Fathers, daughters, and anorexia nervosa

The Paternal Function in Anorexia Nervosa

The role of the father, both flesh-and-blood and symbolic, is explored in a subset of families of patients with anorexia nervosa. In these families the mother's narcissistic investment in her child makes separation-individuation difficult. A factor potentially influencing whether the child goes on to develop anorexia nervosa is the strength of the paternal function, which optimally helps the child learn how to appropriately deploy his aggression in the service of separation-individuation and as a means of developing "the experience of agency": the phenomenological experience of oneself as having an intentional impact. The role of the paternal function in developing the experience of agency is illuminated by the metaphor of rough-and-tumble play, which encapsulates the kind of experience with early objects that facilitates or forecloses the child's capacity for experiencing agency. In the families of these patients, the father is frequently described as passive or absent and the paternal function as compromised, which arguably leads the anorexic-to-be to relegate his experience of agency to his body, which he subjugates through omnipotent control.

Paternity and Parenting in the Context of Eating Disorders: An Integrative Literature Review

Abstract Family relationships seem to have relevant contribution to the etiopathogenesis of Eating Disorders (EDs). This study aimed to analyze the scientific production about the paternity and parenting experiences of fathers whose daughters developed EDs. The literature review was conducted through the databases LILACS, PubMed, PsycINFO, Web of Science and EMBASE, in the period from 1999 to 2019. From the 878 retrieved papers, 23 were selected for the analysis. The results show that paternity and parenting experiences are influenced by father’s personality traits. The dominant representation is of an affectionless and not empathetic father, as well as punitive and insensitive to the daughter’s emotional needs. Knowing the paternal experiences is central to subside sensible care to both, daughters’ and fathers’ demands.

SYMBIOTIC ILLUSION AND FEMALE IDENTITY CONSTRUCTION IN EATING DISORDERS: A PSYCHOANALYTICAL PSYCHOSOMATICS’ PERSPECTIVE

Abstract: This study aims primarily to reflect on the role of symbiotic illusion in the construction of female identity in women with eating disorders (ED), using premises from psychoanalytic psychosomatics. Considering ED as psychopathologies related to the affective economy, Oedipal relations play crucial role in the process of identity constitution. Mother-daughter relationships in ED are shaped in the molds of symbiotic illusion, with weak father figures. We presented a case study to briefly illustrate the theoretical framework. The omissive posture of a father to interdict the symbiotic relation leads daughters to find themselves unable to libidinally invest in other objects.

Relação Pai-Filha e Transtornos Alimentares: Revisando a Produção Científica

Resumo Investigou-se a produção científica dedicada ao estudo da relação entre pai e filha com transtornos alimentares. Foi realizada uma revisão integrativa nas bases PsycINFO, CINAHL, PubMed e LILACS, no período de janeiro de 2000 a junho de 2014. Foram selecionados 27 artigos, a maioria proveniente de países europeus e constituída de estudos quantitativos. A vinculação pouco segura com a figura paterna e o relacionamento emocionalmente distante entre pai e filha foram aspectos recorrentes nas publicações selecionadas. Os estudos apontaram a importância de se investigar e assegurar a participação do pai no tratamento. Porém, nenhum dos artigos revisados investigou o envolvimento paterno no contexto da assistência. Destaca-se a necessidade de investir em estudos qualitativos e no contexto brasileiro.

[Nursing intervention in the family treatment plan for anorexia nervosa]

One of the main nursing interventions in the treatment of eating disorders is family psycho-education, an essential aspect of mental health treatment. This article describes and analyses the difficulties families expressed in the performance of a treatment plan for patients hospitalised for anorexia nervosa (AN) in the adolescent Day Hospital of Mental Health, of the Corporació Sanitària Parc Taulí, during 2009. Data was also collected data on professional interventions, performed by the nurse assigned to this unit, in order to group and categorise them, and as an aid to nursing intervention. A total of 10 families of the 10 patients admitted with a diagnosis of AN were included in the study period. In all cases, the patients were young women who had received treatment before in an Outpatient Unit, with partial or no response to the treatment. The difficulties expressed by the families were grouped into five categories from content analysis: problems in preparing a balanced diet, problems as they are unable to handle the behaviour and emotions of the patient, problems because as there are no previous family eating habits, problems because there is no family control or supervision, and problems with the established guidelines. Specific individualised interventions are proposed for developing and promoting a nursing care plan, and assessing the results.