What drives a girl who does not seem to have suffered serious traumas or dramas to refuse food and risk losing her life? Why does anorexia arise during adolescence in the absolute majority of cases? And why is it still an almost exclusively female disease? What aspects of family dynamics play an important role in fostering the development of anorexia and other eating disorders? And how much does the broader social context affect it? Why has anorexia, previously a rare disease, become an epidemic since the late seventies in the West? What social conflicts emerged in that period that this psychopathology expresses?
The model of family semantic polarities, which I developed in “Family semantic polarities and psychopathology in the family. Permitted and forbidden stories” (1998, 2012/13, 2018), answers these questions
A FAMILY CONVERSATION DOMINATED BY THE SEMANTIC OF POWER
One of the main thesis I put forward is that the semantic of power dominates the conversation in families where eating disorders develop
What dominates the conversation is the semantic of power, where some win and some lose, some are successful, some become central figures in the family and the community, and others give up. As well as the “winner/loser” polarity, these families also have a second polarity – “strong-willed/yielding” – which is hierarchically dependent on the first, based on a relation of means to an end. These people are winners because they are willful, determined or efficient, or they are losers because they are passive, compliant or liable to give in to others. Affability, amenability, acceptance of the definitions given by the other person to the relationship are construed within these families as passivity, faint-heartedness, ineptitude. (UGAZIO, 2013, p. 181-182)
HAVE STUDIES BEEN CARRIED OUT CONFIRMING THE THESES PUT FORWARD?
Yes, that is, the thesis that the semantic of power dominates the conversation in families where eating disorders develop has been empirically confirmed.
Some studies were carried out by me, in collaboration with colleagues, using a specifically designed instrument to identify and classify the family semantics – the Family Semantics Grid ( see sub-section semantic analysis) :
Ugazio, V., Guarnieri, S., Anselmi, P., Castelli,D. e Pandolfi.M. (2021)
La relazione terapeutica con i pazienti con disturbi fobici, ossessivo-compulsivi, alimentari e depressivi: Quali significati prevalgono?
Rivista italiana di Costruttivismo, 9,1, 19-46.
Ugazio, V., Guarnieri S., Anselmi P., Castelli, D., Pandolfi, M. (2020).
The therapeutic relationship with clients with phobic, obsessive-compulsive, eating and depressive disorders: Which meanings prevail? Journal of Constructivist Psychology, 16 October, 2020 on line. To link to this article: https://doi.org/10.1080/10720537.2020.1828203
Ugazio, V., Negri A., & Fellin L. (2017) Libertà, Bontà, Potere e Appartenenza: le semantiche dei disturbi fobici, ossessivo compulsivi, alimentari e dell’umore. Rivista italiana di costruttivismo, 5, 1, Aprile 2017, pp.4-27.
Ugazio, V, Negri, A., e Fellin, L. (2015), Freedom, Goodness, Power and Belonging. The Semantics of Phobic, Obsessive-Compulsive, Eating, and Mood Disorders Journal of Constructivist Psychology, vol. 28, 4, 293-315 doi:10.1080/10720537.2014.951109
Ugazio, V., Negri, A., & Fellin, L. (2011). Significato e psicopatologia la semantica dei disturbi fobici, ossessivi, alimentari e depressivi. Quaderni di Psicologia Clinica, 2 (pp.69-100). Bergamo: Bergamo University Press.
Other independent researchers, who used different instruments, also confirmed the prevalence of the semantic of power in eating disorders.
Castiglioni M., Faccio E., Veronese G. e Bell C. R. (2013) The Semantics of Power among People with Eating Disorders Journal of Constructivist Psychology, vol. 26, 1, 62-76 doi: 10.1080/10720537.2013.740263.
Castiglioni M., Pepe A., Gandino G. e Veronese G. (2013) Self-Other Positioning in Obesity. A Pilot Study Using Repertory Grid Technique The Open Psychology Journal, vol. 6, 61-68 doi: 10.2174/1874350101306010061.
Faccio E., Belloni, E. e Castelnuovo G. (2012)
The Power of Semantics in Self and the Repertory Grid Representations. A Comparison between Obese and Normal-Weight Adult Women
Frontiers in Psychology, vol. 3, doi:
Faccio,E., Belloni Cipolletta S., Iudici A., Castiglioni M. e Mannarini S. (2016) The Power of Weight and the Weight of Power in Adolescence. A Comparison between Young and Adult Women Journal of Family Studies, 1-15 doi: 10.1080/13229400.2016.1187660
DOES THE SEMANTIC OF POWER DOMINATE THE CONVERSATION ALSO WITHIN FAMILIES WHERE DISORDERS OTHER THAN EATING ONES DEVELOP?
Laura Colangelo put forward the interesting hypothesis that families in which borderline disorders develop are characterized by the same semantics as eating disorders.
Colangelo, L. (2005). Il disturbo borderline di personalità come esito di un processo di costruzione sociale. Terapia Familiare, 78: 53-82
DOES THIS MODEL HAVE THERAPEUTIC IMPLICATIONS?
Yes, mainly because the therapeutic relationship changes in relation to semantics. The therapeutic alliance, the possible fractures, the dysfunctional circuits are as different as the prevailing semantics.
Ugazio, V.& Fellin, L.C. (2022)
Le dinamiche di potere nella terapia con anoressiche e bulimiche: da vincolo a risorsa? [The power dynamics in the terapy with anorexic and bulimic girls: from constraint to resource?] Terapia Familiare, 128,31-54.
Ugazio V. (2019) Anorexic girls and their families: how can we deal with their semantic and its dilemmas? Psychotherapy Section Review,63, pp. 10-23.
Ugazio V. (2013) La famiglia nel trattamento dei disturbi alimentari. In M.G. Gentile (a cura di), Nutrizione clinica e psicopatologie correlate (pp.45-57). Fidenza: Mattioli.
Ugazio V. (2010).
Los trastornos de la conducta alimentaria: cuando el rechazo a la jerarquia se vuelve derrumbamiento de las diferencias
Mosaico, 44: 25-35.