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This volume is written by the most prominent contributors to the current understanding and treatment of anorexia, bulimia, and obesity. It details the techniques that can resolve these patients' strong defenses against the acknowledgment of their underlying conflicts, and it provides an understanding of the psychodynamic structure of the various personality disorders that are masked by eating disorder symptoms.
Eating disorders are symptom complexes that occur in a variety of character disorders: hysterical, obsessive-compulsive, borderline, and--in some cases--psychotic conditions. The major problem for the psychotherapist is that these patients do not readily seek treatment, and if they do, they want a resolution of the symptom rather than a comprehensive approach to the underlying personality disorder. As the conflicts underlying the symptoms are analyzed, a variety of affects emerge, particularly those of depression. It is the handling of these affects that is crucial to therapeutic success.
The authors explore the nature of object relations in a wide range of diagnostic categories, including neurotic compulsive eating, restrictor and bulimic anorexia nervosa, obesity, and rumination. Special therapeutic problems are detailed, such as severe regressive symptomatology, the use of medication, hospitalization, and countertransference. The authors deal with preverbal and early verbal communication, separation-individuation, the underlying impulse disorder, part-object relations, and projective identification.
This book demonstrates that a psychotherapeutic approach that focuses on the underlying neurotic conflicts can result in normal eating and psychic health. It is an important resource for every mental health professional called on to treat these difficult but rewarding patients.
