Bulimia, Separation Anxiety, and Finding the Authentic Self

Abstract

Eating disorders, such as anorexia, bingeing, and purging, have recently been widely discussed in the interpersonal/ relational psychoanalytic world. The interpersonal/relational perspective of eating disorders is that of a thwarted, gendered, agentic self. To these psychoanalysts, the eating disorders represent dissociated self-states [1-5] and express a forestalled sense of personal agency or “not-I-ness” [5-7]. Petrucelli [8] maintains that an eating disorder is a maladaptive attempt to be self-protective rather than simply self-destructive. It is therefore useful in working psychotherapeutically with eating-disordered people to reclaim dissociative pockets of their psyche which are paradoxically split-off explosive energies of “not-I-ness” that also contain the seeds of the patient’s psychological recovery [9]. A clinical example illustrates these concepts. At the start of therapy, Michelle’s bingeing was multi-determined: part of her wanted to be passive, not grow up, and be taken care of like her mother; her bingeing also represented her conflict of finding it impossible to consciously acknowledge this. In our relationship, Michelle played out her maternal dyad by worrying that our self-representations would “infect” each other. But after five years of therapy she realized she could begin to make choices in her life without debilitating terror. As Michelle became more emotionally self- attuned to her affective needs, her bingeing and purging diminished and ultimately stopped. Michelle found the courage to define and fulfill her desires as a woman. It was no longer necessary to express those dissociated parts of her desire through her eating disorder.