Beresin E V, Gordon C, Herzog D B
Child Psychiatry Service, Massachusetts General Hospital.
J Am Acad Psychoanal. 1989 Spring;17(1):103-30. doi: 10.1521/jaap.1.1989.17.1.103.
The authors describe the process of recovering from anorexia nervosa as it is revealed by 13 women who have recovered from the illness. Emphasizing the patient's perspective, the paper reviews the perceived causes of the disorder, helpful and harmful therapy-related and life experiences, features hardest to change, the defensive function of anorexia nervosa and residual traits. Generally, the movement toward health entails forming a therapeutic relationship in which the anorexic can identify and express feelings, experience the empathic, nonjudgmental understanding of another person, separate from a pathological family system, resolve hostile dependent attachment to parents, assuage primitive guilt, and engage in the trials of adolescent psychosexual development to enter adulthood with the beginnings of a firm, cohesive sense of self.
作者描述了13位从神经性厌食症中康复的女性所展现出的从该病中康复的过程。该论文强调患者的视角,回顾了该疾病的感知成因、与治疗相关的有益和有害经历及生活经历、最难改变的特征、神经性厌食症的防御功能和残留特质。总体而言,走向康复的过程需要建立一种治疗关系,在此关系中,厌食症患者能够识别并表达情感,体验他人的共情、无评判的理解,脱离病态的家庭系统,解决对父母的敌对依赖依恋,减轻原始内疚感,并参与青少年性心理发展的考验,以带着初步形成的坚定、连贯的自我意识步入成年。