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The contributors to this book are members of the Psychosomatic Study Group of the Psychoanalytic Association of New York, and specialize in the treatment of psychosomatic disorders. This group was led initially by Melitta Sperling and, since 1973, by Wilson. The purpose of this book is to provide a framework for understanding both the bulimic and restricting forms of anorexia nervosa and, based on this,
an approach to treatment. The treatment emphasizes a focus on pregenital conflicts, part-object relations, and the central issue of the transference. Psychoanalysis is described repeatedly as the treatment of choice for these patients, even when they are extremely emaciated.
The 18 chapters have been organized into five sections. The first, on predisposing factors, consists of two chapters by Wilson. This is followed by four chapters on psychodynamic structure; these begin with an older paper of Sperling's, giving her views of the syndrome. Section Three deals with transference and countertransference; Section Four, with treatment; and Section Five, with special issues such as the amenorrhea in anorexia nervosa and problems with the use of medication in bulimia.
There are strengths to the volume. These include (1) the emphasis by various contributors on the problems of control experienced by these patients; (2) the careful distinction between bulimic and restricting forms of the illness and the characterization of the bulimic as having an impulse disorder; (3) a large component to each chapter consists of clinical case descriptions; and (4) the material on transference and countertransference is particularly helpful. However, there are serious deficiencies. The reader is left with an impression that the contributors are either unaware of other work on similar subjects or deliberately ignore the writings of others. For example, Wilson describes the central feature of the disorder as a "fat phobia," stating that this term should replace the misnomer "anorexi