La tanière et le territoire : esquisse d’une topo-analyse des troubles du comportement alimentaire

Abstract

ObjectivesClinical and phenomenological exploration of the manner in which patients with eating disorders inhabit their dwellings. MethodsDiscussion of a series of four adult patients treated in long-term psychotherapy. ResultsWe describe two distinct, interrelated modes of dwelling: the den and the territory. The territory is the parental home, where the patients grew up; the den is the current place of living. The territory is an arena of rivalry and conflicts with parents and siblings. Patients have a strong attachment to the territory, exerting a sharp surveillance through frequent inspection visits, with violent reactions to changes happening in the house. Even in their absence, they haunt the territory. In contrast, the den is a place where they disappear, severing all links with the outside world and abandoning themselves to binge eating. The den is an escape from the demands of social relationships, painfully experienced as intrusions or the threat of desertion. ConclusionsEating disorders, because they are related to fundamental difficulties in the processes of emancipation, result in specific, altered modes of dwelling. These alterations are mutually reinforcing, and can be understood as pathological solutions developed in response to difficulties in the emancipation process. Systematic, empirical studies would help to shed more light on modes of dwelling in eating disorders. These aspects of the patients’ experience should be included in clinical care.