Family meal as therapy

I have few T-shirts with words or pictures on them, preferring simple solid colors instead. But there’s one I couldn’t resist, and my family loves it….the blue one with a drawing of a little house and a family sitting around a dinner table with the caption “Value Meal”. I wore it on Father’s Day evening at the family table in the rare instance that we were all together. The value of that goes deeper than we think we know…

A few years ago, Time magazine did a fine piece on ‘The Family Meal’ that so captured my attention, I’ve shared it in print and on radio time and again to reinforce the message.

This is where the tribe comes to transmit wisdom, embed expectations, confess, conspire, forgive, repair. The idealized version is as close to a regular worship service, with its litanies and lessons and blessings, as a family gets outside a sanctuary.

That ideal runs so strong and so deep in our culture and psyche that when experts talk about the value of family dinners, they may leave aside the clutter of contradictions. Just because we eat together does not mean we eat right: Domino’s alone delivers a million pizzas on an average day. Just because we are sitting together doesn’t mean we have anything to say: children bicker and fidget and daydream; parents stew over the remains of the day…

Yet for all that, there is something about a shared meal–not some holiday blowout, not once in a while but regularly, reliably–that anchors a family even on nights when the food is fast and the talk cheap and everyone has someplace else they’d rather be. And on those evenings when the mood is right and the family lingers, caught up in an idea or an argument explored in a shared safe place where no one is stupid or shy or ashamed, you get a glimpse of the power of this habit and why social scientists say such communion acts as a kind of vaccine, protecting kids from all manner of harm.

And healing them when they’ve already become wounded. This story was front and center on Tuesday’s Chicago Tribune.

War broke out on the day Rina Ranalli and her husband told their 12-year-old anorexic daughter the strict new house rules: three meals and three snacks a day.

Initially, their bright and previously sweet-natured girl cried, screamed insults and raged. She threw things. Punched holes in the wall. And she pretended to eat while plotting ways to hide the food. But when the seventh-grader realized her parents had her trapped — they would sit with her 24/7 if they had to — she ventured down the only available path. She began eating.

Chicago’s Ranalli family was using the little-known Maudsley Approach, a grueling but evidence-based treatment for adolescents suffering from the eating disorder anorexia nervosa. The approach, also called “family-based therapy,” flips conventional treatment on its head.

Family meal as treatment for disorder. Something so fundamentally tribal and ancient as that has resurfaced as a revolutionary approach to dysfunction. Plenty of young people suffer anorexia, and there are plenty of treatment therapies.

But under Maudsley, parents immediately start the daunting task of “re-feeding” their malnourished child. Once weight is restored — and, theoretically, rational thinking returns because the brain has some nourishment — parents step back, and control over eating is gradually returned to the child. The final phase of treatment is the initial step in traditional therapy; it addresses the underlying psychological issues that may have caused the disorder.

And…

…Maudsley has something other remedies for anorexia do not: A modest body of clinical evidence suggesting that most adolescent patients respond favorably after relatively few treatment sessions. For parents, it’s a glimmer of hope for a serious illness still lacking a gold-standard treatment.

And that’s what it’s all about in the first place.