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IJP 55:577-579 (1974)

A Discussion of the Paper by John A. Sours on 'The Anorexia Nervosa Syndrome'

Author: Selma Kramer

Abstract

Dr Sours' paper (this issue) applies the child analytic developmental research of Margaret Mahler to the understanding of a very important and perplexing syndrome—anorexia nervosa.

He describes three main forms of this syndrome with important considerations for prognosis and treatment. In the forms which occur in girls, in particular, it seems that the differences stem from quantitative variations in impairment of psychic structure related to the child's experiences during the separation-individuation process. Dr Sours shows that experiences during the separation-individuation phase markedly and dramatically affect the adolescence of these girls, causing illness so serious that it may be life-threatening.

I am delighted that Dr Sours is making use of this very important child analysis research. His thoughtful paper which is part of an ongoing study of patients with anorexia nervosa gave rise to a number of questions which I will attempt to delineate for the sake of clarity, but which are very much related to each other.

1My first concern has to do with what I feel is an over-emphasis on pathological mothering and an inattention to what Mahler and her co-workers have described in many papers, i.e. the contribution of the child to the disturbed mother–child interaction and to his own pathology. Mahler recognizes broad individual differences in both mothers and children; she has studied how these differences affect the health of the symbiosis and the vicissitudes of the separation-individuation process. She has delineated the intrapsychic processes in the child to the stage of libidinal object constancy, and has described the complexities of the mother–child relationship (1968).
Mahler & Furer (1963) described the 'mutual cuing' during infancy and the early toddler stage, holding that a child with reasonably good endowment will extract mothering that will protect him from profound pathology, especially symbiotic psychosis. In a recent presentation in Philadelphia, in

IJP 55:577-579 (1974)

A Discussion of the Paper by John A. Sours on 'The Anorexia Nervosa Syndrome'

Author: Selma Kramer

Abstract

Dr Sours' paper (this issue) applies the child analytic developmental research of Margaret Mahler to the understanding of a very important and perplexing syndrome—anorexia nervosa.

1My first concern has to do with what I feel is an over-emphasis on pathological mothering and an inattention to what Mahler and her co-workers have described in many papers, i.e. the contribution of the child to the disturbed mother–child interaction and to his own pathology. Mahler recognizes broad individual differences in both mothers and children; she has studied how these differences affect the health of the symbiosis and the vicissitudes of the separation-individuation process. She has delineated the intrapsychic processes in the child to the stage of libidinal object constancy, and has described the complexities of the mother–child relationship (1968).
Mahler & Furer (1963) described the 'mutual cuing' during infancy and the early toddler stage, holding that a child with reasonably good endowment will extract mothering that will protect him from profound pathology, especially symbiotic psychosis. In a recent presentation in Philadelphia, in