Shame as safeguard of subjectivity in case of clinic eating disorders ; La honte comme sauvegarde de la subjectivité dans la clinique des troubles alimentaires

To be a slave, to lose one’s autonomy, to have one’s freedom curtailed: there are many ways to experience the enslavement that is addiction. Addiction is defined as a repetitive behavior due to dependence and that causes excessive consumption. This definition reveals a form of slavery and, by extension, broadens the scope of research on addictions to the field of eating disorders. Eating disorders involve indeed often addictive behaviors with respect to food, to the point of making the disorder a real alienation. Even though the affected patients behave more like objects than subjects, an affect emerges in the transfer: shame. Shame is a hidden, secret, and most often silent emotion. Patients do not confess it easily. In fact, patients "are ashamed of their shame” and this prevents them of “saying their shame". This brings to light an impossibility of expressing the inexpressible. While noting that a majority of subjects with eating disorders feel shame, many authors (M. Corcos, G. Apfeldorfer) considered that this sentiment, especially in the cases of obesity, was linked to body image, and relegated shame to the rank of a secondary symptom. We propose here in contrast to consider shame as a cause of eating disorder. Not only would shame not be a secondary symptom, but it would indeed be a primary symptom and eating disorder its avatar. Shame will be considered here from the point of view of traumas, including childhood traumas and we will strive to demonstrate its origins. We will use this conceptual basis to discuss the specific requests that arise in the clinical practice of treating patients with eating disorders and how artistic mediation can offer a therapeutic opening. ; « Etre esclave de », perdre son autonomie, voir sa liberté personnelle entravée ; autant de manières de vivre l’asservissement que représente toute addiction. Un comportement répétitif lié à une dépendance entraînant une consommation excessive, c’est ainsi qu’on définit l’addiction, ce qui la rattache à une forme d’esclavage et, par ...