Notes on anorexia.

The plural of the term indicates a warning: there is no "anorexia", there are anorexics. The approach of this manifestation in adolescence, and in neurotic subjects, supposes to connect it -as I understand it-, by its direct relation, with the appearance of the secondary sexual characters. They involve the subjectification of a new image of the body that requires certain conditions, but if these are not met, the recourse to anorexia is to make disappear the marks they leave. They become "a table": A young woman of twenty uses the analysis after "putting on new boobs", since she lost her own when she stopped eating at fourteen. At that time they had grown abruptly and did not know what to do every time in the street they said obscenities. At school the boys looked at her with lasciviousness and her friends died of envy. The image she had of herself was that of a "crazy girl", a bit of a bitch, a bit chubby. The significance of his anorexia could be constructed during his analysis. She feared being swallowed by the gaze of others. Because the oral drive and the scopic were superimposed, not intricate, he found a way to differentiate them by not eating. But it turns out that there he found the typical look of horror of others in front of a body too skinny. The failed attempt to escape the voracious gaze led her to sacrifice her own boobs.

The sacrifice of the secondary sexual characteristics, which included an important amenorrhea, made it obtain a secondary benefit. The maternal grandfather, who at that time lived in the family home, who was said to have senile dementia, every time he was alone with his granddaughter, he pounced on her breasts and told her that they were equal to his grandmother's. She told her parents, between laughter and anguish, but they only took it for a laugh, as they alluded to the innocence of the poor old man who was not in his right mind. The reading he made of such a comment was that they handed it over to his grandfather as an offering of grace for his deplorable senile state. With a whiff of incest, his response was not long in coming. This episode added one more reason -not any- to his anorexia. Several years of analysis led this young woman to inscribe this episode in the record of the neurotic's family novel. In Manuscript G, Freud establishes a parallel between anorexia and melancholy. Melancholy, whose affection is mourning or affliction for some loss, is loss in the instinctual life of the subject itself.

Adolescent anorexia nervosa represents "[...] a melancholy in the presence of a rudimentary sexuality". Freud concludes that: "Loss of appetite is equivalent, in sexual terms, to loss of libido." Therefore, sometimes anorexia is accompanied by melancholy that result from duels not processed symbolically and that as a consequence bring the fall of desire, lack of libido and disinterest in sexuality. But the analytical cure, under the times that the transfer sponsors and the desire function of the favorable analyst, allows the traumatic facts to become myths and that their transmission is possible. The alternation of anorexia-bulimia is homologous to that between depression-mania. Anorexia is to depression, what bulimia is to mania. In both cases it is about duels that do not finish producing. If anorexia is a response to the intrusion of the Other, we must think what joys are played in this response that is undoubtedly instinctive. In order for the phantom to fulfill its function of responding to the desire of the Other and regulate the joys that are played in the social bond, the passage is required, in a previous time, by the proof of the desire of the Other.

Lacan says that the anorexic eats nothing, that is to say that he rejects the circuit of the necessity that implies to feed, in exchange for the demand for the test of some desire of the Other, sometimes the mother. His message says that the object of necessity is not the food of desire.

The Other that says eat incarnates the superego that orders to enjoy, and the answer not as, which is symmetrically opposed to that order, appears when the demand is perceived as an arbitrary mandate that is "unassimilable" by the intake. The fundamental question is missing: when you order me to eat, what do you want from me? When the Other has such a compactness that there is no loophole to enter, that question can not be formulated. For the subject to have a place in the Other, in order to be located, the Other must be able to offer his fault. To lose weight, to lose weight until disappearing, is to offer one's own fault in order to inscribe a place. Dying of hunger displaces the place of the lack that the Other did not offer to the subject, who offers himself to the Other, a sacrifice that connotes a masochistic enjoyment that aims to generate the anguish of the Other.

It is an attempt to separate that extreme question: can you lose me? The analyst must be warned about this and be very cautious in their interventions, so that they are not homologated to the intrusion of the others surrounding the patient, whether their parents, other relatives, the nutritionist, the doctor, etc. In the first interview, a patient with serious "eating disorders" that is referred by her doctor to solve their psychological problems, begins to talk about their intakes, their schedules, their weight, their dental problems and a few issues more about the monothema, unable to hide my boredom I ask him what other things happen to him in his life. "To his surprise at my question, he grabs a fit of laughter and tells me that for a long time no one has cared about her except for her "Eating disorders" that, far from registering any fault filled his life and the relationship with others.This intervention of the most innocuous in appearance, read in the après-coup [retroactively] gave rise to the deployment of the conditions of possibility We started with an agreement: she was the one who knew about food, calories, kilos, physical activity, and I knew about femininity, the sexual love, love, men, etc. Of course it was not to be believed, but rather to produce a playful framework that would lead to the unfolding of desire. We do not know in advance how a patient will respond to our interventions. The laughter of this girl guided me to propose the pact of exchange of knowledge in the way of the game.

Sometimes the analyst is called to intervene in emergency situations. Such was the case of an adolescent interned in a clinic, about to be operated with a nasogastric tube for having passed the line of nutritional risk. Muda, with a lost look and an excruciating thinness, I ask you to tell me a dream. He relates almost babbling that he is in front of a bakery, he wants to eat churros, but they seem unattainable. I ask him if there is any "churro" (in Argentina the word "churro" is used to talk about a good looking man) that he likes in particular The body response was immediate, he sits up in bed, smiles, looks at me carefully and she tells me that those "churros" are not for her.

She is the youngest of several brothers and the daughter of her parents' old age. Your destiny is already determined: stay in your father's house to take care of your parents until they die. In this case, anorexia was the attempt to reverse the places. She was going to die and the parents had to take care of her. Specular response that fixes the same object position in which it was. The substitution of churro for churro, that our legitimate jargon, aspired to inscribe or re-write the phallic order so that churros would not be unattainable.

If puberty is, as I say at the beginning of the chapter, a favorable field for the cultivation of edge phenomena, they do not make the structure of the subject, so the challenge with which the analyst faces in the clinic has to see with situating, in each case, what each phenomenon is about.

The triggering of psychosis at puberty is not the same as a toxic psychosis produced by the consumption of certain drugs. Or delusions in paranoia, which are not equivalent to delusional theories (because of their accurate character), than anorexics that know all about nutrition, calories, physical exercises, etc. These observations guide the possible treatment of different tables, when psychoanalysis is on the horizon.

When the language has not been incorporated, its effect is not symbolic and the body, or parts of it, are pure organism. Avatars of life sometimes result in losses of the body image as such, returning the soma in a raw state.

To go through adolescence, which is not an avatar, takes place in the body, for which the alternation between consumption and abstinence reproduces the game of fort-da, at best, of the construction of the phantom. The edge phenomena also try to play the fort-da, but the difference with the absence-presence is that the disappearance of the subject, for the Other has no symbolic value, hence the monotony of repetition, but in its compulsive face . For not being able to metaphorize the lack, this must occur in reality: disappear to death, if necessary.

Alcohol, drugs, food work, sometimes, as supplements that fuel narcissism. When they are the only dish on the menu, we must elucidate the possible treatment by psychoanalysis. Freud said that the cure of drug addiction was possible in an internment to investigate the origin of it.

Almost all healing offers in the health market aim to achieve abstinence from addictions, without taking into account the subject of the same. Therefore, the analyst should not retreat from these phenomena, as long as he takes into account the scope of the analysis and the inventive capacity to intervene in the field of desire that, crushed the plus of enjoyment, is forbidden for the subject.