Psychopathology of eating behavior: semantic deconstruction and self-narratives between Wittgenstein, Binswanger and Bruch

Abstract

Eating disorders are a rapidly increasing reality. In this essay we will try to show that they are a special case of linguistic psychopathology. Unfortunately, clinical treatments for these disorders, which typically prescribe diets and/or simple lifestyle changes, often prove ineffective. Even today, the therapies that appear most effective in managing these pathologies are those centered around the recalibration of personal self-narratives. This especially pertains to how patients describe themselves and their bodies, and the meanings they attribute to food. The essay will briefly trace the historical narrative of the concept of anorexia nervosa from the Middle Ages to the early psychoanalytic theories. Subsequently, Wittgenstein's criticism of the psychoanalytic approach will be used to illustrate its limitations in understanding eating disorders. Secondly, a new critical analysis of the famous case of Ellen West will be proposed, attempting to demonstrate the relevance of the anthropoanalytic approach for understanding some specific dynamics typical of eating disorders and how it still partially persists in some clinical practices. In this regard, the work of Hilde Bruch will be analyzed, highlighting how the combination of the anthropoanalytic method on the destratification of meanings in the minds of patients and a medical approach that considers those self-narratives leading to dysfunctional behaviors as pathological appears to be the most effective form of treatment. Finally, the delicate question of the existence or otherwise of free will in the nutritional field will be discussed.