46

The managed care of patients in addictology constantly questions the articulation between co-diagnostics. The change in the definition of “Addiction”, made in the latest version of DSM, opens a possible cross-checking between addictions and impulse control disorders. The dimensional approach of nosography led us to study instinctual behavioral disorders, such as eating disorders and sexual conduct disorders, as addictions. The purpose of this work is to illustrate this nosographic reflection by two clinical situations encountered in CSAPA. We intend to investigate if these disorders should be independently considered or taken as several dimensions of one pathology, using an integrative reading which is both psychoanalytic and neurobiological via the use of ghrelin. Both clinical cases deal with the impact of infantile ill-treatments on management strategies of the grown-up and their negative effects. Carelessness and abuses by parental figures are studied through the prism of the construction of identity, body pattern, and the concept of incorporation, to understand the origin of these addictive and compulsive disorders. The notion of “disincarnating experiences” underlines the inscription of trauma in the organism.