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Paper short abstract:

Drawing on fieldwork in an eating disorder facility in Italy, the paper argues that treatment here rests on an operationalization of kinship care, but that the time chronic patients need in treatment generates a dangerous mix between what is seen as ‘functional’ and ‘dysfunctional’ in kinship care.

Paper long abstract:

Drawing on fourteen months of fieldwork in a public residential facility for eating disorders in central Italy, this paper examines 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, this paper both draws on and goes beyond anthropological works that, by looking at kinship in practice, have usefully highlighted the potentially harmful side of kinship – including those works that have explored how kinship can be framed as a source of mental distress and at the same time a vehicle for remedy. In addition to all of these aspects, kinship here becomes a risky therapeutic tool, because professionals need to borrow from kinship practices in their own work with patients, balancing those with the necessary clinical detachment. The paper argues that the time chronic patients need in residential treatment generates a particularly dangerous mix between what is seen as ‘functional’ and what is seen as ‘dysfunctional’ in kinship care. This is because the ‘efficacy’ of the kind of 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 care and family care mixing ‘too much’ with one another.