Characteristics of family background in bulimia.

21 women consulting for bulimia were followed in individual psychotherapy and assessed for family background characteristics. Two sets of data are reported: objective data concerning the incidence of 'broken homes', i.e., with a history of separation or divorce or death of parents; subjective data concerning the image of the family and the identifications which are worked through in psychotherapy. Among our 25 bulimic patients, 13 patients came from 'broken homes' in which, in 9 cases, separations were so radical that it was impossible to maintain relationships with both parents; 12 patients came from close-knit families which in 6 cases were actually 'closed families' hiding massive internal tensions. The proportion of broken homes is significantly higher than in a population of 25 overweight patients without bulimia also undergoing individual psychotherapy. There exists a sharp discrepancy between the actual family failings and the wish of patients to maintain their 'family unit' fantasy. The hypothesis is made that the occurrence of bulimia may be related to the combination of a history of violent separations (or threats of violent separation) in the family, and the endless denial of these separations.