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Anorexia Nervosa as a ‘Passion’—or an ‘Addiction’

Since the first descriptions of the disorder there have been attempts to place anorexia nervosa (AN) within established psychiatric categories (e.g., see, Russell 1970; Vandereycken and van Deth 1997). These have included depression, obsessional neurosis, variants of ‘hysteria,’ and phobia. However, the constancy of association of the various clinical features and their consistency over time argue against AN being a pathoplastic feature occurring in the course of other disorders. In the Diagnostic and Statistical Manual of Mental Disorder-IV, the eating disorders stand on their own under the broad rubric of ‘disorders usually first diagnosed in infancy, childhood or adolescence.’ Charland, Hope, Stewart, and Tan (2013), in an original contribution, present a case that AN might be best construed as a passion. Their description of passion is based on that of Ribot (1907), who offered a tripartite characterization of the ‘affective life’: The relatively fleeting or unstable feelings and emotions, and by contrast, the passions—longlasting (months or years), intense, and playing a significant role in motivating and organizing a person’s long-term behavior around an idée fixe with its associated values and beliefs. Ribot’s description is further developed by the authors who offer more detailed criteria for identifying a passion. They suggest that seeing the condition as a passion provides a promising way forward for our understanding and treatment of AN.