We will now discuss how we conducted this analysis, quite typical in fact of an anorexia nervosa in teenage where it predominates an incestuous problematic coupled with a questioning related to the sexual identity. First sessions show, as we mentioned in the introduction, some anguish of the genital and of the pubertal sexuality: Isabelle changes a budding romance into an accomplice friendship in order to neutralise the possibility of a physical relationship. Does this anguish recall those of the virgins and that of their “full horror of feeling” vis-à-vis the sexuality? In the early stages of the treatment, the patient is surprised to dream “sexually from one of her university professors with whom she lives in pairs”: the transference seems to work. This perspective, mentioned painfully in her free associations, is barred with a sanction which plays the role of a psychic dyke: “That’s impossible.”
As a priori argument, her early age is gradually set aside by the patient, which permits to widen this notion of that impossibility to other registers. One of the dreams brings up a valuable aid: “She is on a beach for a party with a group of friends of her generation and there is an appetising buffet. With her boyfriend, the patient approaches in order to serve herself – the hunger torments her – when a series of unpredictable events (eruption of persons that the patient claims not to recognise, lively scuffle with others) happen and, abruptly, take her away from the big table.”
Reinforced by the interpretation, the patient understands that the implementation of the diet seeks to reduce and to contain the instinctual claims of her body by weakening it and by self-inflicting painful restrictions: these are all paradigmatic manifestations of the pubertal crisis. The abundant victuals on the table are easily assimilated by her to the sexual pleasure. She manages gradually to distinguish fears of weight gain by eating from those due to the deformation of the body caused by a pregnancy. These are displacements in the representations and in the affects. Strangely, we never talked again about food for months. This issue also gives way to a questioning about her sexual identity, and, in doing so, through an obsessive thought: since her childhood, Isabelle questions herself compulsively and on an anxious mode, about her possible sexual preference for girls. She remembers in particular a movie which featured a female couple and, immediately after, a discussion with her mother about it. This obsession has never abandoned her even though she firmly claims feeling a desire for young men.
Jean-Luc Vannier is a French psychoanalyst based in Nice (French Riviera), and is full-time lecturer of psychoanalysis at Nice Sophia-Antipolis University, EDHEC Business School, Ipag Business School. He regularly writes for several French magazines and has his own columns. At the University of Côte d’Azur, he is the official Referent for the PPP (Personal and Professional Project) aimed at helping the students to work on their own identity and to define their job choices. Jean-Luc is an editorial board member of the Psychreg Journal of Psychology. You can follow him on Twitter @jlv06