Approche psychanalytique de l’anorexie mentale

The essential difficulty of these adolescents suffering of anorexia nervosa lies within their personalities and their incapacity to deal with conflict. The relationships of these patients to others are similar to their relationships to food: both are often characterized by a paradoxical aspect: an alternating between a great eagerness for relationships and a capacity for isolation and withdrawal, with intolerance for loneliness; a great awareness of the attitude and the opinion of others; difficulties in regulating relationships and in finding optimal distancing; oscillation between an anxiety due to fear of separation and an anxiety due to fear of intrusion; the coexistence of exacerbated expectations concerning important people, along with the ability to be easily influenced, but at the same time a large capacity for opposition and an obstinate refusal of change. Globally these characteristics find a common ground in the concept of dependency. In all these patients there is a predisposition towards an exaggerated dependency on certain people in the outside world, especially parents with a lack of autonomy. The psychopathological significance of these conducts; its stakes, and its therapeutical consequences are discussed.