Two Cases of Anorexia Nervosa 1

Our purpose is to bring forward certain aspects of the relationship between mother and child which can develop in hypotrophic infants born at the end of their term. We shall present a detailed observation and then make use of a second case to draw several conclusions. Only in passing do we intend to look at the structural characteristics of primary anorexia2 in infants in order to improve our understanding of the relationship between the mother and her child.

Charles is a small boy of six-and-a-half. I saw him for the first time when he was five. He impressed me with the mien of a child suffering from malnutrition: he is blond, and his blue eyes were deeply sunk in their sockets beneath chiselled temples; his veins were so apparent that his face had a bluish tinge.

The story of the child is also that of his illness, for Charles was born anorexic.

Early History and Background

Charles is the second child, following a sister one year older. Another child was born when he was two-and-a-half years old. His parents are young. There are no major conflicts between them, nor are there psychiatric antecedents.

The first meeting with Mr. and Mrs. D. was dramatic. The mother cried incessantly. Charles had been vomiting everything he ate for several months. He had got thinner. Though tall, he weighed barely twenty-six pounds.

The child had never been well, the mother said. When she was two-and-a-half months pregnant she was operated on for appendicitis. Speaking of her own vomiting during pregnancy, she later said, “I vomited him out”. The baby was born at full term and weighed five pounds one ounce. Mrs. D. felt annoyed and ashamed to have so thin an infant. This feeling remained with her throughout the years and it marked the relationship between mother and child. Though she breast fed him during the first three months, he had no appetite. He accepted very little food, and his weight hardly increased. He cried a great deal and did not sleep at night. His health was fragile. H