“Tell Them it is Not Too Late for Someone like Me”: A “Failure-to-Thrive Child” Grows Old and Begins an Attachment Based Psychotherapy at Sixty-Seven

Although anorexia nervosa has the highest mortality rate of any psychiatric diagnosis, with one in five people dying from the illness or committing suicide, those with anorexia have a disturbing lack of anxiety about their own life-threatening behavior. Mortality rates are highest among elderly women, most of whom have had a late onset of their eating difficulties. Babies who fail to thrive can develop infantile anorexia and not surprisingly profound attachment difficulties were found in both mothers and infants in this situation. This article is an account of the life and the psychotherapy relationship of a woman of sixty-seven whose eating problems began in infancy when she failed to thrive, and lasted throughout her life. She had a disorganised/preoccupied attachment state of mind thus her preoccupation with pain, suffering and death were unresolved, prolonged, and idealised. Her caregiver part was nevertheless strong willed with remarkable sensitivity to others. The therapy relationship was based on the formation of a safe and secure attachment relationship that facilitated mourning past trauma and promoted the capacity to be attuned to the mental states in herself and in others. As she became increasingly attached to her therapist, she was able to relinquish her preoccupation with pain and suffering. The patient used her psychotherapy as an opportunity to find meaning in the many lost years of her life and to find some pleasure in her remaining years.