections in which loya l ty and protect ion take precedence over se l f r e a l i z a t i o n and autonomy. Other researchers have reported t h i s qua l i ty in the family. For example, Bruch (1978) has described the family as functioning as i f they could read each others minds. "Overprotectiveness" describes a r e l a t ionsh ip in which ind iv idua l autonomy i s s a c r i f i c e d and highly nurturant 23 transactions predominate. Minuchin (1978) observed that th i s t ransact ional qua l i ty pervaded the family systems in that the anorexic c h i l d was often highly protect ive of her parents and s i b l i n g s , just as they were of her. This tone of concern seemed to overwhelm the clamour of a growing need for independence and was seen as maintaining the c h i l d ' s state of dependency. A further consequence of th i s pattern i s that i t impeded the development of age appropriate s o c i a l s k i l l s , e ssen t ia l to ef fec t ive dealings in e x t r a - f a m i l i a l se t t ings . Yager (1981) concurs with t h i s view describing anorexic famil ies as focused on high achievement, communicating along narrow l i ne s and f a i l i n g to recognize the anorexic c h i l d ' s i n d i v i d u a l i t y . " R i g i d i t y " refers to a family pattern in which the change or va r i a t i on from the norm of family cont inui ty (which i s necessary to the development of an adolescent) i s unacceptable to others. While i t i s acknowledged that a l l family systems t ry to maintain a semblance of order and respond to deviat ion when behavior exceeds the l i m i t s of the family ru les , Minuchin (1978) noted that in the anorexic family "even the smallest deviat ions are swi f t ly and comprehensively r e s t r i c t e d " (p. 69). Sours (1980), h ighl ighted th i s f a m i l i a l need to maintain harmony and subvert d i s t ress and upset cogently in h is book, "Starving to Death In a Sea of Objects". Lack of c o n f l i c t resolu t ion points to f a m i l i a l t ransaction patterns in which problems or d i f f i c u l t i e s do not tend to be solved or put to res t . Rather, c o n f l i c t i s in some way detoured and or avoided. The process and resul t of th i s pattern are explained by Sargent et a l . 24 (1985), who suggested that: One member of the disagreeing pair may abandon the c o n f l i c t , or other family members may enter preventing mutually sa t i s fy ing agreement. As these disagreements remain, a chronic state of tension and stress develops. (p.260) F i n a l l y , the role of the anorexic c h i l d in unresolved parental c o n f l i c t s , can be explained by to poorly delineated boundaries between the spousal and c h i l d subsystems. Seen as "parent-watchers" anorexics become eas i ly involved in spousal disagreement. Furthermore, unresolved mar i t a l c o n f l i c t s and mutual d i s t rus t make spousal co l labora t ion a problem. Thus the anorexic 's responses to her parents have in f l a t ed meaning for both of the parents. The systems view of anorexia nervosa as proposed by Minuchin, portrays the c h i l d ' s symptom as emerging within a pa r t i cu l a r f a m i l i a l climate (Minuchin et a l . , 1975). The symptom functions to s t a b i l i z e the fami ly ' s t ransact ional patterns and thus1 ensures the symptom's continuance (Bemis, 1978). Minuchin has suggested that anorexia nervosa should be framed as an interpersonal , rather than ind iv idua l problem. He has stressed that the successful treatment of the problem should include s t ruc tu ra l changes wi th in the family context (Minuchin, 1978). In considering Minuchin's s t ruc tu ra l theory of anorexia, i t i s important to h igh l igh t that an e t i o l o g i c a l explanation i s e x p l i c i t l y not intended by i t s proponents (Sargent et a l . , 1985). The systemic view describes the family phenomena that may maintain and/or reinforce the symptomatic behavior. This view does not assert that the family "causes" the symptom 25 (though th i s i s often the impression many may have). Instead the systematic perspective stresses that the family can act in ways which diminish the symptomatic behavior and encourage more adaptive behavior in both the anorexic c h i l d and other family members. Unfortunately, the subtlety of t h i s d i s t i n c t i o n between cause and maintenance leaves much room for misunderstanding and disagreement. In considering systemic models, i t i s d i f f i c u l t not to get the impression that although the family i s viewed as a t ransact ing un i t , comprised of component parts , ce r ta in parts of that unit seem to transact "more" than other par t s . This was prec i se ly the point made by Norr is and Jones (1979). These researchers argued that the anorexic c h i l d must be seen as an ac t ive part of the system rather than a passive pa r t i c i pan t . Their contention i s in accord with Maturana's theory of on to log ica l biology described e a r l i e r . E x p l i c i t y there are two rela ted points which are relevent . F i r s t l y , as observers we have a propensity to punctuate what we see as involving c a u s a l i t y . From our perspective we tend to give "causal" denotation to act ive agents. Using the image of a b i l l i a r d s game, D e l l (1985) i l l u s t r a t e s that from our point of view: " . . . The moving b a l l in b i l l i a r d s 'causes' the s tat ionary b a l l to caromb away" (p .8) . The error in th i s perspective i s that; " . . . We are ignoring the fact i t i s the structure of the second object ( i . e . The stat ionary b a l l ) which determines that i t may be perturbed, and how i t w i l l be perturbed, by other objects". (p.8) 26 Secondly, i t i s erroneous to think of some part of a composite unity which i s dynamic and changing as passive or ac t ive , since what takes place within a consensual domain (the family) i s ac tua l ly a s t r uc tu r a l l y determined, in ter locked behavioral conversation. Maturana (1978) asserts that: . . .each element of the behavior of one organism operating in a consensual domain acts as a t r igger ing preturbation for another. Thus, the behavior of organism A perturbs organism B, t r igge r ing in i t an in te rna l change of state that establ ishes i t in a new s t ruc tu ra l background for i t s further in terac t ions and generates a behavior that, in turn perturbs an organism A, which . . . Perturbs organism B, which . . . . And so on in a recursive manner u n t i l the process stops - e i ther because, as a resul t of the s t ruc tura l changes of A and B some behavior i s tr iggered that does not belong to the consensual domain, or because some independent in te rac t ion occurs that leads them out of the consensual domain. (p. 53) Seen in consideration of these two points i t i s c lear that any notion of "causa l i ty" s t r i c t l y has no place within a systems framework. Since famil ies do not cause symptoms to occur, e t i o l o g i c a l formulations are out of the quest ion. This i s so, not because the functioning of family systems are unimportant, .but because "causal i ty" i s not an appl icable construct in a systemic world. While i t i s true that a systems perspective w i l l not be able to help tease apart the . causative ingredients of anorexic behavior, i t i s also true that the systemic offers a unique and broad perspective of anorexia which may provide a more complete understanding of the phonomena and improve the treatment of the anorexic and her family . 27 Other Family Descript ions of Anorexic Functioning In contrast to systems theor is t s l i k e S e l v i n i (1978) and Minuchin (1978) who present a r e l a t i v e l y concise universal view of re la t ionships wi thin the i n t e r i o r of fami l ies with an anorexic member, other researchers are not as convinced that such a dominant family pattern e x i s t s . Strober and Yager (1985) postulated that two broad groupings of anorexic famil ies e x i s t . The f i r s t group's transactions c lose ly resembled the famil ies described by S e l v i n i (1978) and Minuchin (1978) which i s characterized by a "cent r ipe ta l process" which was t y p i c a l l y expressed through excessive cohesion. The hallmarks of th i s pattern are lack of permissiveness, reduced emotional express iv i ty and l i m i t s placed on outside contacts ." (Strober & Yager, 1985). The second- group they have observed i s characterized by a ' c en t r i fuga l process ' . These famil ies lack cohesion and attachment and are seen as being highly con f l i c t ed , torn , and broken wel l before the onset of the symptomatic behavior. Garf inkel and Garner (1982) presented yet another view of anorexia in regards to family t ransact ional processes. These researchers suggest that a wide spectrum of t ransact ional patterns ex i s t in famil ies with an anorexic member. Basing the i r comments on the i r c l i n i c a l experiences Garf inkel and Garner (1982) state that : I t i s our impression from the parents we have treated that there i s no one family cons te l l a t ion nor a s ingle type of mother-child r e l a t ionsh ip that w i l l regular ly be associated with anorexia nervosa. Rather there i s a var ie ty of d i f f i c u l t i e s in famil ies that may 28 predispose to anorexia nervosa. (p. 177) In the fol lowing sect ion, relevant research issues and findings w i l l be considered, such that the present study may be placed in an inves t iga t ive context. Family Research of Anorexia Nervosa Family research in the area of anorexia nervosa can read i ly • be divided into two d i s t i n c t c lasses . While both classes may be said to be interested in family s t ructure , the confusion i s a resul t of differences in semantics employed by researchers. In some a r t i c l e s the use of the term "structure" refers to demographic information, while in others, "structure" denotes t ransact ional phenomenon. To avoid any further misunderstanding, and in keeping with the theore t i ca l underpinnings of the present study, these two research classes w i l l be treated separately and l abe l l ed as demographic data and t ransact ional data respec t ive ly . Demographic Data Information on famil ies with an anorexic c h i l d appears in Table I . As the table reveals , no pa r t i cu l a r demographic feature cons is tan t ly characterizes these f ami l i e s . Despite the preponderance of cases reportedly found in upper middle and upper classes (Crisp et a l . , 1980; Garf inkel & Garner, 1982; H a l l , 1978; Nor r i s , 1979; Kalucy et a l . , 1977) a l l socio-economic classes are represented. 29 Table 1. Demographic Findings Author(s) Findings Measure Kay, Schapira and Brandon (1967) Dal ly (1969) Theander (1970) Bruch (1973) a l l s o c i a l classes represented C l a s s i c a l 38% of famil ies experienced Data environmental hardships; non-serious b i r t h complications; 50% were only c h i l d . stable homes; 18% of fami l ies with C l i n i c a l patient 15 years or younger exper- Data ienced loss of one parent through, death, separation, or divorce; death or serious i l l n e s s in 17% r e l a t i v e s ; anorexia preceded by physica l i l l n e s s . a l l s o c i a l classes represented; C l i n i c a l 37% f i r s t b o r n , 32% second born, Data 31% t h i r d born, 15% only c h i l d , 40% of mothers less than 30 at time of proband as compared to 55% in cont ro l group. small family s i z e ; 10% only c h i l d ; C l i n i c a l preponderance in oldest c h i l d ; Data parents tend to be older ; stable marriages (few separations or divorces) Kalucy et a l . (1977) H a l l (1978) Norr is (1979) 50% from s o c i a l c lass I and I I ; death in 29% of f ami l i e s ; 34% 34% patients had l e f t home; 7% parents had separated 70% from s o c i a l c lass I and I I ; death in at b i r t h of c h i l d (fa=30, mo=29) as compared to general populat ion; 36% of parents had broken homes by age of 16; 6% patients parents divorced; family s ize nonsigni f icant ; 38% oldes t , 5% middle, 42% youngest. A l l s ize f ami l i e s ; s i b l i n g pos nonsignif icant - roughly 6% only c h i l d ; 40% f i r s t b o r n , 38% youngest g i r l s outnumber boys in family 3:1 nearly 1/2 s i b l i n g s were female; C l i n i c a l Data Personal Interviews C l i n i c a l Data 30 Table 1 (continued) Author(s) Findings Measure Low incidence of divorce (40% as compared to 27%-30% in the populat ion; 70% from high income bracket. Cr i sp et a l . (1980) 14% only c h i l d , 27% f i r s t bo rn , 41% youngest; 62% from s o c i a l c lass I and 11. C l i n i c a l Data Garf inkel and Garner (1980) 59% from s o c i a l c lass I and I I ; 7% only c h i l d ; 17% mothers over 35; and 17% over 40 - higher than nat ional average ( soc ia l c lass not control led) C l i n i c a l Data Though there appeared to be more incidences of anorexic behaviour in f i r s t borns in some studies (Bruch, 1973; Nor r i s , 1979), other studies have reported c o n f l i c t i n g findings (Crisp et a l . , 1980). Thus anorexia does not seem to be spec i f i c to s i b l i n g , b i r t h order, or family s i z e . Consistant with family theory related to notions of family environment, there would appear to be less parental separation and divorce in these famil ies (Bruch, 1973; Kalucy et a l . , 1977; H a l l , 1978; Nor r i s , 1979). While demographic data suggests ce r ta in trends, general izat ions and assumptions per ta ining to the nature of the symptomatic process are unwarranted at t h i s time. Inferences of th i s kind would seem unwise as genera l i t i e s tend to exclude much of the demographic data and as such are misleading and s i m p l i s t i c . 31 Transactional Data U n t i l r e l a t i v e l y recent ly , t r u l y t ransact ional research was quite rare in the area of anorexia. Despite the appealing convergence of ideas forwarded by systems theories such as Minuchin (1978) and S e l v i n i (1978), empir ica l backing for systemic theory i s only now mounting (Humphrey, 1984 b) . The extant empir ica l research generally supports the c l i n i c a l notion that famil ies of anorexics and other related eating disorders sub-groups (bul imics , anorexic-bulimics) generally have disturbed t ransact ional patterns as compared to non-symptomatic f ami l i e s . The t ransact ional inves t iga t ions , which view the family as the unit of ana lys i s , w i l l be reviewed in th i s sec t ion . Reporting an in-depth c l i n i c a l evaluation of twenty-eight anorexic patients and the i r f ami l i e s , Norr is (1979) found that mothers of anorexics i n i t i a t e d and con t ro l l ed family in teract ions in 21 of the famil ies while fathers played a s imi l a r role in 3 of the 28 f ami l i e s . A strange entanglement between the anorexic and one of her parents was reported in 75% of the f ami l i e s . Of th i s percentage, the re la t ionsh ip was between the mother and c h i l d in 18 of the famil ies (64%) and between the father and the c h i l d in 6 other famil ies (21%). These findings were complemented by a consistant denial of mar i ta l c o n f l i c t in the f a m i l i e s . In a more systematic study, Fromm (1981) invest igated parental behaviour related to behaviours the i r daughters might use when seeking autonomy or i nd iv idua t ion . Using the Structure 32 Analys is of Soc ia l Behaviour (SASB) to codify and analyze parents responses when presented with vignettes of adolescent g i r l behaviour, Fromm (1981) found that the parents of anorexics responded with more at tacking types of behaviour than the i r cont ro l parent counterparts. This study showed that parents of anorexics were more l i k e l y than the cont ro l parents to view normal indiv iduat ion ef fec ts , as being re la ted to an oppressive se l f concept in the i r daughters. Employing the Family Environment Scale FES (Moos & Moos, 1980), Strober (1981) found di f ferent family re la t ionships ex i s t i ng in anorexic subgroups. Invest igat ing differences between bulimic-anorexics and c l a s s i c a l r e s t r i c t i n g anorexics, the resul ts of th i s study showed that a more negative, c o n f l i c t u a l and d i s s a t i s f i e d family enviroment was perceived by bulimic-anorexic famil ies as compared to the i r " c l a s s i c a l " counterparts bulimic-anorexic famil ies were less cohesive and less organized than the famil ies of c l a s s i c anorexics. Adding corroborative evidence to the notion that the famil ies of anorexic subgroups are t r ansac t iona l ly d i f fe ren t , Humphrey (1984b) studied 80 young women with anorexia nervosa, bul imia , bulimia-anorexia or no h is tory of an eating disorder (n=20). Using Benjamin's SASB ra t ing scales to measure the g i r l s descr ipt ions of the i r re la t ionships with the i r parents, Humphrey (1984b) found that the members of the eating disordered groups perceived greater blaming and su lk ing , a t tacking and protes t ing , and neglecting and wal l ing off among the i r famil ies r e l a t i v e to con t ro l s . The bulimic subtypes also experienced 33 less understanding and d i s c l o s i n g , nurturing and approaching and helping and t rus t ing family behaviours, as compared to normal con t ro l s . S i m i l a r l y , Garner, Garf inkel and 0'Shaughnessy (1983) found that family i n t e r ac t iona l s ty les of both bulimic" subtypes were perceived to be more disturbed than those of r e s t r i c t i n g anorexics, e spec ia l ly in the areas of cont ro l and affect ive expression. Using the Family Assessment Measure (FAM), these researchers found that anorexic ch i ldren and the i r mothers perceived more d i f f i c u l t y on scales re la ted to task accomplishment, role performance, communication and affect ive expression than nonsymptomatic chi ldren and the i r mothers. In add i t ion , anorexic famil ies were found to have supr i s ing ly lower s o c i a l d e s i r a b i l i t y scores than normal f ami l i e s . Family t ransac t ional inves t igat ions which focus on bulimic symptoms have consistantly- reported that bulimic famil ies are disorganized and less cohesive and expressive than normal cont ro l famil ies (Johnson & Flack , 1984; Ordman & Kitschenbaum, 1984). In a study contrast ing bulimic subtypes and normal cont ro l f ami l i e s , Humphrey, ( in press) found that the famil ies of the two bulimic subtypes were comparable to each other and very dis t ressed r e l a t i v e to normal f ami l i e s . Employing the Family Environment Scale , these famil ies reported less involvement, support and detachment as wel l as greater i s o l a t i o n and nondisclosure as compared to nonsymptomatic f ami l i e s . In t h i s study bul imic-anorexics and the i r parents perceived poorly defined boundaries wi thin the family while bulimics and the i r 34 parents did not d i f f e r from controls in perceiving wel l defined in t r a f a m i l i a l boundaries. Examining family processes through d i rec t observation, Goldstein (1981) found that anorexic famil ies communicated greater dependency and insecur i ty in the i r verbal transactions than other psych ia t r i c comparison groups including schizophrenic f ami l i e s . In accord with t h i s , Humphrey (1984a) reported that bul imic-anorexics exhibi ted greater enmeshment, neglectfulness and blaming and less protectiveness arid nurturance than did con t ro l s . In add i t ion , the resu l t s of th i s study showed that parents of anorexics were more double binding towards the i r daughters, in taking control rather than giving autonomy as compared to parents of nonsymptomatic f ami l i e s . The complementary role of the anorexic herself in th i s c o n f l i c t was an ambivalence between resentful submission verses taking autonomy. The nonsymptomatic daughters in contrast demonstrated unambivalent, t rus t ing and approaching behaviours towards the i r parents. In a study comparing famil ies with a daughter and famil ies with daughters receiving medical services for non-psychiatr ic problems, Sheppy (1985) reported s i gn i f i c an t discrepancies between how anorexics perceive the i r mothers behaviour towards them and how the mother perceived the same r e l a t i onsh ip . Using Benjamin's SASB, (Benjamin, 1974) to obtain family members perception of the i r t ransact ions, t h i s study found that while the anorexic daughter experienced the i r mothers as being 35 overprotective and c o n t r o l l i n g the mothers d id not concur with the i r daughters. At the same time, anorexic daughters and the i r fathers did not see the i r r e la t ionsh ip as being s i g n i f i c a n t l y d i f fe ren t , as compared to the cont ro l group. In Sheppy's study, the anorexic daughters rated themselves as being less f r iendly to both parents than d id the control daughters. In te res t ing ly , while the mothers of the anorexics concurred with the i r daughter's appraisal of herself in th i s regard, the fathers of the anorexics did not see the i r re la t ionships with the i r daughters as unfriendly and negative as the i r daughters d i d . Anorexic famil ies rated themselves as s i g n i f i c a n t l y less cohesive on the FES than d id the control group. This f inding suggests that famil ies of anorexics are less committed and less supportive and helpful with one another than nonsymptomatic f ami l i e s . The convergent evidence from the preceding studies suggests that famil ies with daughters suffering from eating disorders exhib i t patterns on a range of t ransac t iona l ly relevent dimensions. Some differences in family patterns between c l a s s i c a l anorexics, bul imic-anorexics and bulimics appear to be emerging in the research l i t e r a t u r e . This trend i s ref lected in d i f ferent c l i n i c a l approaches to these related but different problems (Garner & Gar f inke l , 1985). Research i s only now beginning to shed l i g h t into the i l l u s i v e family patterns which connect the behaviour of the anorexic with the behaviour of her family. With the development of research tools such as Benjamin's SASB (Benjamin, 1974) and 36 Moos's FES (Moos & Moos, 1981), po ten t i a l areas of inves t iga t ion have become poss ib le . Many questions remain unanswered in regard to family t ransact ional patterns in the areas of anorexia nervosa. While the " indiv iduat ion f a i l u r e " (Benjamin, 1979a) hypothesis appears to be gaining empir ical substant ia t ion, further research into the t ransact ional process which underlies th i s notion i s required. The present study i s focused upon that i l l u m i n a t i o n . Statement of the Problem Transactional research at a systemic l e v e l was not an easy task. While i t i s problematic to study an i n d i v i d u a l , or even a dyadic t ransact ion accurately, i t seems that by adding a t h i r d character to a. f i e l d of study, the resu l t ing complexity which resu l t s i s even more challenging to analyze. Nevertheless, t h i s was the l e v e l of focus in the present study. Considering the ex i s t i ng research, i t appears that at least one member of the parental dyad in famil ies with an anorexic c h i l d has what has been termed by Norr is (1979) as a "strange entanglement". While t r a d i t i o n a l ana ly t ic thought has stressed the mother-child bond sa l i en t in t h i s regard (Goodsitt , 1979; Masterson, 1977), and some t ransact ional resu l t s have indicated a s imi l a r trend, (Garner et a l . , 1983) the ro le of the father has only recently sparked the interes t of researchers (Humphrey, 1984; Sheppy, 1985). The resul ts of these prel iminary s tudies , suggest that fathers ' behaviour may be an important factor to consider in these symptomatic f a m i l i e s . 37 From a systemic perspective, the mother and the father of a c h i l d form a subfami l ia l unit which has been labeled by Minuchin (1978), as the parental subsystem. In view of the kind of c l i n i c a l observations reported by S e l v i n i (1978), describing t r iangular dynamics as sa l ien t between anorexics and and the i r parents, a study which focused, not on the mother or on the father, but on the parental unit as a whole was indica ted . Therefore, the problem which was addressed in the present study may be a r t i cu l a t ed by the quest ion: how do the parents of anorexics as a un i t , transact with the i r symptomatic daughter, and how does she in turn transact with them? From a systemic stance, there i s the p o s s i b i l i t y that i t i s not just the t ransact ional patterns of just the mother with her daughter or the father with h i s daughter; but rather, the r e l a t i o n a l pattern of the mother and the father with the i r daughter and she with them which may tend to maintain the symptomatic behaviour. The present study invest igated both the re la t ionships between father and daughter and mother and daughter as a s ingle transacting u n i t . The theore t i ca l problem of causation from a systemic perspective has been highl ighted in t h i s chapter. The tendency for "systemic" theor is t s to u l t imate ly a r r ive at l inea r conclusions in re la t ionsh ip to symptomology has been recently addressed (Hoffman, 1981; Keeney, 1983; D e l l , 1980, 1985). This tendency can be found in the family theory of anorexia as exemplified by the words of Minuchin (1978) who writes that : "cer ta in t ransact ional patterns seem to be cha rac t e r i s t i c of a l l 38 anorexogenic famil ies" (p. 29). The same propensity i s s i m i l a r l y evident in the wri t ings of other theor is t s ( S e l v i n i , 1978; Rumney, 1983). In t h i s regard, the present research endeavored to examine the t ransact ional patterns of the parents and the i r anorexic ch i ld ren to empi r i ca l ly question whether or not such a dominant t ransac t ional family pattern was present. Given the presently p r eva i l i ng theory related to the fami ly ' s involvement with the symptom of anorexia nervosa, a r t i cu l a t ed by S e l v i n i (1978), and Minuchin et a l . (1978), the fol lowing hypotheses were formulated: Hypothesis I Famil ies containing anorexic daughters w i l l manifest t ransac t ional patterns r e l i a b l y d i f f e r en t i a t i ng them from the cont ro l group f ami l i e s . Hypothesis II A l l famil ies of anorexics w i l l r ea l i ze a near-isomorphic family t ransac t ional pat tern, as reported on SASB, such that they may be grouped together as a s ingle family type. Yager (1982) put forward the suggestion that the family t ransac t ional patterns which have been suggested as being re la ted to the symptom may in fact be l i t t l e more than stress react ions . The study addresses th i s contention by comparing fami l ies with an anorexic daughter with famil ies in which the daughter i s presently receiving medical a t t en t ion . In doing so, i t i s hoped that the t ransact ional patterns being observed w i l l 39 be s p e c i f i c a l l y related to the pa r t i cu l a r symptom of anorexia nervosa rather than to i l l n e s s in the family in general . 40 CHAPTER III METHODOLOGY Purpose of the Study The purpose of the present study was to explore the in te r -re la t ionships of members of famil ies with an anorexic c h i l d . In view of the differences of theore t ica l opinion related to the range of t ransact ional patterns which have been discussed, the study hoped to address the issue of whether or not a dominant family t ransact ional pattern associated with anorexia nervosa could be demonstrated e m p i r i c a l l y . Subjects The subjects were 22 famil ies with an anorexic daughter, each comprised of a mother, father, and daughter, and 22 fami l ies with a nonanorexic daughter s i m i l a r l y comprised of a mother, father and daughter. The 44 famil ies in the study were drawn from a larger study conducted by Sheppy ' (1985). The fami l ies were selected on the basis of being in tact family units comprized of father, mother, and daughter. The anorexic and nonanorexic famil ies were matched for age and sex of the anorexic daughters and socioeconomic status of the family as determined by Bl i shen ' s Socioeconomic Index (1976). The age of the daughters ranged from 15 to 23 years (M=18.3, SD=2.29). The anorexic daughters a l l s a t i s f i e d the DSM III (1980) c r i t e r i a for anorexia nervosa, with the exception of 41 f ive g i r l s whose weight loss ranged from 15% to 23% standard body weight. Despite t h i s , the diagnosis of anorexia nervosa for these f ive g i r l s were made by a psych ia t r i s t on the basis of the other c r i t e r i a spec i f ied by the DSM I I I . The range of the lowest weight for the anorexics was 27 kilograms to 48 kilograms. The average age of anorexic onset was 16.2 years (SD=1.91) and the mean duration of the symptoms was 23.5 months (SD=16.05). Two anorexics had never menstruated while a l l others suffered from amenorrhea. The non-anorexic g i r l s in the study were a l l receiving care from family pract ice uni ts and other community agencies for medical reasons. None of these g i r l s were diagnosed as having a psych ia t r i c condit ion and the i r immediate medical needs were not long term in nature or l i f e threatening. • I t was hoped that by ensuring both anorexic and non anorexic daughters were receiving medical a t ten t ion , i l l n e s s factors and po ten t ia l family stress reaction to i l l n e s s in general would be con t ro l l ed for . The non anorexic g i r l s weight ranged from 43 kilograms to 68 kilograms. A l l daughters in the study were presently l i v i n g at home with the i r parents and a l l anorexic subjects were under the care of a medical p rac t i t ione r at the time of t e s t i ng . A l l fami l ies were contacted by a researcher and had questionnaires del ivered to the i r homes. Research procedures were explained to the famil ies by the researcher and the questionnaires were l e f t in the famil ies homes to be completed at the i r l e i s u r e . At the time of data c o l l e c t i o n , a battery of questionnaires 42 were given to the f ami l i e s . This included: the C a l i f o r n i a Psychological Inventory, the Family Environment Scale, the Pat t ison Psychosocial Inventory, and the St ruc tura l Analys is of Soc ia l Behaviour. Related to the SASB, each mother and father independently answered one SASB interpersonal form for the i r in teract ions with the i r daughters. S i m i l a r l y each daughter completed two interpersonal forms, one ra t ing her in teract ions with her mother and one for her in teract ions with her father. Instrumentation The S t ruc tura l Analysis of Soc ia l Behaviour, SASB (Benjamin, 1974), developed with the interpersonal domain in mind, was chosen for th i s study as being the tool most sui ted to measure family t ransact ional phenomena. It has been suggested that SASB offers a new way of opera t iona l iz ing and measuring family processes which have proven to be d i f f i c u l t to empi r i ca l ly va l ida te (Humphrey & Benjamin, 1985). The SASB was developed as a circumplex model of interpersonal re la t ions and the i r intrapsychic representations. For the purpose of the present study, however, only the measurements of interpersonal re la t ions are relevent . Benjamin (1974) f i r s t presents the instrument, drawing on the theore t i ca l pos i t ion of Murray (1938), S u l l i v a n (1954, 1956), and the interpersonal models of Leary (1957) and Schaefer (1965). A more complete discussion of the developmental roots of SASB and i t s r e la t ionsh ip to p r io r theories and models of s o c i a l behaviour can be found elsewhere (Benjamin, 1979, 1984). 43 The .questionnaire form of SASB measures the interpersonal perceptions of the subject. The SASB questionnaires INTREX (see Appendix A) are designed so that subjects rate themselves or other persons on a 10 point i n t e rva l scale ranging from 0 to 100. The ins t ruc t ions to the questionnaires explain that a score of 100 indicates that the item always applies pe r fec t ly . The score of 50 i s the'demarcation point between whether or not an item i s seen as true or f a l se . The advantage of employing an i n t e rva l scale as.compared to a forced choice yes/no dichotomous format i s that i t reduces the amount of variance a t t r ibuted to acquiescence which leads to ind iv idua l differences resu l t ing from the manner in which the response format i s used. While the SASB attempts to minimize the effects of th i s kind of response set, i t a lso functions on the assumption of "good f a i t h" (Benjamin 1985, p .3 ) . This means that variance a t t r ibu tab le to s o c i a l d e s i r a b i l i t y i s included in the resul ts and not measured or con t ro l led fo r . It i s important to note that the questionaire form of SASB measures the perceptions of the ind iv idua l raters in terms of how they see themselves and others in te rac t . As such i t presents a subjective view of an ind iv idua l t ransact ional world as he/she experiences i t and does not claim to measure transactions ob jec t ive ly . However, Benjamin (1980) has developed a more objective SASB ra t ing system for coding actual transactions which was not used in the present study. Interested readers are referred to Benjamin (1985) for a complete discussion of t h i s coding system. 44 A t y p i c a l series of r e l a t ionsh ip rat ings would involve 180 items inc luding 36 items re la ted to intrapsychic phenomena and 72 items re la ted to t ransact ional perceptions. An item such as: "She accuses and blames me; she t r i e s to get me to admit that I am wrong", measures t ransact ional perception of an ind iv idua l in terms of another person. The SASB model c l a s s i f i e s t ransact ional a c t i v i t y in terms of focus of the event, and the two key interpersonal dimensions of a f f i l i a t i o n and interdependence, the cen t ra l axis of the •model. Focus of a t ransact ional event, re lates the subjects a t t r i b u t i o n of a c t i v i t y in terms of other, or s e l f . In th i s manner SASB allows for a view of how family members see other members i n i t i a t e and respond towards them. It a lso provides a se l f r e f l e c t i v e view of how the respondent views his /her own behaviours in terms of i n i t i a t i n g and responding behaviours v i s -a -v is another. These di f ferent focuses are reported on separate surfaces in the SASB output which are referred to as maps. As mentioned e a r l i e r such a d i s t i n c t i o n of ac t ion , rests with the observer. The SASB model allows the subject to report the i r own views of who does what, to whom. Thus SASB rat ings allow for the emergence of d i f ferent views of the same "objective" re la t ionship . The two centra l dimensions of a l l focus surfaces are a f f i l i a t i o n and interdependence. A f f i l i a t i o n i s on the hor izonta l ax is and ranges from f r iendly and loving on the r ight hand side to hos t i l e and at tacking on the l e f t hand s ide . 45 Reflect ing interdependence, the v e r t i c a l axis extends from independent, free behaviour at the top, and dependent con t ro l l ed behaviour at the bottom. A l l 36 points on each surface represents a blend of these two core constructs (Appendix B ) . While the poten t ia l of the SASB model has been recognized, so too has i t s complexity. Wiggins (1982) accurately described the SASB as "the most de ta i l ed , c l i n i c a l l y r i c h , ambitious and conceptually demanding of a l l contemporary models" (p. 18). In order to s impl i fy the model as wel l as increase i t s r e l i a b i l i t y , a c lus te r version of SASB was developed and i s presented in Appendix C (Benjamin, 1979b). In t h i s process, the scores for the o r i g i n a l 36 points on each focus surface were col lapsed, resu l t ing in an eight point circumplex for each surface. Cluster scores re f lec t the degree to which each of the eight behaviour c lus te rs (TBC) i s endorsed by the subject as being e s sen t i a l l y a cha rac te r i s t i c descr ip t ion of t ransact ional s t y l e . For example, i f c lus ter #2 on the focus on other surface receives a low endorsement, then the respondent i s ind ica t ing that he/she does not perceive the other as i n i t i a t i n g aff i rming and understanding behaviour towards them. For the purpose of th i s study behaviour c lus te r measures w i l l be used as indices of t ransac t ional behavior and are presented in Table 2. While i t may be argued that these rat ings do not accurately measure observable t ransact ional behavior, they do measure the subjects perceptions of t ransact ions . That which may be los t in r e ly ing on subjects perceptions i s balanced out by the p r a c t i c a l gain of r e ly ing on views which present 46 Table 2. Transactional Behavior Clusters (TBC) Measured on SASB Focus TBC# I n i t i a t i n g Responding 1 . 2. 3. 4. 5. 6. 7. 8. Freeing and Forgett ing Affirming and Understanding Nurturing and Comforting Assert ing and Separating Disc los ing and Expressing Trusting and Relying Helping and Protect ing Watching and Managing B e l i t t l i n g and Blaming Attacking and Rejecting Ignoring and Neglecting Deferring and Submitting Disc los ing and Expressing Sulking and Appeasing Protest ing and Withdrawing Walling off and Avoiding themselves in therapy. In connection with th i s Benjamin (1979b) asserted that : . In . . . therapy, the r e a l i t y of childhood experience i s ignored under the ra t ionale that i t i s the perception and memory which affect feel ings about the se l f and re la t ions with s ign i f i can t others. (p. 12) The opera t iona l iza t ion of t ransact ional behavior in th i s manner not only provides descr ipt ions of the ways which respondents see themselves and others transacting together, but a lso allows for comparisons between di f ferent family member views of the same re la t ionsh ip to be drawn. Benjamin's SASB model has been tested and improved upon over the course of s ix major revis ions (Benjamin, 1985). The construct v a l i d i t y of the model has been supported by a range of s t a t i s t i c a l procedures including factor ana lys i s , autocorre la t ions , and circumplex ana lys i s . Content and face v a l i d i t y has been establ ished using naive judges (Benjamin, 1985). Test-retest technology has been reformulated by Benjamin (1984) in recognit ion of the need for tolerance of v a r i a b i l i t y 47 for an instrument which measures ind iv idua l moods and states. Normal subjects have shown a tes t - re tes t r=.87 for d i f ferent moods and re la t ionships (Benjamin 1984). Thus SASB i s a highly sens i t ive instrument capable of measuring and quantifying subtle interpersonal sh i f t s and intrapersonal adaptation and change. For further information per ta ining to the v a l i d i t y of the SASB model, the reader i s referred to Benjamin (1974, 1979b, 1983, 1985) . Method of Analysis In order to a r r ive at a view of the pa ren ta l / ch i ld subsystem functioning, the i n d i v i d u a l rat ings of each fami ly ' s mother, father and daughter w i l l be combined and contrasted with the rat ings of the i r f ami l i e s . Father, mother, and daughter t ransac t ional views w i l l be combined in order to es tab l i sh i n t e r f a m i l i a l s i m i l a r i t i e s and dif ferences . As a l l three views w i l l be reported, i t w i l l a lso be possible to compare and contrast the i n t r a f a m i l i a l s i m i l a r i t i e s and discrepancies ex i s t i ng between parents' and daughters' views of the same t ransact ional experience. The study w i l l center on two t ransact ional focuses in each family . These are the parent 's i n i t i a t i n g behavior towards the i r daughter and the daughter's responsive behaviors towards her parents. Each family t ransact ional view, comprised of both daughter and parent perspectives on these t ransac t ional foc i w i l l be compared and contrasted with one another, such that 48 t ransac t iona l ly s imi la r famil ies may be i den t i f i ed and grouped together. S t a t i s t i c a l Procedures The method of data analysis in the present study involved two d i s t i n c t l y separate though re la ted steps. The f i r s t step of the analysis employs the mul t ivar ia te s t a t i s t i c c lus te r ana lys i s . This technique allowed for i n t e r - f a m i l i a l grouping based on patterns of i n t r a - f a m i l i a l t ransact ional responses on the SASB questipnaire as i d e n t i f i e d by the U . B . C . "CGroup" s t a t i s t i c a l program (Patterson & Whitaker, 1978). The h i e r a r ch i ca l c lus te r analysis compared the t ransact ional ra t ing p r o f i l e s of each family member in the data set . Having obtained a measure of i n t r a - f a m i l i a l s i m i l a r i t y of p r o f i l e s , the analysis progressively grouped the famil ies in such a way that the i n t r a - f a m i l i a l p r o f i l e s were as s imi l a r as possible and the va r i a t ion of the interfami 1 i a l ra t ings in each group were as small as possible (Ward, 1963). At each step of the grouping process, the within-group va r i a t ion (error) was minimally increased. Since a substant ia l increase in the error at any pa r t i cu l a r step suggests the beginning of a new c lus te r or group (Boldt & Housego, 1984), the f i r s t major jump in the error term which occurred after a l l fami l ies had been grouped at least once was established as a c r i t e r i o n for ha l t ing the grouping process. The reported c lus te r s are those which had been formed pr io r to th i s cut -of f po in t . This step of the analys is focuses s p e c i f i c a l l y on the issue 49 of family t ransact ional patterns associated with anorexia nervosa. If theor is t s Minuchin, Rosman, and Baker (1978) and S e l v i n i (1978) are correct in the i r views of anorexia nervosa as a symptom which i s rooted and maintained in a f a i r l y uni f ied set of family t ransact ional behaviors, then the t ransact ional response patterns of the anorexic famil ies would be predicted to group c lose ly together in a s ingle family c l u s t e r . On the other hand, i f the symptom i s embedded in a broad range of family t ransact ional patterns which are not necessar i ly spec i f i c to the symptom as proposed by Garf inkel and Garner (1982), then the anorexic family response patterns w i l l group in such a way as to re f l ec t a range of i n t r a - f a m i l i a l behaviors which include members of the cont ro l group. The second step of the analys is provided an indepth view of the family t ransact ional behaviors as they re la ted to the family groups which were i d e n t i f i e d through the c lus te r ana lys i s . Mean average response p r o f i l e s of family members in each family c lus te r were computed, es tab l i sh ing a s ingle family composite. The averaging procedures allowed for a view of the dynamic processes which characterize the di f ferent family groups as wel l as d i s t ingu i sh ing them from one another. A s imi la r group averaging procedure has been used elsewhere to draw out dominant group t ransact ional s ty les of c l i n i c a l and normal populations (Benjamin, 1984, 1985). The average family responses were entered as data to be analyzed by Benjamin's program "Figure" (FIG). An example of the output generated by th i s program appears in Appendix ' D ' . 50 The chief functions of th i s program are (1) to transform the SASB circumplex model onto a l inea l -p lane producing graphic displays of each TBC #score, and (2), to compare empi r i ca l ly obtained data with a t heo re t i c a l l y established b e s t - f i t curve (Benjamin 1984). The majority of the theore t i ca l curves representing dominant t ransact ional s t y l e s , have been characterized by psychological labels (Benjamin 1985). The psychological descr ip t ive labels and the re la ted theore t i ca l curves are presented in Table 3. In consideration of the meaning of the b e s t - f i t curve which i s defined as the maximal co r r e l a t ion ( r . Value) between the empir ica l data and the 21 theore t i ca l curves, Benjamin (1985) has pointed out that: By conventional l o g i c , If r has a value of .71 or more i t passes the c r i t i c a l test for the .05 l e v e l because r has 6 degrees of freedom (8 c lus te r scores) . However, because of the large number (21) of possible f i t s t r i e d by program FIG, .71 does not define the .05 l eve l of expected Type I error on a random populat ion. The value .71 does, however, mark the point which more than %50 of the variance has been defined. (p.8) In view of the above i t would seem that the b e s t - f i t curve generated by program FIG has explanatory u t i l i t y in the present study. The b e s t - f i t curve provides a concise overview of the general t ransact ional s ty le of the respondent's view of the ind iv idua l being rated. Thus, where i t was appropriate the b e s t - f i t curves were employed in a id of exp l i ca t ing the family t ransact ional dynamics in the second step of ana ly s i s . I t should again be stressed that in the present study a s ingle family i s operat ional ized as the combination of the 51 Table 3. Psychological Names for Bes t -F i t Curves from Program FIG. Behavior Focus Curve# I n i t i a t i n g Responding 1. Fr iendly I n i t i a t i v e Fr iendly Reaction 2. Attacking I n i t i a t i v e Hos t i l e Reaction 3. Fr iendly I n i t i a t i v e Fr iendly Reaction 4. Attacking I n i t i a t i v e Hos t i l e Reaction 5. Give Autonomy Take Automony 6. Control Submit 7. . Give Autonomy Take Autonomy 8. Control Submit 9. Power Double Bind Ambivalent D i f f e r en t i a t i on 10. Fr iendly Control Fr iendly Submit 11. Fr iendly Control Fr iendly Submit 12. m m 13.. m m 14. Give Autonomy Take Autonomy 15. Control Submit 16. m m 17. m m 18. Power Double Bind Ambivalent D i f f e r en t i a t i on 19. Attachment Double Bind Ambivalent Attachment 20. Power Double Bind Ambivalent D i f f e r en t i a t i on 21. Attachment Double Bind Ambivalent Attachment Note: Lines marked 'm' are miscellaneous and have no reasonable psychological name. ind iv idua l component members' perceptions of the i r re la t ionships with one another as rated on Benjamin's S t ruc tura l Analys is of Soc ia l Behavior. That i s , each family contains a view of: (A) fa ther ' s perception of transactions between himself and h is daughter (B) mother's view of transactions between herself and her daughter, (C) daughter's perception of her transactions with her father, and (D) the daughter's view of her transactions with her mother. The two-step analys is procedure described above i s employed 52 in consideration of a set of data drawn from the families* responses on the SASB. The data set i s concerned with the pa ren t / ch i ld subsystem and i s punctuated as parent i n i t i a t i n g and daughter responding behaviors. While other t ransact ional foc i would produce di f ferent r e su l t s , t h i s punctuation ref lected the parents' role of authori ty over the c h i l d and her response to that agency which was of cen t ra l concern to the invest igat i on . In defining the family in th i s way, both the parents and the c h i l d are given a chance to re f lec t the i r own views. The way the parents, as the i n i t i a t o r s of ac t ion , approach and deal with the i r daughter and how she in turn acts in response to the i r ef for ts e s sen t i a l l y served as the data for analysis in the parent inves t iga t ion . 53 CHAPTER IV RESULTS Hie ra rch ica l Cluster Analysis Family t ransact ional rat ings punctuating the re la t ionsh ip in terms of the parents as the ac t ive component and the daughter as the react ive component, were entered as data into the c lus te r analys is computation. The resu l t ing tree diagram appears in Appendix E . Figure 1 reproduces the essent ia l groupings displayed in the tree diagram, however, i t only presents the groupings which had been formed pr ior to the occurence of the cut -off c r i t e r i o n . Famil ies with an anorexic daughter were coded numbers 1 - 22 i n c l u s i v e l y . A l t e rna t e ly , the control group famil ies were coded numbers 23 - 44 i n c l u s i v e l y . As revealed in figure 1, seven family groups were i d e n t i f i e d through the c lus te r ing procedure and are l abe l l ed 1 -7. These var ied in s ize and composition, according to the number of famil ies that reported s imi l a r i n t r a - f ami l i e s t ransac t ional patterns. Thus while a large number of famil ies reported l i k e were grouped together in c lus te r 7, a much smaller number of famil ies rated the i r t ransact ional patterns in s imi la r fashion in c lus te r 3. An in terpre ta t ion of the family dynamics charac te r iz ing each c lus te r appears l a t e r . F i r s t the family composition of the groups was considered. 54 Cluster Numbers 1 i—i fsr 41 | | • 3 5 | » I 2 I I 3 0 2 3 4 5 2 1 J 4 19 J | 13 I I 15 ' ' 28 "3!3 * 12 32 I 1 4 4 1 I I 14 9 I I 4 I I 2 0 I i J 4 0 22 " 15" 3B ~ J I 26 2 3 24 , • 39 10 » 31 "4-2 2 9 2 5 LT 2 7 ; 3 4 ; 4 3 I IJ Figure 1 . Family Clusters Establ ished Through H i e r a r c h i c a l Clus ter Analys i s Note: Famil ies numbered 1-22 contain anorexic daughters. Famil ies numbered 23-44 contain nonanorexic daughters. 55 Composition of Family Clusters Table 4 presents a breakdown of 7 c lus te r group's composition. As indicated by the table , at least 1 family with an anorexic daughter i s present in every group. However, t h i s i s not the s i tua t ion with the cont ro l group. Table 4. Composition of Family Clusters Cluster Total Anorexic Control Number Population Famil ies Famil ies n % n % n % 1 3 6.82 1 33.3 2 66.66 2 9 20.45 5 55.56 4 44.44 3 3 6.82 3 100.00 0 0.00 4 4 9.09 4 100.00 0 0.00 5 4 9.09 4 100.00 0 0.00 6 9 20.45 4 44.44 5 55.56 7 12 27.27 1 8.33 1 1 91 .67 Three dif ferent groups emerged which were exc lus ive ly composed of famil ies with an anorexic member, c lus te rs 3, 4, and 5. These three groups combine to account for exactly half the t o t a l number of fami l ies with an anorexic daughter (11 of 22). The remaining 11 fami l ies in th i s group were spread out across the remaining 4 c l u s t e r s . Cluster 7 stands out as being the largest group clustered together ' (27.27% t o t a l sample population) and i t i s almost e n t i r e l y made up of con t ro l group f ami l i e s . Half of the ent i re cont ro l group sample (11 of 22) was located in th i s group, while 56 only 1 anorexic family was found s imi l a r enough to the others to be grouped into t h i s c l u s t e r . Equal in s ize (n=9), c lus te r s 2 and 6 were comprised of a r e l a t i v e l y even blend of famil ies with and without an anorexic member. These 2 composit ionally s imi la r groups together contained a large percentage of the t o t a l anorexic and cont ro l f ami l i e s , (40.91% respec t ive ly ) . The las t group establ ished through the c lus t e r ing process to be considered in terms of i t s family composition was group 1. This group (n=3) was s imi l a r to the previous two, and contains a blended composition of symptomatic and nonsymptomatic f ami l i e s . While one of the three famil ies had an anorexic daughter the other two famil ies did not. In summary, the compositional cha rac t e r i s t i c s of the family c lus te rs based on parental i n i t i a t i n g and daughter responding t ransact ional behaviors and i d e n t i f i e d through a c lus te r analysis procedure, revealed 3 separate family groups which were exc lus ive ly associated with fami l ies with an anorexic daughter. A large, and predominantly non-anorexic family group was also i den t i f i ed through the c lu s t e r ing process. Three add i t iona l t ransact ional family systems were i den t i f i ed and were comprised of a blend of cont ro l and experimental f ami l i e s . Interpretat ion of the seven c lus te rs of famil ies was based on a mean averaged pro to typ ica l family establ ished for each c l u s t e r . Order of presentation was based p r imar i ly on the s ize of the c lus te r (percent of sample population) moving from largest to smallest . The fol lowing in terpre ta t ion of the 57 sa l ien t t ransact ional patterns and family dynamics charac ter iz ing the 7 c lus te rs was obtained. Interpretat ion of Family Clusters Family Cluster 7: "The Harmonious Transactional Family" The average family group p r o f i l e s for t h i s , the largest c lus te r of famil ies i d e n t i f i e d in the study, are shown in Figure 2. Comprised of 12 f ami l i e s , 11 of which belong to the cont ro l group, th i s c l u s t e r ' s t ransact ional s ty le may be broadly characterized as f r iendly and consis tent . A quick perusal of the family t ransact ional p r o f i l e s revealed a high degree of agreement between family member's view of parent i n i t i a t i n g and daughter responding behaviors. Both parents and c h i l d viewed the parents' i n i t i a t i n g behaviors as predominately characterized by affirming and understanding (TBC #2), and helping and protect ing (TBC #4) behaviors, as the peaks of the t ransact ional patterns a t t es t . S i m i l a r l y , both parents and c h i l d rated the parental i n i t i a t i n g behaviors of b e l i t t l i n g and blaming, at tacking and re jec t ing , and ignoring and neglecting (TBC #6, 7, and 8) as very rare. A high degree of accord was shown between parents and daughter in terms of how each saw daughter's responses towards them. They agreed that daughter mainly responded with d i sc los ing and expressing, and t rus t ing and r e ly ing behaviors (TBC #2 and 4 r e spec t ive ly ) . In harmony with her parents' i n i t i a t i n g s t y l e s , both parents viewed daughter as rare ly responding with the 58 .FAMILV CLUSTER 7 ,MEAN SCORES FATHER RATES SELF , RE DAUGHTER INITIATE 39 78 46 63 36 10 2 5 STARS INOICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY, ONLY DATA ARE SHOWN 100 • 95 90 85 * • 80 0 75 70 65 0 60 5S SO « O « 45 40 0 O 35 30 25 20 15 10 0 5 0 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.907 -0.907 0.689 -0.689 0.069 -0.069 -0.592 0.592 0.222 0.824 0.896 -0.791 0.791 -0.289 0.289 0.398 -0.398 -0.005 0.005 0.144 -0.144 THE MAXIMUM CORRELATION WAS- 0.907 WITH PROFILE 1 .FAMILY CLUSTER 7 .MEAN SCORES FATHER RATES .DAUGHTER RESPONO 54 72 48 63 39 14 5 9 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY, ONLY DATA ARE SHOWN 100 • • 95 90 85 • * 80 75 0 70 65 0 60 55 0 50 0 • 45 40 O 35 30 25 20 15 0 * 10 5 0 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.897 -0.897 0.726 -0.726 0.131 -0.131 -O.S41 0.541 0.299 O.S07 0.926 -O.S78 0.878 -0.202 0.202 0.298 -0.298 0.1OO -0.102 0.090 -O.090 THE MAXIMUM CORRELATION WAS- 0.926 WITH PROFILE 11 F i g u r e 2 . The Harmonious T r a n s a c t i o n a l F a m i l y .FAMILY CLUSTER 7 ,MEAN SCORES MOTHER RATES SELF .RE DAUGHTER INITIATE 39 78 53 56 36 8 3 4 STARS INDICATE THEORY, CIRCLES SHOW OATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 95 90 85 * • 80 0 75 70 6 5 60 0 53 O SO * * 45 40 0 0 35 30 25 20 IS i o a s a o 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.933 -0.933 0.735 -0.735 0.108 -0.108 -0.583 0.583 0.145 0.880 0.892 -0.818 0.81B -0.276 0.276 0.425 -0.425 -0.060 0.059 0.121 -0.121 THE MAXIMUM CORRELATION WAS- 0.933 WITH PROFILE 1 .FAMILY CLUSTER 7 ,MEAN SCORES MOTHER RATES .DAUGHTER RESPONO 42 66 52 64 39 14 5 7 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY OATA ARE SHOWN 100 • 95 90 85 « • 80 75 70 0 65 0 60 55 0 SO • • 45 0 40 0 35 30 25 20 15 0 10 5 0 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.950 -0.950 0.668 -0.668 -O.O04 O.004 -0.674 0.674 0.196 0.840 0.935 -0.813 0.813 -0.353 0.353 0.378 -0.377 0.091 -0.092 0.04S -0.045 THE MAXIMUM CORRELATION WAS- 0.950 WITH PROFILE 1 F i g u r e 2. ( c o n t i n u e d ) 60 ,FAMILY CLUSTER 7 ,MEAN SCORES DAUGHTER RATES ,FATHER INITIATE 43 66 42 63 33 6 3 3 STARS INOICATE THEORY. CIRCLES SHOW OATA IN CASES WHERE DATA-THEORY. ONLY OATA ARE SHOWN 100 95 90 85 • • 80 75 70 0 65 0 60 55 50 * • 45 0 a 40 35 0 30 25 20 15 10 0 5 0 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.90S -0.905 0.699 -0.699 0.084 -0.084 -0.579 0.579 0.248 0.782 0.904 -0.819 0.819 -0.250 0.250 0.355 -0.355 0.094 -0.095 0.038 -0.038 THE MAXIMUM CORRELATION WAS- 0.9O5 WITH PROFILE 1 .FAMILY CLUSTER 7 .MEAN SCORES DAUGHTER RATES SELF .RE FATHER RESPOND 44 80 70 76 49 14 3 7 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY, ONLY DATA ARE SHOWN 100 * 95 90 85 -80 0 0 75 70 0 65 60 55 50 • 0 45 0 40 35 30 25 20 15 0 10 5 0 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.974 -0.974 0.658 -0.658 -0.043 0.043 -0.718 0.718 0.128 0.864 0.920 -0.776 0.776 -0.404 0.404 0.442 -0.442 0.073 -0.073 0.040 -O.040 THE MAXIMUM CORRELATION WAS- 0.974 WITH PROFILE 1 F i g u r e 2. ( c o n t i n u e d ) 61 .FAMILY CLUSTER 7 .MEAN SCORES DAUGHTER RATES .MOTHER INITIATE 43 75 48 65 37 10 1 3 STARS INDICATE THEORY, CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY, ONLY DATA ARE SHOWN 100 • • 95 90 8S • • " 80 75 0 70 65 0 60 55 50 0 * 45 0 40 0 35 30 25 20 15 10 0 5 0 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.919 -0.919 0.688 -0.688 0.054 -0.054 -0.611 0.611 0.232 0.829 0.921 -0.821 0.821 -0.297 0.297 0.364 -0.364 0.041 -0.042 0.102 -0.102 THE MAXIMUM CORRELATION WAS- 0.921 WITH PROFILE 11 .FAMILY CLUSTER 7 ,MEAN SCORES DAUGHTER RATES SELF .RE MOTHER RESPOND 46 66 52 68 37 15 11 13 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE OATA-THEORY. ONLY DATA ARE SHOWN 10O 95 90 85 • • ao 75 70 O 0 65 60 55 0 50 0 45 40 0 35 30 25 20 15 0 0 10 5 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.938 -0.938 0.698 -0.698 0.050 -0.050 -0.627 0.627 0.181 0.799 O.905 -0.808 0.808 -0.294 0.294 0.394 -0.394 0.101 -0.102 -0.021 0.021 THE MAXIMUM CORRELATION WAS- 0.938 WITH PROFILE 1 Figure 2. (continued) 62 behaviors measured in the l as t three t ransact ional c lus te rs (TBC #6', 7, and 8) . That i s , she seldom was seen as exh ib i t ing the behaviors of sulking and appeasing, protest ing and withdrawing, or wa l l ing-of f and avoiding. Differences between members of th i s family group were evidenced in the considerat ion of the b e s t - f i t curves. In t h i s family group, father saw himself as approaching his daughter with a " f r iendly i n i t i a t i v e " (curve 1) and viewed his daughter's response as one character ized by a " f r iendly submission" (curve 11). Mother pictured hersel f as t ransact ing l i k e father from a " f r iend ly i n i t i a t i v e " pos i t ion (curve 1), however her view of her daughter's reaction d id not contain a element of submission and was seen as a " f r iendly react ion" (curve 1). Daughter in t h i s family c lus te r agreed with her fa ther ' s view of the i r approaching behaviors as being character ized by a " f r iend ly i n i t i a t i v e " . Simultaneously, they portrayed themselves as responding to the i r father with a " f r iendly react ion" (curve 1) without iden t i fy ing a submissive element in her r e l a t i onsh ip . In a s im i l a r ve in , daughter concurred with her mother's assessment of her responding behavior as being e s sen t i a l l y a " f r iendly react ion" (curve 1). In conclusion, there exis ted some differences in view between family members in terms of the c o n t r o l l i n g and submitting side of the i r re la t ionsh ips in t h i s family c l u s t e r . As the family was negotiat ing through the adolescent t r a n s i t i o n a l stage, which i s h ighl ighted by a sh i f t in the amount of r e s p o n s i b i l i t y taken by the c h i l d , such differences in 63 view were to be expected as the family adjusted to changes. While th i s was occuring, the emotional tenor of th i s family c lus ter was one of f r iendl iness with scarcely a murmur of h o s t i l i t y present. Family Cluster 6: "The Perfect Family" Equal in s ize with c lus te r number 2 (n=9), the 6th c lus te r was const i tuted by a blend of 5 famil ies from the cont ro l group and 4 famil ies from the anorexic daughter group. The mean average family c lus te r p r o f i l e s are presented in Figure 3. The general o v e r a l l trend of t ransact ional patterns between parents and c h i l d were marked with a high degree of f r i end l iness and v i r t u a l l y void of any disagreement. Both parents and daughter viewed the parents as p r imar i ly i n i t i a t i n g with aff i rming and understanding, as wel l as helping and protec t ing , behaviors (TBC #2 and 4 r e spec t ive ly ) . The accent of these two p r i n c i p l e t ransact ional behaviors f e l l on aff irming and understanding which was highly endorsed by a l l family members. At the same time, the more hos t i l e related i n i t i a t i n g t ransact ional behaviors such as b e l i t t l i n g and blaming, a t tacking and re jec t ing , and ignoring and neglecting were apparently v i r t u a l l y never exhibi ted by parents in e i ther the i r own or the i r daughter's appra i sa l . It i s c lear that father viewed his daughter's response to him as less colored by d i s c lo s ing and expressing (TBC #2) and t rus t ing and re ly ing t ransact ional behaviors, as compared to h is wi fe ' s view of her re la t ionsh ip with the i r daughter. Father ' s ,FAMILY CLUSTER 6 ,MEAN SCORES FATHER RATES SELF .RE OAUGHTER INITIATE 48 83 62 66 21 6 5 3 STARS INDICATE THEORY. CIRCLES SHOW OATA IN CASES WHERE OATA-THEORY, ONLY DATA ARE SHOWN 100 • 95 90 85 O « 80 75 70 0 65 0 60 55 50 0 • 45 40 35 30 25 0 20 15 • 10 0 5 0 0 * 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.926 -0.926 0.809 -0.809 0.219 -0.219 -0.499 0.499 0.038 0.852 0.840 -0.840 0.840 -0.178 0.178 0.440 -0.440 -O.101 0.099 -0.038 0.038 THE MAXIMUM CORRELATION WAS" 0.926 WITH PROFILE 1 .FAMILY CLUSTER 6 .MEAN SCORES FATHER RATES .DAUGHTER RESPOND 56 67 58 63 39 1 1 3 8 STARS INDICATE THEORY. CIRCLE5 SHOW DATA IN CASES WHERE DATA-THEORY. ONLY OATA ARE SHOWN 100 • 95 90 85 • • 80 75 70 0 65 0 60 0 0 55 50 * 45 40 0 35 30 25 20 15 0 10 5 0 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.940 -0.940 0.753 -0.753 0.124 -0.124 -0.576 0.576 0.220 0.834 0.927 -0.892 0.892 -0.216 0.216 0.333 -0.333 0.140 -O.141 -0.O07 O.007 THE MAXIMUM CORRELATION WAS- 0.940 WITH PROFILE 1 F i g u r e 3. The P e r f e c t F a m i l y .FAMILY CLUSTER 6 .MEAN SCORES MOTHER RATES SELF .RE DAUGHTER INITIATE 50 92 67 77 26 4 2 0 STARS INOICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE 100 • 95 0 90 85 * • 80 0 75 70 0 65 60 55 50 O • » 45 40 35 30 0 25 20 15 10 5 0 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.936 -0.936 0.777 -0.777 0.163 -0.163 -0.545 0.545 0.064 0.848 0.860 -0.826 0.826 -0.226 0.226 0.440 -0.440 -0.067 0.066 -0.026 0.026 THE MAXIMUM CORRELATION WAS- 0.936 WITH PROFILE 1 .FAMILY CLUSTER 6 .MEAN SCORES MOTHER RATES .DAUGHTER RESPOND 45 82 63 73 51 16 4 6 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY, ONLY DATA ARE SHOWN 100 • • 95 90 85 0 • 80 75 0 70 65 0 60 55 0 50 • • 45 0 40 35 30 25 20 0 15 • 10 3 0 O • 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.949 -0.949 0.641 -0.641 -0.042 0.042 -0.700 0.700 0.190 0.864 0.936 -0.790 0.790 -0.396 0.396 0.391 -0.391 0.059 -0.059 0.104 -0.104 THE MAXIMUM CORRELATION WAS- 0.949 WITH PROFILE 1 F i g u r e 3. ( c o n t i n u e d ) ) 66 ,FAMILY CLUSTER 6 .MEAN SCORES OAUGHTER RATES ,FATHER INITIATE 45 77 54 73 36 3 1 2 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY OATA ARE SHOWN 100 • 95 90 85 • • 80 O 75 0 70 65 60 55 0 50 * • 45 0 40 0 33 30 25 20 15 • 10 5 0 0 0 • 1 2 3 4 3 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.935 -0.935 0.702 -0.702 0.059 -0.059 -0.619 0.619 0.177 0.818 0.9O6 -0.809 0.809 -0.295 0.295 0.398 -0.398 0.057 -0.058 0.015 -0.015 THE MAXIMUM CORRELATION WAS- 0.935 WITH PROFILE 1 .FAMILY CLUSTER 6 ,MEAN SCORES OAUGHTER RATES SELF .RE FATHER RESPOND 44 80 70 76 49 14 3 7 STARS INDICATE THEORY. CIRCLES SHOW OATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 1O0 • 95 90 85 80 0 0 75 70 0 65 60 55 50 • 0 45 0 40 35 30 25 20 15 O 10 5 0 O " 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.974 -0.974 0.658 -0.658 -0.043 0.043 -0.718 0.718 0.128 0.864 0.920 -0.776 0.776 -0.404 0.404 0.442 -0.442 0.073 -0.073 0.040 -O.040 THE MAXIMUM CORRELATION WAS - 0.974 WITH PROFILE 1 F i g u r e 3. ( c o n t i n u e d ) 67 .FAMILY CLUSTER 6 ,MEAN SCORES DAUGHTER RATES .MOTHER INITIATE 46 90 63 80 34 5 0 0 STARS INDICATE THEORY, CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY, ONLY DATA ARE SHOWN 100 -95 90 0 85 • • 80 0 7S 70 65 0 60 55 50 O • 45 40 35 O 30 25 20 15 • 10 5 0 O 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.941 -0.941 0.722 -0.722 0.081 -0.081 -0.607 0.607 0.119 0.838 0.887 -0.801 0.801 -0.292 0.292 0.433 -0.433 -0.012 0.011 0.016 -0.016 THE MAXIMUM CORRELATION WAS- 0.941 WITH PROFILE 1 .FAMILY CLUSTER 6 .MEAN SCORES DAUGHTER RATES SELF ,RE MOTHER RESPOND 48 88 75 80 49 17 3 9 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 10O • 95 90 0 85 * • 80 0 75 0 70 65 60 55 50 0 0 45 40 35 30 25 20 O 15 • 10 5 0 O • 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.974 -0.974 0.685 -0.685 -0.006 0.006 -0.693 0.693 0.125 0.871 0.914 -0.787 0.787 -0.376 0.376 0.453 -0.453 0.O46 -0.046 0.056 -0.056 THE MAXIMUM CORRELATION WAS- 0.974 WITH PROFILE 1 Figure .3. (continued) 68 assessment of h is daughter's responses towards him were nonetheless favorable. Daughter's view of her responses towards her two parents indeed added a sense of credence to father 's view, however the high endorsement of the rat ings suggested that daughter apparently d id not see that she was less d i sc los ing and expressing (TBC #2) and t rus t ing and re ly ing (TBC #4) of father, as much as she exhibi ted even more of these behaviors in repsonse to her mother. A consideration of the b e s t - f i t curves corre la ted with the average TBC scores revealed a pattern of s o l i d agreement in th i s family. Both father and mother saw themselves as t ransac t i ing with a " f r iendly i n i t i a t i v e " (curve 1) and viewed the i r daughter's response towards them as a " f r iendly reaction" (curve 1). • The daughter's view of her re la t ionsh ip with both of her parents in terms of the i r i n i t i a t i v e s ty le and her responsive behaviors mirrored her parent 's perception of the i r " f r iendly i n i t i a t i v e " actions and her " f r iendly reaction" behaviors. In summary, th i s group of famil ies was characterized by highly pos i t ive warm fee l ings , p a r t i c u l a r l y between mother and daughter and a dearth of h o s t i l e , c o n f l i c t re lated behaviors. Responses by family members were r e l a t i v e l y consistent with one another. No major difference between parent 's and daughter's perceptions of the i r re la t ionships was reported. 69 Family Cluster 2: "The Marginal Trans i t iona l Family" Like c lus te r 6, t h i s c lus te r was comprised of 9 f ami l i e s , however, in th i s c lu s t e r , 5 of i t s consti tuents were famil ies with an anorexic daughter while 4 famil ies were drawn from the cont ro l sample. In . contrast to the. family t ransact ional patterns found in c lus te r 6, ratings were subs tan t i a l ly less pos i t i ve and where once there was agreement, cracks of discord had appeared as shown in Figure 4. Both parents in t h i s family c lus te r rated themselves as i n i t i a t i n g transactions with the i r daughter in a s imi la r fashion. Both p r imar i ly f e l t they i n i t i a t e d with aff irming and understanding (TBC #2) behaviors and rated nurturing and comforting (TBC #4) as the second highest endorsed behaviors. Reca l l ing that an endorsement of 50 was the ra t ing which de l in i a t ed a behavior as being more present than not, both father 's and mother's ratings of the i r occurence of helping and protect ing behaviors (TBC #4) of 54 and 59 respect ive ly showed that these parents d id not see themselves as exh ib i t i ng th i s behavior very regu la r ly . While the parents viewed the i r daughter as responding pr imar i ly with t rus t ing and r e ly ing behaviors (TBC #4), they also saw her respond with a degree of sulking and appeasing behaviors (TBC #6) and rated i t 26. Daughter rated fa ther ' s i n i t i a t i n g behaviors less p o s i t i v e l y than he d i d . While the general pattern of t ransac t iona l behaviors i s s imi l a r there are differences . Daughter viewed her father as less aff irming and understanding, (TBC #2) endorsing the behavior with a 56 to h i s 7 0 . Also she 70 .FAMILY CLUSTER 2 .MEAN SCORES FATHER RATES SELF .RE OAUGHTER INITIATE 42 70 49 S4 37 13 3 3 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY OATA ARE SHOWN 100 • • 93 90 85 • • • BO 75 70 0 65 60 55 0 50 0 * 45 0 40 0 35 30 25 20 15 0 • 10 5 0 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.927 -0.927 0.705 -0.705 0.070 -0.070 -0.606 0.606 0.210 0.883 0.935 -0.857 0.857 -0.296 0.296 0.340 -0.340 -O.0O2 0.001 0.130 -0.130 THE MAXIMUM CORRELATION WAS- 0.935 WITH PROFILE 11 .FAMILY CLUSTER 2 .MEAN SCORES FATHER RATES .DAUGHTER RESPOND 48 56 43 62 41 26 12 17 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 • • 95 90 85 • • • • 80 75 70 65 0 60 0 55 50 O * 4S 0 0 40 35 30 0 25 20 15 0 10 5 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.878 -0.878 0.594 -0.594 -0.038 0.038 -0.646 0.646 0.376 0.739 0.947 -0.820 0.820 -0.320 0.320 0.237 -0.237 0.244 -0.245 0.085 -0.085 THE MAXIMUM CORRELATION WAS- 0.947 WITH PROFILE 11 Figure 4. The Marginal T rans i t iona l Family 71 .FAMILY CLUSTER 2 ,MEAN SCORES MOTHER RATES SELF .RE DAUGHTER INITIATE 46 69 55 59 31 15 6 5 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE OATA-THEORY. ONLY DATA ARE SHOWN 100 95 90 85 • • 80 75 70 0 65 60 0 55 0 50 0 • 45 40 35 O 30 25 20 15 0 10 0 5 O • 1 2 3 4 5 6 7 8 ' CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.945 -0.945 0.748 -0.748 0.113 -0.113 -0.5B7 0.587 0.131 0.880 0.917 -0.872 0.872 -0.265 0.265 0.363 -0.363 -0.012 0.011 0.020 -0.020 THE MAXIMUM CORRELATION WAS- 0.945 WITH PROFILE 1 .FAMILY CLUSTER 2 ,MEAN SCORES MOTHER RATES .DAUGHTER RESPOND 46 60 41 62 34 26 12 24 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE OATA-THEORY. ONLY DATA ARE SHOWN 100 * * 95 90 85 • • • 80 75 70 65 0 60 0 55 50 O • 45 0 40 35 0 30 0 2S 20 15 0 10 5 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE t 0.859 -0.859 0.677 -0.677 0.098 -0.098 -0.537 0.537 0.363 0.682 0.863 -0.774 0.774 -0.197 0.197 0.364 -0.364 0.187 -0.188 0.126 -0.126 THE MAXIMUM CORRELATION WAS- 0.863 WITH PROFILE 11 F i g u r e 4. ( c o n t i n u e d ) 72 .FAMILY CLUSTER 2 ,MEAN SCORES OAUGHTER RATES ,FATHER INITIATE 43 36 36 52 45 37 15 18 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY, ONLY DATA ARE SHOWN 100 • • 95 90 85 * * 80 75 70 65 60 0 55 0 50 43 0 0 40 0 0 35 30 25 20 15 0 10 5 O 1 2 3 4 3 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.749 -0.749 0.415 -0.415 -0.162 0.162 -0.643 0.643 0.516 0.724 0.940 -0.758 0.758 -0.407 0.407 0.069 -0.069 0.162 -0.163 0.372 -0.372 THE MAXIMUM CORRELATION WAS- 0.940 WITH PROFILE J.' .FAMILY CLUSTER 2 ,MEAN SCORES DAUGHTER RATES SELF ,RE FATHER RESPONO 43 38 48 59 44 54 16 24 STARS INOICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 • • 95 90 85 * • • 80 75 70 65 60 0 0 55 0 50 0 • 45 0 0 40 35 30 23 20 0 15 10 S 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.719 -0.719 0.313 -0.313 -0.277 0.277 -0.704 0.704 0.373 0.690 0.849 -0.633 0.633 -0.517 0.517 0.119 -0.119 0.125 -0.125 0.367 -0.367 THE MAXIMUM CORRELATION WAS- 0.849 WITH PROFILE 11 F i g u r e ( c o n t i n u e d ) .FAMILY CLUSTER 2 ,MEAN SCORES DAUGHTER RATES .MOTHER INITIATE 37 44 32 44 49 27 17 25 STARS INDICATE THEORY, CIRCLES SHOW DATA IN CASES WHERE OATA-THEORY. ONLY OATA ARE SHOWN 100 * « 95 90 85 • • • 80 75 70 65 60 55 50 0 • 45 0 0 40 0 35 0 30 0 25 20 0 15 10 5 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.692 -0.692 0.326 -0.326 -0.229 0.229 -0.651 0.651 0.623 0.570 0.851 -0.604 0.604 -0.388 0.388 0.149 -0.149 0.415 -0.414 0.385 -0.385 THE MAXIMUM CORRELATION WAS- 0.851 WITH PROFILE 11 .FAMILY CLUSTER 2 .MEAN SCORES DAUGHTER RATES SELF .RE MOTHER RESPONO 49 51 40 52 37 42 26 39 STARS INDICATE THEORY, CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE 100 • • 95 90 85 * • • 80 75 70 65 60 55 0 0 50 0 45 0 40 0 0 35 30 25 20 15 10 5 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.646 -0.646 0.599 -0.599 0.200 -0.200 -0.314 0.314 0.559 0.458 0.704 -0.687 0.687 0.007 -0.007 0.231 -0.231 0.297 -0.299 0.294 -0.294 THE MAXIMUM CORRELATION WAS- 0.704 WITH PROFILE 11 Figure 4 . (continued) 74 perceived him as more b e l i t t l i n g and blaming (TBC #6) than he saw himself . In a s imi la r ve in , daughter apparently pictured father a s ' more at tacking and re ject ing (TBC #7), more ignoring and neglecting (TBC #8), and more watching and managing (TBC #5) than he saw himself . Daughter's ra t ing of her responses to her father c lose ly mirrored fa ther ' s view of her with one noteworthy exception. She rated her responsive behavior of sulking and appeasing (TBC #6) considerably higher than he d id (54 vs . 26). This indicated that daughter saw her responsive behaviors as more colored by th i s kind of behavior than father was apparently aware of. Daughter's view of her re la t ionsh ip with her mother was generally less favorable than mother's as w e l l . Daughter f e l t that her mother i n i t i a t e d p r imar i ly out of a mode of watching and managing (TBC #5). Her rat ings of the f i r s t four c lus t e r s , focusing on mother's i n i t i a t i n g behavior were considerable lower than mother's and did not exceed a ra t ing of 44. Thus daughter's view of mother suggested that the i n i t i a t i n g behaviors of freeing and forget t ing , aff i rming and understanding, nurturing and comforting, and helping and protect ing were not c h a r a c t e r i s t i c a l l y common ones she perceived in her mother. Mother, as mentioned above, d id not share t h i s view of he r se l f . Daughter's rat ings of her responsive behavior towards mother was again somewhat less pos i t ive than mother's view and as in the case of her view of her responsive behavior focused on father. Daughter saw herself responding with more sulking and 75 appeasing (TBC #6) behaviors than her mother d id (42 vs . 26). This trend of daughter viewing her responsive behavior s l i g h t l y less p o s i t i v e l y than mother was ref lec ted in her higher endorsement of protest ing and withdrawing (TBC #7), and wal l ing off and avoiding behaviors (TBC #8). Consideration of the b e s t - f i t curves suggested that father found himself as i n i t i a t i n g out of a b a s i c a l l y " f r iendly c o n t r o l l i n g " (curve 11) stance towards daughter. Mother maintained that she i n i t i a t e d out of a predominantly " f r iendly i n i t i a t i v e " (curve 1). Both parents saw the i r daughter as responding in a p r imar i ly " f r iendly and submitting" fashion (curve 11). Daughter's b e s t - f i t curves in r e l a t ionsh ip to her parents indicated that she was b a s i c a l l y in accord with fa ther ' s view of the i r r e l a t i onsh ip . She portrayed him as i n i t i a t i n g in a " f r i e n d l y - c o n t r o l l i n g " manner (curve 11) and'viewed her response as a " f r iendly-submit t ing" way (curve 11). In regards to daughter's view of r e l a t ionsh ip with mother, the b e s t - f i t curve showed a s l i gh t disagreement in the way mother's in which i n i t i a t i v e behavior was seen. Daughter included a c o n t r o l l i n g element into the i n i t i a t i v e focus of " f r iend ly con t ro l " (curve 11). Both mother and daughter seemed to share a s imi l a r view in daughter's responding behavior with the b e s t - f i t curve of " f r iendly submit" (curve 11) charac te r iz ing her response. In t h i s family c l u s t e r , the b e s t - f i t curve, based on c o r r e l a t i o n , while capturing the general shape of the reponse 76 pattern, did not re f l ec t the magnitude of the ra t ings . The endorsements were considerably lower than the idea l i zed curve in most' instances and th i s should be kept in mind in considering th i s family group. In summary, th i s family c lus te r may be characterized as transacting in re la t ionships which were neither highly pos i t ive nor excessively negative. Famil ies in th i s c lus te r seemed marginally engaged with one another and issues around c h i l d r e s p o n s i b i l i t y appeared present. A l l family members rated a more dominant element of sulking and appeasing behaviors on the part of the daughter than in the previous two groups. There exis ted a difference in perspective between mother and daughter perspectives on the i r r e l a t ionsh ip , with daughter seeing both mother's i n i t i a t i n g and her own responding in a somewhat less pos i t ive way. Family Cluster 4: "The Discordant Distancing Family" The mean average family p r o f i l e s i s presented in Figure 5. For th i s c lus ter of f ami l i e s . Comprised of 4 f ami l i e s , a l l of which had an anorexic daughter, t h i s family presented a countenance quite di f ferent from the previous 3 family groups. A cursory scanning of the family p r o f i l e s revealed some r a d i c a l l y di f ferent views of re la t ionships ex i s t ing between both parent and c h i l d assessments of the i r r e l a t ionsh ips . Father pictured himself as i n i t i a t i n g p r imar i ly with freeing and forget t ing (TBC #1) behaviors. The remaining 7 behavioral c lus te rs were rated r e l a t i v e l y low. Thus, he 77 .FAMILY CLUSTER 4 .MEAN SCORES FATHER RATES SELF ,RE OAUGHTER INITIATE 6S 43 29 40 30 22 13 25 STARS INOICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 • 95 90 85 • 80 75 • 70 65 0 60 • 55 50 45 0 • 40 0 35 30 0 0 -25 0 20 15 0 10 5 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.491 -0.491 0.676 -0.676 0.464 -0.464 -0.018 0.018 0.5B5 0.400 0.641 -0.843 0.843 0.335 -0.335 -0.075 0.075 0.356 -0.362 0.072 -O.072 THE MAXIMUM CORRELATION WAS- 0.843 WITH PROFILE 13 ,FAMILY CLUSTER 4 .MEAN SCORES FATHER RATES ,DAUGHTER RESPOND 58 46 42 54 42 33 19 35 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 • • 95 90 85 • • * 80 75 70 65 60 0 S5 0 50 0 • 45 0 0 40 35 0 30 25 20 0 15 10 5 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.685 -0.685 0.599 -0.599 0.160 -0.160 -0.371 0.371 0.608 0.473 0.782 -0.787 0.787 0.012 -0.012 0.112 -0.112 0.546 -0.548 0.107 -0.107 THE MAXIMUM CORRELATION WAS- 0.782 WITH PROFILE 11 Figure 5. The Discordant Distancing Family 78 .FAMILY CLUSTER 4 , MEAN SCORES MOTHER RATES SELF ,RE OAUGHTER INITIATE 33 74 50 57 31 7 2 3 STARS INOICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 95 90 85 • • 80 75 0 70 85 SO 0 55 50 • 0 • 45 40 35 O 0 30 25 20 15 • 10 0 5 • 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.937 -0.937 0.718 -0.718 0.079 -0.O79 -0.607 0.607 0.116 0.865 0.880 -0.784 0.784 -0.306 0.306 0.457 -0.457 -0.065 0.065 0.097 -0.097 THE MAXIMUM CORRELATION WAS- 0.937 WITH PROFILE 1 .FAMILY CLUSTER 4 ,MEAN SCORES MOTHER RATES ,DAUGHTER RESPOND 58 43 35 41 18 20 14 23 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 • 95 90 85 • 80 75 • 70 65 60 0 * 55 50 45 0 0 • 40 35 O 30 ' • 25 20 0 0 15 0 10 5 O 1 2 3 4 3 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.619 -0.619 0.820 -0.820 0.538 -0.538 -0.056 0.056 0.326 0.509 0.642 -0.875 0.875 0.313 -0.313 0.113 -0.113 0.187 -0.192 -0.094 0.094 THE MAXIMUM CORRELATION WAS- 0.875 WITH PROFILE 13 F i g u r e 5. ( c o n t i n u e d ) 79 .FAMILY CLUSTER 4 ,MEAN SCORES OAUGHTER RATES .FATHER INITIATE 20 16 18 30 49 45 18 32 STARS INDICATE THEORY. CIRCLES SHOW OATA IN CASES WHERE DATA-THEORY. ONLY OATA ARE SHOWN 100 95 90 85 • • 80 75 70 65 60 55 50 • 0 45 • 40 35 30 0 25 20 0 0 0 0 15 * • 10 5 0 « 1 2 3 4 3 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 -0.323 0.323 -0.728 0.728 -0.707 0.707 -0.273 0.273 0.518 -0.374 -0.085 0.440 -0.440 -0.422 0.422 -0.311 0.311 0.529 -0.526 0.492 -0.492 THE MAXIMUM CORRELATION WAS- 0.728 WITH PROFILE 4 .FAMILY CLUSTER 4 .MEAN SCORES OAUGHTER RATES SELF .RE FATHER RESPOND 58 22 15 31 21 46 37 47 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 95 90 85 • • 80 75 70 65 60 0 55 50 * 0 45 40 0 35 0 30 23 0 0 20 15 0 10 5 0 • 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 -0.633 0.633 -0.168 0.168 0.393 -0.393 0.727 -0.727 0.364 -0.656 -0.454 0.157 -0.157 0.682 -0.6B2 -0.525 0.525 0.252 -0.257 -0.024 0.024 THE MAXIMUM CORRELATION WAS- 0.727 WITH PROFILE 7 F i g u r e 5. ( c o n t i n u e d ) 80 .FAMILY CLUSTER 4 ,MEAN SCORES DAUGHTER RATES .MOTHER INITIATE 22 9 13 27 69 SI 19 40 STARS INOICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 95 90 85 • • 80 75 70 0 65 60 55 0 50 • 45 40 35 30 0 23 O 20 0 15 • 0 10 0 5 0 • 1 2 3 4 3 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 -0.412 0.412 -0.729 0.729 -0.618 0.618 -0.147 0.147 0.526 -0.446 -0.171 0.469 -0.469 -0.297 0.297 -0.357 0.357 0.551 -0.548 0.460 -0.460 THE MAXIMUM CORRELATION WAS- 0.729 WITH PROFILE 4 .FAMILY CLUSTER 4 ,MEAN SCORES DAUGHTER RATES SELF ,RE MOTHER RESPOND 65 30 8 20 21 42 42 47 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY OATA ARE SHOWN 100 95 90 85 • • 80 75 70 65 0 60 55 50 45 0 0 40 35 30 0 25 0 20 0 15 • • 10 0 5 0 • 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 -0.640 0.640 -0.051 O.OSI 0.567 -O.S67 0.855 -0.855 0.365 -0.552 -0.435 0.059 -0.059 0.804 -0.804 -0.546 0.546 0.051 -0.056 0.085 -O.085 THE MAXIMUM CORRELATION WAS- 0.855 WITH PROFILE 7 Figure 5. (continued) 81 portrayed himself as neither very f r iendly nor h o s t i l e , but rather as r e l a t i v e l y removed from i n i t i a t i n g behaviors with h is daughter. Mother, on the other hand, represented hersel f as i n i t i a t i n g in a warm engaged manner h igh l igh t ing aff i rming and understanding behavior (TBC #2) and very seldom i n i t i a t i n g with b e l i t t l i n g and blaming (TBC #6), at tacking and re jec t ing (TBC #7) or ignoring or neglecting (TBC #8) l i k e behaviors. Both parents in t h i s family group saw the i r daughter in a r e l a t i v e l y s imi l a r fashion with an accent on her responding towards them with asser t ing and separating (TBC #1) behavior. Father rat ings of h is daughter was both more t rus t ing and re ly ing (TBC #4), and wal l ing off and avoiding (TBC #8) than was mother's r a t i ng . However, the ove ra l l trend of the i r views of the i r daughter with them was one character ized be predominantly removed behaviors. Daughter had a di f ferent p ic ture of both of her parents' i n i t i a t i n g behavior than they reported. Far ~from being predominantly freeing and forget t ing towards her, daughter cont ras t ingly rated father as i n i t i a t i n g mainly with watching and managing (TBC #5) behaviors. As w e l l , daughter casts fa ther ' s act ions towards her as being frequently character ized by b e l i t t l i n g and blaming (TBC #6) and ignoring and neglecting behaviors. Thus, while father saw himself as functioning out of a removed, freeing and forget t ing p o s i t i o n , daughter pictured him as being c o n t r o l l i n g in a hos t i l e fashion with her. The differences in view between mother and daughter in th i s family group were even more stark than the differences just described between father and daughter. In contrast to mother's 82 view of herse l f , daughter saw mother as extremely rare ly aff i rming and understanding her (TBC #2). Neither d id daughter see mother as being very helpful or protect ive in re la t ionsh ip to herself (TBC #4). Daughter framed mother as act ing p r imar i ly with watching and managing (TBC #5), b e l i t t l i n g and blaming (TBC #6), and ignoring and neglecting (TBC #8) behaviors towards her. In terms of how daughter in t h i s family group rated her own responsive behaviors towards her parents, again the average p r o f i l e re f lec ted a wide difference in views between parents and c h i l d . While there was agreement between a l l family members that daughter responded pr imar i ly in an asser t ing and separating (TBC #1) manner towards her parents, daughter also personally a t t r ibu ted displays of sulking and appeasing (TBC #6), protest ing and withdrawing (TBC #7), and wa l l ing off and avoiding (TBC #8) behaviors to herself in r e l a t i on to her parents. These behaviors she feels were demonstrated with a frequency which neither her parents apparently were aware of. The b e s t - f i t curve descr ip t ions of the family members rat ings r e f l ec t the sal ience of the difference in views between family members which exis t in t h i s c l u s t e r . While the b e s t - f i t curve descr ibing fa ther ' s responses focusing on his i n i t i a t i v e behavior has not been named (curve 13), i t remains predominantly character ized by a "removed stature". The b e s t - f i t curve which described mother's assessment of her own i n i t i a t i n g behaviors towards daughter was l abe l l ed " f r iendly i n i t i a t i v e " (curve 1). In stark contrast , daughter painted her parents i n i t i a t i n g behaviors with e s sen t i a l l y the same brush. Unlike her parents, 83 the b e s t - f i t curve describing both parents' behavior was that l abe l l ed "attacking i n i t i a t i v e " (curve 4) . The curve which best described fa ther ' s view of his daughter's responsive behaviors towards him had been l abe l l ed " f r iendly submit" (curve 11). Discordant ly , daughter's assessment of her responsive behavior was best characterized by a "taking of automony" ( curve 7) . The b e s t - f i t curve which described mother's assessment of her daughter's responsive behaviors had no psychological l abe l (curve 13), however in view of the actual data, i t was characterized as a "detached response". Daughter's ra t ing of herself in r e l a t ionsh ip to her mother was best captured by the curve r e f l ec t i ng a "taking of autonomy" (curve 7) . The b e s t - f i t curves analys is revealed that while parents in th i s family c lus te r described the i r i nd iv idua l re la t ionships with the i r daughter in d i f ferent ways. She e s sen t i a l l y described her r e l a t ionsh ip with them in the same fashion. In conclusion there exis ted , in th i s family c l u s t e r , widely inconsistent views between parents and c h i l d as to the nature and t ransact ional dynamics of the i r r e l a t ionsh ips . While the anorexic daughter perceived both her parents as act ing with an at tacking i n i t i a t i v e and herself as responding with autonomy-taking behaviors, her parents had a d i f ferent view. Father viewed himself as being removed from his daughter, however he found her to be marginally f r iendly and submitting to h is au thor i ty . Mother maintained that as opposed to father, she was engaged in a f r iendly way with her daughter despi te , as she 84 perceived i t , a somewhat detached response from the anorexic c h i l d . There remained a sense of i nd iv idua l family members insu la t ing and dis tancing themselves from one another in th i s family c l u s t e r . Family Cluster 5: "The Hos t i l e Conf l ic ted Family" A l l the famil ies which were grouped together in th i s c l u s t e r , as in the previous c l u s t e r , had a daughter suffering with anorexic nervosa. The mean averaged family p r o f i l e s presented in Figure 6. , c l e a r l y i l l u s t r a t e d the cont ra l dynamics of the family system. An overview of the p r o f i l e s revealed an angry and dis tancing father, complemented by a mother who perceived herself as f r iendly with the i r daughter. Daughter for her part observed her parents as t ry ing to cont ro l her and responded with a blend of hos t i l e compliance. Father 's ra t ing of h is own i n i t i a t i n g behavior h ighl ighted act ions of freeing and forget t ing (TBC #1), and b e l i t t l i n g and blaming (TBC #6) as c h a r a c t e r i s t i c a l l y the most common ways he re la ted to h is daughter. Both at tacking and re jec t ing (TBC #7), and ignoring and neglecting (TBC #8) behaviors were rated at 50, ind ica t ing that they, too, were not uncommonly expressed. In keeping with th i s approach towards h is daughter, father rated h is behaviors of aff irming and understanding (TBC #2), nurturing and comforting (TBC 3), and helping and protect ing (TBC #4) as being r e l a t i v e l y infrequently d isplayed. Mother had a very di f ferent view of her i n i t i a t i n g behaviors towards her daughter than father had of h i s . In 85 .FAMILY CLUSItH 5 ,MEAN SCORES FATHER RATES SELF .RE DAUGHTER INITIATE 59 34 20 28 43 59 50 50 STARS INDICATE THEORY. CIRCLES SHOW OATA IN CASES WHERE DATA-THEORY, ONLY DATA ARE SHOWN 100 • 95 90 85 • 80 73 70 es 60 0 0 55 50 • - 0 49 0 40 3S 0 30 0 23 20 0 15 • • 10 5 0 • 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 -0.832 0.832 -0.459 0.459 0.182 -0.182 0.718 -0.718 0.401 -0.655 -0.516 0.302 -0.302 0.518 -0.518 -0.746 0.746 0.074 -0.077 0.258 -0.258 THE MAXIMUM CORRELATION WAS- 0.832 WITH PROFILE 2 .FAMILY CLUSTER 5 ,MEAN SCORES FATHER RATES ,DAUGHTER RESPOND 62 36 24 39 28 46 46 61 STARS INOICATE THEORY. CIRCLES SHOW OATA IN CASES WHERE DATA-THEORY. ONLY OATA ARE 100 95 90 85 • 80 75 70 65 0 60 55 50 0 45 40 0 0 35 30 0 23 0 20 15 • 10 5 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 -0.607 0.607 -0.020 0.020 0.577 -0.577 0.838 -0.838 0.321 -0.694 -0.541 0.205 -0.205 0.835 -0.835 -0.298 0.298 0.202 -0.206 -O.016 0.016 THE MAXIMUM CORRELATION WAS- 0.838 WITH PROFILE 7 Figure 6. The Hos t i l e Conf l i c ted Family 86 .FAMILY CLUSTER 5 ,MEAN SCORES MOTHER RATES SELF ,RE DAUGHTER INITIATE 44 77 67 73 48 30 10 10 STARS INDICATE THEORY, CIRCLES SHOW DATA IN CASES WHERE OATA-THEORY. ONLY DATA ARE SHOWN 100 • 95 90 85 • , • 80 0 75 0 70 0 65 60 55 50 • 0 45 0 40 35 30 0 25 20 15 • lO 0 5 O • 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.956 -0.956 0.599 -0.599 -0.109 0.109 -0.752 0.752 0.132 0.885 -0.775 0.773 -0.471 0.471 0.376 -0.376 0.026 -0.026 0.091 -0.091 THE MAXIMUM CORRELATION WAS- 0.956 WITH PROFILE 1 .FAMILY CLUSTER 5 .MEAN SCORES MOTHER RATES .DAUGHTER RESPOND 44 63 51 50 51 57 32 37 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY, ONLY OATA ARE SHOWN 100 • • . 95 90 85 * • * 80 75 70 65 0 60 0 55 0 0 50 O 45 0 40 35 0 30 25 20 15 « 10 5 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.604 -0.604 0.270 -0.270 -0.222 0.222 -0.585 0.585 0.323 0.712 -0.532 0.532 -0.480 0.480 0.140 -0.140 -0.123 0.124 0.622 -0.622 THE MAXIMUM CORRELATION WAS- 0.72B WITH PROFILE ' 11 F i g u r e 6. ( c o n t i n u e d ) ,FAMILY CLUSTER S ,MEAN SCORES DAUGHTER RATES ,FATHER INITIATE 36 24 27 42 66 58 27 45 STARS INDICATE THEORY, CIRCLES SHOW DATA IN CASES WHERE OATA-THEORY, ONLY DATA ARE SHOWN 100 * 95 90 85 * 80 75 70 0 65 60 0 55 50 45 0 40 0 35 30 0 0 25 • 20 15 • • 10 5 O * a CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 -0.324 0.324 -0.682 0.682 -0.642 0.642 -0.226 0.226 0.601 -0.390 -0.058 0.372 -0.372 -0.337 0.337 -0.367 0.367 0.621 -0.619 0.466 -0.466 THE MAXIMUM CORRELATION WAS- 0.682 WITH PROFILE 4 ,FAMILY CLUSTER 5 ,MEAN SCORES DAUGHTER RATES SELF .RE FATHER RESPONO 49 40 36 47 47 77 58 59 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY, ONLY DATA ARE SHOWN lOO . 95 90 85 80 o 75 70 65 60 0 55 50 0 • 0 0 45 40 0 0 35 30 25 20 15 • . 10 5 O • 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 -O.S29 0.829 -0.748 0.748 -0.230 0.230 0.424 -0.424 0.125 -0.717 -0.628 0.639 -0.639 0.102 -0.102 -0.553 0.553 -O.012 0.013 0.221 -O 221 THE MAXIMUM CORRELATION WAS- 0.829 WITH PROFILE 2 F i g u r e 6. ( c o n t i n u e d ) ,FAMILY CLUSTER S .MEAN SCORES OAUGHTER RATES ,MOTHER INITIATE 37 48 54 75 71 48 27 31 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 93 90 85 • « 80 75 0 0 70 63 60 -55 0 50 0 0 43 40 0 35 30 0 25 20 15 • • 10 5 O 1 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.628 -0.628 -0.054 0.054 -0.704 0.704 -0.942 0.942 0.308 0.456 -0.282 0.282 -O.809 0.809 0.156 -0.156 0.447 -0.444 0.129 -0.129 THE MAXIMUM CORRELATION WAS- 0.942 WITH PROFILE 8 .FAMILY CLUSTER 5 .MEAN SCORES OAUGHTER RATES SELF .RE MOTHER RESPOND 42 69 52 65 54 67 55 55 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY, ONLY OATA ARE SHOWN 100 95 90 85 • * 80 75 • 70 0 0 65 0 60 55 0 0 0 50 45 0 • • 40 35 30 25 20 15 10 5 0 • 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.115 -0.115 -0.180 0.180 -0.368 0.368 -0.341 0.341 0.003 0.140 0.177 -0.177 -O.480 0.480 0.229 -0.229 -O.364 0.368 0.449 -0.449 THE MAXIMUM CORRELATION WAS- 0.480 WITH PROFILE 15 F i g u r e 6. ( c o n t i n u e d ) 89 contrast to him, she underlined the actions of aff i rming and nurturing (TBC #2), and helping and protect ing (TBC #4) as being those most c h a r a c t e r i s t i c a l l y frequent in her r e l a t ionsh ip with her daughter. S i m i l a r l y , mother d i f fered sharply from father in her low endorsement of b e l i t t l i n g and blaming (TBC #6), a t tacking and re jec t ing (TBC #7), and ignoring and neglecting (TBC #8), which she perceived as being rare ly demonstrated. The parents in t h i s family c lus ter saw the i r daughter's responsive behavior v i s - a - v i s themselves as qui te d i f ferent indeed. Father portrayed his daughter as responding toward him most frequently with dis tancing behavior, endorsed the reactions of asser t ing and separating (TBC #1), and wa l l ing off and avoiding (TBC #8) higher than any other behaviors. He ra re ly perceived her respond in a warm engaged manner. Thus he rated d i s c l o s i n g and expressing (TBC #2), approaching and enjoying (TBC #3), and t rus t ing and re ly ing (TBC #4) r e l a t i v e l y low. He also rare ly perceived deferring and submitting (TBC #4) l i k e behaviors, but rated both sulking and appeasing (TBC #6), and protes t ing and withdrawing (TBC #7), as being more c h a r a c t e r i s t i c a l l y shown towards him by his daughter. Mother's view of daughter's responsive behavior towards her again ref lec ted the theme that mother and father perceive themselves in very di f ferent re la t ionships with t he i r daughter. Contrary to father, mother rated the behavior of d i s c l o s i n g and expressing (TBC #2) as being the behavior most dominantly shown by her daughter. Scores which hovered around the 50 mark, re f lec ted that the behaviors were expressed somewhat 90 ambivalently, capture mother's sense of how much her daughter responded with approaching and enjoying (TBC #3), t rus t ing and re ly ing (TBC #4), and deferr ing and submitting behaviors. Mother also endorsed sulking and appeasing (TBC #6) as being the second most frequently shown behavior with which her daughter responded. While she acknowledged protest ing and withdrawing (TBC #7) and wal l ing off and avoiding responses (TBC #8), these were nonetheless the most infrequently perceived behaviors which mother a t t r ibu ted to her daughter. Daughter's view of fa ther ' s i n i t i a t i n g behavior resembled the general trends which father reported, except that the strength that she saw him i n i t i a t e in terms of dis tancing behaviors was less pronounced. That i s , the magnitude of freeing and forget t ing (TBC #1), and ignoring and neglecting (TBC #8) i s somewhat lower. In a s imi la r ve in , daughter ' s t ressed her fa ther ' s watching and managing behaviors as being his most common i n i t i a t i n g act ion which stood in contrast to h i s views. Thus her view of father was somewhat more pos i t ive than his own se l f - r epor t . Daughter had a different view of her mother's i n i t i a t i n g behaviors than her mother reported. Daughter perceived considerably less aff irming and understanding (TBC #2) behavior from her mother and considerably more watching and managing i n i t i a t i o n (TBC #5). Along with helping and protect ing (TBC #4), watching and managing behaviors were the most frequently displayed act ions with which mother related according to her. Daughter also saw behaviors l i k e b e l i t t l i n g and blaming. (TBC 91 #6), at tacking and re jec t ing (TBC #7), and ignoring and neglecting (TBC #8) as being more prevalent in mother's repertoire of actions towards her than mother had reported. Daughter's view of her responding behavior towards her father, again ref lec ted an incongruity between family perceptions. She saw hersel f respond with mainly sulking and appeasing behaviors (TBC #6), towards him, and gave i t a ra t ing of 77 as opposed to h i s endorsement of 46. S i m i l a r i l y , she perceived herself as a lso expressing more protest ing and withdrawing (TBC #7) than he apparently was aware of. At the same time, she pic tured herself as exh ib i t i ng s l i g h t l y more approaching and enjoying (TBC #3), and t rus t ing and re ly ing behaviors (TBC #4), in response to her father than he perceived. Discrepancy in view of daughter's responding behavior towards mother was a lso apparent. While there was general agreement in regards to how present the f i r s t three behavioral c lus te rs were endorsed, th i s was where the accord ended. Daughter's rat ings showed that she perceived herself as being more t rus t ing and re ly ing (TBC #4) that her mother d i d . At the same time, daughter a lso scored the behaviors of sulking and appeasing (TBC #6), protes t ing and withdrawing (TBC #7), and wal l ing off and avoiding (TBC #8) as being much more cha rac t e r i s t i c of her own responses to her mother, than mother had rated them. The b e s t - f i t curve descr ibing the trend of father 's own perceptions of his behavior was "attacking i n i t i a t i v e " (curve 2) . Mother's responses were best described as a " f r iendly 92 i n i t i a t i v e " (curve 1). Thus they saw themselves as dealing in very d i f ferent ways with the i r daughter which complement one another. The parents rated the i r daughter's responding towards them d i f f e r e n t l y . In t h i s regard, the b e s t - f i t curve which described fa ther ' s view of daughter was l abe l l ed "take autonomy" (curve 7) . The curve best descr ibing mother's responses on the other hand ref lected the view that daughter submitted in a f r iendly fashion to her authori ty (curve 11). The b e s t - f i t curves related to daughter's perceptions showed that in essence daughter views father in a s imi l a r fashion as he saw himself . The curve most c l o s e l y s imi l a r to the actual data was l abe l l ed "attacking i n i t i a t i v e " (curve 2) . The b e s t - f i t curve for.daughter 's ra t ing of mother's i n i t i a t i v e emphasized her view that mother t r i e d to keep a watchful eye on her and was been l abe l l ed "contro l" (curve 8) . "Host i le react ion" (curve 2) was the l abe l f-or the theore t i ca l curve which best described daughter's view of her own responses in r e l a t ion to her father. No theore t i ca l curve which has been establ ished adequately captured the tone of daughter's perceptions of how she responded towards her mother. As there was a strong sense of ambivalence between warm and engaged behaviors and hos t i l e and disengaged behaviors and her responses were safely l abe l l ed "ambivalent react ions" . In summary th i s family c lus te r may be character ized as one which i s marked by inconsistent views between parents and c h i l d . Father was seen by himself and his daughter as functioning with a hos t i l e at tacking i n i t i a t i v e , and while there was accord with 93 t h i s , the i r views of daughter's response to him were d i f fe ren t . While father perceived his daughter as taking autonomy, the daughter pictured herself as having a less autonomous and more h o s t i l e react ion towards him. Mother's impressions of her own behavior as being a f r iendly i n i t i a t i v e was not shared by her daughter who portrayed her mother as i n i t i a t i n g p r imar i ly in a c o n t r o l l i n g fashion. Differences in mother and daughter's view of her responding behavior ex is ted , but no b e s t - f i t curve had been established which describes the daughter's view of herse l f . I t was none the less c lear that her views sharply d i f fered from her mother's view which portrayed daughter as submitting in a f r iendly way. The wide differences between the t ransact ional re la t ionships reported by parents and the i r daughter h ighl ighted d i f ferent approaches to the c h i l d and a lack of parental accord on i n i t i a t i n g behavior. Family Cluster 3: "The Ambivalently Di f fe ren t ia ted Family" Like the previous 2 family c lus te rs described, the 3 famil ies which were grouped together in t h i s c lus te r a l l had an anorexic daughter. The mean family p r o f i l e graphs presented in Figure 7. Again revealed very di f ferent impressions of the re la t ionsh ip ex i s t i ng between the parents view of the i r transactions with the i r daughter, and her assessment of these r e l a t ionsh ips . The parents saw the i r own i n i t i a t i n g behaviors somewhat d i f f e r e n t l y and indicated a lack of accord as to how they i n i t i a t e d behaviors with the i r daughter. However, t h i s •FAMILY CLUSTER 3 ,MEAN SCORES FATHER RATES SELF .RE DAUGHTER INITIATE 32 SO 33 34 32 32 27 26 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 • 99 90 a s • 80 75 70 65 60 • 55 0 30 0 43 • 40 35 0 0 0 0 30 • 0 25 20 1S 10 3 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.510 -0.510 0.730 -0.730 0.522 -0.522 0.010 -0.010 0.392 0.631 0.676 -0.918 0.918 0.274 -0.274 -0.095 0.095 -0.102 0.097 0.220 -0.220 THE MAXIMUM CORRELATION WAS- 0.918 WITH PROFILE 13 .FAMILY CLUSTER 3 ,MEAN SCORES FATHER RATES .DAUGHTER RESPOND 53 35 40 59 43 52 39 46 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA' ARE SHOWN 100 • 95 90 • 85 80 75 70 65 60 0 55 0 0 50 0 45 0 • 40 O 0 35 0 30 25 20 15 10 5 ' 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 -0.042 0.042 -0.212 0.212 -0.260 0.260 -0.152 0.152 0.455 -0.312 0.131 -0.032 0.032 -0.067 0.067 -0.299 0.299 0.693 -0.694 -0.175 0.175 THE MAXIMUM CORRELATION WAS- 0.693 WITH PROFILE 18 Figure 7. The Ambivalently Di f fe ren t ia ted Family 95 .FAMILY CLUSTER 3 .MEAN SCORES MOTHER RATES SELF .RE DAUGHTER INITIATE 49 51 65 58 54 36 21 27 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY, ONLY DATA ARE SHOWN 100 • 95 90 85 • • 80 75 70 65 0 60 0 55 0 0 50 0 45 40 0 35 30 25 0 20 15 • 10 5 0 • 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.932 -0.932 0.519 -0.519 -0.199 0.199 -0.800 0.800 0.157 0.818 0.909 -0.743 0.743 -0.487 0.487 0.317 -0.316 0.296 -0.296 -0.009 0.009 THE MAXIMUM CORRELATION WAS- 0.932 WITH PROFILE 1 .FAMILY CLUSTER 3 .MEAN SCORES MOTHER RATES .OAUGHTER RESPOND 69 47 40 53 43 57 48 55 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 • 93 90 85 80 75 70 0 65 60 • 0 • 55 0 0 50 0 0 45 0 40 0 35 30 25 20 15 10 5 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 -0.340 0.340 0.057 -0.057 0.418 -0.418 0.538 -0.538 0.524 -0.397 -0.115 -0.166 0.166 0.611 -0.611 -0.487 0.487 0.337 -0.342 0.016 -0.016 THE MAXIMUM CORRELATION WAS- 0.611 WITH PROFILE 14 F i g u r e 7. ( c o n t i n u e d ) 9 6 ,FAMILY CLUSTER 3 ,MEAN SCORES DAUGHTER RATES ,FATHER INITIATE 48 68 59 73 44 18 5 8 STARS INDICATE THEORY. CIRCLES SHOW OATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 • 95 90 85 • • • 80 75 0 70 0 65 60 55 0 50 0 • 45 0 40 35 30 25 20 0 15 • 10 5 0 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.937 -0.937 0.629 -0.629 -0.047 0.047 -0.695 0.695 0.240 0.810 0.947 -0.809 0.809 -0.373 0.373 0.334 -0.334 0.159 -0.159 0.032 -0.032 THE MAXIMUM CORRELATION WAS- 0.947 WITH PROFILE 11 .FAMILY CLUSTER 3 ,MEAN SCORES DAUGHTER RATES SELF ,RE FATHER RESPOND 53 82 52 75 45 29 19 18 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE SHOWN 100 • • 95 90 85 • 0 • • 80 75 0 70 65 60 55 0 0 SO 45 0 4 0 35 30 O 25 20 0 1S • 10 5 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.874 -0.874 0.646 -0.646 0.041 -0.041 -0.588 0.588 0.260 0.792 0.9O8 -O.801 0.801 -0.298 0.298 0.311 -0.311 0.013 -0.013 0.122 -0.122 THE MAXIMUM CORRELATION WAS- 0.908 WITH PROFILE 11 F i g u r e 7. ( c o n t i n u e d ) ,FAMILY CLUSTER 3 ,MEAN SCORES DAUGHTER RATES ,MOTHER INITIATE 27 43 42 58 48 27 1 1 24 STARS INOICATE THEORY, CIRCLES SHOW DATA IN CASES WHERE OATA-THEORY, ONLY DATA ARE SHOWN 100 95 90 85 • • 80 73 70 65 60 0 53 50 * 0 • 45 0 0 40 33 30 0 0 25 20 15 * 0 10 5 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.820 -0.820 0.285 -0.285 -0.417 0.417 -0.875 0.875 0.320 0.585 0.807 -0.450 0.450 -0.622 0.622 0.417 -0.417 0.403 -0.401 0.164 -0.164 THE MAXIMUM CORRELATION WAS- 0.875 WITH PROFILE 8 ,FAMILY CLUSTER 3 .MEAN SCORES DAUGHTER RATES SELF .RE MOTHER RESPOND 57 64 43 65 36 48 23 28 STARS INOICATE THEORY. CIRCLES SHOW OATA " IN CASES WHERE OATA-THEORY. ONLY DATA ARE SHOWN 100 « • • •95 90 85 • • • 80 75 70 65 0 0 60 O 55 50 0 45 0 40 0 35 30 25 0 20 15 10 5 0 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.684 -0.684 0.535 -0.535 0.072 -0.072 -0.430 0.430 0.418 0.614 -0.774 0.774 -0.176 0.176 0.079 -0.079 0.094 -0.096 0.199 -0.199 THE MAXIMUM CORRELATION WAS- 0.817 WITH PROFILE 11 F i g u r e 7. ( c o n t i n u e d ) 98 difference does not appear as pronounced as i t was in previous family c l u s t e r s . Taken on i t s own, the mean averaged father 's p r o f i l e depicted a man who was somewhat removed from his daughter, ra t ing the t ransac t ional behavior of freeing and forget t ing (TBC #1) as the most commonly expressed behavior. With an endorsement of 52 t h i s did not represent a p a r t i c u l a r l y strong assessment of the behavior, however i t was none the less the most highly rated. An ambivalent degree of aff irming and understanding (TBC #2) behavior, rated 50 was fa ther ' s second most frequently expressed behavior towards daughter as he pictured i t . The remaining t ransact ional behaviors measured were not seen as p a r t i c u l a r l y pronounced on fa ther ' s p r o f i l e . I t was c lear father saw himself as i n i t i a t i n g more with b e l i t t l i n g and blaming (TBC #6), a t tacking and re ject ing (TBC #7), and ignoring and neglecting (TBC #8) and subs tan t ia l ly less with aff i rming and understanding (TBC #2), nurturing and comforting (TBC #3), and helping and protect ing (TBC #4) behaviors. The b e s t - f i t curve re la ted to fa ther ' s data (curve 13) was not been named, but the response pattern was l abe l l ed "removed i n i t i a t i v e " . Mother pictured herself as i n i t i a t i n g in a somewhat more f r i end ly , .caring manner than d id the father in th i s family c l u s t e r . The b e s t - f i t curve corre la ted with her response was l abe l l ed " f r iend ly i n i t i a t i v e " (curve 11). The average mother p r o f i l e accented nurturing and comforting (TBC #3), helping and protect ing (TBC #4), and watching and managing (TBC #5) as being 99 mother's most frequently expressed behaviors in re la t ionsh ip to her daughter. These behaviors were not highly endorsed, peaking at a ra t ing of 65. They were balanced by moderately low expressions of b e l i t t l i n g and blaming (TBC #6), at tacking and re jec t ing (TBC #7), and ignoring and neglecting (TBC #8) behaviors which were reminiscent of fa ther ' s views of these behaviors. Taken together, the parents in th i s family c lus te r were in accord with one another as to the moderately low degree of expression of more hos t i l e related behaviors in the i r i n i t i a t i n g s ty les of r e l a t ing with the i r daughter. While father rare ly i n i t i a t e d with more warm and engaged behaviors towards daughter, mother complemented him, compensating with helping, and protect ing as well as watching and managing behaviors in re la t ionsh ip to the i r c h i l d . Daughter's view of her fa ther ' s i n i t i a t i n g behaviors was in contrast to h is assessment of himself . Far from being removed and rare ly warm and ca r ing , her endorsements of both aff irming and understanding (TBC #2) as wel l as helping and protect ing (TBC #4) were moderately high (endorsed with scores of 68 and 73 respect ively as compared to his assessments of 50 and 34). Al so , in contrast to him, she ra re ly perceived her father as i n i t i a t i n g with displays of b e l i t t l i n g and blaming (TBC #6), a t tacking and re ject ing (TBC #7), or ignoring and neglecting (TBC #8) behaviors. . Thus, to her, he appeared quite warm and supportive of her in h is i n i t i a t i n g behaviors. This i s ref lec ted in the b e s t - f i t curve associated with her responses 100 l abe l l ed " f r iendly con t ro l" (curve 11). This trend of disagreement in view between parents and c h i l d continued to be evident in average daughter's assessment of mother's i n i t i a t i n g behaviors. However, the inconsistency in view here was not as r a d i c a l l y pronounced as that between father and daughter, contrary to mother, endorsed freeing and forget t ing (TBC #1), and at tacking and re jec t ing (TBC #7) behaviors as subs tan t ia l ly less frequently expressed by mother. She was in accord with mother in her moderate stress upon helping and protect ing (TBC #4), and watching and managing (TBC #5) i n i t i a t i n g behaviors. These differences and s i m i l a r i t i e s in view amounted to a different flavour of i n i t i a t i n g behavior which i s captured in the b e s t - f i t curve. The curve most c lose ly related to daughter's assessment of mother was named simply "contro l" (curve 8) . This revealed the watchful or ien ta t ion which daughter sees in mother. Father 's assessment of how his daughter responded to him indicated that while he found no s ingle pa r t i cu l a r behavior to be strongly cha rac t e r i s t i c of h i s daughter (no endorsements exceed a ra t ing of 60), neither were any of the t ransact ional behaviors infrequently expressed (no endorsements rated lower than 35). What he apparently saw in h is daughter was a confused display of moderately expressed behaviors. That was, he rated her t rus t ing and re ly ing behavior (TBC #4) as being the most frequently expressed by her, but simultaneously accented asser t ing and separating (TBC #1) and sulking and appeasing (TBC #6) behaviors. The b e s t - f i t curve described th i s kind of 101 response pattern was l abe l l ed "ambivalent d i f f e r e n t i a t i o n " (curve 18). While the b e s t - f i t curve co r re l a t ion f e l l below the c r i t i c a l value ( r= .7 l ) , i t f e l l just short (r=.693), and seemed to capture much of the flavour of fa ther ' s view of h is daughter. Mother reported her view of daughter's responsive behavior in a somewhat s imi l a r fashion to father. She assessed daughter's asser t ing and separating (TBC #1) behavior to be the strongest cha rac t e r i s t i c response daughter d isplayed. Thus, she endorsed i t moderately high. She too accented t rus t ing and re ly ing (TBC #4), and sulking and appeasing (TBC #6) as being moderately frequently expressed behaviors. Mother also viewed daughter as responding towards her with more protest ing and withdrawing (TBC #7), and ignoring and neglecting (TBC #8) behaviors than father reported in regards to daughter's responses to him. The b e s t - f i t curve l abe l l ed "take autonomy" (curve 14) was the most c lo se ly corre la ted theore t i ca l curve re la ted to mother's rat ings of daughter's responses. The actual co r r e l a t i on again did not a t t a in the c r i t i c a l value (r=.611), and f a i l e d to capture the element of ambivalence which mother found in daughter's response. Daughter pictured her response towards her parents as being e s s e n t i a l l y the same. She saw herself as c h a r a c t e r i s t i c a l l y responding with the warm and engaged behaviors of d i s c lo s ing and expressing (TBC #2), and t rus t ing and re ly ing (TBC #4). She f e l t that she expresseed s l i g h t l y more h o s t i l i t y towards her mother than her father. She endorsed both the behaviors of protes t ing and withdrawing (TBC #7), and wal l ing off and 1 02 avoiding (TBC #8), as subs tan t ia l ly lower than e i ther of her parents. She did not share in her fa ther ' s view of her as responding with b e l i t t l i n g and blaming (TBC #6) behaviors towards him, but acknowledged i t as being more frequently expressed towards mother. The b e s t - f i t curves re la ted to how daughter understood her responsive behavior towards both her father and her mother were named "f r iendly submit" (curve 11). Unlike the b e s t - f i t curves related to the parental assessment of her responding, the be s t - f i t curves associated with daughter's view of her own behavior were above the c r i t i c a l value (r=.908 and .817 respec t ive ly ) . In summary, the family system which character ized th i s c lus te r of famil ies was comprised of a father who saw himself as somewhat removed. Being only occasionaly warm, and at times hos t i l e towards his daughter, he was teamed with a wife who viewed herself as i n i t i a t i n g in a complementary, moderately f r iendly fashion. They found that thei r daughter responded towards them in an ambivalent way. Not infrequently she expressed separating and dis tancing responses as wel l as both more warm t rus t ing and h o s t i l e a t tacking . Daughter had a d i f ferent t rans la t ion of her re la t ionsh ip with her parents. In contrast , she found her father to be warm, f r i end ly , and involved in a somewhat c o n t r o l l i n g way with her. To him she f e l t she responded in a f r iendly and submitting manner. Rather than being f r i end ly , she saw her mother as t ransact ing in a p r imar i ly c o n t r o l l i n g way. Despite t h i s view, she bel ieved she responded towards her mother as she d id with her father, in a 1 03 f r iendly and submitting fashion. Family Cluster 1: "The Symmetrical Family" Three fami l ies were grouped together to comprise t h i s , the f i n a l family c lus te r reported. Of the 3 f ami l i e s , 1 family had an anorexic daughter, while the other 2, drawn from the cont ro l group, d id not. The average family p r o f i l e s for th i s c lu s t e r , presented in Figure 8., provided a p ro to typ ica l family embodying the sa l ien t family dynamics of the famil ies in the c l u s t e r . Father 's image of his i n i t i a t i n g behaviors with h is daughter was characterized by a moderate display of two behavioral c l u s t e r s . Both freeing and forget t ing (TBC #1), and aff irming and understanding (TBC #2), are endorsed as being the most frequently expressed behaviors. Father 's low ratings of the t ransact ional behaviors of b e l i t t l i n g and blaming (TBC #6), at tacking and re jec t ing (TBC #7), and ignoring and neglecting (TBC #8) indicated that these behaviors are r e l a t i v e l y rare ly expressed in r e l a t ionsh ip with h is daughter. While the b e s t - f i t curve for th i s pattern of response has not been named (curve 13), i t was c lear that father e s sen t i a l l y viewed his i n i t i a t i n g ef for ts as being somewhat removed but in a warm, favorable way as opposed to a manner born out of h o s t i l i t y . Mother's perception of her own i n i t i a t i n g behavior was highly supportive and engaged. The most common behaviors ref lec ted in the peak of the response pattern focussed on aff irming and t rus t ing (TBC #2), nurturing and comforting (TBC #3), and helping and protect ing (TBC #4) behaviors and were 104 .FAMILY CLUSTER 1 .MEAN SCORES FATHER RATES SELF ,RE DAUGHTER INITIATE 58 38 37 46 29 11 11 19 STARS INDICATE THEORY. CIRCLES SHOW OATA IN CASES WHERE DATA-THEORY, ONLY DATA ARE SHOWN 100 * 95 90 85 • 80 75 • 70 65 60 0 0 * 55 50 0 45 • 40 0 35 30 0 • 25 20 15 0 0 10 3 O 1 2 3 4 3 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.767 -0.767 0.840 -O.840 0.422 -0.422 -0.243 0.243 0.364 0.672 0-793 -0.910 0.910 0.134 -0.134 0.235 -0.235 0.133 -0.136 0.046 -0.046 THE MAXIMUM CORRELATION WAS- 0.910 WITH PROFILE 13 .FAMILY CLUSTER 1 ,MEAN SCORES FATHER RATES .DAUGHTER RESPOND 65 21 9 20 17 34 37 26 STARS INDICATE THEORY. CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE 100 • < 95 90 85 80 75 70 65 0 60 55 50 45 40 35 0 30 • 25 0 20 0 0 15 • 10 O 5 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 -0.454 0.454 0.013 -0.013 0.471 -0.471 0.656 -0.656 0.319 -0.322 -0.169 -O.205 0.205 0.644 -0.644 -0.700 0.700 0.070 -0.077 -0.122 0.122 THE MAXIMUM CORRELATION WAS- 0.700 WITH PROFILE 17 Figure 8. The Symmetrical Family 105 ,FAMILY CLUSTER 1 ,MEAN SCORES MOTHER RATES SELF .RE OAUGHTER INITIATE 49 89 7 1 66 25 11 S 4 STARS INOICATE THEORY, CIRCLES SHOW OATA IN CASES WHERE OATA-THEORY. ONLY OATA ARE SHOWN 100 95 90 0 85 • • 80 75 0 70 0 65 60 55 SO 0 • 45 40 35 30 25 o 20 15 o 10 s 0 0 . 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.940 -0.940 0.807 -0.807 0.201 -0.201 -0.522 0.522 0.012 0.888 0.845 -0.840 0.840 -0.208 0.208 0.454 -0.454 -0.129 0.128 -0.005 O 005 THE MAXIMUM CORRELATION WAS" 0.940 WITH PROFILE 1 .FAMILY CLUSTER 1 .MEAN SCORES MOTHER RATES ,DAUGHTER RESPOND 52 75 58 61 30 19 13 20 STARS INOICATE THEORY, CIRCLES SHOW OATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE 100 • 95 90 8 5 * * 80 75 0 70 65 0 60 0 55 0 50' • * 45 40 35 30 0 25 20 a 15 10 5 o 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.922 -0.922 0.839 -0.839 0.264 -0.264 -0.464 0.464 0.122 0.827 0.839 -0.854 0.854 -0.118 0.118 0.451 -0.451 -0.036 0.034 0.026 -0.026 THE MAXIMUM CORRELATION WAS- 0.922 WITH PROFILE 1 F i g u r e 8. ( c o n t i n u e d ) 10 6 .FAMILY CLUSTER 1 .MEAN SCORES ,DAUGHTER RATES FATHER INITIATE 34 40 17 22 37 24 13 21 STARS INOICATE THEORY, CIRCLES SHOW DATA IN CASES WHERE DATA-THEORY. ONLY OATA ARE SHOWN 100 • • 95 90 8S 80 75 • • * 70 65 60 55 SO 43 40 0 0 35 0 30 25 0 0 20 0 15 0 10 S O • • 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.280 -0.280 0.305 -0.305 0.152 -0.152 -0.091 0.091 0.762 0.387 0.565 -0.555 0.555 0.068 -0.068 -0.147 0.147 0.123 -0.125 0.707 -0.707 THE MAXIMUM CORRELATION WAS- 0.762 WITH PROFILE ° .FAMILY CLUSTER 1 .MEAN SCORES DAUGHTER RATES SELF ,RE FATHER RESPOND 57 41 26 40 21 30 22 31 STARS INDICATE THEORY. CIRCLES SHOW OATA IN CASES WHERE OATA-THEORY, ONLY OATA ARE SHOWN lOO • 95 90 85 80 75 70 65 60 0 • 55 50 45 0 • 40 0 35 30 O 0 25 0 0 20 15 • 10 3 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.285 -0.285 0.617 -0.617 0.386 -0.586 0.215 -0.215 0.502 0.192 0.412 -0.688 0.688 0.499 -0.499 -0.112 0.112 0.220 -0.225 0.026 -0.026 THE MAXIMUM CORRELATION WAS- 0.688 WITH PROFILE 13 F i g u r e 8. ( c o n t i n u e d ) 107 .FAMILY CLUSTER 1 .MEAN SCORES DAUGHTER RATES .MOTHER INITIATE 48 85 44 58 33 19 6 16 STARS INOICATE THEORY, CIRCLES SHOW OATA IN CASES WHERE DATA-THEORY. ONLY DATA ARE 100 * 95 90 85 • « 80 75 70 65 0 60 0 55 50 0 • 45 0 40 35 0 30 25 20 15 0 10 S 0 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.900 -0.900 0.763 -0.763 0.180 -0.180 -0.508 0.508 0.300 0.771 0.888 -0.850 0.850 -0.152 0.152 0.375 -0.375 0.116 -0.117 0.099 -0.099 THE MAXIMUM CORRELATION WAS- 0.900 WITH PROFILE 1 ,FAMILY CLUSTER 1 .MEAN SCORES DAUGHTER RATES SELF ,RE MOTHER RESPONO 56 56 45 55 32 21 13 16 STARS INOICATE THEORY. CIRCLES SHOW OATA IN CASES WHERE DATA-THEORY, ONLY OATA ARE SHOWN 100 • 95 90 85 • 80 75 -70 65 60 0 0 • 55 0 50 45 0 • 4 0 35 0 30 • 25 O 20 15 0 10 5 O 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.860 -0.860 0.7GO -0.760 0.215 -0.215 -0.454 0.454 0.297 0.760 0.899 -0.928 0.928 -0.094 0.094 0.216 -0.216 0.155 -0.158 -0.019 0.019 THE MAXIMUM CORRELATION WAS- 0.928 WITH PROFILE 13 ' F i g u r e 8. ( c o n t i n u e d ) 108 h e a r t i l y endorsed. Con t ro l l ing and h o s t i l e behaviors were ra re ly found in mother's i n i t i a t i n g s ty le according to her. Thus the t ransact ional behaviors of watching and managing (TBC #5), b e l i t t l i n g and blaming (TBC #6), a t tacking and re ject ing (TBC #7), and ignoring and neglecting (TBC #8) received low endorsements indeed. The b e s t - f i t curve of " f r iendly i n i t i a t i v e " (curve 1) was highly corre la ted with the mother's view of her own i n i t i a t i n g s ty le and character izes mother's o v e r a l l perceptions a p t l y . ..Daughter had a d i f ferent view of her fa ther ' s i n i t i a t i n g behavior than he d i d . While she found him e s sen t i a l l y removed as evidenced by the very low o v e r a l l endorsement magnitude, he was removed in a confused manner for her. As she saw, he displayed a moderate amount of both aff irming and understanding (TBC #2), and also watching and managing (TBC #5), i n i t i a t i n g behaviors towards her. The b e s t - f i t curve associated with th i s pattern of endorsements was l abe l l ed "power double-bind" (curve 9) . This curve captured the confusion and somewhat contradictory nature in the way daughter perceived her fa ther ' s i n i t i a t i n g behavior. While not as strongly endorsed, daughter's view of mother's i n i t i a t i n g t ransact ional s ty le was in basic accord with mother's view. Daughter did not f ind mother's behaviors of aff irming and understanding (TBC #2), and helping and protect ing (TBC #4), to be as fo rce fu l ly pronounced as mother pictured them. Daughter was in close agreement with mother in terms of the infrequent amounts of watching and managing (TBC #5), b e l i t t l i n g and 109 blaming (TBC #6), a t tacking and re jec t ing (TBC #7), and ignoring and neglecting (TBC #8) which she a t t r ibuted to her mother in r e l a t ionsh ip to herse l f . The b e s t - f i t curve l abe l l ed " f r iendly i n i t i a t i v e " (curve 1) mirrored the ove ra l l agreement in perception between mother and daughter in terms of mother's i n i t i a t i n g behaviors and was descr ip t ive of the warmth and engagement which mother showed her daughter. Father ' s descr ip t ion of h i s daughter's responsive behavior towards him was one which was c l e a r l y character ized as asser t ing and separating in nature. Moreover, father reported that h is daughter was rarely warm and engaged with him, endorsing the behaviors of d i c lo s ing and expressing (TBC #2), approaching and enjoying (TBC #3), and t rus t ing and re ly ing (TBC #4), with low ra t ings . He d id not see her as d i sp lay ing deferring and submitting (TBC #5) behaviors. He accented the more dis tant and h o s t i l e behaviors of sulking and appeasing (TBC #6), protest ing and withdrawing (TBC #7), and wal l ing off and avoiding (TBC #8) as being the most cha rac t e r i s t i c of his daughter's responses when she was not assert ing and separating from him. The best-f i t curve for th i s response pattern (curve 17) was not named. However i t was evident that father f e l t that h i s . daughter was very much assert ing and separating herself from him and th i s behavior had a somewhat hos t i l e tinge attached to i t . In contrast to father, mother's view of her daughter in r e l a t ionsh ip with herself i s very much warm and engaged. She pictured her daughter as responding with d i sc los ing and expressing (TBC #2), as wel l as t rus t ing and re ly ing (TBC #4). 1 10 In keeping with t h i s , mother seldom found her daughter responding with d i f f e r i n g and submitting (TBC #5), sulking and appeasing (TBC #6), protest ing and withdrawing (TBC #7), and ignoring and neglecting (TBC #8). The b e s t - f i t curve l abe l l ed " f r iendly react ion" (curve 1), was c lose ly corre la ted with the actual data and described mother's pervasive fee l ing of warm connectedness with her daughter. Daughter shared her fa ther ' s view of her own responsive behavior towards him, in as much as she s i m i l a r l y endorsed deferring and submitting (TBC #5), sulking and appeasing (TBC #6), protest ing and withdrawing (TBC #7), and wal l ing off and avoiding (TBC #8), as present to the same degree. She also agreed with him that she predominantly responds towards him with behaviors that were asser t ing and separating (TBC #1) in nature. However, unl ike him she believed that she responded with subs tan t ia l ly more warmth than he picked up. While she d id not describe herself as commonly responding with d i s c lo s ing and expressing (TBC #2), approaching and enjoying (TBC #3), or t rus t ing and r e ly ing (TBC #4) behaviors, they were much more frequently expressed than father apparently recognized. The b e s t - f i t curve related to daughter's view of her own responses towards her father (curve 13) was not named. I t was c lear that to her, she was dis tancing herself from him, however, for her the h o s t i l e tone of that dis tancing was tempered by some displays of warmth and engagement. Daughter had a somewhat s imi l a r view of herself in response to her mother as she d id with her father. The flavour of her 111 responding behavior towards her mother in her view was an equal blend of assert ing and separating (TBC #1), d i s c lo s ing and expressing (TBC #2), and t rus t ing and re ly ing (TBC #4) behavior. She perceived herself as expressing the l a t t e r two behaviors more frequently towards her mother than her father. She also endorsed behaviors which were sulking and appeasing (TBC #6), protest ing and withdrawing (TBC #7), and wal l ing off and avoiding (TBC #8), in nature, as being less c h a r a c t e r i s t i c a l l y shown towards her mother than her father. The bes t - f i t curve associated with the data was not named (curve 13), however i t was the same b e s t - f i t curve which described daughter's r e l a t ionsh ip towards her father. In th i s regard, towards her mother daughter responded pr imar i ly with a somewhat moderate d isp lay of warmth and engagement which included elements of asser t ing and separating. Mother's view of her daughter's responsive behavior with her d i f fe red in that mother perceived a greater expression of both d i sc lo s ing and expressing, and t rus t ing and re ly ing behaviors. Thus the family system which characterized t h i s c lus te r of fami l ies was one made up of a father and mother who c l e a r l y saw themselves as having quite d i f ferent re la t ionships with thei r daughter. They d id not perceive themselves as i n i t i a t i n g behavior in the same fashion. Father presented himself as being an understanding but somewhat removed person to h is daughter, while mother portrayed herself as being engaged in a very f r iendly manner. Their views of her responses towards them was discrepant in that father found his daughter to be removed in a 1 12 somewhat hos t i l e manner from him, while mother maintained that her daughter responded in a warm and f r iendly fashion. Daughter did not share her father 's view of the i r r e l a t i onsh ip . She saw him as disengaged, however, there was an edge here of a power double-bind. This suggested she received contradictory and confusing messages from him. In response to her father she viewed herself as separating and asser t ing her own independence and while she d id th i s with a degree of h o s t i l i t y , she also a t t r ibu ted elements of warmth and car ing to herself which he did not perceive. Thus, the father/daughter r e l a t ionsh ip in th i s family c lus te r was one in which disagreement and confusion about one another was pronounced. Daughter's view of mother was s imi l a r to mother's own assessment as predominantly f r i end ly , however daughter perceived her response towards mother not as being s t r i c t l y f r iendly as mother understands i t . Daughter viewed mother as a blend of both warmth and engagement. She asserted and separated herself from her mother. There was a sense of inconsistency between the views expressed by mother and daughter as to the t ransact ional nature of the i r r e l a t i onsh ip . This incongruency was less pronounced and g la r ing than the one which co-exis ted between fa ther ' s and daughter's perceptions. Comparison of Family Clusters These resu l t s showed that of the 22 famil ies with a daughter diagnosed as anorexic nervosa and the 22 cont ro l f ami l i e s , 7 d i f ferent family groups with c h a r a c t e r i s t i c a l l y 1 1 3 different ways of seeing their transactional relationships were identified through the cluster analysis procedure. Of these 7 clusters of families, 3 were strictly associated with families with an anorexic daughter, 3 were comprised of a blend of control and anorexic containing families, while 1 large group was virtually exclusively composed of non-anorexic families. The dynamic family issues revealed through the interpretation of the 7 family clusters provided a sense of identity for each group which distinctly differentiated one family cluster from another. Family cluster identity not only relied on the actual transactional views reported by family system members, but also included a consideration of the relative agreement existing between parent's and child's interpretation of their relationship. In this regard, the study uncovered a range of intra-familial agreement which varied from complete accord to radical inconsistency between family members. -In the "Harmonious Transitional Family", the overall tone of the family was one of friendly and warm, engaged relationships. As a unit, the parents saw themselves as initiating in much the same fashion, however, father viewed his daughter as being essentially friendly yet recognising his authority over her. Mother pictured daughter's responses to be characteristically friendly. Daughter had a slightly different impression of the situation and while she maintained that she basically responded towards her parents in a friendly way. It was mother rather than father that daughter recognised as functioning with an element of authority over her. 1 1 4 In "The Perfect Family" there was no such disagreement over t ly recognized by family members. Everyone viewed the i r re la t ionships as dominantly f r iendly with the mother/child re la t ionsh ip being espec ia l ly c lose . Parents viewed the i r i n i t i a t i n g behaviors in a common, un i f ied manner. Conf l i c t and h o s t i l i t y was not reported as present. Despite the strong pos i t ive accord which was reported in th i s family c l u s t e r , i t was important to bear in mind that 4 of these famil ies had daughters who were diagnosed as having the condi t ion of anorexia nervosa and were not eating enought food to e s sen t i a l l y maintain the i r heal th . "The Marginal Trans i t iona l Family" maintained a f r iendly visage, but the issue of cont ro l and authori ty was cen t ra l to the fami ly ' s concern. Father 's image of himself was f r iendly but c o n t r o l l i n g while h is wife did not see herself as having an au thor i ta t ive side of her re la t ionsh ip with the i r daughter. Despite t h i s , both parents viewed the i r daughter's responses as f r iendly but respectful of the i r au thor i ty . While daughter was in accord with father 's impressions of himself , she recognised a c o n t r o l l i n g aspect in mother's i n i t i a t i n g behavior which mother did not see herself demonstrating. She responded towards her parents in much the same fashion. This f r iendly and submitting f lavour , daughter reported, a lso included an expression of h o s t i l i t y towards mother which mother d id not detect. "The Discordant Distancing Family", was e n t i r e l y composed of famil ies with an anorexic daughter. I t presented sharp contrasts in view co-ex i s t ing between parents and c h i l d . The 115 parents did not present a common front of i n i t i a t i n g behavior. Father was e s sen t i a l l y removed and mother presented a f r iendly and involved impression of he r se l f . Their assessments of the i r daughter's response towards them also d i f f e r ed . While father found his daughter's responding behavior to him to be f r iendly and respectful of h is au thor i ty . Mother saw the i r daughter as responding in a somewhat detached manner despite her f r iendly i n i t i a t i v e . The anorexic daughter in th i s family c lus te r had a very di f ferent story to report in terms of her parent 's behavior. The prototypic daughter reported that they both dealt with her in the same manner and that was in an a t tacking , hos t i l e fashion. In her opinion, she responded in a s imi l a r way towards them, that was with a somewhat unfriendly taking of her own autonomy. This view was in dramatic c o n f l i c t with fa ther ' s ideas about how she responded towards him. I t also contained much more h o s t i l i t y d i rected at mother than her mother was aware of. The extremely inconsistent view of one another, the r e l a t i ve absence of father along with the poignant sense of attack which daughter experienced in re la t ionsh ip to her parents and her h o s t i l e behaviors of grabbing her own autonomy which was not perceived by ei ther parent, c l e a r l y defined th i s group. I t was in sharp contrast to the previous 3 family c lus te rs described. The second en t i r e ly anorexic re la ted family c l u s t e r , "The Hos t i l e Conf l ic ted Family", presented a c l e a r l y complementary set of parent views of the i r own i n i t i a t i n g behaviors. While father reported that he was h o s t i l e and at tacking towards h is 1 16 d a u g h t e r , h i s w i f e m a i n t a i n e d t h a t she was f r i e n d l y t o w a r d s t h e i r d a u g h t e r . F u r t h e r m o r e , m o t h e r m a i n t a i n e d t h e i m p r e s s i o n t h a t d a u g h t e r s u b m i t t e d i n a f r i e n d l y way t o w a r d s h e r , w h i l e f a t h e r v i e w e d h i s d a u g h t e r as t a k i n g autonomy i n a h o s t i l e way. D a u g h t e r s h a r e d h e r f a t h e r ' s a t t a c k i n g v i e w o f h i m s e l f t o w a r d s h e r , b u t r a t h e r t h a n t a k i n g h e r autonomy i n a n g e r , she saw h e r s e l f a s r e s p o n d i n g more e x c l u s i v e l y o u t o f h o s t i l i t y . She e x p e r i e n c e d m o t h e r as b e i n g m a i n l y a c o n t r o l l i n g f o r c e i n h e r l i f e r a t h e r t h a n t h e f r i e n d l y one m o t h e r r e p o r t e d . To t h i s , d a u g h t e r r e s p o n d e d i n an a m b i v a l e n t way, t h a t was, s o m e t i m e s w i t h warmth and t r u s t and o t h e r t i m e s w i t h h o s t i l i t y and w i t h d r a w a l . The h o s t i l e a t t a c k i n g a p p r o a c h o f f a t h e r ' s i n t h i s c l u s t e r , c o m p l e m e n t e d by m o t h e r ' s a t t e m p t s t o be f r i e n d l y t o w a r d s t h e i r d a u g h t e r , c o u p l e d w i t h d a u g h t e r ' s v i e w s o f them gave t h i s f a m i l y , g r o u p a s e n s e o f i t ' s own. I t d i d n o t seem t o i n c l u d e s u c h r a d i c a l l y d i f f e r e n t v i e w s o f t h e p a r e n t / d a u g h t e r r e l a t i o n s h i p s a s was e v i d e n t i n t h e p r e v i o u s f a m i l y c l u s t e r , h o w e v e r , d i f f e r e n c e s i n p e r c e p t i o n c l e a r l y c o - e x i s t e d and c o n f l i c t was e x p l i c i t . The l a s t e x c l u s i v e l y a n o r e x i c r e l a t e d f a m i l y c l u s t e r 7, l a b e l l e d " T h e A m b i v a l e n t l y D i f f e r e n t i a t e d F a m i l y " , was c h a r a c t e r i z e d as h a v i n g a f a t h e r who c l a i m e d a removed i n i t i a t i n g s t a n c e f o r h i m s e l f , and a m o t h e r who p e r c e i v e d h e r s e l f a s b e i n g f r i e n d l y t o w a r d s t h e i r a n o r e x i c d a u g h t e r . B o t h p a r e n t s r e p o r t e d an a m b i v a l e n t s i d e o f t h e i r d a u g h t e r ' s r e s p o n s e s t o them w h i c h c o n t a i n e d s l i g h t l y d i f f e r e n t m e a s u r e s o f 1 17 warmth and h o s t i l i t y . In te res t ing ly , far from removed, daughter's impression of father i s that he ref lec ted that he was engaged in a f r iendly and c o n t r o l l i n g way. She found her mother to be less f r iendly and more c o n t r o l l i n g than her father. Towards both of them, she claimed to respond in a s imi la r f r iendly and submitting manner. The las t group i d e n t i f i e d , "The Symmetrical Family", was comprised of 1 family with an anorexic daughter and 2 without, appeared dis t ressed in i t s own r i g h t . Father 's view of himself suggested that he was removed yet hos t i l e towards h is daughter. Simultaneously, mother maintained a moderately f r iendly view of herse l f . Not su rp r i s ing ly , they reported di f ferent responses from the i r daughter. Father perceived her as e s sen t i a l l y responding with hos t i l e separating behaviors, while mother claimed her daughter responded towards her in a f r iendly way. Their daughter had a s imi l a r impression of her mother''s i n i t i a t i n g behavior as did mother but she apparently saw father as sending her a mixed communication which included elements of both understanding and hos t i l e managing. Towards him, daughter reported a dis tancing react ion, which father viewed as being h o s t i l e . Daughter's responses with mother also had a dis tancing q u a l i t y , however i t was teamed with some warmth and ambivalence according to the c h i l d . Thus, though some sharp differences in opinions to the nature of the i r re la t ionships were present in t h i s family c lu s t e r , a point of agreement c l e a r l y existed between daughter and mother. Mother's view of her f r iendly i n i t i a t i n g behavior was shared by her daughter and i s r e l a t i v e l y 1 18 strong. In summary, the resul ts c l e a r l y establ ished di f ferent i n t e r f a m i l i a l patterns of r e l a t i onsh ip . Of these 7 t ransact ional family systems, 3 were s t r i c t l y related to famil ies with daughters suffering from the condit ion of anorexia nervosa. No s ingle family c lus te r const i tuted a purely non-anorexic family group. These resu l t s as wel l as the dynamic issues re la ted with the family c lus te r s w i l l be discussed in the fol lowing chapter. 1 19 DISCUSSION Discussion of Family Transactive Patterns The major thurst of the study was to examine family t ransac t ional re la t ionships as they might re la te to the symptom of anorexia nervosa. The largest hurdles to the study were d i f f i c u l t i e s re lated to the effor t of remaining t heo re t i c a l l y and p r a c t i c a l l y consistent wi th in a systemic framework. As the the resul ts section t e s t i f i e s , t h i s kind of family research i s a challenging and complex matter for researcher and reader a l i k e . Hypothesis I Famil ies containing anorexic daughters w i l l manifest t ransact ional patterns, r e l i a b l y d i f f e r en t i a t i ng them from the cont ro l group f ami l i e s . Hypothesis I was not supported by the resu l t s of the present research. Eleven of the 22 famil ies of anorexics were grouped with cont ro l group f ami l i e s . The t ransact ional patterns of these 11 anorexic g i r l s and the i r f ami l i e s , half the anorexic sample, were found to be more s imi la r to cont ro l group fami l ies than they were to other famil ies with an anorexic daughter. I t i s worth noting that the remaining 11 famil ies containing anorexic daughters manifested t ransact ional patterns of r e l a t ionsh ip which did c l e a r l y separate them from cont ro l group f ami l i e s . Thus, while experimental Hypothesis I d id not gain empir ical substant ia t ion, there would appear to be at least some famil ies of anorexics which re la ted in ways c l e a r l y 120 d i s s i m i l a r to the control group sample. Hypothesis II A l l famil ies of anorexics w i l l r ea l i se a near-isomorphic family t ransact ional pattern, as reported on SASB, such as they may be grouped together as a s ingle family type. The focus on the t ransact ional patterns of r e la t ionsh ip chrac te r i z ing famil ies with an anorexic daughter and famil ies from a cont ro l group, allows for some comment as the ubiqui ty of a s ingle anorexogenic family t ransact ional s t y l e . Based on the present research, no supportive anorexogenic family in te rac t ion pattern was i d e n t i f i e d . Rather than being grouped c lose ly together, the c lus te r analys is procedure, stated in Hypothesis I I , at least one family with an anorexic c h i l d was found present in every family c lus te r establ ished through the s t a t i s t i c a l technique employed. Thus the resu l t s of the inves t iga t ion stand in contrast to the o r i g i n a l family theories re la ted to anorexic nervosa put forward by Minuchin et a l . (1978) and S e l v i n i (1978). In fact , three d i s t i n c t l y separate family t ransact ional patterns were found to be exc lus ive ly related to the anorexic symptom. Differences were c l e a r l y evident between these 3 famil ies in terms of how the parents and the c h i l d in each c lus te r perceived the r e a l i z a t i o n of the r e l a t ionsh ips . I t was equally apparent in a l l 3 f ami l i e s , that the parental subsystem was s p l i t in the i r functioning and d id not present any semblance of a un i f ied front in dealing with the i r daughters. In t h i s 121 regard, these family patterns s t r i c t l y related to the anorexic condit ion shared the cha rac t e r i s t i c s of complementarity between parents which Bateson (1979) l inked to unhealthy systems. These famil ies also had the existence of r a d i c a l l y divergent perceptions of r e la t ionsh ip between parents and c h i l d as a common thread between them, however the pa r t i cu l a r content of the divergent perceptions var ied from family to family. In connection to those two points of s i m i l a r i t y , which on one l e v e l could c h a r a c t e r i s t i c a l l y bond the family patterns of those exc lus ive ly associated with the symptomatic behavior, i t should be mentioned that the same cha rac t e r i s t i c s were also apparent in The Symmetrical Family Cluster which contained two famil ies from the cont ro l group. Thus the symptomatic behavior cannot so le ly be related to these two general s i m i l a r i t i e s . The unidimensional, causational family t ransact ional model i s further challenged by the emergence of anorexic re la ted famil ies being c lus tered together with many of the famil ies from the control group. These family c lus te rs c h a r a c t e r i s t i c a l l y display neither complementarity between parents nor r a d i c a l l y divergent in perceptions between parents and c h i l d . In both the Harmonious Transactional Family and the Perfect Family Clus te rs , there appeared to be some issues related to how parental authori ty over the c h i l d was expressed, however, taking the adolescent age of the daughters in the sample into considerat ion, such a c o n f l i c t waw not e n t i r e l y unexpected or beyond c u l t u r a l norms. I t .was in te res t ing that the f ive famil ies with an anorexic 122 daughter grouped together along with famil ies from the cont ro l group in family c lus te r 6, reported complete accord and high degree of f r iendly accord in the i r f ami l i e s . One must wonder how i t was possible that such warm, lov ing c o n f l i c t free re la t ionships could continue in any family system in which the daughter's refusal to eat had achieved l i f e threatening proport ions. Reca l l ing the reported needs of some anorexic related famil ies to deny c o n f l i c t and maintain the veneer of a perfect family (Minuchin et a l . , 1978), characterized in Yager's (1982) sketch of a symptomatic family, i t would seem that th i s could be a l i k e l y explanation for th i s occurence. The i n t r i n s i c d i f f i c u l t y of invoking t h i s explanation, i s that then a shadow of doubt i s cast across the face of the data which the study i s based upon. Thus, while i t i s - p l a u s i b l e that th i s pa r t i cu la r resul t can be explained through the introduct ion * of an argument re la ted to family need to appear in a s o c i a l l y desirable manner and/or to deny c o n f l i c t , i t remains perhaps more useful to accept the data as the true and v a l i d experiences of the family respondents. Accepting the data as representing the phenomenological experience of family members, th i s pa r t i cu l a r resul t was important in two ways. F i r s t l y , despite what any external observer may say to the contrary, such a family unit experiences i t s e l f as f r iendly and congruent. I t i s therefore at least cogn i t ive ly and emotionally i f not behaviora l ly , a d i f ferent system than others in which symptomatic behavior i s present. Secondly, in a p r a c t i c a l way, any therapist attempts to change 1 23 or a l t e r family dynamics of famil ies which might f i t into th i s family c lu s t e r , w i l l almost c e r t a i n l y be seen in an unfavourable l i g h t by family members. Members in th i s family c lus te r did not seem to d i r e c t l y experience interpersonal d i s t r e s s . While one may maintain an observer 's opinion that such a family unity must in some way be transformed, a very di f ferent approach to „the matter may be required such that the chance for therapeutic change i s maximized. Considering that famil ies with an anorexic daughter c lustered together with famil ies from the cont ro l group, and bearing in mind the breadth of t ransact ional patterns and dynamic issues related to the various family c lus te rs (made e x p l i c i t in the r e s u l t s ) , i t seems c lear that a unidimensional t ransact ional family model cannot account for the d i v e r s i t y of family structured functioning found in th i s study. The resul ts of the inves t iga t ion lend further empir ical weight to the multidimensional thesis proposed by Garf inkel and Garner (1982), supports the i r c l i n i c a l impressions. The present inquiry offers empir ical credence to the view of anorexic nervosa as a psychosomatic symptom embedded in a troubled family which but not the resul t of a s ingle dominant family pat tern. Limi ta t ions to the Study A d i f f i c u l t y in in terpre t ing the resu l t s of the study and a reason for maintaining a tentativeness in the conclusions i s found in the nature of the cont ro l sample used. In response to the concern expressed by Yager (1982) that the family 1 24 t ransact ional patterns may be more related to the stress of i l l n e s s rather than being spec i f i c to the anorexic i t s e l f , the cont ro l sample was selected on the basis of the daughter's present involvement as recipient of medical a t ten t ion . The i n t r i n s i c problem with th i s i s that the cont ro l group cannot be construed as being "normal". Indeed, i f the hypothesis that any symptomatic behavior in general i s re lated non-spec i f i ca l ly to disturbed family t ransact ional patterns i s cor rec t , then i t may wel l be that some of the famil ies included in the cont ro l sample were as d is t ressed as the fami l ies related to the anorexic cond i t ion . This issue seems po t en t i a l l y very important, e spec ia l ly when one views the highly conf l i c t ed family pattern which character izes the "Symmetrical Family" c lus te r #1. A second reason for considering the resu l t s with a degree of reserve i s again re la ted to the sampling procedures in the study. Since a l l of the anorexic daughters were receiving some form of therapeutic medical a t ten t ion , i t i s en t i r e ly possible that the daughters and the i r famil ies were at d i f ferent stages along the l i n e of recovery. As i t would be theorised that disturbed family t ransact ional patterns would tend to normalize over the course of successful treatment, some of the f ami l i e s , classed in the anorexic sample which in turn c lus tered in family groups appearing less troubled ( i e . The Marginal Family) , may have f i t in to t h i s category. The sample s ize used in the inves t iga t ion may hve been too small to adequately sample the family population under study. Thus the resu l t s should not be seen as suggesting that there are 1 25 only 7 c lus te rs of famil ies related to the symptomatic condi t ion , 3 of which were so le ly related to an incidence of anorexia. Rather, the resul ts are best seen as suggesting that there are at least these seven family t ransact ional c lus te rs which were in some way related to the symptomatic behavior. In a s imi la r ve in , the conclusion that the 3 family t ransact ional c lus ters which were exc lus ive ly comprized of famil ies with an anorexic c h i l d , are uniquely re la ted to the anorexic symptom, i s indefensible . In order to make such a statement, i t would be necessary to sample and compare a much wider range of family systems which embraced other c l i n i c a l l y re lated symptomatic behavior. This was wel l beyond the means of t h i s study. In consideration of the above, the resu l t s are best viewed with a degree of care, l es t unfounded overgeneralizations be in some way infer red . The c r i t i c i s m that the study does not focus on actual observable t ransact ional data at a l l can be raised with some v a l i d i t y . In fact , as mentioned e a r l i e r , the se l f reported perceptions of re la t ionsh ip used in the inves t iga t ion are almost c e r t a in ly not the view of the re la t ionships which would have been captured by a video camera. There i s no argument that observations made by t rained observers might prove to have very d i f ferent things to say about the nature of family transactions which were studied and how they related to anorexic nervosa. Nonetheless, the contention here i s that the ideosyncratic meaning of behavior, rather than the behavior i t s e l f , has a great deal of worth. Furthermore, as i t i s the manner which the 1 26 family punctuates and understands each other 's ac t ions , rather than the perceptions of the observers, which i s the focus of therapy. The data used in the study i s both appropriate to the question and empi r i ca l ly valuable . Implications and Concluding Remarks The view of anorexic nervosa as a symptom rela ted to family systems which i s borne out of the study i s that the famil ies may be best seen on a continuum ranging from dis t ressed and conf l i c t ed to non-distresses and congruent. The pa r t i cu l a r way which family uni ts r e a l i z e the structure of the i r re la t ionships provides a unique iden t i ty for each family. Three family patterns of t ransact ion were found to be s t r i c t l y cha rac t e r i s t i c of the symptomatic behavior. These 3 patterns shared the s i m i l a r i t i e s of complementary perceptions on how the parents transact with the i r daughter as wel l as r a d i c a l l y d i f ferent perceptions present between daughter and parents. However, they varied in the ways which family members gave meaning to and related through the s t ruc tu ra l arrangements i . e . , who was hos t i l e with whom. At the other end of the continuum were family t ransac t ional c lus te rs based on perceptions which were f r iendly and congruent. These family systems d id not view themselves as being any more dis t ressed than the cont ro l sample and can be seen to approximate "normal" t ransact ional pat terns. Again, the stress i s on the meaning and in terpre ta t ion which family members held in regards to one another. At th i s end of the spectrum, member behavior was seen as being 1 27 c h a r a c t e r i s t i c a l l y f r iendly and v i r t u a l l y never hos t i l e and angry. The p r a c t i c a l impl ica t ion of the research i s that since no s ingle family t ransact ional pattern was established a therapist would be wise to remain sens i t ive to the di f ferent and unique needs and worlds which famil ies have and l i v e i n . The tendency to r e i fy family systems as i f they were " rea l " things which could cause th ie r members to behave in cer ta in ways tends to t r i v i a l i z e l i v i n g dynamic systems and i s a notion in need of careful considera t ion. The very dif ferent ways in which famil ies presented themselves in the study i s a reminder that i t i s the experienced meaningful worlds of c l i e n t s and famil ies that must be given due respect in therapy, least we as therapists attempt to superimpose perspectives onto famil ies which simply do not f i t theory. Theore t ica l ly the research has been able to es tab l i sh a wide range of possible t ransact ional patterns which may be associated with anorexic nervosa. The question of the e t io logy of the symptom has not even been attempted to be answered as in terms of t ransact ional research, causation remains a matter of punctuation and in the world of l i v i n g systems a matter of accent as much as anything e l se . What i s c lear from the study i s that further systemic work i s required in the area of symptom formation and pers is tence. The 7 family patterns established in th i s inves t iga t ion only represent a small piece of the anorexic puzzle and the way in which the symptom f i t s into the family ecology. Moreover the study points to a need to develop further 128 research methods and approaches to systemic research. The present research, while at times seeming clumsy and long, offers promising areas of expansion for further study, however i t i s only a beginning. Problems with systemic research have been highl ighted e a r l i e r in the paper. Kaye (1985) succ inc t ly captured these d i f f i c u l t i e s when he wrote: Our methods for the study of the family as a system lag far behind our rhe to r i c . The methods e x i s t . . . But they are and must remain conceptually d i f f i c u l t , time consuming and labour- in tens ive . Computer-aided coding, easy database manipulation, time se r ies , and sequential analysis are marvelous tools but no subst i tute for o ld fashioned s tar ing and thinking and head-scratching u n t i l the patterns come into view. Hence th i s i s no f i e l d for the would-be reduc t ion is t , or for the l azy ; and i t i s one in which academic pressure to produce d e f i n i t i v e work, fast , may be completely counter productive. (p.280) The need for new systemic research t heo re t i c a l l y consistent with epistemological innovations presently coming to the fore (Del l 1985) i s pronounced. Throughout the research procedures of t h i s study, an effort to remain true to systemic theory was attempted. Despite t h i s , i t would seem that the epistemological ground upon which systemic thought has had i t s foundations i s now s h i f t i n g , making for a p a r t i c u l a r l y challenging cybernetic balancing act for researchers. A var ie ty of research questions d i r e c t l y growing out of the present study could be asked, however only two w i l l be expressly mentioned. One wonders what kind of an affect simply changing the punctuation of the re la t ionsh ips , thereby g iv ing the daughter the ac t ive role and the parents the react ive role would have on the r e su l t s . Secondly, what would the effect be on the resu l t s i f more points of view were added to the family system 1 29 equation i . e . , mother's view of fa ther ' s i n i t i a t i v e behavior towards daughter, or daughter 's, view of mother's i n i t i a t i n g behavior with father. By adding these various points of view, the information generated might provide an analogic method of examining the kind of information gained by the technique of c i r c u l a r questioning ( S e l v i n i , Boscolo, Checchin, & Prata, 1980). In summary, then, the research has been aimed at exp l i ca t ing family perceptions of the t ransact ional re la t ionships ex i s t i ng between parents and c h i l d associated with the symptom of anorexia nervosa. From the data, 7 d i f ferent family structures r ea l i zed in a var ie ty of systems of transactions were i d e n t i f i e d as being in some way connected to the anorexic cond i t ion . Thus the study lends support to the multidimensional vvew of the symptom (Garfinkel & Garner, 1982; Garner & Garf inkel 1985) and challenges the notion of a s ingle dominant family t ransact ional pattern as an essent ia l ingredient for the emergence of the anorexic cond i t ion . The complexity of systemic t ransact ional data presents both a po ten t ia l richness and overwhelming amount of information to a s s imi la t e . However, i t would seem that t h i s l i n e of research could wel l further enr ich the understanding of the symptomatic process. The d i f f i c u l t i e s in undertaking such research are mul t ip l e , but the opportunity to expand empir ical knowledge i s a lso a l l u r i n g . Bateson (1979) reminded researchers that : . . . As of 1979, there i s no conventional way of explaining or even descr ibing the phenomena of b i o l o g i c a l organization and human in t e rac t ion . (p.22) 130 This study has represented an effort focused in the d i r ec t ion of such an explanation. 131 REFERENCES American Psych ia t r i c Associat ion (1980). Diagnostic and  s t a t i s t i c a l manual of mental disorder (3rd ed . ) . Washington D . C . , Author. Anchin, J . , & K i e l s e r , D. (Eds . ) . (1982). 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S t ruc tura l analysis of d i f f e r e n t i a t i o n f a i l u r e . Psychiat ry , 42,1-23. Benjamin, L . S . (1979b). A manual for using SASB questionaires to  measure correspondence among family h i s to ry , self-soncept .and current re la t ions with s ign i f i can t others (SASB). Unpublished Manuscript. Univers i ty of Wisconsin, Department of Psychiatry and the Wisconsin Psychia t r ic I n s t i t u t e , Madison. 1 32 Benjamin, L . S . (1980). Use of s t ruc tu ra l analysis of soc i a l behavior (SASB) to guide in te rvent ion . In D. Ke i s l e r & J . Anchin (Eds . ) , New perspectives in interpersonal  psychotherapy, New York: Pergamon Press. Benjamin, L . S . , (1981). A psychosocial competence c l a s s i f i c a t i o n system. In J . D . Wine & M.D. Smye (Eds . ) , Soc ia l  competence, (pp.181-231). New York: Gui l fo rd Press. Benjamin, L . S . (1981). P r i n c i p l e s of predic t ion using s t ruc tu ra l analysis of s o c i a l behavior. Personal i ty and the  p red ic t ion of behavior, 2A,\2\-\lb. . Benjamin, L . S . (1982). Va l ida t ion of s t ruc tu ra l analysis of s o c i a l behavior (SASB). Unpublished manuscript. Univers i ty of Wisconsin, Department of Psychiatry and the Wisconsin Psychia t r ic I n s t i t u t e , Madison. Benjamin, L . S . (1985). Interpersonal diagnosis and treatment: The SASB approach, New York: Gui l fo rd Press. Bl i shen , R . B . , & McRoberts, H.A. (1976). A revised socioeconomic index for occupations in Canada. Canadian Review of  Sociology and Anthropology, 13,71-79. Boldt , W.B. , & Housego, B. (1984). C r i t i c a l incidents in the supervision of student teaching: A c lus te r analysis of the  perceptions of graduate transfer students. Unpublished Manuscript: The Univers i ty of B r i t i s h Columbia. Bruch, H. (1977). Anorexia nervosa. Adolescent Psychiatry, Developmental and C l i n i c a l Studies, 3_,293-303. Bruch, H. (1978). The golden cage, Cambridge, Massachusetts: Harvard Univers i ty Press. Bruch, H. (1983). Eating disorders . New York: Basic Books. Bruch, H. (1985). Four decades of eating disorders . In D.M. Gardner & P . E . Garf inkel (Eds . ) , Handbook of psychotherapy  for anorexia nervosa and bulemia (pp.7-18). New York: Gui ldford Press. 1 33 C h i l e s , J . A . , Stauss, F . S . , & Benjamin, L . S . (1980). Mar i t a l c o n f l i c t and sexual dysfunction in a l coho l i c and non-a lcohol ic couples. B r i t i s h Journal of Psychiat ry , 137,266-273. C r i s p , A . H . , Harding, B . , & McGuinness, B. (1974). Anorexia nervosa: Psychoneurotic cha rac t e r i s t i c s of parents re la t ionsh ip to prognosis. Journal of Psychosomatic-Research, 18,167-173. Cr i sp , A . H . (1980). Anroxia nervosa: Let me be. New York: Grune & St ra t ton . D a l l y , P. (1969). Anorexia nervosa. New York: Grune & St ra t ton . D e l l , P .F . (1980). 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APPENDIX A : INTREX QUESTIONAIRE APPENDIX A INTREX QUESTIONNAIRE Directions for INTREX questionnaires INTREX form A INTREX form C Leaves 1 ^ 3 - ^ 8 not filmed; permission not obtained. Copyright, 1 9 8 0 , INTREX Interpersonal Institute, Inc. APPENDIX B : FULL VERSION SASB APPENDIX B FULL VERSION SASB Fig. 1 F u l l Version of the SASB model From "Structural analysis of differentiation failure," Psychiatry k2 ( 1 9 7 9 ) : 1 - 2 3 . Copyright^ 1 9 7 9 , William Alanson White Psychiatric Foundation. Leaf 150 not filmed; permission not obtained. 1 . Try the William Alanson White Institute of Psychiatry, Psychoanalysis, and Psychology, New York, N.Y. 1 0 0 2 3 . APPENDIX C : CLUSTER VERSION SASB 151a APPENDIX C CLUSTER VERSION SASB The SASB model, intrapsychic focus: introject (I) of other to se l f . 1 The SASB model, interpersonal other ( 0 ) focus. The SASB model, interpersonal self (S) focus. Copyright 1 9 7 9 , William Alanson White Psychiatric Foundation;' copyright on the cluster model registered, 1 9 8 1, by INTREX Interpersonal Institute, Inc.; copyright on the questionnaire items, 1 9 8 3 » Lorna Smith Benjamin. LEAVES 1 5 2 - 5 ^ NOT FILMED; PERMISSION NOT OBTAINED. 1. The quadrant model i s from L.S. Benjamin, "Structural Analysis of Differentiation Failure," Psychiatry k2 ( 1 9 7 9 ) : 1 - 2 3 . 2 . Try the William Alanson White Institute of Psychiatry, Psychoanalysis, and Psychology, New York, N.Y. 1 0 0 2 3 APPENDIX D: EXAMPLE OF OUTPUT GENERATED BY PROGRAM FIG ,FAMILY CLUSTER 6 ,MEAN SCORES FATHER RATES SELF ,RE DAUGHTER INITIATE 48 83 62 66 21 6 5 3 STARS INDICATE THEORY, CIRCLES SHOW DATA IN CASES WHERE DATA=THEORY, ONLY DATA ARE SHOWN 100 * 95 90 85 0 * 80 75 70 O 65 O 60 55 50 O * 45 40 35 30 25 O 20 15 * 10 O 5 O 0 * 1 2 3 4 5 6 7 8 CORRELATIONS WITH SUCCESSIVE THEORETICAL PROFILES WERE 1 0.926 -0.926 0.809 -0.809 0.219 -0.219 -0.499 0.499 0.038 0.852 0.840 -0.840 0.840 -0.178 0.178 0.440 -0.440 -0.101 0.099 -0.038 0.038 THE MAXIMUM CORRELATION WAS= 0.926 WITH PROFILE 1 APPENDIX E : TREE DIAGRAM ESTABLISHED BY CLUSTER ANALYSIS 1 r EMS G R O U P E D p I J ERROR 1 7 36 14 . 1 1 2 8 3 9 2 28 4 0 14 . 4 1 8 5 7 9 3 2 5 42 16 . 8 1 8 7 5 6 4 7 28 18 . 5 1 6 5 2 5 5 2 1 32 18 . 8 3 1 1 9 2 6 27 34 2 1 . 5 5 6 6 4 1 7 17, 2 1 2 3 . 4 0 1 8 4 0 a 27 43 23 . 7 1 7 7 7 3 9 7 22 24 . 2 1 9 7 2 7 10 16 26 25 . 3 9 2 3 9 5 1 1 3 1 38 25 . 5 3 8 8 0 3 12 2 37 26 . 2 0 5 5 9 7 13 7 33 27 . 0 2 6 9 1 7 14 23 29 29 3 9 8 4 6 8 15 16 3 9 3 1 . 4 0 9 8 8 2 16 1 4 1 3 1 . 8 2 5 9 8 9 17 2 5 27 3 1 9 1 0 6 2 9 18 12 17 32 3 9 5 8 7 4 19 2 5 34 0 7 5 2 5 6 2 0 7 14 34 6 1 2 5 9 5 21 12 44 37 0 9 6 4 3 6 22 8 19 4 0 . 7 7 8 9 7 6 23 2 3 0 44 1 1 5 9 9 7 24 6 15 44 7 6 8 3 1 1 2 5 1 1 13 4 5 4 2 3 5 0 8 26 7 24 46 3 5 3 8 0 6 27 16 31 47 . 8 7 2 8 7 9 28 1 1 2 0 5 0 . 254 135 29 7 10 5 5 . 1 0 5 3 7 7 3 0 23 25 59 . 9 4 2 7 6 4 3 1 1 35 6 0 . 4 7 9 4 3 1 32 8 9 6 1 . 7 2 0 8 5 6 33 16 23 64 . 5 9 3 8 4 2 34 3 6 7 0 . 0 3 5 5 5 3 35 4 1 1 7 0 . 2 8 1 0 9 7 36 2 12 73 . 6 0 5 1 0 3 37 3 18 83 . 6 8 7 6 5 3 38 7 16 98 . 9 0 4 8 7 7 39 1 2 1 14 . 4 4 0 1 9 4 0 1 8 126 . 8 3 8 13 4 1 1 4 170 . 0 3 2 2 3 42 1 3 2 18 . 0 6 0 7 3 43 1 7 6 2 6 . 1 7 4 8 0 1 37 17 8 11 6 36 33 16 38 42 •4 1 5 2 1 19 13 15 28 14 26 23 27 35 3 0 32 9 2 0 18 4 0 24 39 29 34 2 12 44 4 3 7 22 10 31 25 43 LI L * Ul 1 DIRECTIONS for INTREX QUESTIONNAIRES This package ol Questionnaires asks you to rate ways you teei about yourseif ana some significant others. You are asked to rate eacn question on a scale of 0 (never, not at all) to 100 (always, perfectly). The analysis of the Questionnaires organizes your answers in ways wnich can help you ana your health care provider unaerstana wny you feel the way you ao. ana can even make some suggestions for what to do about it. People wno go anead and answer honestly, avoiding any lemotation to "whitewash" or "paint a rosy picture" usually are very pleased with the results. II your health care proviaer agrees, the results can be maae available to you to nelo you with your unaerstancing of yourself. If you are in osychotheraoy. it can help with therapy planning and can be usea to measure progress. !n most.cases, this procedure, if used correctly, can improve the efficiency of psychotherapy. Sometimes it is helptul to use the INTREX Questionnaires again in different "phases" ol osycnotnerapy. Please answer the questions for how you really think or feel. Your initial reaction to each question wiil most often be your ces; answer. II a question oifenos you. score it zero or leave it oiank. There are no "rignt" or "wrong" answers. It's your view wnicn is important—not what is necessarily "true." "false" or wnat someone else might think you should say. If mere are questions about the past (e.g. wnen you were age 5-10) try to recall your home and the peoDle to get back into tne mood" ol Ihmgs as they were. Put your answers on the prooer answer sheets making sure you match the letter of the Questionnaire with the letter of the answer sneet. When you've finished, give the oackage of questionnaires ano the answer sheets back to the person who gave you these materials. The results will be returnee as quicKly as possiole to your health care provider. PLEASE DO NOT WRITE ON THIS PACKAGE 144 INTREX FORM A* Please use the answer sheet marked "A" and indicate how well each question describes yourself. Use the scale which appears at the top of the answer sheet. 1. I neglect myself, don't try to develop, my own potential skills, ways of being. 2. I examine, analyze myself sensibly, carefully, realistically. 3. I leave myself to daydream and fantasize instead of actually doing what would be good for me. 4. I just let important choices, thoughts, issues, options slip by me without paying much attention. 5. Knowing both my faults and my strong points. I comfortably let myself be as I am. 6. I let myself feel glad about and pleased with myself just as I am. 7. I accuse and blame myself, make myself feel bad. guilty, ashamed, unworthy. 8. I practice, work developing worthwhile skills, ways of being. 9. I love, cherish, adore, feel really good—maybe even sexy—about myself. 10. I naturally and easily nurture, care for, restore, heal myself as needed. 11. I harshly reject, dismiss myself as worthless. 12. I let unwarranted ideas I have about myself go unchallenged. I don't bother to know myself. 13. I like myself very much and welcome and enjoy opportunities to be with myself. 14. I am very careful to restrain myself, to hold back. 15. I control, manage myself according to goals I've set for myself. 16. I torture, kill, annihilate myself just because I'm basically so bad. 17. I drain, overburden, and deplete myself greatly. 18. I gently and warmly "pat myself on the back" just because I feel very good about the way I am. 19. I keep an eye on myself to be sure I'm doing what I should be dping. 20. I try very hard to make myself as ideal as I can. 21. I understand and accept myself and let myself go by what lies deep within. 22. I let my own sickness and injury go unattended even when it means harming myself greatly. 23. I put a lot of energy into making sure I conform to standards, am proper. 24. I vengefully punish myself. I "take it out on myself." 25. I make myself do ana be things which I know are not right for me. I fool myself. 25. I am happy-go-lucky, content with "here today, gone tomorrow." 27. I reliably protect myself, look after my own interests. 28. I drift with the moment, have no particular internal direction, standards. 29. I put a lot of energy into anticipating and finding everything I need for myself. 30. In a free and easy way, I let myself do what comes naturally, and everything goes well enough to suit me. 31. I understand and feel good about myself. I'm.relaxed, solid, "together", completely okay "as is." 32. I feel free to let my basic nature unfold as it will. 33. I am reckless, carelessly end up in self-destructive situations. 34. I am always open to and "up for" situations which will be very pleasant and good for me. 35. I am very unsure of myself because I tell myself I do things all wrong. I feel others can do better. 36. I approach myself with a negative, destructive attitude: I am my own worst enemy. • © 1 9 8 0 . INTREX Interpersonal Institute. Inc. INTREX FORM C* Please use the answer sheet marked " C " and indicate how well each question describes Use the scale which appears at the top of the answer sheet. 1. Constructively, sensibly, persuasively analyzes situations involving me. 2. Has her own separate identity, internal standards. 3. Insists I follow her norms and rules so that I do things "properly." 4. Puts me down, tells me I do things all wrong, tells me her ways are superior. 5. Learns from me. takes advice from me. 6. Just does things my way without much feeling of her own, is apathetic. 7. Angrily leaves me out, absolutely refuses to have anything to do with me. 8. Warmly, comfortably accepts help, caregiving when I offer it. 9. Does her own thing by doing the exact opposite of what I want. 10. Is straightforward. Clearly expresses her positions so I can give them due consideration. 11. Enthusiastically shows, shares herself or "thing" with me. 12. Tortures, murders, annihilates me no matter what I do just because "I'm me." 13. Does strange, irrelevant, unrelated things with what I say or do: goes on her "own trip." 14. Ecstatically, joyfully, exuberantly, lovingly responds to me sexually. 15. Warmly, cheerfully invites me to be in touch with her as often as I want. 16. Warmly, happily keeps in contacl with me. 17. Freely comes and goes as she pleases. 18. Out of great love for me. she tenderly, lovingly touches me sexually if I seem receptive. 19. Stimulates and leaches me, shows me how lo understand, do. 20. Accuses and blames me; tries to get me to admit I am wrong. 21. Enthusiastically, very lovingly shows me how glaa she is to see me just as I am. 22. Looks to me. depends on me to take care of everything for her. 23. Harshly punisnes me, takes revenge, makes me suffer greatly. 24. Unoerstands me well, shows empathy and warmth even if I don't see things as she does. 25. Is trusting. Asks for whal she wants and counts on me to be kind and considerate. 26. Willingly accepts, yields to my reasonable suggestions, ideas. 27. Screams, agonizes, protests desperately that I am destroying, killing her. 28. Gently strokes me verbally and/or physically; she lovingly gives me pleasure with "no strings attached." 29. Intrudes, blocks, restricts me. 30. Even though very suspicious and distrustful of me. she goes along with my arguments, ideas. 31. Obeys my preferred rules..standards, routines. 32. Rips me off. gouges me. grabs all she can from me. 33. Pleasing me is so important that she checks with me on every little thing. 34. Is obviously lernlied. very fearful of me: is extremely wary. 35. Misleads, deceives, deludes and diverts me. 36. In a very grouchy, surly manner, she goes along with my needs and wants. 37. Provides for. nurtures, takes care o( me. 38. Lets me speak freely ana can be trusted to negotiate fairly even if we disagree. 39. Ignores me. just doesn't nonce me at all. 40. Uncaringly lets me go. do what l want. 41. Snarls angrily, hatefully refuses my caregiving, my offers to assist. 42. Filled with rage and/or fear, she does wnat she can to escape, flee or hide from me. *<£;1980. INTREX Interpersonal Institute, Inc. 43. Believing it's tor my own good, sne checks on me and reminds me ol wnal I should do. 44. Gives me her "blessing" and leaves me free lo develoo my own separale identity. 45. Forgets me, just doesn t remember our agreements, plans. 46. Gives in and does things the way I want, but sulks quietly with resentment and anger. 47. Yields, submits, gives in to me. 48. Approaches me very menacingly; hurts me very badly il sne gets a chance. 49. Manages, controls me, takes charge of everything. 50. Leaves me to do things on my own because she believes I am competent. 51. Expresses her thoughts in a clear and friendly manner so I have every opportunity to understand her well 52. Feels, thinks, becomes what sne tninks I want. 53. Leaves me to starve, lo get what I vitally need all on my own. 54. Actively listens, accepts and affirms me as a person even if our views disagree. 55. Angrily detaches from me. doesn't ask for anything; weeps alone about me. 56. Pays close attention in order to anticioate all my needs: takes care of absolutely everything for me. 57 Whines, protests, tries to explain, justify, account for herself 58. Asserts, holds her own without neeaing external support 59. Avoids me by being busy and alone with her "own thing." 60. Warmly shows how much she likes and appreciates me just exactly as I am. 61. Walls herself off from me. doesn't hear, doesn't react. 62. Relaxes, enioys. really lets go witn me. Feeis wonderful about being with me. 63. Believing it's lor my own gooa. sne tells me exactly what to oo. be. think. 64 Buries ner rage ana resentment ana scurries to appease me to avoid my disapproval. 65. Approaches me wnh unwarrantea. even crazy ideas about me. and aoesn't notice how or if I respond. 66. Goes her own separate way. 67. Looks alter my interests, takes steps to protect me, actively backs me up. 68. Freely and openly discloses her innermost self so I can truly know "who she is." 69. Is joylul and exuoerant and exoects to have wonderful fun with me. 70. Just when sne is needed most, sne apanaons me. leaves me "in the lurch " 71. Neglects me. my interests, neeas. 72. Leaves me free lo oo and be whatever I want. For questions #73-144, change from rating her to rating yourself in this relationship. Continue using the same scale at the top of answer sheet " C . " 73. I constructively, sensibly, persuasively analyze situations involving her. 74. I have my own separate identity, internal standards. 75. I insist she follow my norms and rules so that she does things "properly." 76. I put her down, tell her she does things all wrong, tell her my ways are superior. 77. I learn Irom her, take advice from her. 78. I just do things her way without much feeling of my own; I am apathetic. 79. I angrily leave her out. absolutely refuse to have anything to dd with her. 80. I warmly, comfortably accept help, caregiving when she offers it. 8 1 I do my own thing by doing the exact opposite of what she wants. 82. I am straightforward. I clearly express my positions so she can give them due consideration. 83. I enthusiastically show, share myself or "thing" with her. 84. I torture, murder, annihilate her no matter what she does just because she is who she is. 85. I do strange, irrelevant, unrelated things with what she says or does; I go on my "own trip." 86. I ecstatically, joyfully, exuberantly, lovingly respond to her sexually. 87. I warmly, cheerfully invite her to be in toucn with me as often as she wants. 88. I warmly, happily keep in contact with her. 89. I freely come and go as I please. 90. Out of great love for her, I tenderly, lovingly touch her sexually if she seems receptive. 91. I stimulate and teach her, show her how to understand, do. 92. I accuse and blame ner: try to get her to admit she is wrong. 93. I enthusiastically, very lovingly show her how glad I am to see her just as she is. 94. I look to her. depend on her to take care of everything for me. 95. I harshly punish her. take revenge, make her suffer greatly. 96. I understand her well, show empathy and warmth even if she doesn't see things as I dd. 97. I am trusting. I ask for what I want and count on her to be kind and considerate. 98. I willingly acceot. yield to her reasonaole suggestions, ideas. 99. I scream, agonize, protest desperately that she is destroying, killing me. 100. I gently stroke her verbally and/or physically; I lovingly give her pleasure with "no strings attached." 101. I intrude, block, restrict her. 102. Even though very suspicious and distrustful of her. I go along with her arguments, ideas. 103. I obey her preferred rules, standards, routines. 104. I rip her off. gouge her. grab all I can from her. 105. Pleasing her is so important that I check with her on every little thing. 106. I am obviously terrified, very fearful of her; I am extremely wary. 107. I mislead, deceive, delude and divert her. 108. In a very grouchy, surly manner. I go along with her needs and wants. 109. I provide for. nurture, take care of her. 110. I let her speak freely and can be trusted to negotiate fairlv even if we disaaree 111. I ignore her. just don't notice her at all. 112. I uncaringly let her go, do what she wants. 113. I snarl angrily, hatefully refuse her caregiving. her offers to assist. 114. Fillea with rage ana/or fear. I do what l can to escape, flee, or hide from her. 148 115. Believing It's lor her own good. I check on her ana remina her of whai she should do. 116. I give her my "Blessing" and leave her tree to develoo her own separate identity. 117. I torget her. just don't remember our agreements, plans. 118. I give in and do things the way sne wants, but sulk quietly with resentment and anger. 119. I yield, submit, give in to her 120. I approach her very menacingly: I hurt her very badly if I get a chance. 121. I manage, control her, take charge ot everything. 122. I leave her to do things on her own because I believe she is competent. 123. I express my thoughts in a clear and friendly manner so she has every opportunity to understand me well 124. I feel, think, become what I think she wants. 125. I leave her to starve, to get what she vitally needs all on her own. 126. I actively listen, accept and affirm her as a person even if our views disagree. 127. I angrily detach from her, don't ask lor anything; I weep alone about her. 128. I pay close attention in order to anticipate all her needs; I take care of absolutely everything for her. 129. I whine, protest, try to explain, lustily, account for myself. 130. I assert, hold my own without needing external support. 131. I avoid her by being busy and alone with my "own thing." 132. I warmly show how much I like and appreciate her just exactly as she is. 133. I wall myself off from her. don t hear, don't react. 134. I relax, enioy. really let go with her I feel wonderful aOout being with her. 135. Believing it's tor her own good. I tell her exactly wnat to do. be. think. 136. I bury my rage and resentment and scurry to appease her to avoid her disapproval. 137 I appioacn ner with unwarranted, even crazy ideas aoout her: I don't notice how or if she responds. 138. I go my own separate way. 139. I look alter her interests, take steps to protect her. actively back her up. 140. I freely and ooenly disclose my innermost self so she truly can know "wno I am." 141. I am joyful and exuberant and expect to have wonderful fun her. 142. Just when I am needed most. I abandon her. leave her "in the lurch " 143. I negiect her. her interests, neeos. 144. I leave her free to oo and be whatever she wants. 120 Endora fraadotn I N T E R P E R S O N A L Uncanngly 1st 90 128 Forget 127 OTHER l9nore. pretend not there 126 Neglect interests, needs 125 illogical initiation 124 Abanoon leave to lurch 123 Starve, cul out 122 Angry dismiss, re»ct 121 y Annihilaong attack 130 —+• Approach menacingly 131 Rio off. dram 132 Punisw. take revenge 133 Delude, divert, midead 134 Accuse. b>*me 135 Put down, act suoeriof 136 Intrude, block, restrict 137 Enforce conformity 138 E3 118 Encourage separate identity 117 You can do ft fine 116 Carefully, fairly consider 115 Friendly listen 114 Show emoatnic understanding 113 Confirm as OK a> .{ - 112 Stroke, soothe, calm 111 Warmty welcome 110 Tender sexuality 141 Friendly invite 142 Provide for. nurture i 143 Protect, back uo 144 Sensible analysis 1 145 Constructive stimulate 146 Pamper, overindulge 147 Benevolent monitor, remind 146 Specify what j best Manage, control 140 220 Freefy coma and 90 SELF Go own separate way 228 Defy, do oooosite 227 Susy wirti own thing 226 Wall-off. nondisctose 225 Noncontingent reaction 224 Oetacn. weeo *one 223 Refuse assistance, care 222 Ftee. escaoe. wimdraw 221 Desperate protest 230 -Wa/v. feartul 231 Sacrifice greeny 232 Whtne. defend, lustify 233 Uncomorenendina agree 234 Aooease. scurry 235 Sulk, act out upon 236 Aoatnetic comodance 237 Follow rules, proper 238 218 Own identity, standards 217 Assert on own <!16 "Put cards on (ne taole" 215 Ooenly disclose, reveal 214 Clearly en press 213 Enthusiastic snowing 212 Relax, flow, enioy 211 Joyful aooroacn — 210 Ecstatic response 241 Follow, maintain contact 242 Acceot earetakmg 243 Ask, trust, count on 244 Acceot reason 2*5 Take m. learn from 246 C1 ing, depend !47 Offer, overconform 248 Submerge into role Yield, submit, give in 240 320 Happy -go-lucky I N T R A P S Y C H I C Introject of OTHER to SELF Orif t with the moment 328 Neglect options 327 Fantasy, dream 326 Neglect own potential 325 Undefined, unknown self 324 Reckless 323 Ignore own uasic needs 322 Reiect. dismiss sett 321 Torture, annihilate self 330 " Menace to self 331 Oram overburden sett 332 Vengeful self Dumsh 333 Oece.v*. divert self 334 Guilt, biam*. baa wit 335 t Oouot. put seit -lown 338 Restrain. h 0iu self 337 ptnw propriety 338 318 Let nature unfold 317 Let self do <t. confident 316 Balanced self acceptance 315 Explore, mten to inner self 314 Integratea. ioud core 313 Pleased with self 312 StroKe. soothe sett * 311 Entertain, entov self T™~ 310 Love, cherish self 341 Seek Dest tor self 342 Nurture, restore self 343 Protect self 344 Examine, anatvje t«if 345 Practice. Oecome accompnsned 346 Self oamoer. <nou*oe 347 Benevolent eve on seif "148 Force 'deal identity Control, man ape self 340 Figure 1. P u l l version of the SASB model. 108 c l a s s i f i c a t i o n s of interpersonal and intrapsychic behavior can be made on the basis of only 3 decisions: Focus, amount of a f f i l i a t i o n , and amount of interdependence (see te x t ) . Identifying the 3 underlying dimensions and arranging them according to the structure shown i n this Figure also permits a number of inferences. Examples include predictions of what w i l l go with what (complementarity), what w i l l draw cut the opposite of what you have now (antitheses), and the connection between the s o c i a l milieu and the self-concept ( i n t r o j e c t i o n ) . From "Structural ana Syria of d i f f e r e n t i a t i o n f a i l u r e " . Psychiatry, 1979, 42, 1-23. Copyright 1979. William Alanson White Psychiatric Foundation. Reprinted by permission. 128. Inataad o l galling wound M do what ha or the raally naodi lo do tor him or harMlt. f toll htm or harMl go •nd lull daydr imi 126 I nagtacu him 01 harMl. doatn'i try 10 davatop good •ktllt, m  v i a l bain*. 324. I « n o r n and doatn't boih«r 10 know (tit or hot raol M*l 321 I It rackkw; I caralauly k i t him or hotwll end up In Mil-datirucilva uiuallona. I 127. I lu l l toil Important perianal maiari. chokaa, thought!, b u N alip by without paying much auaniton. 321. I M i h m oi harMl dril l with i h * rnomaril; 8 hat no irttarnal direction, goal* or uendardi. 320. S Ian him or harMl Juu 90 along with today aa II la, and doatn'i plan lor tomorrow. 111. Without concern, 8 |uil lata him or ha*tall ba l»aa 10 lurn into whaiavar ha 0* aha wi* . 317. t Iraaly. aui ly and confidently Ian him or haraall do whatever comat naiurally. S P O N T A N E O U S S E L F 322 321 E««n whan ii meant harming him or haraall greatly, t tali hi* or har own tick net t and Injury to unaiiandad. . S anajfily and harthty rejecti him or heriell at wot thlen. and leevet what happent 10 110 laie 330. 1 tan him or haisall mutda>. kill, daitioy and raduca him o< hat tell to nothing. 331 I think 1 up wayi to hurl and demoy him or hartall. I ii | ' i own worn enemy. 332 I taari away at and ampliat him or harjafl by greatly Overburdening him or haraall. 333. 8 harihly punithet, torture*, "tadat It out" on him or har tall. 334 1 maker him or harMll do and ba things which ara known 10 ba no I riohi lor t S lool i him or haraall. 338 8 accusal and blamat him or harMll until 8 laali guilty, bad and aahamad. 136. t pul l him or har Mil down, t i l l * him or haraHt thai iha or ha hai dona everything wrong and lhai oihari can do bat tar. 318 Knowing both hit or har leolit and iirong polnU. t comfortably lata him or harMll ba "aa i t " 318. S comlorubly Ian him or harMll haar and go by hit or har own daapaat innar leeilngi. 314. 8 undartundi and Ukea htm or harMll |utt at ha or tha Il 8 'nIi aolld. "together." 313. S lati him or harMll laal glad aboul and pleated with him or h « M l l iuti at 8 « . 312. 8 gently and warmly w o k e * and appreclatee him or har-Ml lor Jut 1 baing him or harMtf. 311. 8 Wiaa him or harMl wary much, and laalt vory good whan ha 01 aha hat a chanca 10 ba wih him or har-Ml. 310. 8 tenderly, lovingly charlthaa and adorat him or haraal "at Ii." 341. 8 keep! him or harMl open to connecting wlh people, placai or ihingi which would ba vaiy good lor 8. 342. 8 naturaly and aaity provide! lor. nurturaa and lafcei Cart ol him or harMlt. 147. 8 keepa en aya on him or harMl to ba aura 8 tadoing what ihould and ought lo ba dona. 348. 8 iriai vary hard to make him or harMl ba like an idaal. 140 8 hat tha habit ol keeping wary tight control ovar htm 0« harMl 138. 8 puti all fctndi ol energy inio making ture 8 lollowi tha right nandafdi and it propar. 117. Svaryura lu l l y we it net holdi back and rattralni him or hartall. 143. 8 comlortably looki after hit or har own Inter**: it and protacti him or harMlt. 344 Secauee 8 wantt 10 halp him or harMl. 8 iriat 10 ligura out what u raally going on within him or harMlt. 34S. 8 practical and worki on davalopingworihwhlia M i lk , wayi ol bains 148. 8 pun a lot ol anarffy into figuring out what 8 it going to naad lor him or harMl and how to gat II The SASB model, intrapsychic focus: imroject (!) of other to self. Sec Figure 4.2a legend for explanation. Figures 4.2a, b, and c each show three levels of complexity *>f the SASB model: the quadrant version (4 categories), the cluster version (8 categories), and the hill version (36 categories). O 1979 by the William AJanson White Psych 2 TIC Foundation, Copyright on the cluster model has been registered by INTREX Interpersonal Institute, Inc., 1981; copyright on the questionnaire items, b, Lorna Smith Benjamin, 1983. Reprinted by permission. I 126 S toil doesn't noiica 0* pw f Wt»rtIiOfl IO 0 | l til 125. S nagltcu 0 . O i Intwatu » n d i . 124. S ignotai lha lacit and oi l v i 0 unttaliawbia nontanM and ctajinau 123. Jui l whin S b naadad m a m. % itMnrjora 0. l u m 0 • lo»« With trouble. 121. S 'o<0ail »U about 0. ir*w *g>Mm«i ' i l . £>Uo>. t2fl Without concatn. S t a u 0 to and ba anything, at ail. 120 S peacalulty leawt 0 complaialv on hi io) ha* own. I I 9 S laawi 0 liaa IO do and b> whjtavai 0 thinki ti ba«l. I If. Bal-wing 0 do*» thing* wall. S leave* 0 to do irnm hit Oi he* own way. 122. S angrily laavtt 0 to oo without waiat 0 naadl vary much awn whan S aaiily could giva .t to 0. 121. S angrtly l u m 0 CKJl. S co<np**iai r raluaa* to hay* anything (•> Oo wtlh 0 . 130 S murdari. kilU. datt/ayi and l a a * » 0 as a wtatcti haap. 131 looking v « y maan. 5 loltowi 0 and III * * i© ho*i 0 . 132. S rip* O o f . I tan, ttaaJl. giabi a* ha « the can licxn Q. 133 S hatihly punitna* and W t u ^ 0 . Ujtetlewnge. 134. S miikad* O, di»QuiMi th**9*. I I W w i h i M 0 o i l Hack 135 S accum and bUmt i 0. S V «a» IO OM 0 10 bahaw and tay O it mor<Q I 36. S pul l 0 down. ialh> 0 or ha* x i y i aia wrong, and S'l wayi a<> baiter. 116. S ton 0 tpaafc liaaly and head 0 awn il I hay diiagiM 115 S '«a'ly Iviafi 0 , acknowtadoai 0 » viawt even II I hay d>W9>aa. 114 Sclaa«lv undwatendaO and UkeaOavan whan iha> diaapea. 113. 8 hkat O and thinki 0 » I ma juil a* 0 ia. S gently, lovingly mokat and tootha* O milhoul aaking lor anything in raturn. 111. Full ol happy amllat. S lovingly graati O |vMt aa O ia. 110. With ganily loving tandarnau. S uarutmcu MMually il O taamt (o want i i . 141. S waimly. chaadully inviiat O lo ba in touch with S at olttn at Q w*ni i 142. ft providei lot. nurture*, ukat cata ol O . W A T C H I N G A N D M A N A G I N G I _ J Z . 147 Btliaving it'i raally >o> O l own good. $ chacki olian on O and i amindi 0 o' what inould ba dona. 146 Behaving ha or the raally knowt what U ban lor 0. S talli 0 n a c i l y what lo do, ba. ihinfc 140. & contioli O in a maitai -ol l ao May. S hai I ha habit ol Ukino cha'ga ol awrything 136. S make* 0 follow hit or her rulai and ld*ai of what tl rtght and propar, 131. S built In and u a a i ovar. blocki and raiuicit 0. 143. 3 lovingly looht »IIM O'I interem and ukaa napa io p*0iati O S aciivaly backi O up. 144. Wuh much kindnaii and good tanta, S dotwa* out and • •pla*ni ininot lo 0. M 5 . S gait 0 i n t i m i t d and laachet 0 how io undar iund and do i hi not. 146. S payi CIOM attaniktn t o O t o l can ligura out all ol O' i naadi and take caJB of avaiy thing. The SASB model, interpersonal other (O) focus. The quadrant version appearing at the center of the figure simply divides each rype of focus into four sections. The middle ring provides names for eight clusters or subdivisions for each type of focus. The outer ring contains eight boxes corresponding to each of the eight clusters; the boxes contain 1983 questionnaire items for each of the model points from Figure 4.1 belonging to a cluster. The clusters arc numbered from I to 8, starting at 12 o'clock on the top of each surface and proceeding cl(xk.wise. Familiarity with cluster numbers is important in interpreting the cluster profiles to be described subsequently. The quadrant model is from "Structural Analysis of Differentiation Failure" by L. S. Benjamin, Psychiatry, 1979, 42t 1-23. €> 1979 by the William Alanson White Psychiatric Foundation. Copyright on the cluster model has been registered by INTREX Interpersonal Institute, Inc., 1981; copyright on the questionnaire items, by Lorna Smith Benjamin, 1983. Reprinted by permission. 1 276. S n too Owiy end alone with hit or hat "own thing" to ba with O. 275. S walli turn or hertell oi l horn 0: doesn't haar. ooe-sn'i 274. $ i tacit to what O says or does in i n inge. unconnected, ufa leted wayi. 223.. S b-itnty. angrily detechat l i s m O and doatn'i ask ft* anyiMng S weep* alone about 0. 222 S Iwtoutly. angrily, hatefully (*lut*i 10 eec*p< O't ollart w naip out 721. 6o<l<ng o v * with rage and/or laer, S trie* lo t t d M . IUa. o> h*da I ron 0 . 230 In or**i pain and reoa, S screami and shouti that O n o « t l ' O v ' n 4 him or har 731 S * v**r tenia, theky. we*y, fearful with 0. 232 S b ' t in ly . hatefully, i tu rn fully chootat to Ml 0 » ne*dt *nd vutnu count mora then hit o> ttci Own 233. & *ah>nci. unhappily proict i i , met to defend him or hcrul l l iom 0 224. Full o> doubt I and u n n o n , S tori o ' goat along with O't v«#wt anyiway. 23V To awotd O't diMPpiovel. 5 boittet up h*» or har faoa and mcn iman i . 236 S ce«*t >n to 0 *nd do*t ihtnfjt O't #.«y. bul S tulfci and l u m r i about ii. 227. To do hn or har own thing. S does I ha oppotii* ol what O wenit. 22ft. S goat hit or ha* own tape* at* way apart l iom 0 220. S lieely comet and goat, doe* hit or har own thing eeperetily l iom 0. 218. S hat a clear tenae ol wtio he or »ha it seoeteiety from O. 217. S speeM up. cUaily and 'vmly u t i n hit or har own tepe'ate pontion. A S S E R T I N G AnO S E P A R A T I N G 218. S •! U'atCjhtlotiMerd. tiuthlul and clear miih O about S i own pot >t ion 21 f» S t i » « l v and openly talk* with O about hit or har innermost tall. 2 M . S e«pf *tt*t him or hat Mil cleat ly tn a warm and litandly way. 21 3. S it fOylui. happy and wary open wilh O. 247. S checkt with O about every l u d * ihmg because S caiet to much about what 0 thinkt 2*8 S taelt. thinks, do*t. becomei whai ha o* tha ihmki O wmit . 240. S in to 0, y>*kJi and tuhmut to O 238. S mimlieitly oti«vi O't twin, miv ia id i . Kfroi about how Ihingt ihouliJ be aona 237. S givei up. helulettly do«t i fungi O l may without laadngt Of viewt o' hit o< he* own 217. S i i U i i t . I*ti go, enioyt, lealt wonderlul about being w . tnO 211. S it "*«y happy, playful, |0ylut. delighted 10 belwith 0 210. S joyfully, lovingly, very happily retpondt to 0 teaually. 241. S w » m l y . happily nayt around and kaapt m touch wi l t O 2*2. S warmly, comfortably accept! O't help endcereonnnf. 243 S *l trusting with O. S comfortably counti on 0 to coma through wh«n needed. 744. S willingly accapit, go*t along with O't reasonable lugotitiont. Kleat. 245 S learnt l iom O. comfortably lata* advice and guidance f iom 0 248 S trusting** depandt on 0 to matt every need The SASB model, interpersonal sell (S) focus. Sec Figure 4.2J legend liir explanation €J 1979 by the William Abnsnn Wliiic Psychiatric t-oundaiion Copyright on the cluster model has been registered by INTREX lntcr|>crsoiul Institute, Inc., 1981; copvright on the ipicsiionnairc items, by l.onu Smith benjamin, 1983. Reprinted bv permission. 

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