Abstract of P.T. Hertz Lecture

FEEDING DISORDERS: UNTYING DYADIC PATHOLOGY AND
BENEFITING FROM TRIADIC RELATIONSHIP


P.T. Hertz
Hadassah HospitalIsrael


Infants and young children frequently refer to feeding disorders' clinic
with a background of either an objective medical factor, as hypo tonus,
digesting disorders etc., or low motivation for eating. Medical causes
tend to mix with the child's psychological factors (temperament) and
the parental factors (parenting style). Although medical aspects are
somehow objective and can be measured quantitatively, some parents
tend to intensify them while others might reduce those same factors.
Therefore reciprocity relationships occur between the two basic
factors of feeding disorders; the physical aspect affects the
psychological aspect, and vice versa. Parents who tend to intensify
the physical situation, as known in the extreme case of Factitious
Disorders, aren't always aware of the damage caused. The range of
those cases of parental interference with the child's wellbeing is quite
wide. In most cases the professional staff meets with cases of slight
emotional pathology which is hard to assess, due to the fact that the
average population seems to function in everyday life. Those parents
show specific difficulties enabling autonomy or space during feeding
and play episodes as developmentally recommended, and therefore
can benefit from psycho-social intervention. Dan was six years when
referring Hadassah hospital's eating and feeding center. His medical
background included spinal bifida and hypo tonus. His specific eating
record included FTT accompanied with difficulties sucking at infancy
and a tendency to vomit. The dyadic relationship with Dan's mother
was characterized by her will to control and decide for Dan,
impingement and anxiety which Dan absorbed. The main goal was to
untie the dyadic pathological relationship, by creating a triadic
relationship which was characterized with openness and new
opportunities.



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