Anorexie mentale et problématique familiale

Abstract

The etiological factors associated with the syndrome of anorexia nervosa are heterogenous. This pathology which is connected with adolescence and the effect of the onset of puberty has in particular been associated with narcissistic disorders (notably the concept of negative narcissism), leading to behavioral disorders. Although some studies have examined the role of the parents’ personality in the etiology of this disorder, only few studies have focused on certain specificities of family dynamics. The functioning of the family group can thus lead to an intergenerational lack of differentiation, and an intense interactivity that is fostered by an incestual bond. On the basis of a case study in which a multifocal treatment approach was adopted, we have analyzed how traumatisms, the suppression of mourning and loss at the parental level can be responsible for the development of an intergenerational lack of differentiation. This results in an impossibility to integrate the sexual element during adolescence: sexuality is viewed as a threat by the anorexic subject. The trauma associated with puberty is intensified by a particularly stimulating and exciting reality, i.e. that of a continuing state of narcissistic seduction. It is therefore necessary to determine what prevented the initial expression of mourning and loss which could have instigated a first separation with the primary object. From this viewpoint, a multifocal approach is advocated so that the symptoms of the young adolescent and their relation to family history can be more widely investigated and understood.