[Food addictions]. / Les addictions alimentaires.

Addictions are invading our daily lives. Eating and body image have become major preoccupations. Anorexia nervosa and bulimia nervosa are eating disorders with a high risk of chronicity and death. Curing them and preventing their recurrence requires a solid therapeutic alliance that aims to work around individual symptoms. The low self-esteem associated with these disorders may contribute to their maintenance, despite their negative impact on quality of life. One of the challenges of treating these disorders is to help patients find the motivation to seek treatment.

[Healing the mind by healing the body in anorexia nervosa]. / Soigner le mental en soignant le corps dans l'anorexie mentale.

In anorexia nervosa, physical and psychological vulnerability confines the sufferer to the confines of his or her pathology. The physical body is the first victim of undernutrition, but also the first resource for restoring the psychic and emotional body. Reduced food intake has repercussions on cognition and affect, all of which affect relational capacities. Accompanying, understanding and caring for people means reaching out to them and their bodies, to re-establish the link between what has been broken, and to establish a relationship of trust with them.

[The caregiving posture, a progressive construction]. / La posture soignante, une construction progressive.

The professional identity and know-how of the caregiver are acquired throughout his or her career and professional development. The support of patients unfolds by moving from an action to a singular, adapted, personalized and relational care. This experience is particularly present in psychiatric care, when the poïesis relies on acquired and obligatory praxis and must sometimes find the kairos. We can ask ourselves if caring, in a context of uncertainty and undefined temporality, requires a surpassing of oneself on the part of the caregiver, or results from a gradually acquired mastery of the profession.

[Touch in the care relationship]. / Le toucher dans la relation de soins.

Touching someone is a multisensory encounter with the other, it is listening, hearing, seeing, smelling, feeling, perceiving, etc. This contact allows for the interpersonal circulation of a host of information in a close relationship. The caregiver touches the patient's body with his or her eyes before beginning to grasp it with his or her hands. In order to adjust his or her approach to care, he or she must be attentive to the messages that the patient sends. But touching a patient's body also means that the caregiver is touched by the emotions produced by the confrontation of the person's body with his or her own body.

[Body care in anorexia nervosa]. / Les soins du corps dans l'anorexie mentale.

Therapeutic touch body care in the management of eating disorders, particularly anorexia nervosa, aims to deepen the relationship of trust and the therapeutic alliance. Nursing research and the development of clinical nursing care, with nursing diagnoses as a support, have made it possible to provide new responses adapted to the patient's needs. This reassuring helping relationship favors the work around the patient's psychic and physical perceptions. The notion of the gender of the caregiver in the body approach care is a dimension to be taken into consideration.

[From "hysterical anorexia" to anorexia nervosa]. / De l'"anorexie hystérique" à l'anorexie mentale.

Anorexia nervosa and hysteria are two entities whose concepts have evolved through the ages, from "hysterical anorexia" to become distinct both in their presentations and in the representations within the community. Today, the psychiatric approach has been enriched by the contribution of neuroscience. Hospital treatment of anorexia nervosa allows intervention on the symptoms of the disease, but also takes into account the associated needs and disorders.

[Development of a psychiatric care facility into a Covid unit]. / Aménagement d'une structure de soins psychiatriques en unité Covid-19.

Covid-19 did not spare the psychiatric care services. At the Sainte-Anne Hospital, as in the medicine-surgery-obstetrics departments, several care units had to be transformed and organised in order to accommodate positive patients who did not need to be admitted to intensive care. Feedback on the transformation of a care structure of the "Clinique des maladies mentales et de l'encéphale" for more than two months.

[Eating disorders and care without consent]. / Troubles du comportement alimentaire et soins sans consentement.

It is not usual to use care without consent in the management of eating disorders when the patient refuses the care indicated. Yet, these are psychiatric disorders responsible for a high mortality rate and a high risk of chronicity. Their management is complex, multidisciplinary and the refusal of care in the most severe cases raises ethical questions. It is important for the clinician to know the impact of these disorders, notably on the patient's cognitive and judgment capacities, in order to evaluate the necessity of implementing a restraint measure.