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PIETRO CASTELNUOVO-TEDESCO INTRODUCED THE PANE. By Stating that the subject of anorexia and bulimia currently is attracting great interest both in scientific circles and among the general public. It is also a topic to which psychoanalysis has made important contributions.
He observed that although there are differences between anorexia and bulimia, most analysts prefer to think of them as facets of a broader eating disorder. He presented a historical overview of the eating disorders with case examples dating as far back as the 1600's. He traced an evolution of our current understanding from both a biological and a psychoanalytic perspective. He mentioned the role of unconscious pregnancy fantasies regressively experienced in oral terms, reaction formations against oral-sadistic impulses, failure to neutralize aggression, defects in ego functioning, preoedipal issues in the motherchild relationship, separation-individuation factors, and the influence of self psychology. He raised the question, "Should emphasis be placed on the drive abnormalities, which are the obvious, presenting difficulty, or on the ego defects which, while consistently pervasive, often are less obvious and even artfully camouflaged?"
The first presentation, "The Psychoanalytic Treatment of Anorexia Nervosa and Bulimia," was given by C. Philip Wilson, who stated that there has been evidence accumulating for the past 30 years that anorexia nervosa is a generic term for a psychosomatic disorder that includes the bulimic as well as the restrictor syndromes. He commented that, "The technique of analyzing anorexia patients is similar