Adoption and identity: a case of anorexia nervosa

Anorexia nervosa, as a retreat from and subsequent avoidance of intolerable maturational turmoil, can provide a vivid insight, especially as body weight is restored to normal within treatment, into the sexual and identity conflicts that have previously characterized the adolescence of the individual. When the adolescent has been adopted into the family then the challenge of developing biological (genetic) identity is especially great to the individual and his adoptive parents. A rare case of anorexia nervosa in a male adoptee is presented against this background. Our patient's dependent and smothering bond with his adoptive mother, which was loving but highly conditional, left him with no room for negotiation when it was threatened by his emerging sexual and other impulsivity and new assertiveness. Understanding and treatment of such cases can also help to shed light on the particular challenges that face many adoptive parents when their adopted children experience the thrust of puberty and enter adolescence.