Abstract
The article presents a qualitative exploration of psychoanalytic psychotherapy cases in a randomized controlled trial comparing psychoanalytic psychotherapy and cognitive behavior therapy for bulimia nervosa. The cases selected represent both clients with good symptomatic outcome as well as clients with no clinically significant change in core bulimic pathology. All clients have a preoccupied attachment pattern. The aim of the study is to obtain a more differentiated picture of what constitutes “good” and “poor” outcome and to learn about strengths and limitations of psychoanalytic psychotherapy for bulimic clients with a preoccupied attachment pattern. The cases illustrate the diversity of clients' experiences of psychotherapeutic process and the variety of outcomes with regard to bulimic pathology, attachment patterns, interpersonal problems, depression, and general symptomatic distress.
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