Autorzy prezentują swoje dotychczasowe doświadczenia w terapii
pacjentek z rozpoznaniem jadłowstrętu psychicznego hospitalizowanych
w młodzieżowym wielodiagnostycznym oddziale psychiatrycznym. Opisując
model opieki nad pacjentkami z zaburzeniami odżywiania się zwracają
uwagę na trudności w pracy terapeutycznej, wynikające m.in. z gwałtowności narastania objawów i ich chroniczności, niskiej motywacji pacjentek do
leczenia, wątpliwości zespołu leczącego co do zasadności łączenia metod
behawioralno-poznawczych z podejściem psychodynamicznym, mnogości
ról podejmowanych przez terapeutów.
abstract in English:
The present article attempts to summarize the authors’ experiences in the
therapy of patients diagnosed with anorexia nervosa treated within the frames of the adolescent multi-diagnostic in-patient ward. One of the most important elements that determines
our therapy offer is the specificity of the group of patients diagnosed with anorexia nervosa
and hospitalized in the ward. Patients can be described as difficult-to-treat for many reasons,
among others, because of sudden symptoms’ increase, their chronicity, or ineffectiveness of
outpatients clinic treatment. Our comments and observations are made from the perspective
of psychodynamic psychiatry and psychotherapy. In psychodynamic and psychoanalytical
literature, anorexia nervosa is sometimes treated as a syndrome of a prepsychotic, personality
or neurotic character. At least a dozen different understandings of dynamic causative mechanisms are mentioned in this context. An important supplement of dynamic theories that we
have taken up is an attempt to understand the relations between individual psychopathology
of a patient and functioning of the family system. Families of girls with the anorexia nervosa
problem can be perceived as not helping their children in creating their own personality, one
that is well-separated from the outside world. Therapy in the ward is based on therapeutic community, nutrition contract, family therapy, individual therapy, group therapy, artetherapy, and
physiotherapy. None of the therapy forms can be deemed as dominating. They should rather
be perceived as complementary. The model for treatment of patients with eating disorders that
we have developed within the frames of the ward is accompanied with our numerous doubts,
concerns and discussions, and it is not yet final.
keywords in English:
anorexia nervosa, therapy, adolescent ward
affiliation:
Wydział Lekarski : Klinika Psychiatrii Dzieci i Młodzieży