Empathy in medicine: A ritualistic healing function?

Marcel Réja (1873-1957) French alienist evokes in his book « Au pays des miracles ¼ this innumerable people of healers, mystics, empirics, magnetizers, mediums and fantasists. All operating "cures more wonderful than each other". This book questions in a very relevant way the role of the power of the spirit, of healing by the spirit and therefore of suggestion. This "art" of healers includes an affective and emotional coefficient which constitutes its essential spring. There is a mysterious force between the sick and the physician that goes "soul to soul". Current medicine is still very much borrowed from its past with a remnant of "magical" thought. Also, the empathetic dimension of the care relationship remains one of the most necessary dimensions for the exercise of the medical profession.

Marcel Réja and theatre therapy.

We report on the play entitled Le Pain quotidien (The daily bread) by Marcel Réja (1873-1957), a French alienist and historian of art in asylums. He also wrote short plays, although he is less well known as a playwright. The plays were printed just in time for the performance, which often took place on the day of the asylum fair. Here, we discuss a one-act play consisting of four scenes in which the actors are his patients.

Specificity and wealth of autobiographical memories in restrictive and mixed anorexic patients.

The reduced specificity of positive and negative autobiographical memories observed in anorexic (AN) patients may reflect a global disturbance in their emotional information processing. However, their emotional difficulties may differ according to the subtype of AN, implying possible differences in the manifestation of autobiographical memory impairments. The aims of the study were (1) to confirm the autobiographical memory deficits in AN patients in terms of specificity and wealth of memories, and (2) to compare autobiographical deficits according to the AN subtype: restrictive type (AR) or binge/purging type (AB). Ninety-five non-clinical (NC) individuals and 95 AN patients including 69 AR and 22 AB patients were administered the Williams' and Scott's Autobiographical Memory Test. The results confirmed a lack of specificity regardless of emotional valence in the overall AN patient group without any distinction of subtype, which was linked to the number of hospitalizations. When the AN subtype was considered, AR patients demonstrated reduced specificity for negative memories only, suggesting differences in emotional functioning or in the mechanisms underlying reduced specificity between AR and AB patients. Furthermore, the overall AN group demonstrated lower variability and complexity in their memory content than the NC group. However, this difference in the complexity of recalled memories was only found in response to negative cues. When AN subtypes were considered, AR patients showed fewer complex memories than NC individuals. Beyond a reduced specificity, AN patients also depict a poverty in the range of event recall and a difficulty in developing narrative content. The clinical implications of such autobiographical memory deficits need to be further investigated.

Living as a couple with anorexia nervosa: A dyadic interpretative phenomenological analysis.

This study examined the difficulties couples face in relation to anorexia nervosa. Using interpretative phenomenological analysis, five couples in which one of the partners lives with anorexia nervosa were interviewed separately. The findings are conceptualized into three areas: first, the encounter 'at the crossroads between remission and relapse'; second, the way that 'anorexia reveals itself'; and finally, the way the 'ménage à trois' works, including the illness fully as part of the couple. Psychotherapists should take into account the context of the couple and the complex interaction between the couple and the illness to support both partners' development of appropriate responses.