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A Psychosomatic Approach of Anorexia Nervosa

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Person Centered Approach to Recovery in Medicine

Part of the book series: Integrating Psychiatry and Primary Care ((IPPC))

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Abstract

Based on the literature review and on experiences with clinical cases, this paper presents a psychosomatic approach of anorexia nervosa. Psychosomatic is defined here as the entanglement of a double formation of symptoms: somatic symptoms on the one hand and psychological symptoms on the other. Are considered psychosomatic, psychological functioning favoring a somatic symptom or impacting its evolution. Coming within this scope, the psychosomatic school of Paris (Marty in particular) described operational thinking as a form of thinking frequently associated with psychosomatic disorders corresponding to this global definition. This paper shows that this form of thought can be seen as a failure of integration of the imaginary and affective life. By several aspects, operational thinking overlaps with alexithymia as described by Sifneos and the Boston School. The consequence of operational thinking functioning is a personality, often rigid, leaving little space to fantasies and to psychic elaboration. This functioning induces a body unbalance due to the arousal that cannot be elaborated otherwise, particularly during adolescence. The main aim of this paper is to consider if the approach proposed by the psychosomatic schools can have a clinical interest in the understanding and the cares of adolescent patients with anorexia nervosa.

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Notes

  1. 1.

    The notion of “mother” involves, in this context, much more than the sole person of the mother; the concept of “mother-environment” has been proposed by Winnicott to define all of the infant’s caring environment, generally, but not always, represented by the biological mother or the main caregiver but involving also other caregivers who are not differentiated from her. In this paper, the term “mother” refers to this Winnicottian concept.

References

  1. American Psychiatric Association. DSM-5: diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Publishing; 2013.

    Book  Google Scholar 

  2. Marty P. La psychosomatique de l’adulte. Paris: Presses universitaires de France; 2011. 126 p.

    Google Scholar 

  3. Marty P, de d M’UM. La « pensée opératoire ». Rev Fr Psychosom. 2016;6(2):197–208.

    Google Scholar 

  4. Sifneos PE. The prevalence of ‘Alexithymic’ characteristics in psychosomatic patients. Psychother Psychosom. 1973;22(2–6):255–62.

    Article  CAS  PubMed  Google Scholar 

  5. Marcelli D, Cohen D. Enfance et psychopathologie. Issy-les-Moulineaux: Elsevier Masson; 2012. 672 p.

    Google Scholar 

  6. Kreisler L, Fain M, Soulé M, Lebovici S. L’enfant et son corps : études sur la clinique psychosomatique du jeune âge. Paris: Presses universitaires de France; 1974. 516 p.

    Google Scholar 

  7. Alexander F, Baendek T. La Médecine psychosomatique, ses principes et ses applications. Paris: Payot; 1967. 256 p.

    Google Scholar 

  8. Jadoulle V. Les dérives de la pensée psychosomatique. L’évolution Psychiatr. 2003;68(2):261–70.

    Google Scholar 

  9. Roussillon RAD de la Publication, Brun A, Chabert C, Ciccone A, Ferrant A, Georgieff N, et al. Manuel de psychologie et de psychopathologie clinique générale. Issy-les-Moulineaux: Elsevier Masson; 2014.

    Google Scholar 

  10. Corcos M, Atger F, Jeammet P. Évolution des approches compréhensives des troubles des conduites alimentaires. Ann Méd-Psychol. 2003;161(8):621–9.

    Google Scholar 

  11. Aulagnier P. La violence de l’interprétation : du pictogramme à l’énoncé. Paris: Presses universitaires de France; 1991. 363 p.

    Google Scholar 

  12. Spitz RA. De la naissance à la parole : la première année de la vie. Paris: PUF; 1984. 306 p.

    Google Scholar 

  13. Winnicott DW. Jeu et réalité: l’espace potentiel. Paris: Gallimard; 2002. 276 p.

    Google Scholar 

  14. Brazelton TB. Points forts. I: les moments essentiels du développement de votre enfant. Librairie générale française: Paris; 2007. 607 p.

    Google Scholar 

  15. Garralda ME. Somatisation in children. J Child Psychol Psychiatry. 1996;37(1):13–33.

    Article  CAS  PubMed  Google Scholar 

  16. Lasègue C. De l’anorexie hystérique et Les exhibitionnistes. Paris: Théraplix; 1970. 35 p.

    Google Scholar 

  17. Jeammet P. Anorexie, boulimie: les paradoxes de l’Adolescence. Paris: Hachette littératures; 2011.

    Google Scholar 

  18. Anzieu D, Bowlby J, Chauvin R. L’attachement. Zazzo R, éditeur. Neuchâtel, Suisse, France; 1979. 250 p.

    Google Scholar 

  19. Freud A. Le moi et les mécanismes de défense. Paris: Presses universitaires de France; 1990. 166 p.

    Google Scholar 

  20. Green A. Narcissisme de vie, narcissisme de mort. Paris: Minuit; 2016. 384 p.

    Google Scholar 

  21. Grabe HJ, Frommer J, Ankerhold A, Ulrich C, Gröger R, Franke GH, et al. Alexithymia and outcome in psychotherapy. Psychother Psychosom. 2008;77(3):189–94.

    Article  PubMed  Google Scholar 

  22. de Tychey C. Alexithymie et pensée opératoire : Approche comparative clinique projective franco-américaine, Abstract, Resumen. Psychol Clin Proj. 2010;16:177–207.

    Google Scholar 

  23. Recommandations de bonne pratique. Anorexie mentale : prise en charge. Médecine Thérapeutique. 2012;17(4):334–61.

    Google Scholar 

  24. Botbol M, Mammar N, Barrère Y. Institutions soins etudes en psychiatrie de l’adolescent et du jeune adulte (Care and study institutions in adolescent and young adult psychiatry).

    Google Scholar 

  25. Selvini M. L’Anoressia mentale. Milano: Feltrinelli; 1963. xi+245.

    Google Scholar 

  26. Jeammet P. Réalité externe et réalité interne. Importance et spécificité de leur articulation à l’adolescence. Rev Fr Psychanal. 1980;44(3–4):481–522.

    Google Scholar 

  27. Brusset B, Widlöcher D. L’assiette et le miroir: l’anorexie mentale de l’enfant et de l’adolescent. Toulouse: Privat, impr; 1991. 274 p.

    Google Scholar 

  28. Minuchin S, Rosman BL, Baker L, Minuchin S. Psychosomatic families: anorexia nervosa in context. Cambridge, MA: Harvard University Press; 2009. 366 p.

    Google Scholar 

  29. Neuburger R. L’autre demande: psychanalyse et thérapie familiale. Paris: Payot & Rivages, DL; 2003. 195 p.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Child and Adolescent Psychiatry Department of the Brest University Hospital, University of Western Brittany, Brest, France

    Thibaut Lebailly, Stéphane Saint-André, Anne-Sophie Lancien-Dereine, Adeline Gourbil & Michel Botbol

  2. Psychologist, Child and Adolescent Psychiatry Department of the Brest University Hospital, University of Western Brittany, Brest, France

    Stephane Laplace

  3. Service Universitaire de Psychiatrie Infanto-Juvénile, Hôpital de Bohars, Bohars, France

    Michel Botbol

Authors
  1. Thibaut Lebailly
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  2. Stéphane Saint-André
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  3. Stephane Laplace
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  4. Anne-Sophie Lancien-Dereine
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  5. Adeline Gourbil
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  6. Michel Botbol
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Editor information

Editors and Affiliations

  1. Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy

    Luigi Grassi

  2. University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA

    Michelle B. Riba

  3. Inova Fairfax Hospital, Johns Hopkins University Inova Fairfax Hospital, Falls Church, VA, USA

    Thomas Wise

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Lebailly, T., Saint-André, S., Laplace, S., Lancien-Dereine, AS., Gourbil, A., Botbol, M. (2019). A Psychosomatic Approach of Anorexia Nervosa. In: Grassi, L., Riba, M., Wise, T. (eds) Person Centered Approach to Recovery in Medicine. Integrating Psychiatry and Primary Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74736-1_13

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  • DOI: https://doi.org/10.1007/978-3-319-74736-1_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74735-4

  • Online ISBN: 978-3-319-74736-1

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