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01.12.2014 | Case Report | Ausgabe 1/2014 Open Access

Child and Adolescent Psychiatry and Mental Health 1/2014

Melancholy and separation in prepuberty: the choice of anorexia nervosa as a subjectivation attempt

Child and Adolescent Psychiatry and Mental Health > Ausgabe 1/2014
Manon Rivière, Marion Haza
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1753-2000-8-25) contains supplementary material, which is available to authorized users.

Competing interests

We, Manon Rivière and Marion Haza, declare that we have no competing interests of any kinds (financial, political, personal, religious, ideological, academic, intellectual, commercial, etc.).

Authors’ contributions

MR has made substantial contributions to conception, data acquisition and analysis of in Clementine’s case. MH has been involved in drafting the manuscript and revising it critically for all intellectual content, both theoretical and clinical. Both MR and MH have given final approval of the version to be published and are accountable for all aspects of the work and for ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.



This article considers the question of the subjective elaboration of a subject’s relationship to the family-other within a hospitalization facility. Our starting point is the therapeutic follow-up of Clementine, a melancholic adolescent, thrown into an institutional setting following a severe case of anorexia nervosa. We posit that, in the case of Clementine, the choice of the anorexic symptom may demonstrate both a necessity to detach herself from love objects and a difficulty in doing so, but also provides the start of a subjectifying solution.

Case presentation

We propose a qualitative method for the analysis of the individual interviews conducted with this young patient in a patient/psychologist/researcher configuration. A psychoanalytical approach sheds light on several topics: anorexia nervosa, melancholy, twinning, puberty and subjective elaboration. We present the changes in the psychological dynamics and discourse of the young girl during psychological interviews, but also in the wider framework of hospitalization (medical follow-up, family interviews, relationships to the peer group and to the healthcare team, etc.).


We think of the anorexic symptom more as a way of setting up the subjectivation process than as a self-destructive behavior, which enables us to address the specific features of a possible therapeutic approach. We open the debate on the question of the benefits of separation from the family and of hospitalization, as well as on the potential impact of the therapeutic framework on the symptom.
Authors’ original file for figure 1
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