While seeking to draw out the repetitive patterns in the current family experience, I also look for ways to connect present tensions to multigenerational themes.

Exploration of both parents' family of origin revealed potent themes that fed into the intense struggle of the nuclear family triangle between Tanya, her father and her mother.  While ever Mr Barret and Mrs Barret could worry about her, they did not have to address the relationship disappointments that they had hoped would be mended through their marriage.

A key task of ongoing therapy was to help the parents separate these unresolved family of origin issues from their interactions with Tanya.

Both parents had been in the same middle child position as Tanya, which had intensified their identification with her.  Reflecting on their own adolescence and their relationship with their parents helped Mr Barret and Mrs Barret to assume a more objective stance towards their daughter.

Mrs Barret was able to stop herself encouraging Tanya to look after her father following an argument.  Mrs Barret was also able to see how her striving to create a different relationship from the distant and critical one she had with her own mother was getting in the way of her being able to set any limits with Tanya.

Mr Barret was able to start viewing Tanya as a separate person from himself or his father and was thus more able to notice her unique strengths.  This shift was a particularly painful journey for Mr Barret, who recounted his memories of his alcoholic father, who had died in an emaciated state after choking on his own vomit.

The parallel to Tanya's symptoms helped to make sense of his intense reactivity in their relationship.

Tanya was able to hear that her parents' reactions were more about where they had come from than about what kind of a daughter she was.

During therapy she struggled to cope with the shift in family patterns.  She was excluded from the triangle with her parents where she had occupied a pivotal role in helping to regulate their closeness.

To assist with this shift, some sessions were held with her and her older sister Roslyn, so that the sisters could establish a connection as young adults sharing similar life cycle tasks, rather than being their parents' caretakers.  A couple of months down the track, she mentioned that she had been writing to Roslyn and that they were sharing information about boyfriends that their parents were not privy to.

After about five months of therapy, her weight had increased to a level which put her out of the medical risk category.  At this time Mr Barret and Mrs Barret felt that they wanted to focus on some of their own family of origin issues as a couple and individually.  Tanya was busy rehearsing for a school play in which she had the female lead, so she asked if she could take a break from family sessions and let her parents come on their own.