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“The flesh should be the obedient dog of the spirit, running to do its bidding; but we-how do we live? The flesh rages and riots, and the spirit follows it helpless and miserable.”1
Many authors have observed the intensity, velocity, and ferocity of the strivings that Freud referred to as instinctual drives. Neo-Freudian psychoanalytic theorists have replaced the instinct theory with interpersonal formulations. Horney, for example, argued against the libido theory and viewed human activities, including sexuality, as spontaneous (healthy) and neurotic (compulsive). Compulsive activities were seen as derivatives from attempts to actualize the pride system (self-actualization), while spontaneous activities were seen as derivatives from moves toward healthy strivings (self-realization). More recent theorists, notably the Object-Relations School, while largely abandoning the instinctual model, have retained the libido concept to account for human development and character formation. Whatever the theoretical persuasion, a clinician must account for and deal with the powerful and/or frail appetites that humans experience as motivational.
Isak Dinesen2 says in her tale “The Monkey”: “The Countess Anastasia has a heavy cross. The love of eating is a heavy cross.” In this formulation, she refers to the love of eating, gluttony, as the final common pathway for the dissipation of tension. Tension can arise from a variety of sources but often involves real or imagined deprivation of love in human relationships. For an individual who has embraced the love of eating as a lifestyle, nearly any stimulus will trigger the behavior. A success can be celebrated with a dinner, while a failure can be ameliorated with a meal or two. A holiday would be nothing without food, but loneliness and isolation can also be assuaged with the leftovers.
The inner experience immediately preceding eating behavior may consist of increasing displeasure and tension. The eating response is rationalized as acce