Bereavement and triangular relationships in a case of a child suffering from anorexia

An Italian version of this paper, ‘Lutto e relazioni triangolari in un caso di anoressia infantile’, was published in Psiba in 2014 (39: 151–65) (Morra, 2014). This English translation by Michela Benuzzi is published with the permission of Mimesis Edizioni.

Abstract

This paper describes the mother–child assessment of a five-year-old girl suffering from anorexia since weaning, which was carried out in an Italian NHS neuropsychiatric child and adolescent unit. The author aims to show how she was able to link the little girl’s refusal of food to a death in the maternal family, which occurred soon after her birth. As well as this post-traumatic formulation, the author links the child’s anorexia to two related aspects of the family dynamics: avoidance of the awareness of death and the inability to manage triangular relationships, due to important intrusion and exclusion anxieties. Using extracts from the sessions, the author shows how the little girl was able to begin to work through the death phantasy which was previously inaccessible to her and her family. The concept of the death phantasy is defined and explored and possible analogies between this case and what is observed in some anorexic adolescent girls and their families are described.

Keywords:

• anorexia
• bereavement
• mother–child assessment
• death anxiety
• death phantasy
• triangular relationship

Acknowledgements

The author wishes to thank Jeanne Magagna for her important suggestions and warm support and Mimesis Edizioni and Francesco Mancuso for allowing the translation of this paper.

Notes

An Italian version of this paper, ‘Lutto e relazioni triangolari in un caso di anoressia infantile’, was published in Psiba in 2014 (39: 151–65) (Morra, 2014). This English translation by Michela Benuzzi is published with the permission of Mimesis Edizioni.