Introduction to Body Meets Mind: Eating Disorders and Body Image—A Twenty-First Century Perspective

Abstract

This special issue of the Clinical Social Work Journal looks at problems in eating and body image from a twenty first century perspective. Contemporary scientific research and medical innovations have influenced current clinical theory and thinking about these complex disorders. Increasingly, we have come to recognize a fundamental link between body and mind, as well as the need for ways to integrate these interlocking systems in both assessment and treatment of individuals with eating disorders. Our clinical lens now includes advances in technology and specifically social media, which have exponentially increased the cultural domain for body image scrutiny and concomitant body shame. A paradoxical dilemma of our time is that the ability to transform our bodies through surgeries and multiple diet/exercise regimes has also exacerbated problems of self-objectification and associated body shame, commonly associated with problems in eating and body image. The current volume is made up of articles by authors with a wide range of contemporary perspectives on eating disorders and body image. Their blend of expertise and innovative thinking takes us on a journey into an extremely important aspect of eating disorders: the crucial interplay of body image and disordered eating issues. Introducing a new feature to the journal, we begin this special issue with an interview of Susie Orbach by guest co-editor Holly Starkman. An international spokeswoman on the topic, Orbach has been influential in both professional and public arenas. Her now classic book, Fat is a Feminist Issue, opened wide the door to women’s problematic relationships to their bodies and their eating. The interview presents not only some of Orbach’s historic contributions to the field, but also her take on these dynamics today. A significant focus of Orbach’s work is her integration of psychological and cultural contexts that can thwart healthy body image development. She addresses her concerns about the pervasiveness of this link in the interview and underscores that clinicians are in a unique position to increase awareness of cultural as well as psychological influences in our work with clients. Following the interview with Orbach are several clinically oriented articles that integrate an understanding of psychodynamics with a variety of symptom-focused interventions. The first article, ‘‘Psychodynamic Issues in the Treatment of Binge Eating: Working with Shame, Secrets, No-Entry, and False Body Defenses’’ is by Kathryn Zerbe, whose widely read books and articles have made a significant contribution to the field. She has long encouraged clinicians to pay attention to body image in clients with eating disorders and has been a leading voice for the value of bringing together psychodynamic and symptom-focused interventions when working with clients with these symptoms. In this article Zerbe presents two clients diagnosed with binge eating disorder who struggle with body image issues that they ignore or deny. She explores and explains how understanding defense mechanisms such as ‘no entry’ fantasies and ‘the false body’ can help a client uncover and work through split off aspects of their bodily self. She also introduces a theme that readers will find throughout this special issue: the importance of a clinician’s relationship to her or his own body and the transference and countertransference issues that may & F. Diane Barth fdbarth@gmail.com