When the clinic becomes home: on the limits of kinship care in an eating disorder treatment centre in Italy.

Abstract

Drawing on fieldwork in a public residential facility for eating disorders in central Italy, the paper examines the relational temporalities of therapeutics by looking at how time affects treatment at the intersection of professional and family care practices. In arguing that 'chronic cases' put into question the specific kind of kinship care that is at the basis of treatment, the paper contributes to the anthropological literature on eating disorders by bringing time under the analytical lens, and to the literature on 'chronicity' by complicating simplified assumptions about structural care problems. In addition, the paper draws on and goes beyond anthropological works that have highlighted the potentially harmful side of kinship - including those that have explored how kinship can be framed as a source of mental distress and at the same time as a therapeutic tool. Kinship as a therapeutic tool here becomes risky because professionals need to borrow from kinship practices in their own work with patients, balancing those with the necessary clinical detachment. The paper shows that the time chronic patients need in residential treatment generates a particularly complex mix between what is seen as 'functional' and what is seen as 'dysfunctional' in kinship care, because the 'efficacy' of the kinship work that is at the basis of treatment rests on that being partial and temporary. Long term care in the facility complicates what otherwise allows clinical detachment: the treatment team ends up literally substituting the patient's family, with professional and family care mixing 'too much' with one another.