Academic journal article International Journal of Psychoanalysis

Three Boys and Their Stories: Atypical Eating and Primitive Relations1

Academic journal article International Journal of Psychoanalysis

Three Boys and Their Stories: Atypical Eating and Primitive Relations1

Article excerpt

Eating disorders of whatever category, especially the most severe ones such as anorexia or bulimia, are often considered typical of the female sex. While this is correct concerning these two disorders, I suggest that there are other eating disorders that are more frequent among boys, especially the ones concerning atypical relations to food, notwithstanding the evidence that the already very well-known syndromes of bulimia and anorexia are also gaining ground among males. However, similar, unspecified eating disorders do not seem to occur so often among girls. Clinical data from my private practice should be taken for granted considering these matters, since I do not yet have statistical data to back up my thesis. In examples from three clinical cases involving boys and one female vignette, I shall attempt to establish a relation between eating disorders and primitive relations with men and women. This relation goes well beyond the oft-cited 'contemporary' causes of eating disorders. In addition, I shall situate these differences among symptoms of both sexes and relate them to impasses in different stages of emotional development, as well as to the extent to which girls' identification with their mother's sex can influence their acquisition of eating disorders.

Keywords: defences with perverse characteristics, depressive position, eating disorders, imprisoned in one's body, mother's body, paranoid-schizoid position, partial objects

Eating disorders are, to a great extent, attributed by contemporary media and taste patterns to the vicissitudes coming from constant pressure mainly upon girls, where anything beyond the equation that thinness equals beauty should be rejected, even at the risk of one's health or, indeed, one's life.

Pychoanalysis can offer us better and more profound understanding, concerning these matters, than the media, which influences contemporary ideas and cultural patterns. The power of aesthetics over men and women is neither unheard of nor exactly contemporary. Bruch (1974) reminds us of the scorn obesity aroused in the ancient Greek and Roman courts. There, men and women were subject to the same pressure we believe to be peculiar to our times. They stimulated their epiglottis with long feathers and brought on vomiting so as to go on with what was assumed to be the unending, ineffable pleasure of ceaseless eating. This activity was in tacit agreement with the orgiastic activity associated with these banquets. We could also consider the act of eating Rabelais described at Pantagruel's banquets, who controlled his audience by celebrating abundant food and fun. Eating has always been linked to other impulses and needs beyond those of bodily nutrition.

Whereas anorexia and bulimia are pathologies fundamentally related to the female sex, some information should be added to this picture. The Bulimic and Eating Disorder Clinic at São Paulo's Hospital das Clínicas (Ambulim) in its first 14 years of existence registered only five eating disorder cases among males. Today it has 16 males in treatment.2 One can find data regarding an increase in clinical treatments of men internationally from their website - http://www.ambulim.org.br/ Their statistics data show an increase of 5 to 15% for eating disorders in adult men between age 18 and 26. These data should not be considered mere international journalism. In addition to the private clinical experience of our colleagues who deal with eating disorders, several other sources concur, for example, the Center for Eating Disorders and Obesity at Rio de Janeiro's Santa Casa de Misericórdia (NUTTRA). It registered clinical evidence for a five-fold increase of male anorexia between the years 2002 and 2003. The challenge to formulate something new in understanding eating disorders in men will probably be huge, since there are no research statistics available at this time.

On the other hand, even if clinical data suggest a change in patterns of eating disorders, I certainly agree that the data are not so striking that one should consider anorexia / bulimia to occur haphazardly among men and women. …

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