In this case of the week, the author presents three cases of patients with chronic eating disorders and uses hereby the metaphor of the medieval castle to characterize the negotiable identity, sense of self and the control of fear of intrusion in family relationships. The first case presents the story of Mme A, an incest survivor with a long history of bulimia nervosa. The therapist noticed that the patient had problems with allowing anyone into herself, both literally meaning sexually and by processes of mutual empathy and identification. The patient didn’t let her guard down as she monitored carefully that she didn’t reveal intimate information about herself and equally seem to have difficulties in taking in what the therapist had said. The author discusses how these processes can lead to impoverished self-object and hindering of the progressive enrichment of a core self.
The following case describes a family based approach to a couple of which one partner, Angela, also suffered from a long history of eating disorders and a history of sexual abuse. At first the therapist perceived Angela’s partner Sophie with her many friends, educational background and what seemed to be a loving family as the opposite of Angela. Soon the therapist noticed that the partners were more similar than first suspected. Sophie actually was a heavy drinker and confessed that she hadn’t been completely faithful to Angela. The therapy revealed that both partners needed each other to negotiate their identity, one of the caregiver or the dependant receiver. The therapy confronted the partners with these ongoing processes.
The last case highlights the metaphor of a person as a castle with a young patient named Annie. Annie’s family broke up and she felt abandoned by them since nor her father nor her mother wanted Annie to stay with them. She became anorexic and the author portrays her in the ‘castle model’ as having retreated to the keep with a diminished, simplified core self. In doing so she had let the bulwark walls and the contained area decay, standing for the negotiable area of the self. This image was reliant upon the symptoms of anorexia although later in therapy she managed to gain insight into her problems and turned her life around.
The cases are illustrative of the metaphor of a person as a castle, here in particular it’s used for persons who suffer from eating disorders.
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The SCA team
boulemia, anorexia nervosa, incest, self-object,
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