Anorexia Nervosa: Historical, Clinical, Biographical, and Phenomenological Considerations

Abstract

Anorexia nervosa (AN) just appears at the end of the nineteenth century. It was a seldom disease till the second world war. After this, its frequency is gradually increasing. At least in the Western world, it has become a public health problem among young women. After a detailed description of its short history, the authors first attempt to do a psychopathology that goes beyond the classical descriptions, finding probably new manifestations such as intellectualization, eagerness to control, fragmentation of the body experience and a series of paradoxes which point to the essence of this disease. A third chapter is dedicated to the family structure and dynamics of AN, on the basis of several studies carried out by one of the authors (O. D.-Z.). Another chapter deals with the premorbid situation. The authors think to have found two forms depending on the age of onset: one which breaks out with the beginning of puberty and the other group, which has a later onset, mostly related to a maturity step, such as the end of studies or the beginning of work life. Finally, the authors attempt an understanding of the relationship between anorexia nervosa and postmodernity. So, they found essential links between anorexia nervosa and at least three fundamental features characterizing postmodernity: the power of technique, the obscenity and the loss of religious sense of existence. Concerning obscenity, it does not deal with the progressive tendendy to eliminate every form of shame, but rather the fact that our world is dominated by the sense of sight and desperately searches to look at the objects in the most minute detail, from all possible angles; and nothing can be more obscene than the body of the anorectic. In both cases, when the anorectic patient shows her cachectic body or when she hides it with enormous gowns, she is in a scene. There is here an absolute predominance of the appearance, the rule of the image, that is, obscenity.