Psychopathology of anorexia nervosa: a defence from depression. An interpretation according to Massimo Fagioli’s Human Birth Theory – two case reports
Notice bibliographique
Résumé
This paper focuses on anorexia nervosa with an emphasis on its onset and treatment, and it particularly addresses two aspects of the disease, which seem completely in contrast with one another – prolonged fasting and recurrent episodes of binge eating/purging behaviour. From a psychopathological viewpoint, these can be considered two symptoms of the same disease, whose psychopathological core is often depression. The anorexic phase is characterised by control of food intake and interpersonal relationships due to a paralysis of affections and mental rigidity, which often provide a schizoid defence against depression and sometimes against fragmentation. In the bulimic phase, a break in this defence reveals violent and uncontrollable affects beneath depression. One possible hypothesis to evaluate would be whether these alternating phases can be overcome if they are interpreted as a false resolution of an intrapsychic conflict as defined by Fagioli’s Human Birth Theory, based on a psychic defence reaction that may arise in newborns, and which he termed annulment pulsion. If pathogenic factors are present in the first year of life, the annulment pulsion may become pathological and can explain the psychosis in anorexia nervosa patients. This paper presents two clinical cases involving two young women, one suffering from anorexia nervosa purging type with self-induced vomiting complicated by comorbid drug abuse and the other suffering from anorexia nervosa binge eating/purging type and comorbid drug and alcohol abuse. Both were successfully treated with psychodynamic psychotherapy (individual and in groups) based on the interpretation of dreams according to Human Birth Theory, which posits that a dream is a thought expressing itself through images. The patients were treated for 4 and 5 years, respectively. The scores on three standardised tools, Eating Disorder Inventory-3, Symptom Checklist-90-Revised and Toronto Alexithymia Scale, administered before and at the end of treatment, accurately reflected their baseline condition and their clinical improvement. The treatment induced a reduction or resolution of symptoms and a qualitative improvement in the patients’ oneiric activity. The encouraging outcomes for these patients support the interpretative hypothesis proposed in this article and the value of the approach based on Human Birth Theory in treating anorexia nervosa. Further work on the subject is clearly warranted.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».