DOMENICO COSENZA: NEW WAYS IN PSYCHOANALYSIS FOR THE TREATMENT OF ANOREXIA AND BULIMIA
My theoretical-clinical research in these years has focused on the reading and analytical treatment of anorexia in the light of Lacan’s teaching. In fact, Lacan proposes a very original perspective on mental anorexia, with many implications for clinical practice. In my main work on the subject, I have tried to rebuild Lacan’s perspective by putting it into play in the different ways of treatment I have used: the small monosymptomatic group, the therapeutic community, working with family members, as well as analytically oriented individual treatment. Lacan reconnects the phenomenology of anorexic disorder to two structural fundamentals: refusal and object rien. Refusal indicates the relationship of the anorexic subject to the Other, and we have tried to indicate the different variations, which allow us to isolate heterogeneous forms of anorexia on the structural plane. It is essential to distinguish the modes of anorexic refusal in a dialectical relationship with the Other – here the rejection works as a metaphor, appeal, unconscious question, as in hysterical anorexia – and modes which on the contrary represent a real refusal of the Other, as it is in a more radical manifestation in psychotic forms of anorexia. Rien is the object that causes the jouissance of the Anorexic: that is its radical attachment to its symptom. Even in this case, it is necessary to distinguish between a rien with a significant function, which refers to the impossible satisfaction of desire, and a rien that is an object of full jouissance, without rest or limitation, as we encounter in the real anorexia. The two perspectives outlined here illustrate two different modes of treatment of anorexia, reflected in the light of the different structural requirements in play.