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Early in this book the author makes the point that eating disorders follow neither orderly nor predictable patterns of development. This contributes to difficulties when it comes to attempts to understand and to work therapeutically with patients who express their conflicts via overeating or starving themselves. Lost for Words is a sensitive attempt to understand and describe patients who present with such symptoms. Farrell's presentation is stimulating and her therapeutic work of interest, although her overall approach to eating disorders is not always consistent.
The book offers a quick survey of pre-Freudian, classical-Freudian and post-Freudian approaches to anorexia and bulimia. Farrell finds that power and control are one of the fundamentals of the symptomatology. Although she says in the preface of the book that her orientation is predominantly Kleinian, she finds that Kleinian ideas and theories are less appropriate to understanding anorexia and bulimia than are Winnicott's ideas of transitional objects and transitional space. However, I notice that she repeatedly oscillates between finding concepts she considers ‘Kleinian’ (such as narcissism and envious destructiveness) to be inappropriate to an understanding of these patients, and finding that they do have a place in such considerations. For instance, having indicated (p. xv) that she does not ‘do justice to pathological