ANOREXIA NERVOSA: A PSYCHOLOGICAL BIRTH ANOMALY (SEPARATION INDIVIDUATION, PSYCHOANALYTICAL, DEVELOPMENTAL PSYCHOLOGY, BORDERLINE PERSONALITY DISORDER, OBJECT RELATIONS).

摘要

The objective of this study is to describe the phenomenological experience of the anorexic, and to analyze that experience with the intent of understanding when and how the anorexic experienced conflict, why she chose such destructive measures to resolve her conflicts, and how these choices affected her further development. The emphasis on development of ego structure of the anorexic rather than on the late stage symptomatology is directed toward determining a clearer understanding of the "pre-existing, underlying disturbance" (Bruch, 1974) of anorexia nervosa. Because recognition of pre-morbid symptomatology, etiology, ego structure, treatment, and definition of cure are all essential to diagnosis, each of these areas is treated in the study.;The findings of the study support the contention that anorexia nervosa is much more than "dieting gone wild" (Bruch, speech, 1979), and that each young woman has serious ego structure problems; that her choice of symptomatology is an adaptation to her family milieu; that faulty separation/individuation can explain the pre-morbid and morbid symptomatology of aloofness, constipation, refusal of food and hyperactivity. Findings also indicate why there is a preponderance of women with anorexia nervosa over men and why there is a growing number of reported cases.;Recommendations emphasize the need for recognizing anorexia nervosa not as an eating disorder of the pubescent young woman, but as a personality disorder resulting from the failure in the parenting of the anorexic from the first days of her life. It is suggested that studies be instituted to determine how best to raise the role of mothering to the prime importance it deserves for the health of society. Finally, recommendations are made that more emphasis be put into educating professionals and lay people on the evolutionary demand of the altricial human infant, and the specific demands which must be met for a successful psychological birth.;The method employed is case study/participant-observation. The researcher worked as a clinician with three anorexic young women. The transcripts of their therapy sessions are analyzed using psychoanalytical developmental theory as delineated by Blanck and Blanck in their Descriptive Developmental Diagnosis (1974).