Anorexia nervosa and the family: Effects on younger sisters to anorexia nervosa patients

The aim of this study was to describe and analyze the experience of the sister of the anorexia nervosa (AN) patient. This experience was examined in terms of the illness, the sister herself, and relations within the family during the course of coping with AN. A qualitative study method was employed in an attempt to understand the complexity and nature of a younger sister's subjective experience regarding an anorexia patient. Nine sisters of AN patients in the active stage of the illness were interviewed. Data were gathered through in-depth, semi-structured taped interviews and content-analyzed by using the layer system theory. The findings provide the sister's personal perspective in regard to her emotional experience in the shadow of the illness and in regard to the systemic processes that take place in the course of a family's coping with the illness. The findings are divided into six main content categories: (1) structural processes; (2) family dynamic processes; (3) emotional processes; (4) change in life functions; (5) body image; and (6) narrative of the illness. Two theoretical concepts are presented that analyze the reality of the sister as an individual and of the family as a system. The first concept relates to the illness as a new member of the family system. The second concept relates to the sister's emotional experience as one of duality. These two concepts underscore the implications of the illness in terms of placing the sister at risk of developing additional pathological symptoms. The present study provides an in-depth description, explanation, and analysis of the younger sister's experience, thus elucidating risks to her emotional and mental functioning. In addition, it opens a window to the world of a family coping with the illness, and clarifies processes of change taking place within it.