A Psychosomatic Approach of Anorexia Nervosa

Based on the literature review and on experiences with clinical cases, this paper presents a psychosomatic approach of anorexia nervosa. Psychosomatic is defined here as the entanglement of a double formation of symptoms: somatic symptoms on the one hand and psychological symptoms on the other. Are considered psychosomatic, psychological functioning favoring a somatic symptom or impacting its evolution. Coming within this scope, the psychosomatic school of Paris (Marty in particular) described operational thinking as a form of thinking frequently associated with psychosomatic disorders corresponding to this global definition. This paper shows that this form of thought can be seen as a failure of integration of the imaginary and affective life. By several aspects, operational thinking overlaps with alexithymia as described by Sifneos and the Boston School. The consequence of operational thinking functioning is a personality, often rigid, leaving little space to fantasies and to psychic elaboration. This functioning induces a body unbalance due to the arousal that cannot be elaborated otherwise, particularly during adolescence. The main aim of this paper is to consider if the approach proposed by the psychosomatic schools can have a clinical interest in the understanding and the cares of adolescent patients with anorexia nervosa.