When speaking publicly about the topic of my most recent book I am often asked what could have possibly been my motivation for developing such a strange specialty as working with those with pituitary tumors and other neuroendocrine and endocrine disorders? I completely agree that upon first glance, the fields of endocrinology and neurosurgery have no relevance to Marriage and Family Therapy. However, when I tell the story of how I became interested in this there is a direct, logical connection. First, I not only met someone who had a pituitary disorder, but someone who strongly felt there was a mental health component (that was largely ignored by the medical community). So, a personal connection/relationship began to spark my interest.
As MFTs we are keenly attuned to the importance of human to human connections. When I decided to explore the topic further I discovered that hormones are part of a “system” within the body that connects to virtually all parts of the body, and this system is closely connected to areas of the brain affecting emotions. Next, I was horrified to learn that even today it often takes patients months to years (if they are lucky to find the right physician) to get proper medical diagnosis and even longer to find qualified specialists for treatment. The idea that patients and their families are so intensely impacted by these disorders and yet cannot find help seems impossible in a modern age. Lastly, after talking to hundreds of patients and their family members worldwide I was struck, as a therapist, by the impact that disorders of the endocrine system have on the external family and social system. It was this internal/biological system’s impact on the external family/social system that gave me the impetus to delve into learning about such a highly specialized medical world.
Students of Marriage and Family Therapy are taught to stay within the boundaries of their license and not to practice outside their expertise. But, how is one to gain expertise if not to stretch beyond the zone of comfort? In this brief missive I am not going to attempt to answer this important question but will say it is something I had to face in the early years of developing my unique area of specialty. After practicing over thirty years now I have witnessed an overall growth in the depth of the MFT profession that includes a wider array of options for use of systemic theory and concepts. This also includes opportunities to bring a systemic and family therapy understanding to those who would never have previously thought it could apply or be helpful.
When I first began my work with pituitary/endocrine disorder patients and their families, the physicians I came to know would refer to me as a psychiatrist or psychologist. Rather than let this lie, I gently and briefly began to let them know the differences among the mental health professions. I have also had wonderful opportunities to reach a wide audience through writing/editing books (with contributions from world-renown physicians, patient advocates, medical family therapists, and patients) as well as online newsletters, blogs etc. Not only have I used such opportunities to provide education/support about a wide array of endocrine disorders, but conversely to inform readers about MFT and systemic thinking as it may apply to family and social dynamics of serious and/or chronic medical illnesses. I encourage MFT students as well as seasoned professionals to seek-out potential opportunities to use and teach MFT concepts to those outside the walls of a psychotherapy practice or graduate program specific to MFT.
Linda M. Rio, MA, MFT co-authored a book with her daughter, Tara, on eating disorders and her most recent book, The Hormone Factor in Mental Health: Bridging the Mind-body Gap, includes contributions from some of the world’s top experts in endocrinology, medical family therapy, nutrition, case studies and accounts from patients and their family members. She has served AAMFT in a variety of roles in her division and nationally. She has been married for 47 years, has two children and 3 granddaughters who are now in college. Find her at www.lindamrio.com.