Four children are described with a potentially life threatening condition manifested by profound and pervasive refusal to eat, drink, walk, talk, or care for themselves in any way over a period of several months. The multiplicity and severity of the symptoms in these children do not fit comfortably into any existing diagnostic category. Long term and highly skilled nursing and psychiatric care is required to help these children to recover. The possible causes of this syndrome are discussed.
The concept of the internal objects and internal and external spaces has been further developed in this paper. These objects are an important part of patients seeking treatment for themselves for they are also looking unconsciously for 'treatment' of these objects. The objects are ' damaged' and the patient does not know how to repair them. He keeps them alive in the hope that help will come. The methods used to keep them alive, even when dying, have been described. The stages at which these objects have been, or are thought to have been, damaged is vital. For example, they can range from the sensori-motor level to higher levels of maturation, to produce psychosis, borderline or hypochondria. The concrete level is stressed for it leads to concrete repair as opposed to psychic reparation.Dr Henri Rey, psychoanalyst and member of the British Institute of Psychoanalysis, has been well known for his own integration of Freudian-Kleinian object relations theory with Piagetian, psycholinguistic and biophysical conceptual frameworks. He worked for many years as a consultant psychotherapist at the Maudsley Hospital where he developed his theoretical models for the treatment of borderline and psychotic patients.
In this article, we describe the role and functions of a group for the parents of children receiving treatment for eating disorders. We comment on the group process and evaluate the usefulness of the group from our viewpoint as therapists, and from the point of view of parents who have attended the group over the last year. Examples are given from the leaders' session notes. The role and content of the group is discussed in relation to other treatment modalities and to the current thinking about effective treatment for severe eating disorders in the younger age group. In our view, a group for parents is a valuable adjunct to other therapies in the treatment of early onset eating disorders.
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