An Application of the Family Dinner Session to a Case of Anorexia Nervosa : Therapeutic hypothesis versus understanding of family secret

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  • ディナーセッションを実施した神経性食欲不振症 : 適切な病態理解とその効果

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A 10-year-old girl with anorexia nervosa visited our outpatient clinic because of appetite loss, weight loss and headache. At the initial stage, her maladjustment to school life and/or a conflict with her brothers might cause her anorexia, and an over-interference from her mother with her eating might be a factor to prolong her anorexia. She was admitted to our hospital accompanied by her mother and received a tube feeding in order to restore her weight. Furthermore, her mother accepted a psychological education, particularly in relation to her interference with the daughter's eating. During 3 months of admission, She recovered her weight and became able to eat by herself. Then, she was discharged from the hospital : however, she was not able to go to school nor to eat. She was admitted to our hospital again, not accompanied by her mother this time, because her mother's interference might cause her symptoms, However, her symptoms did not improve. At this point of treatment, a family dinner session. originated by Minuchin, was applied. After that, she recovered her weight and, was discharged from our hospital, and since then she has been going to school. After the dinner session, she disclosed her family secret of her father's alcoholic problems. Sometimes therapeutic hypotheses set up by the physician might cause the prolongation of the disease and the opening of secret on the part of the patient might mean the working out a solution for his problems.

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