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Joint family consultations for psychiatric inpatients with severe eating disorders transitioning to adulthood: psychoanalytic design of a therapeutic setting

While family work is acknowledged as relevant in the care of eating disorders (EDs), not much literature has explored it in the period of transition from adolescence to young adulthood (16–18 to 30 y.o.). Yet this period is of significant importance in the prognosis and evolution of EDs; but its par...

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Autores principales: Putois, Olivier, Riegert, Myriam, Bahi, Nadine, Pires, Joël, De Luca, Manuella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10590888/
https://www.ncbi.nlm.nih.gov/pubmed/37876621
http://dx.doi.org/10.3389/fpsyt.2023.1270499
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author Putois, Olivier
Riegert, Myriam
Bahi, Nadine
Pires, Joël
De Luca, Manuella
author_facet Putois, Olivier
Riegert, Myriam
Bahi, Nadine
Pires, Joël
De Luca, Manuella
author_sort Putois, Olivier
collection PubMed
description While family work is acknowledged as relevant in the care of eating disorders (EDs), not much literature has explored it in the period of transition from adolescence to young adulthood (16–18 to 30 y.o.). Yet this period is of significant importance in the prognosis and evolution of EDs; but its particular stakes require specific therapeutic settings–especially for inpatient EDs. In this paper, we start from the paradoxical observation that some families refuse this type of work in its usual form, with a family-dedicated therapist, and require to only exchange with the psychiatrist in charge of the treatment plan. We use a psychosomatic-informed psychoanalytic approach to shed light on this refusal as a latent denial of the contribution of family dynamics to the current symptom, and an unconscious tendency to stick to a dependency-laden family scheme. We then explain the conception of a specifically dedicated therapeutic setting, designed to address this specific type of resistance, offered to families as a therapeutic compromise designed to give them a specific position in the care of their child. In our joint therapeutic consultations, family dynamics are addressed on the basis of exchanges regarding treatment and in particular feeding. While such exchanges start from medical considerations, the therapeutic couple (psychiatrist-psychologist) uses them to address the parent and patient expectations underlying the symptom. We propose to call this act “inscription”; it enables a separation from the underlying dependency-oriented family scheme, while stressing the importance to care for associated parental anxieties.
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spelling pubmed-105908882023-10-24 Joint family consultations for psychiatric inpatients with severe eating disorders transitioning to adulthood: psychoanalytic design of a therapeutic setting Putois, Olivier Riegert, Myriam Bahi, Nadine Pires, Joël De Luca, Manuella Front Psychiatry Psychiatry While family work is acknowledged as relevant in the care of eating disorders (EDs), not much literature has explored it in the period of transition from adolescence to young adulthood (16–18 to 30 y.o.). Yet this period is of significant importance in the prognosis and evolution of EDs; but its particular stakes require specific therapeutic settings–especially for inpatient EDs. In this paper, we start from the paradoxical observation that some families refuse this type of work in its usual form, with a family-dedicated therapist, and require to only exchange with the psychiatrist in charge of the treatment plan. We use a psychosomatic-informed psychoanalytic approach to shed light on this refusal as a latent denial of the contribution of family dynamics to the current symptom, and an unconscious tendency to stick to a dependency-laden family scheme. We then explain the conception of a specifically dedicated therapeutic setting, designed to address this specific type of resistance, offered to families as a therapeutic compromise designed to give them a specific position in the care of their child. In our joint therapeutic consultations, family dynamics are addressed on the basis of exchanges regarding treatment and in particular feeding. While such exchanges start from medical considerations, the therapeutic couple (psychiatrist-psychologist) uses them to address the parent and patient expectations underlying the symptom. We propose to call this act “inscription”; it enables a separation from the underlying dependency-oriented family scheme, while stressing the importance to care for associated parental anxieties. Frontiers Media S.A. 2023-10-09 /pmc/articles/PMC10590888/ /pubmed/37876621 http://dx.doi.org/10.3389/fpsyt.2023.1270499 Text en Copyright © 2023 Putois, Riegert, Bahi, Pires and De Luca. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Putois, Olivier
Riegert, Myriam
Bahi, Nadine
Pires, Joël
De Luca, Manuella
Joint family consultations for psychiatric inpatients with severe eating disorders transitioning to adulthood: psychoanalytic design of a therapeutic setting
title Joint family consultations for psychiatric inpatients with severe eating disorders transitioning to adulthood: psychoanalytic design of a therapeutic setting
title_full Joint family consultations for psychiatric inpatients with severe eating disorders transitioning to adulthood: psychoanalytic design of a therapeutic setting
title_fullStr Joint family consultations for psychiatric inpatients with severe eating disorders transitioning to adulthood: psychoanalytic design of a therapeutic setting
title_full_unstemmed Joint family consultations for psychiatric inpatients with severe eating disorders transitioning to adulthood: psychoanalytic design of a therapeutic setting
title_short Joint family consultations for psychiatric inpatients with severe eating disorders transitioning to adulthood: psychoanalytic design of a therapeutic setting
title_sort joint family consultations for psychiatric inpatients with severe eating disorders transitioning to adulthood: psychoanalytic design of a therapeutic setting
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10590888/
https://www.ncbi.nlm.nih.gov/pubmed/37876621
http://dx.doi.org/10.3389/fpsyt.2023.1270499
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