Educative Treatment of Patients and Parents in Anorexia Nervosa

Extract

Although there is now universal agreement that the reduction of food-intake is the central phenomenon in the syndrome of anorexia nervosa, the cause of the food refusal is still incompletely understood. One of the difficulties in elucidating the psychogenic roots of the anorexia is the fact that the patients themselves are unable to explain their thoughts and feelings. Conversations with them give the impression that one is speaking to a very young child who cannot or dare not express herself, so that the interviews are reduced to monosyllabic answers to questions and long periods of silence without relevation of pertinent material. After having spent much time with such patients in the past, we have since tried to obtain additional information from parents and other family members, neighbours and family doctors who knew the patients and their environment. Although we are well aware that this kind of information pertains more to outward behaviour than to “endopsychic” processes and therefore will probably be considered as of limited value by those who are interested in the so-called psychodynamics of the disease, we were able to formulate at least a tentative hypothesis that seemed to fit the life situation in our patients and bring them under a common denominator. From this hypothesis, which will be formulated below, a simple prediction followed as to how these patients should be treated. In the present paper we wish to formulate the hypothesis and present the preliminary results of a form of treatment, based on this prediction.